Unavailability Of Vaccine Research Articles

Symptoms, Course, and Factors Related to Long-Term Morbidity, Including Differences between Infection Strains, in Patients with Long COVID in a Primary Care Clinic in Japan: An Observational Study.

Objectives: The objectives were to investigate the clinical characteristics and course of long COVID, defined as the persistence of symptoms at least one month after the onset of COVID-19, in outpatients and to clarify differences in symptoms between SARS CoV-2 mutant strains. Methods: Our observational study in a primary care institution in Japan included 1053 patients with long COVID who visited our outpatient clinic between April 2021 and March 2023. Symptom distribution, performance status, and patient background at the time of the first outpatient visit were compared between infectious strains (Delta and before group and Omicron group). Background factors and symptoms related to time to remission were also analyzed. Results: The severity of COVID-19 in the acute phase was mild, moderate, and severe in 82.2%, 14.9%, and 2.9% in the Delta and before group; and in 97.6%, 1.7%, and 0.4% in the Omicron group, respectively. Vaccination coverage was significantly different between the Delta and before (37.1%) and Omicron groups (73.1%) (p < 0.001), probably due to the period of vaccine unavailability in the former group. Symptoms of fatigue and headache occurred most frequently, irrespective of infectious strain. The mean number of symptoms per patient was significantly higher in the Delta and before group than the Omicron group (3.4 vs. 2.7, p < 0.0001). The median time overall to remission of long COVID was 169 days. Cox hazard model analysis identified female sex, high body mass index, and dyspnea (but not infectious strain) as significant factors prolonging the time to remission (p < 0.05). Conclusions: Differences in the number of symptoms between infectious strains may be related to differences in viral virulence and/or vaccination coverage. However, the clinical course was found to be minimally influenced by the infectious strain. The present results should improve the understanding of prognosis in patients with long COVID from both the clinical and social perspectives.

Identification, Characterization, and Homology Analysis of a Novel Strain of the Crimean-Congo Hemorrhagic Fever Virus from Yunnan, China.

Wildlife serve as potential microbial reservoirs, accounting for approximately 70% of emerging infectious diseases. Crimean-Congo hemorrhagic fever virus (CCHFV), which causes Crimean-Congo hemorrhagic fever (CCHF) in humans, is a highly pathogenic tick-borne virus prevalent in several parts of Asia, Africa, and Europe with high case fatality rates. Several CCHFV cases have been reported in Asia, the Middle East, Africa, and Southern and Eastern Europe. The disease is endemic in several parts of western China, particularly Xinjiang. Ticks of the genus Hyalomma have been identified as a principal vector and reservoir for CCHFV, although other tick species may also have a crucial role in maintaining CCHFV in endemic regions. On infection, CCHF begins as a nonspecific febrile illness that can progress to severe hemorrhagic manifestations with a higher case fatality due to the unavailability of vaccines or other therapeutic agents. In this study, we collected tissue samples from a wild dead Chinese serow (Capricornis milneedwardsii) and three Naemorhedus griseuses from Deqin County, Tibetan Autonomous Prefecture, Yunnan, China, to investigate for contagious viruses that could be transmitted to humans. We identified a novel CCHFV strain, YNDQL-415G, in the liver tissue of a dead C. milneedwardsii. We performed nucleotide and amino acid sequence homology on the full-length viral genome. The results revealed significant homology between the viral S segment to that of the Africa1 strain, while the M and L segments showed similarity with the Asia CCHFV strain, indicating potential gene reassortment in the YNDQL-415G strain. The genetic characterization of a novel CCHFV strain from a dead C. milneedwardsii raises concerns about the possibility of a new zoonotic infection. A regular survey program is recommended to track the distribution of wild animals as well as the viruses they may transmit to humans and other domestic mammals in the region.

Vaccination Status Against the Hepatitis B Virus of the Patients Visiting a Tertiary Care Dental Hospital

Abstract: Objective To assess the vaccination status for Hepatitis B virus among patients attending a tertiary care dental hospital in Multan, aiming to identify gaps and opportunities for improvement in vaccination coverage. Methods This cross-sectional questionnaire study conducted at Multan Dental College from June 2023 to Feb 2023 included patients attending the dental OPD. 181 participants completed the questionnaire regarding vaccination status. Ethical approval and informed consent were obtained from Multan Dental Hospital. Results Among 181 participants, 98 (54.14%) were males and 83 (45.86%) were females. Regarding age groups, 36 (19.9%) were 16-20 years old, 69 (38.12%) were 21-25 years old, 54 (29.83%) were 26-30 years old, and 22 (12.15%) were 31 years old or above. Out of 181 participants, 51 (28.17%) were non-vaccinated, while 130 (71.83%) were vaccinated. Among the vaccinated, 47 (26%) received the 1st dose, 36 (19.9%) received the 2nd and 3rd doses each, and 11 (6.07%) received the Booster dose. The majority (58.82%) of non-vaccinated individuals cited multiple reasons for not receiving immunization, including vaccine unavailability and busy schedules. Additionally, 9.8% lacked awareness of the vaccination, while others mentioned injection phobia and lack of motivation Conclusion The study emphasizes the challenge of incomplete vaccination among patients, which necessitates coordinated efforts by public health officials. Implementing AI-powered reminder systems could effectively address this issue, improving vaccination rates and public health outcomes.

A comprehensive survey on the present scenario and future production potentials of small-scale turkey farming in Bangladesh

Turkey (Meleagris gallopavo) is one of the potential species of specialized fowls, quite popular in western countries, has recently been introduced in Bangladesh, and gained considerable attention from small-scale poultry farmers. The purpose of this study was to assess the current scenario, production systems and potentialities of turkey farming in Bangladesh. Data were collected using a pre-tested questionnaire from 100 turkey farmers residing in rural areas in different districts of Bangladesh. The problems and prospects of turkey rearing in the selected areas were quantified and assessed. No illiterate farmers were involved in turkey farming and 97% of the farmers have small household with 3.67 members per family. Most of the farmers (60%) were medium income size with income range BDT 250001 to 400000 year. Most of the farmers (57%) reared turkey for meat purpose whereas the average turkey population per household was 43.20 birds. About 24% of farmers reared turkey in confinement system, and 76% of farmers reared in semi-intensive management system and 68% of farmers had no related training on turkey farming. All farmers use ready broiler/layer feed due to the unavailability of turkey feed that was bought from local market. Grazing was practiced to supply vegetative plants as diet for turkeys. Most of the farmers (86%) vaccinate turkey regularly, and among them 96% complained about vaccine unavailability. Average mortality was recorded at around 6.2%. All the farmers follow a natural breeding system for reproduction. The farmers mentioned that turkey farming is decreasing day by day due to unskilled farmers, lack of turkey ready feed, unavailability of vaccines and lack of marketing facilities. Collectively, it can be inferred that the introduction of ready-made turkey feed, ensuring vaccination, providing financial and technical assistance and offering training to small-scale turkey farmers are the pivotal factors in boosting small-scale turkey farming in Bangladesh. This, in turn, may have the potential to increase household income and generate employment opportunities for youth, rural women, and small-scale marginal farmers. Bangladesh Journal of Animal Science 53 (2): 40-54, 2024

Qualitative Insights on Barriers to Receiving a Second Dose of Measles-Containing Vaccine (MCV2), Oromia Region of Ethiopia.

Introduction: Ethiopia introduced a second dose of measles-containing vaccine (MCV2) in 2019 to provide further protection against measles and further progress toward elimination. However, the sub-optimal coverage of both MCV1 and MCV2 suggest challenges with vaccine uptake. In this qualitative study, we explored barriers to the uptake of MCV2 among caregivers, community leaders, and healthcare workers (HCWs). Method: A qualitative study was conducted between mid-April and mid-May 2021. We selected ten woredas (districts) in the Oromia Region, Ethiopia, stratified by settlement type (urban/rural), MCV1 coverage (high ≥ 80%; low < 80%), and history of measles outbreaks between June 2019 and June 2020. Experiences surrounding barriers to MCV2 uptake were discussed via focus group discussions (FGDs) and in-depth interviews (IDIs) with caregivers of children 12-23 and 24-36 months and key informant interviews (KIIs) with HCWs who administer vaccines and with community leaders. Participants were recruited via snowball sampling. Recorded data were transcribed, translated to English, and analyzed using ATLAS.ti v.09. Results: Forty FGDs and 60 IDIs with caregivers, 60 IDIs with HCWs, and 30 KIIs with community leaders were conducted. Barriers among caregivers included lack of knowledge and awareness about MCV2 and the vaccination schedule, competing priorities, long wait times at health facilities, vaccine unavailability, negative interactions with HCWs, and transportation challenges. At the community level, trusted leaders felt they lacked adequate knowledge about MCV2 to address caretakers' questions and community misconceptions. HCWs felt additional training on MCV2 would prepare them to better respond to caretakers' concerns. Health system barriers identified included the lack of human, material, and financial resources to deliver vaccines and provide immunization outreach services, which caretakers reported as their preferred way of accessing immunization. Conclusions: Barriers to MCV2 uptake occur at multiple levels of immunization service delivery. Strategies to address these barriers include tools to help caretakers track appointments, enhanced community engagement, HCW training to improve provider-client interactions and MCV2 knowledge, and efforts to manage HCW workload.

Development of in-house ELISA based on recombinant gag proteins of small ruminant lentiviruses isolated from goats in Thailand

Small ruminant lentiviruses (SRLVs), are grouped in Retroviridae family, remain a significant loss in the small ruminant husbandry. As a result of unavailability of vaccine and effective treatment, the diagnosis plays a crucial role for the control of SRLV infection. However, the major challenge of diagnosis of SRLV infection is the genetic and antigenic variability of the viruses that can lead to a failure in serological detection. This study investigated the circulating strains of the viruses in goats in Thailand and an in-house ELISA was developed. The coding sequences for gag protein were optimized, synthesized, and expressed in Escherichia coli for increasing the sensitivity of ELISA test. A total of 365 serum samples were examined against the recombinant protein in an in-house ELISA. The results showed that the recombinant gag achieves 96.67% sensitivity and 93.18% specificity as compared with the commercially available ELISA test kit.

Assessment of Parents' Knowledge, Attitudes, and Satisfaction of Childhood Immunization: A Cross-Sectional Survey from a Rural District of Sindh, Pakistan

Background: Immunization is a cornerstone of public health, preventing millions of deaths annually, especially among children. Despite global efforts to increase vaccination coverage, significant gaps remain, influenced by parental knowledge, attitudes, and satisfaction with immunization services. These gaps are particularly pronounced in rural and socio-economically disadvantaged regions. Objective: This study aimed to assess parents' knowledge, attitudes, and satisfaction regarding childhood immunization and to identify barriers to vaccination in a rural district of Sindh, Pakistan. Methods: A cross-sectional survey was conducted in two cities, Mirpurkhas and Digri, within the Mirpur Khas district. Using the Raosoft® Sample Size Calculator, a sample size of 382 participants was determined with a 95% confidence level and a 5% margin of error. Participants were selected through convenience sampling. Data collection involved a semi-structured questionnaire developed from extensive literature review and validated through expert focus group discussions. The questionnaire covered demographics, perceptions of immunization, knowledge of the Expanded Programme on Immunization (EPI) schedule, and satisfaction with immunization services. Data analysis employed SPSS version 25, utilizing descriptive statistics and Mann-Whitney tests to analyze differences between variables. Results: Among 382 respondents, 55.76% were male, and 44.24% were female. A significant proportion (43.45%) were aged between 21–30 years. The majority acknowledged the importance of immunization (96.85% agreement), yet knowledge gaps were evident, with only 10.98% correctly identifying vaccines given at birth. Satisfaction with immunization services was high (73.56% satisfied with hospital services), despite 88.46% reporting incorrect knowledge about the vaccine given at birth. Barriers identified included affordability, vaccine unavailability, and long waiting times. Conclusion: While parental attitudes towards immunization were largely positive, significant knowledge gaps and barriers to immunization persist. Efforts to improve immunization coverage in rural Pakistan must address these knowledge deficits and structural barriers, emphasizing the development of targeted awareness campaigns and enhancing the accessibility and quality of immunization services.

HPV vaccination in Africa in the COVID-19 era: a cross-sectional survey of healthcare providers' knowledge, training, and recommendation practices.

Although the burden of cervical cancer in Africa is highest, HPV vaccination coverage remains alarmingly low in this region. Providers' knowledge and recommendation are key drivers of HPV vaccination uptake. Yet, evidence about providers' knowledge and recommendation practices about the HPV vaccine against a backdrop of emerging vaccine hesitancy fueled by the COVID-19 pandemic is lacking in Africa. A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior training, the availability of the HPV vaccine in their practice, whether they recommended the HPV vaccine, and, if not, the reasons for not recommending it. Their knowledge about the HPV vaccine was assessed through self-reporting (perceived knowledge) and with three pre-tested knowledge questions (measured knowledge). Of the 153 providers from 23 African countries who responded to the survey (mean age: 38.5 years, SD: 10.1), 75 (54.0%) were female and 97 (63.4%) were based In countries with national HPV immunization programs. Overall, 57 (43.8%) reported having received prior training on HPV vaccine education/counseling, and 40 (37.4%) indicated that the HPV vaccine was available at the facility where they work. Most respondents (109, 83.2%) reported recommending the HPV vaccine in their practice. Vaccine unavailability (57.1%), lack of effective communication tools and informational material (28.6%), and need for adequate training (28.6%) were the most commonly reported reasons for not recommending the HPV vaccine. While 63 providers (52.9%) reported that their knowledge about HPV vaccination was adequate for their practice, only 9.9% responded correctly to the 3 knowledge questions. To increase HPV vaccination coverage and counter misinformation about this vaccine in Africa, adequate training of providers and culturally appropriate educational materials are needed to improve their knowledge of the HPV vaccine and to facilitate effective communication with their patients and the community.

Effectiveness of a community-centered Newcastle disease vaccine delivery model under paid and free vaccination frameworks in southeastern Kenya.

In the absence of effective drugs, vaccines constitute the cornerstone for the prevention of Newcastle disease (ND). Different strategies have been implemented to increase vaccination, but uptake remains low, underscoring the need for novel vaccine delivery methods. We designed and assessed the effectiveness of a community-centered ND vaccine delivery model in southeastern Kenya. Under the model, we sensitized smallholder chicken farmers (SCFs) through structured training on chicken husbandry, biosecurity, ND, and its vaccination, among other aspects. We subsequently engaged trained community vaccinators (CVs) to deliver vaccines and/or provide vaccination services to SCFs at a cost on one hand and, at no cost on the other, in selected sites to address challenges of inadequate service providers, vaccine unavailability, and inaccessibility. We tested this model under paid and free vaccination frameworks over one year and assessed the model's effect on vaccine uptake, ND-related deaths, and vaccine accessibility, among other aspects. Overall, we vaccinated more chickens at free sites compared to paid sites. However, we vaccinated a significantly higher mean number of chickens per household at paid (49.4±38.5) compared to free (28.4±25.9) sites (t = 8.4, p<0.0001). We recorded a significant increase in the proportion of SCFs who vaccinated their chickens from 31.3% to 68.4% (χ2(1, N = 399) = 58.3, p<0.0001) in paid and from 19.9% to 74.9% (χ2(1, N = 403) = 115.7, p<0.0001) in free sites pre- and post-intervention, respectively. The mean number of ND-related deaths reported per household decreased from 18.1±31.6 pre-intervention to 7.5±22.3 post-intervention (t = 5.4, p = 0.000), with higher reductions recorded in paid sites (20.9±37.7 to 4.5±11.2) compared to free sites (15.0±22.6 to 10.7±29.7) pre- and post-intervention, respectively. Farmers with access to vaccines increased significantly from 61.1% to 85.4% (χ2(1, N = 399) = 31.7, p<0.0001) in paid and 43.6% to 74.9% (χ2(1, N = 403) = 38.4, p = 0.0001) in free sites pre- and post-intervention, respectively. We established that type of intervention framework, gender of household head, if the household head attended training on chicken production in the last 12 months, access to information on ND vaccination, and the number of chickens lost to the previous ND outbreak were significant predictors of ND vaccine uptake. Our findings indicate the model has a broader reach and benefits for SCFs. However, policies should be enacted to regulate the integration of CVs into the formal animal health sector.

Infection dynamics of COVID-19 in children of Bangladesh

unavailability of vaccines under 12 years of age in Bangladesh for a long-time during the pandemic. Moreover, as children are not developing many severe symptoms, they did not get priority in empirical studies regarding their COVID-19 infection dynamics. Therefore, this web-based cross-sectional study was conducted aimed to explore the COVID-19 infection status and associated factors among the 372 children in Bangladesh by snowball sampling approach. Adjusted and Unadjusted Odds Ratio (95% CI) were calculated for the specified exposures and a multivariate logistic regression model was used for the analytical exploration. The study revealed that 53.5% of subjects were RT-PCR test positive and 12.9% test negative while 33.6% were found suspected/healthy who did not perform any confirmatory test. Among the asymptomatic cases, 9.4% found tested positive. In addition, children with mild (6.7%) moderate (7.3%), and severe (0.8%) symptoms did not undergo any test. Alarmingly, three of the 30 cases with severe symptoms were found not to do any confirmatory test and suffered much and needed oxygen or ventilation support. Test-positive infection status was found significant among the children with lower educated mothers (AOR/P= 2.74/0.05; 95% CI: 0.97- 7.67) and those who got contact with an unidentified source of infection (AOR/P=3.49/0.02; 95% CI: 1.22-9.98) or suspected family members (AOR/P=1.87/0.27; 95% CI: 0.62- 5.70). Finally, the unique findings portray an alarming scenario for the children in Bangladesh during the current pandemic. It indicates the reluctance of guardians which may be due to a lack of screening support from health care facilities. Policymakers need to be much more concerned about such issues through the implementation of specific intervention programs on the basis of empirical findings from the studies regarding such health problems. Therefore, the health security of children can be achieved and the fatal consequences of the recent pandemic may be combated through such strategies.

Oral cholera vaccine coverage evaluation survey: Forcibly Displaced Myanmar Nationals and host community in Cox's Bazar, Bangladesh.

Cholera remains a significant public health concern in many parts of the world, particularly in areas with poor sanitation and hygiene. Bangladesh and other impoverished nations have been severely affected by cholera outbreaks, especially in areas with a high population density. In order to mitigate the spread of cholera, oral cholera vaccines (OCVs) are recommended as a prophylactic measure. In May 2018, 775,666 of the Forcibly Displaced Myanmar Nationals (FDMN) in the registered and makeshift camps and 103,605 of the residents in the host community received two doses of OCV ShancholTM in Cox's Bazar, Bangladesh, because the conditions in the area favored the transmission of cholera and other waterborne diseases. This study aimed to assess the coverage of OCV among the FDMN and the host community in Cox's Bazar. In August 2018, we enrolled 4,240 respondents for this study following the "World Health Organization (WHO) Vaccination Coverage Cluster Surveys: Reference Manual (2018)." The coverage survey was conducted with three strata of the population: the host community from the Teknaf Upazila, the registered camp, and the makeshift camp from the Ukhia Upazila. We collected information regarding OCV coverage, demographic characteristics, and knowledge and behaviors of people toward the vaccine. The data were analyzed using descriptive statistics. According to our study, the overall OCV coverage was 85%, with 68% in the host community, 91% in the registered camp, and 98% in the makeshift camp. The lower coverage in the host community was due to residents unaware of the vaccination campaign, the unavailability of vaccines, and unaware where to go for vaccination. Our findings demonstrate that the OCV campaign in the FDMN camps was successful, reaching over 90% coverage, while coverage in the host community was much lower. In order to make sure that OCV vaccination efforts are reaching the target population and having the desired impact, our study emphasizes the need to inform the target population of when and where to get vaccinated.

FREQUENCY OF BACTERIAL AND NON-BACTERIAL ACUTE GASTROENTERITIS IN CHILDREN ADMITTED AT A TERTIARY CARE SETTING

Introduction: Acute gastroenteritis is a life-threatening condition especially in children. It is caused by a wide array of pathogens, including bacteria, viruses, and parasites. This study was designed to find out the frequency of acute gastroenteritis in hospitalized children at a tertiary care hospital. Material &amp; Methods: A cross-sectional study was carried out in the pediatric department of Lady Reading Hospital, Peshawar from May 2019 to November 2019. Ethical approval was obtained from the institutional ethical committee and children were enrolled after informed consents were taken from their parents. Patients of age less than 15 years hospitalized due to acute gastroenteritis were included in the study. The demographic information, clinical features and laboratory findings were collected from all children. Stool samples were assessed at the hospital laboratory for bacterial pathogens using culture and microscopy. Results: A total of 292 patients were enrolled in the study. Children in age range from one year to seven years were 61% and 39 % were in the age range from 8 to 15 years. Males were 57% and females were 43%. Out of all 292 children, 18% had bacterial diarrhea while the rest 82% had nonbacterial diarrhea. Conclusion: In this study, the frequency of acute gastroenteritis was higher in children below age 7 years. Males were affected more compared to females. The bacterial causes of acute gastroenteritis may be due to the unavailability of basic life resources including pure drinking water, sanitation and awareness of hand hygiene. Moreover, the frequency of bacterial diarrhea was lower compared to non-bacterial which may be due the unavailability of vaccine against Rotavirus.

Risk Factors of COVID-19 Infection and the Effectiveness of Pre-flight Screening from an Investigation of an International Flight to Thailand, 2020

Thailand implemented pre-flight screening (reverse transcription polymerase chain reaction test for SARS-CoV-2 within 72 hours before departure) to mitigate the importation of COVID-19 during the early phase of the pandemic. We conducted a cross-sectional study to identify factors associated with COVID-19 infection and assess the effectiveness of pre-flight screening among passengers on an India-to-Thailand flight in August 2020. Logistic regression was used to determine the association between the possession of COVID-Free Certificate (CFC) and a positive SARS-CoV-2 test result upon arrival. Twenty-three of 209 passengers (11.0%) had a positive SARS-CoV-2 test. Among 142 CFC holders, 10 (7.0%) tested positive, while 13 of 58 (22.4%) passengers without a CFC tested positive upon arrival (p-value 0.003), equivalent to a case reduction of 68.8%. CFC possession yielded an adjusted odds ratio (AOR) of 0.04 (95% CI 0.01–0.44). Being a massage therapist (AOR 17.04, 95% CI 2.37–122.37) and using public transportation in India (AOR 5.30, 95% CI 1.49–18.77) were significantly associated with COVID-19 infection. With the unavailability of vaccines, people should be mindful of taking local public transportation during a pandemic, particularly when planning to travel abroad. Pre-flight screening is an effective method in reducing positive cases from international travel.

Uptake of COVID-19 vaccines and associated factors among adults in Uganda: a cross-sectional survey

ObjectiveCOVID-19 pandemic remains one of the most significant public health challenges ever faced globally. Vaccines are key to ending the pandemic as well as minimise its consequences. This study determined...

Coverage and Determinants of Birth Dosage of Newborn Immunization in Rural Areas of Dehradun District, Uttarakhand, India: A Community-Based Cross-Sectional Study.

The Universal Immunization Program of India is one of the most cost-effective interventions in public health. Missing or delaying vaccination may elicit an uncertain immune response in the body, making the population susceptible to vaccine-preventable diseases. The objectives of this study were to determine the coverage of newborn immunization for birth doses under the National Immunization Schedule and its epidemiological determinants in the rural areas of the Dehradun district, Uttarakhand. A community-based cross-sectional study was conducted for a period of one year with a sample size of 570. World Health Organization (WHO) 30 Cluster sampling technique was used with 19 children in each cluster. The data on determinants were collected using a semi-structured, pre-designed schedule through a house-to-house survey. Multivariate analysis was conducted to identify factors associated with immunization coverage, taking the significance level as P < 0.05. The coverage of the Bacillus Calmette-Guérin vaccine, oral polio vaccine zero dose and hepatitis B birth dose were 100%, 91.9%, and 58.8%, respectively in the study area with an overall prevalence of incomplete coverage of newborn immunization as 42.5%. The most cited reason for children being unimmunized with birth doses was the unavailability of vaccines at the birthplace center (29.6%). The prevalence of incomplete coverage of newborn immunization was quite high, which was undermining the holistic approach of the National Immunization Program. Vaccine availability and accessibility at the birthplace with capacity building and training of the healthcare workers may be considered to ensure coverage of birth doses.

Lyme disease: an important vector-borne bacterial zoonotic disease with emerging concern

Vector-borne diseases are a significant cause of morbidity and mortality in humans and animals worldwide. Lyme disease, or Lyme borreliosis, is an important emerging vector-borne anthropozoonosis caused by Borrelia burgdorferi. It belongs to the genus Borrelia, phylum Spirochetae. B. burgdorferi is a gram-negative, flagellated spirochete having loosely coiled spiral morphology. Lyme disease is distributed in many parts of Asia, Europe, and the United States. It is the most common arthropod-borne disease in the United States. Due to its dramatically increased prevalence, the disease has become a significant public health problem in many parts of the United States. Hunters, hikers, campers, and travelers involved in outdoor activities in forested areas are at risk of getting the infection. Lyme disease is characterized by a fever that may continue for five days. It is transmitted by the bite of the Ixodid tick (also known as the black-legged tick), commonly found on deer, rodents, and other small mammals. If diagnosed early, the disease can be managed with antibiotics and supportive treatment. Severe complications may occur in immune-compromised, viral-infected, and malnourished individuals. Due to poor diagnosis and the unavailability of vaccines, prevention from tick bites becomes the key strategy to fight the disease.

Barriers and Facilitators Affecting the Uptake of COVID-19 Vaccines: A Qualitative Perspective of Frontline Nurses in Namibia.

Vaccinations remain one of the most effective measures to prevent and control the spread of COVID-19, while also reducing hospitalizations and deaths, yet many are unwilling to be vaccinated. This study explores the barriers and facilitators affecting the uptake of COVID-19 vaccines among frontline nurses. A qualitative, explorative, descriptive, and contextual research strategy was employed. A sample of 15 nurses were selected via purposeful sampling to the point of data saturation. The participants were nurses at the COVID-19 vaccinations Centre in Rundu, Namibia. Data were collected using semistructured interviews and analyzed thematically. Three themes and 11 subthemes were identified, namely: (a) barriers, (b) facilitators, and (c) measures to increase the COVID-19 vaccine uptake. Barriers included living in deep rural areas, unavailability of vaccines, and misinformation, whereas scared of death, availability of COVID-19 vaccines, and family influence and peer pressure emerged as facilitators to the uptake of COVID-19 vaccines. Adoption of vaccination passport as a requirement to work premises and as an international travel requirement were the measures proposed to increase the COVID-19 vaccine uptake. The study found several facilitators and barriers to COVID-19 vaccine uptake among frontline nurses. The identified barriers cover the individual, health system, and social factors hindering the COVID-19 vaccine uptake among frontline nurses. Whereas fear of COVID-19 deaths, family influence, and availability of vaccines were found to promote COVID-19 uptake. This study recommends targeted interventions to improve the uptake of COVID-19 vaccines.

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.

Challenges and barriers to immunization during COVID-19: An experience of parents/caregivers from a well-baby clinic of a tertiary care hospital of Eastern India

BackgroundImmunization in children is one of the best methods of preventing vaccine preventable diseases.With the onset of the COVID-19 pandemic,there have been disruptions in vaccine supply,its uptake and perception towards routine immunization, globally and in India. This study was planned to identify the challenges faced by the parents, the perceived barriers towards childhood immunization and perception regarding vaccination during the ongoing pandemic. MethodsA cross-sectional study was carried out in the well-baby clinic, providing immunization services. The informants were parents/caregivers of under-five children accompanying their children to the well-baby clinic within the study period. Data was collected using a semi-structured interviewer administered questionnaire and analysed using Epi-info software and p value less than 0.05 was considered to be statistically significant. ResultsDelay in immunization was noted in 62% of the children. The challenges stated by respondents for delay in immunization during this pandemic mostly were “fear about getting infected” (30%) and “someone instructed them not to take the child to the hospital if not ill” (13%). The most common perceived barriers were ‘no vaccination sites were open’ or ‘did not know where the baby can be vaccinated’. ‘Child should receive all vaccines’(99%) and ‘safety is more important than vaccination’ (83%)was the perception of respondents about immunization during the pandemic. ConclusionThough the respondents were aware of the need for timely vaccinations of their children, still a substantial delay was seen among majority of them due to fear of getting infected and unavailability of vaccines.

Use of interrupted Time Series Design in COVID-19 data of Nepal

Introduction: Nepal was hit hard by COVID-19 pandemic and is still struggling with its implications for individuals, societies, and health systems. We applied Interrupted Time Series (ITS) analysis to see if the government's decision to end two nationwide lockdowns had an impact on the average daily new cases of COVID-19 reported in Nepal.&#x0D; &#x0D; Method: ITS analysis on daily new cases of COVID-19 was performed for first and second nationwide lockdown on data of Nepal from data depository for 2019 Novel Coronavirus Visual Dashboard operated by Johns Hopkins University Center for Systems Science and Engineering. Impact of ''ending nationwide lockdown'' and possible associated factors were investigated.&#x0D; Result: The impact of removing first nationwide lockdown contributed to statistically significant rise of an average difference of 899 daily new cases due to community transmission of COVID-19. During second lockdown, even after imposing lockdown, cases overwhelmed existing healthcare system due to high infectivity of new Delta variant followed by a lack of adherence to public health measures and delayed decision to impose lockdown due to economic reasons. Whereas significant decline of cases was observed with an average difference of 2970 daily new cases after ending second nationwide lockdown mostly due to vaccine acceptance.&#x0D; &#x0D; Conclusion: First lockdown was imposed early due to uncertainty about progression of disease, curative measures and unavailability of vaccines. Ending of first lockdown was done untimely due to economic reasons and festive seasons. The unusual decline in cases after ending second lockdown could be contributed to increased vaccination in the country.&#x0D;