Vaccine Uptake Research Articles

Childhood opportunity index and vaccine uptake in pediatric COVID-19 hospitalizations.

Risk factors for COVID-19 hospitalization in children include incomplete vaccination and having high-risk chronic conditions. There is concern for a lack of vaccine equity. Our study evaluates the association between socioeconomic child opportunity index (COI), chronic conditions, and vaccine uptake. We included all patients hospitalized with COVID-19 at Lurie Children's Hospital of Chicago until June 2022 who received remdesivir treatment. Demographic data, insurance status, socioeconomic COI, vaccination status, and chronic conditions were recorded. Chi-squared tests were performed. Vaccines were unavailable for most patients (112/198, 56.6%) at the time of hospitalization. In the remaining 86 patients, those with low COI were more often unvaccinated than higher COI counterparts (60.4% vs. 68.4%; p=0.040). There was no difference between groups based on chronic conditions (p=0.487). Targeted outreach is needed to increase vaccination in children with chronic conditions living in neighborhoods with lower socioeconomic COI.

The association between adolescents' knowledge and perception of HPV vaccination and parents' characteristics: A cross-sectional study.

In Italy, the anti-Human Papillomavirus (HPV) vaccination campaign began in 2008. To date, despite the effectiveness and safety of HPV vaccines, coverage among Italian adolescents is still suboptimal. Evidence suggests that different factors could influence parents' choices regarding their children's vaccination uptake. This study aimed to assess the association of parents' sociodemographic characteristics and vaccine hesitancy with adolescents' perceptions and knowledge of the HPV/HPV vaccine. A cross-sectional study was conducted among Italian students aged 11-13 and their parents. The data were collected by structured questionnaires including sociodemographic questions, the HPV Adolescent Vaccine Intervention Questionnaire (HAVIQ) to assess students' knowledge and perceptions on HPV/HPV vaccination, and the Parent Attitudes about Childhood Vaccines (PACV) Survey to measure parents' vaccine hesitancy. This study involved 74 adolescents and 74 parents. Overall, adolescents showed high levels of confidence in "involvement in decision-making", "self-efficacy", "feelings" and "knowledge" factors of the HAVIQ. 94.6% of parents were categorized as "non-hesitant" reporting a PACV overall score<50. Having one or both parents with a university degree in the family was statistically associated with higher students' knowledge (p=0.048) and lower feelings of fear and anxiety (p=0.011). This study identified parents' characteristics related to adolescents' knowledge and perceptions regarding the HPV/HPV vaccination. Specifically, results showed that parents' educational level was associated with adolescents' knowledge and feelings about HPV and HPV vaccination. These factors in turn could play a pivotal role in a shared vaccine decision-making process between parents and their children.

A Qualitative Study of Attitudes Toward HPV Vaccine Recommendation in Otolaryngology Clinics.

The incidence of human papillomavirus (HPV)-related oropharyngeal cancers has increased such that they are now the most prevalent HPV-related cancer. In 2020, the Food and Drug Administration (FDA) expanded the indication for Gardasil-9 to include the prevention of oropharyngeal and other head and neck cancers caused by selected HPV types, but uptake remains low. Otolaryngology office interactions may provide opportunities to increase uptake, given the relevance of HPV to clinical practice. This study explored the feasibility of recommending HPV vaccination in otolaryngology clinics. Participants were recruited between February to June of 2022 from the alumni of the residency and fellowship training programs at the University of Iowa Hospitals and Clinics. Participant interviews comprised open-ended questions pertaining to otolaryngologists' attitudes toward HPV vaccination recommendation. Interview recordings were transcribed, coded, and analyzed for themes. Participants were willing to respond if patients asked about the HPV vaccine, although a common attitude toward vaccine discussions was that they were a pediatrician's responsibility. One barrier to recommending HPV vaccination was providers' concern that discussing the vaccine when not directly relevant to the patient's chief complaint could result in patient frustration. Nevertheless, participants endorsed the feasibility of discussing the vaccine during follow-up visits after the patient's needs had been addressed or via the distribution of educational materials to patients. Otolaryngologists do not currently identify recommending HPV vaccine uptake as their clinical responsibility. While such recommendations may not be feasible in every patient encounter, there could be a role for this in the appropriate clinical scenario. These findings can be used to inform interventions aimed at recommending the vaccine in otolaryngology clinics.

Meeting summary: Global vaccine and immunization research forum, 2023.

At the 2023 Global Vaccine and Immunization Research Forum (GVIRF), researchers from around the world gathered in the Republic of Korea to discuss advances and opportunities in vaccines and immunization. Many stakeholders are applying the lessons of Covid-19 to future emergencies, by advancing early-stage development of prototype vaccines to accelerate response to the next emerging infectious disease, and by building regional vaccine research, development, and manufacturing capacity to speed equitable access to vaccines in the next emergency. Recent vaccine licensures include: respiratory syncytial virus vaccines, both for the elderly and to protect infants through maternal immunization; a new dengue virus vaccine; and licensure of Covid-19 vaccines previously marketed under emergency use authorizations. Malaria vaccine implementation is expanding and a second malaria vaccine has been recommended by the World Health Organization. In a setback for human immunodeficiency virus vaccine development, the only remaining Phase 3 trial has been discontinued. In immunization, greater clarity is emerging on the challenges of achieving access and equity, along with strategies to address those challenges. A better understanding of behavioral and social determinants of vaccine uptake and a validated toolkit for measuring and modifying the drivers of vaccination is informing program design and service delivery, contributing to improved uptake. Implementation research, which has been essential for human papillomavirus and malaria vaccine delivery, will be critical for delivering the new respiratory syncytial virus vaccines and for many other vaccines currently in development. The growing diversity of vaccines and complexity of immunization programs are leading to greater interest in simplified regimens, combination vaccines, and other innovations to facilitate delivery. Collaboration emerged as the unifying theme of GVIRF 2023, underscoring that the combined efforts of many contributors have enabled progress thus far, and going forward will continue to be essential to ensure equitable access to vaccines for all.

Promoting aged care COVID-19 and influenza vaccination through education of Australian residential aged care staff: A mixed methods project evaluation.

Vaccination coverage against COVID-19 and influenza among Australian aged care residents remains suboptimal, placing this vulnerable population at heightened risk of severe illness, frailty, and death. Health care professionals' recommendations significantly influence vaccination uptake. Aged care staff, with their unique proximity to residents, play a pivotal role in promoting vaccination. The aims of this study were to evaluate the acceptance of a vaccine education project and determine the impact on vaccine conversation confidence. This quality improvement project aimed to enhance aged care staff's knowledge and confidence in discussing vaccination with residents and their families. It included a 30-min face-to-face educational session for staff members of residential aged care facilities. The session featured a didactic component on COVID-19 and influenza vaccines, an interactive question and answer component, and role-play exercises to demonstrate effective vaccine conversation skills. Evaluation of the project involved participant survey data collected immediately after the sessions and then again at a delayed timepoint. Project developers, co-ordinators, and facilitators also provided feedback on their experience which was analysed through qualitative thematic analysis. The educational program was delivered to 27 facilities across 32 sessions, with 316 staff members attending (median session attendance: 9, IQR 8-13). 95.4% of attendees reported improved knowledge and skills, 95.8% reported increased confidence in vaccine conversations, and 94.2% would recommend the session to others. Qualitative feedback was positive, highlighting the adequacy of content and improved confidence in discussing vaccines. In-house, face-to-face education is a well-received method of delivering education to residential aged care staff. However, facilities in most need of education may be less proactive in seeking it out. Further research is needed to understand barriers to uptake of staff education and strategies for fostering a culture of quality improvement and ongoing learning within facilities.

Understanding factors contributing to vaccination underutilization among Jewish ultra-orthodox communities in Israel: A cross-sectional study.

This study aims to investigate the factors contributing to the underutilization of childhood and school-age immunizations among parents within the Jewish Ultra-Orthodox community in Israel. It identifies socio-demographic, attitudinal, and belief-related risk factors that affect vaccination decisions. A cross-sectional study was conducted involving 369 Jewish Orthodox parents in Israel, using structured questionnaires distributed through various community channels. Data on socio-demographic variables, vaccination status, and intentions were collected. Attitudinal assessments included the VAX Scale and the Multidimensional Health Locus of Control Scale. The proportion of fully vaccinated children was 46.3% for childhood diseases and 64.2% for school-age vaccinations. Flu vaccination rates were significantly lower, with only 19.2% of parents and 15.2% of children receiving flu shots. Key factors contributing to vaccine underutilization include large family size, lower socioeconomic and educational levels, reliance on the internet for health information, and the absence of media technology at home. Geographical disparities were notable, especially in the Jerusalem District, which demonstrated lower vaccination uptake, and among different Orthodox streams, with the Modern stream showing higher vaccination rates compared to the Lithuanian, Sephardic, and Hasidic streams. The VAX scale and Health-Related Locus of Control measures revealed that attitudinal factors significantly impacted vaccination decisions, such as mistrust in vaccine benefits, preference for natural immunity, and reliance on religious beliefs. To address vaccination disparities, targeted interventions should consider cultural and logistical barriers, engaging community leaders and offering culturally sensitive education to improve uptake within the Jewish ultra-Orthodox community.

Danish parents' vaccination readiness is associated with their children's officially registered vaccination history.

Previous research has shown that parents' vaccination readiness, as measured by the 7C vaccination readiness scale, helps to understand whether and why parents are (not) willing to vaccinate their children. However, there is a lack of research investigating the association between parents' vaccination readiness and their children's actual vaccine uptake. Addressing this gap, we examined how Danish parents' level of vaccination readiness is associated with their child's vaccination status combining survey with official registry data. Specifically, parents residing in Denmark (N=2941, 64% female) completed a survey assessing their level of vaccination readiness with the 7C vaccination readiness scale for parents, trust in different sources of information on vaccination, and certainty about vaccinating their child with the next vaccine in the program. Additionally, official vaccination registry data on various recommended child vaccinations was obtained and matched to the survey data of their parents. Results from logistic regression analyses indicate that parents' readiness to vaccinate their children was substantially associated with completion of children's vaccination doses. More precisely, a one-point increase in parents' vaccination readiness score was associated with a two-fold increase in the likelihood of the child being vaccinated with the three main vaccines in the program. The results also show associations between each of the 7C factors, trust items, and demographic variables with real behavior as well as parents' certainty to vaccinate their children in the future. The findings further substantiate the usefulness of assessing parental vaccination readiness, with potential implications for intervention planning by researchers and policymakers.

Implementing behavioural science-informed letter interventions to increase COVID-19 vaccination uptake in London residents. A difference-in-difference study in London, United Kingdom.

The accelerated development of vaccines to mitigate COVID-19 was crucial in the response to the 2020 pandemic. The success of vaccination strategies relies upon adequate uptake across the population. In the United Kingdom, COVID-19 vaccination began in December 2020, with population groups invited in priority groups according to age and clinical vulnerability. By February 2021, uptake rates were lower in North West London than the national average. This study aimed to explore whether behaviourally-informed (BI) letters could increase the rate of first vaccine uptake in previously uncontactable residents. BI letters were designed to invoke a sense of ownership, and highlight the ease of accessing a vaccine. Letters were sent to unvaccinated uncontactable residents in a Central London Borough over a 3-week period. Three neighbouring boroughs in London with similar non-responder data acted as controls. A linear difference in difference (DID) analysis assessed the change in the rate of vaccine uptake across all four boroughs, with percentage point change adjusted for covariates including ethnicity, age, gender and socioeconomic status. In total, 10,161 residents in Central London were eligible to receive our BI letter. All four boroughs demonstrated an increase in vaccination, with an absolute increase of 4.3% in the intervention borough. Our linear DID analysis showed a 14.7% increase in vaccination likelihood in the intervention borough following the intervention on average across all weeks included in the study. Residents with a mixed or multiple ethnic background were less likely to receive a COVID-19 vaccination. Those from a more deprived socioeconomic background demonstrated the largest rate of change. Our study highlights the effectiveness of traditional communication strategies such as letters in those who are uncontactable by other means. Incorporating behavioural science principles into healthcare communication, such as those designed to evoke a sense of ownership can enhance their effectiveness.

Strategies and resources used by public health units to encourage COVID-19 vaccination among priority groups: a behavioural science-informed review of three urban centres in Canada

BackgroundEnsuring widespread COVID-19 vaccine uptake is a public health priority in Canada and globally, particularly within communities that exhibit lower uptake rates and are at a higher risk of infection. Public health units (PHUs) have leveraged many resources to promote the uptake of recommended COVID-19 vaccine doses. Understanding barriers and facilitators to vaccine uptake, and which strategies/resources have been used to address them to date, may help identify areas where further support could be provided. We sought to identify the strategies/resources used by PHUs to promote the uptake of the first and third doses of the COVID-19 vaccine among priority groups in their jurisdictions. We examined the alignment of these existing strategies/resources with behavioral science principles, to inform potential complementary strategies/resources.MethodsWe reviewed the online and in-person strategies/resources used by three PHUs in Ontario, Canada to promote COVID-19 vaccine uptake among priority groups (Black and Eastern European populations, and/or neighbourhoods with low vaccine uptake or socioeconomic status). Strategies/resources were identified from PHU websites, social media, and PHU liaison. We used the Behaviour Change Techniques (BCT) Taxonomy – which describes 93 different ways of supporting behaviour change – to categorise the types of strategies/resources used, and the Theoretical Domains Framework – which synthesises 14 factors that can be barriers or facilitators to decisions and actions – to categorise the barriers and facilitators addressed by strategies/resources.ResultsPHUs operationalised 21 out of 93 BCTs, ranging from 15 to 20 BCTs per PHU. The most frequently operationalised BCTs were found in strategies/resources that provided information about COVID-19 infection and vaccines, increased access to COVID-19 vaccination, and integrated social supports such as community ambassadors and engagement sessions with healthcare professionals. Identified BCTs aligned most frequently with addressing barriers and facilitators related to Knowledge, Environmental context and resources, and Beliefs about consequences domains.ConclusionPHUs have used several BCTs to address different barriers and facilitators to COVID-19 vaccine uptake for priority groups. Opportunities should be pursued to broaden the scope of BCTs used (e.g., operationalizing the pros and cons BCT) and barriers/facilitators addressed in strategies/resources for ongoing and future COVID-19 vaccine uptake efforts among general and prioritised populations.

Tetanus toxoid vaccination uptake by trauma patients in Japan: A retrospective cohort study using large administrative claims data.

Tetanus remains a major global health issue in both developing and developed countries. Although guidelines are established on tetanus prophylaxis protocol for trauma patients, adherence to tetanus vaccination is unknown. In this study, we aimed to investigate the administration of tetanus toxoid among trauma patients in Japan, where approximately 100 patients are hospitalized for tetanus annually. Using the JMDC claims database, a large administrative claims database, we identified outpatients with trauma between 2005 and 2020. We divided them into those born before 1968 and those born in 1968 or later, as the routine tetanus immunization program started in 1968 in Japan. We described the characteristics of the patients and whether they received the first dose of tetanus toxoid when they visited a medical institution for any injury. Finally, we followed up the patients who received the first tetanus toxoid dose and had a history of incomplete primary vaccination series to examine whether they completed the recommended three doses of tetanus immunization within 12months. We identified 85,761 trauma patients from the database, of whom 19,541 (22.8%) were born before 1968 and not covered by the routine vaccination program. Among the patients covered by the routine vaccination program, 2.1% (1400/66,220) received tetanus toxoid vaccination at the initial clinic/hospital visit for their injuries, whereas the proportion was 5.8% (1139/19,541) in the patients not covered by the routine vaccination program. Among the 1139 patients who received tetanus prophylaxis at the time of wound management and were born before the implementation of the routine vaccination program, 31.4% received the second dose, and 7.0% completed the third dose within 12months. Taken together, most trauma patients without a history of primary tetanus immunization did not receive the recommended tetanus prophylaxis. Increased awareness of tetanus prophylaxis is needed among both patients and healthcare professionals.

COVID-19 Vaccine Preferences in China: A Comparison of Discrete Choice Experiment and Profile Case Best-Worst Scaling.

Little is known about the diversity of residents' preferences for COVID-19 vaccines during the time when COVID-19 management was downgraded in China. This study aims to investigate these preferences using discrete choice experiment (DCE) and profile case best-worst scaling (BWS-2), and to assess the concordance between these two methods. Chinese residents recruited for the online survey were asked to evaluate COVID-19 vaccine profiles through both DCE and BWS-2 from April to July 2023. Attributes included effectiveness, duration of protection, risk of severe adverse events (degree), the total out-of-pocket (OOP) cost, brand, and the vaccination method. We utilized conditional regression and mixed logit regression models to estimate the preferencelevels for potential attributes. To assess preference concordance between the two methods, re-scaling and the Spearman correlation test were used. Additionally, subgroup analysis was conducted to determine the most suitable method for different population groups, categorized by vaccine hesitancy and risk level. A total of 438 (71.22%) respondents were included. A similar pattern was found in the DCE and BWS-2 methods, with the respondents having a strong preference for 90% vaccine effectiveness. However, the methods diverged in other preferences; DCE favored domestic brands and low severe adverse event risk, while BWS-2 preferred moderate risk and three years of protection. Concordance assessment, including Spearman's correlation and linear regression, showed no significant correlation and poor concordance between the methods, underscoring these differences. Preference heterogeneity is revealed among different groups; however, effectiveness remained the most important attribute for all subgroups of the population. Oral vaccination was the preferred option for both the vaccine-hesitant and high-risk groups. This study offers new insights into the varying preferences for COVID-19 vaccines among Chinese residents following the downgrading of pandemic management measures. The findings underscore the need for diverse strategies in vaccine policy design. Special emphasis should be placed on vaccine attributes that align with public priorities, such as high effectiveness and low risk levels, to enhance vaccine uptake.

Missed Opportunities for Adolescent HPV Vaccination in the United States: Parents' Perceptions of a Range of Healthcare Providers and Settings.

Non-traditional providers and healthcare settings (e.g., dental offices, pharmacies) provide an opportunity to increase human papillomavirus (HPV) vaccine accessibility; however, they remain underutilized. The purpose of this study was to examine United States (U.S.) parents' perceptions of healthcare provider recommendations for the HPV vaccine and perceived convenience and likelihood of vaccination across healthcare settings. Parents' perceptions were assessed and compared according to the Transtheoretical Model stages of change (action: adolescent already vaccinated; preparation: intend-to-vaccinate; contemplation: unsure of intention). Parents of adolescents ages 11-12 from across the U.S. were recruited to participate in an online survey via Qualtrics that measured their perceptions of HPV vaccination by healthcare provider type and setting. The convenience and likelihood of vaccinating in different settings and the importance of provider recommendation were evaluated for those in the preparation and contemplations groups using one-way repeated measures ANOVAs. Participants across all stages of change were similar in their perceptions of vaccination across healthcare settings, rating family practice and pediatric offices as the most convenient and most likely settings for vaccination. Dental offices were perceived as the least convenient and least likely settings, and dental provider recommendations were rated as the least important. Among those in the contemplation stage, pharmacies were also rated lower in convenience and likelihood. There is a missed opportunity for HPV vaccination in non-traditional settings, including dental offices and pharmacies. Increasing education on HPV and availability of the vaccine in alternative settings can encourage vaccine uptake and move parents towards preparation and action.

Willingness to take Mpox vaccine and associated factors among health professionals in Ethiopia: A cross-sectional study.

Monkeypox (Mpox) is vaccine preventable a viral infection declared as a public health emergency of international concern by the World Health Organization in 2022. As a response to the epidemic, vaccines against the virus are being implemented in different countries, complementing other public health interventions. However, little is known about the willingness to accept the Mpox vaccine among health professionals in Africa, notably in Ethiopia. Therefore, this study aimed to identify willingness to take the Mpox vaccine and associated factors among health professionals in Ethiopia. A national online cross-sectional study design was employed between August 31, 2024, and September 6, 2024, among health professionals in Ethiopia. The data were collected from purposively selected healthcare professionals utilizing snowball sampling to achieve a high response rate using a semi-structured online survey tool. The tool was pretested, every survey item was drafted as a must-fill, and only data with correct characters were included after removing responses with miss response for the intended questionnaire. Variables with a p-value<0.25 in the bivariable logistic regression analysis were taken as candidates for multivariable analysis. An adjusted odds ratios (AORs) with 95% confidence interval (CI) were computed and p-value <0.05 were used to set statistically significant variables within final model. Finally, text, tables, and figures were used to present the data. The study involved 749 health professionals. Of the participants, 637 (85%) were males, 674 (90%) were currently employed in urban areas, and 543 (72.5%) had received the COVID-19 vaccine. Among all participants, 423 (56.5%) demonstrated a good knowledge of Mpox, whereas 211 (28.2%) expressed a willingness to get vaccinated against Mpox. Besides, recent travel to countries experiencing the Mpox outbreak (AOR=3.21, 95%CI:1.65-6.29), positive attitude towards the Mpox vaccine uptake (AOR=3.08, 95%CI:2.11-4.49), lack of access to Mpox infection information (AOR=1.93, 95%CI:1.05-3.55), the belief that avoiding treatment of Mpox cases would prevent self-contamination (AOR=4.05, 95%CI: 2.83-5.80), and prior contact with individuals diagnosed with COVID-19 (AOR=1.57 95%CI (1.07-2.32)were factors significantly associated with willingness to get vaccinated against Mpox. Despite the ongoing outbreak within the continent, only a low proportion of surveyed health professionals expressed willingness to receive the Mpox vaccine. In addressing the outbreak, it is crucial to consider various factors such as recent travel to Mpox-affected countries, attitude towards Mpox, knowledge about the disease, and prior exposure to confirmed COVID-19 cases when developing and distributing information about Mpox vaccine. Consequently, substantial efforts must be directed towards educating and empowering health professionals in Ethiopia to effectively contribute to prevention and control measures.

Historical analysis of the first smallpox vaccination campaigns in early 19-century northern Italy: organisation and communication insights for contemporary epidemics' prevention and control.

In the annals of public health, smallpox is a watershed, being the first disease eradicated by vaccination. Drawing parallels to contemporary pandemic control measures, we examined the first smallpox vaccination campaigns in early 19th-century northern Italy and the seminal work of Luigi Sacco. Our study delves into this under-explored historical landscape to elucidate lessons that resonate with modern public health dilemmas. We scrutinised primary sources from the Historical Civic Archive of Pavia, the State Archive of Pavia, and the State Archive of Milan. These archives provided exhaustive data on administrative decrees, local epidemiology, and university-health authority collaborations. Using period-specific keyword searches and expert consultations, we extensively reviewed correspondence, vaccination lists, and academic writings, including Luigi Sacco's seminal Trattato di vaccinazione. The epidemiological investigation focused on the pivotal period of 1816-1828 in Lombardy's 19th-century public health landscape. Organisational reforms enacted in 1821 succeeded in doubling the number of vaccinations administered in Pavia, stabilising at elevated rates in subsequent years. Despite improvements, incongruities in epidemiological data and vaccinator remuneration persisted. Communication strategies pioneered by Sacco, encompassing academic and religious collaborations, demonstrated their efficacy. Epidemiological data revealed an initial surge in vaccination uptake in 1822, with a declining trend in the following years, notably impacted by logistical and data recording limitations. Our research underscores three salient dimensions pertinent to contemporary public health paradigms: first, the vital function of local administrative bodies as efficacious service providers, immunisation register keepers, and social safety nets; second, the equilibrium between mandatory vaccination policies and discretionary enforcement as a pragmatic framework for public compliance; lastly, the irrefutable importance of credible communication strategies in fighting vaccine hesitancy. These insights are not merely historical curiosities but cardinal principles for effectively managing modern epidemics and infectious disease threats.

Vaccination against Respiratory Infections in the Immunosenescent Older Adult Population: Challenges and Opportunities.

Respiratory infections are associated with a huge burden of disease every year and disproportionately affect older adults, namely those aged 65 years and older. Older adults are at increased risk of infections compared with their younger counterparts, and once infected, have a higher risk of experiencing severe disease course, complications, and long-term sequelae. Therefore, vaccination is clearly a key strategy to prevent infection and its attendant negative consequences. We review here the burden of common respiratory diseases in older adults, namely influenza, pneumococcal disease, and respiratory syncytial virus. We then review some of the challenges facing immunization of older adults, namely immunosenescence, inflammaging, and low vaccine uptake. Next, potential opportunities for overcoming these challenges are reviewed, including the use of higher antigen doses and/or adjuvants in vaccine formulations for older adults, and the potential of multiomics analyses to improve development, performance, and implementation of vaccines.

A decade of rotavirus vaccination in the World Health Organization African Region: An in-depth analysis of vaccine coverage from 2012 to 2023.

Significant progress has been achieved in the introduction of rotavirus vaccines in the World Health Organization, African Region (WHO/AFR), with only 19% (9/47) of the countries yet to introduce the vaccines. Despite this achievement, a considerable number of eligible children in Africa still lack access to these lifesaving rotavirus vaccines. We performed in-depth data exploration and analysis on the WHO/UNICEF rotavirus vaccine uptake estimates of vaccine coverage to document progress and estimated the number of children missing vaccination through under- or un-vaccination between 2012 and 2023. Thirty-eight countries have introduced the vaccine in the national immunization programs and the vaccine coverage rates have increased from 5% to 61% between 2012 and 2023 in the WHO/AFR, compared to 11% to 55% at the global level. Coverage by sub-regions ranged from 48% in Central African countries to 73% in the Southeast sub-region in 2023. Vaccine coverage has been increasing every year, yet some countries reported a significant drop during the COVID-19 pandemic (2020-2022) compared to the pre-pandemic (2019_or earlier) period. For instance, in Senegal, coverage declined from 94% to 70%; Namibia, 90% to 55%; Republic of Congo, 71% to 23%; for 2019 and 2022, respectively. Four countries experienced a significant decline between 2021 and 2022. For instance, Botswana (85% to 65%), Kenya (95% to 23%), Zambia (87% to 32%), and Zimbabwe (86% to 55%); but coverage increased in 2023 (post-pandemic) in Kenya (71%), Senegal (83%), and Zambia (40%). The estimates of vaccinated children increased steadily over the years, reaching 23.5 million in 2023. However, 257.8 million children missed vaccination between 2012 and 2023, of which 18.5 million in 2022. Although countries in the WHO/AFR have made significant progress in introducing rotavirus vaccines, reaching every eligible child remains a challenge; and more than half of children are missing the full benefit of protection against rotavirus diarrhoea. There is a need for accelerated actions and concerted efforts to reach missed children and support for the nine remaining countries to introduce the vaccine.

P-2059. Perceptions and Factors Associated with Uptake of Monovalent XBB.1.5 BNT162b2 COVID-19 Vaccine among Healthcare Workers in Peru

Abstract Background The implementation of the XBB.1.5 BNT162b2 COVID-19 vaccine (updated vaccine) occurred in Peru in January 2024, since then, many questions about its efficacy and safety have been raised. Addressing these concerns is crucial, especially among healthcare workers, given their high risk of acquiring COVID-19 and their role in promoting vaccination. This study investigated the factors and perceptions associated with healthcare workers’ uptake of the updated vaccine.Figure 1:Perceptions about the updated monovalent vaccine among healthcare workers in Peru Methods We conducted a cross-sectional study based on an online survey from March 21 to May 1, 2024. Healthcare workers (physicians, nurses, etc.) living and practicing in Peru were included. We calculated crude prevalence ratios with 95% confidence intervals to determine the associated factors and perceptions using Poisson regression with robust variance.Table 1:Factors associated with uptake of the updated monovalent vaccine among healthcare workers (Page 1) Results We included 393 healthcare workers, predominantly female (55.2%) and physicians (63.9%), almost half aged 30-49 years (50.9%). The majority (72.8%) reported not being vaccinated with the updated vaccine, but 65% of them intended to do it. Regarding perceptions, more than 70% of respondents thought the updated vaccine was necessary and protective against severe COVID-19 and mortality, but only 16.5% believed it caused severe adverse events. Only 24.7% felt the Peruvian Ministry of Health was informing well about the vaccines (Figure 1). In the bivariate analysis, the uptake of this vaccine was significantly higher among those who had a history of COVID-19 (p = 0.005), had received the bivalent vaccine (p&amp;lt; 0.001), or more than five vaccine doses (p&amp;lt; 0.001), and among those who felt the vaccine should be recommended (p=0.015) or even mandatory for high-risk people (p=0.04). On the other hand, the uptake was lower in those who thought the vaccine was not necessary (p=0.043) or did not protect against mortality (p=0.037) (Table 1).Table 1:Factors associated with uptake of the updated monovalent vaccine among healthcare workers (Page 2) Conclusion History of COVID-19, receiving multiple vaccine doses, and recommending the updated vaccine for high-risk people are factors associated with vaccine uptake. There are still major concerns about the government's communication regarding vaccination. These findings underscore the importance of targeted interventions and communication strategies to improve the poor vaccination rate among healthcare workers in Peru.Table 1:Factors associated with uptake of the updated monovalent vaccine among healthcare workers (Page 3) Disclosures All Authors: No reported disclosures

Provider Determinants of Maternal Influenza and Pertussis Vaccination Uptake in South Australia in a Tertiary Healthcare Setting

Background: In Australia, maternal influenza and pertussis vaccinations have been recommended for every pregnancy since 2010 and 2015, respectively. Aims: This study aimed to determine maternal influenza and pertussis vaccine uptake in South Australia and assess factors associated with vaccine uptake among pregnant women. Methods: This retrospective cohort study collected data from the South Australian Pregnancy Record (SAPR) or other medical records of women who delivered at the Women’s and Children’s Hospital from 2016 to 2018. Results: Of 2230 complete records, 53.5% received influenza vaccination and 66.5% pertussis vaccination. Maternal vaccine uptake significantly increased from 2016 to 2018: influenza 43.1–61.6%; pertussis 58.7–71.6%. Healthcare provider discussions with pregnant women about maternal vaccines more than doubled the likelihood of influenza (AOR 2.74, 95% CI: 2.21–3.39) and pertussis vaccine uptake (AOR 2.22, 95% CI: 1.77–2.78). Lower vaccine uptake was observed among women attending midwifery clinics (influenza: AOR 0.72, 95% CI: 0.58–0.90; pertussis: AOR 0.67, 95% CI: 0.54–0.84) or private maternity care (influenza: AOR 0.51, 95% CI: 0.34–0.77; pertussis: AOR 0.40, 95% CI: 0.27–0.60). Shared antenatal care increased the uptake of influenza (AOR 1.51, 95% CI: 1.12–2.04) and pertussis (AOR 1.39, 95% CI: 1.00–1.91). Additional adjustment for SAPR versions did not appreciably change the results, although attending private practice was no longer significantly associated with lower vaccine uptake. Conclusions: Maternal vaccine uptake varies depending on the antenatal care provider. This study identifies opportunities to improve vaccination access during pregnancy and emphasizes the need for targeted strategies to address provider-related barriers.

P-2062. COVID-19 XBB.1.5-adapted Vaccine Uptake in Immunocompromised Individuals Using Tokenized State Vaccine Registries

Abstract Background Immunocompromised individuals experience a disproportionate burden of COVID-19-associated hospitalization and death. COVID-19 vaccine uptake has declined over time. We evaluated XBB.1.5-adapted vaccine uptake, regardless of brand, during the 2023-2024 season among immunocompromised persons using data from two large state vaccine registries. Methods Individuals with continuous pharmacy and medical enrollment (≥6 months for children &amp;lt; 18 years, ≥12 months for adults ≥18 years) in insurance plans contributing to HealthVerity and residency in either California or Louisiana as of September 11, 2023 (the date XBB.1.5-adapted vaccines were authorized or approved) were selected. A prior dose of any COVID-19 vaccine was required. Persons were defined as immunocompromised if they had one or more of the following conditions as defined by the Centers for Disease Control and Prevention: HIV/AIDS, hematologic malignancy, solid organ or bone marrow transplant, primary immunodeficiency, or recent use of immunosuppressive medications. XBB.1.5-adapted vaccine uptake was assessed using de-identified records from state vaccine registries in California and Louisiana that were linked via tokenization with claims data. Results A total of 321,896 California residents (median age 55 years; 57% female) and 43,250 Louisiana residents (median age 45 years; 64% female) with at least one immunocompromising condition were identified. In both states, the most common immunocompromising condition was use of immunosuppressive medications (78% California and 85% Louisiana). By the end of March 2024, 19% and 6% of immunocompromised individuals in California and Louisiana, respectively, received an XBB.1.5-adapted vaccine. Uptake was generally similar regardless of immunocompromising condition (Table 1). Conclusion During the 2023-2024 season, COVID-19 vaccine uptake in immunocompromised persons was low, with fewer than 20% of this high-risk population receiving the XBB.1.5-adapted vaccine. Enhanced efforts to increase COVID-19 vaccine uptake in this vulnerable population are urgently needed. Disclosures Matthew A. Brouillette, MPH, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Farid L. Khan, MPH, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Santiago M.C. Lopez, MD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Kathleen M. Andersen, PhD MSc, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Tiange Yu, MS, Pfizer Inc.: Employee of Genesis Research Group which has received consulting fees from Pfizer Inc. Benjamin T. Carter, PhD, Pfizer Inc.: Employee of Genesis Research Group which has received consulting fees from Pfizer Inc. John M. McLaughlin, PhD, Pfizer: Employee|Pfizer: Stocks/Bonds (Public Company) Leah McGrath, PhD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company)

P-2048. COVID-19 XBB.1.5 Vaccine Uptake Based on State Vaccine Registries Compared to National Survey Data

Abstract Background Prior to May 11, 2023, all COVID-19 vaccinations were required to be reported by states to the Centers for Disease Control and Prevention. In the post-pandemic era, national vaccination uptake is now estimated using the National Immunization Survey (NIS). While survey methodology attempts to achieve random sampling of the population and accurate assessment of vaccine use through self-report, it is unknown how these estimates compare to state vaccine registries. We aimed to compare estimated COVID-19 vaccine uptake during the 2023-2024 season from state vaccine registries with estimates from the NIS.Figure 1.Uptake of XBB.1.5 COVID-19 vaccine in state vaccine registries versus national survey estimates, September 2023 - February 2024 Methods We utilized two COVID-19 state vaccination registries where COVID-19 vaccine reporting was required: CAIR2 in California and LINKS in Louisiana. We identified COVID-19 XBB.1.5-adapted vaccines administered between September 11, 2023, and February 10, 2024, using CVX vaccine codes 308 - 313. California and Louisiana 2023 population estimates were obtained from the U.S. Census Bureau and used as the denominator to calculate population-level uptake. For the same time period, state-specific COVID-19 vaccine uptake estimates were also obtained from state-specific NIS data for California and Louisiana as a comparison. Results At the end of the study period, 14.4% of adults and 5.6% of children in California were documented as vaccinated in the CAIR2 registry compared to NIS estimates that 23.8% (1.6x) of adults and 17.3% (3.1x) of children in California had been XBB.1.5 vaccinated (Figure). For Louisiana, 5.4% of adults and 0.6% of children were found in LINKS registry data compared to NIS estimates that 12.3% (2.3x) of adults and 3.9% (6.5x) of children were XBB.1.5 vaccinated. Conclusion XBB vaccination coverage was low overall but was substantially lower when measured using state vaccine registry data compared with national survey data, especially for children. Efforts to improve COVID-19 vaccination are warranted, as are future studies to determine why COVID-19 uptake appears higher in national survey data compared to what is captured in state registries. Disclosures Angela Cook, MS, Pfizer: Employee|Pfizer: Stocks/Bonds (Public Company) Kathleen M. Andersen, PhD MSc, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Matthew A. Brouillette, MPH, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Leah McGrath, PhD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) John M. McLaughlin, PhD, Pfizer: Employee|Pfizer: Stocks/Bonds (Public Company)