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This research aimed to explore the challenges of the COVID‐19 vaccination program from the perspective of multiple stakeholders in rural areas of eastern Indonesia. This qualitative participatory action research involved 115 participants selected from various groups in 20 subdistricts across five provinces, including Health Service workers, police staff monitoring the vaccination program, religious figures, and adult and youth community leaders. Furthermore, focus group discussion was conducted using semi‐structured interview guidelines based on the WHO Strategic Advisory Group of Experts (SAGE) for vaccine and immunization model. The manifest content approach was employed to analyze the visible contents within the text. Implementation of the vaccination program was complicated by contextual, individual, and group factors, as well as vaccine and vaccination‐specific factors. The contextual factors were socioeconomic, religious, and cultural conditions, changes in government policies, and geographical and climatic obstacles. Meanwhile, examples of group and individual factors were people's beliefs of COVID‐19 being harmless and their invulnerability to the disease, along with misinformation and disinformation about vaccination, and fatalistic attitudes. Factors related to the vaccine and vaccination process include limited vaccine supplies, inadequate supporting facilities, and insufficient administration of vaccines. Multiple and complex challenges of COVID‐19 vaccination in the rural areas of eastern Indonesia need attention from the local and national government, as well as other parties including the private sector, socio‐religious figures and organizations, and the media. Key Points: This study involved participants from government and nongovernment elements, young and adult age groups, as well as health and nonhealth actors to explore challenges of the COVID‐19 vaccination program in Eastern Indonesia.The results showed that the low COVID‐19 vaccination coverage cannot be attributed to a single factor, as multiple complex and context‐specific factors are at play.Health and nonhealth sectors, as well as governmental and nongovernmental actors with their respective roles can be involved in supporting the COVID‐19 vaccination and other vaccination programs. [ABSTRACT FROM AUTHOR]

Objective: Mathematical models are vital tools to understand transmission dynamics and assess the impact of interventions to mitigate COVID‐19. However, historically, their use in Africa has been limited. In this scoping review, we assess how mathematical models were used to study COVID‐19 vaccination to potentially inform pandemic planning and response in Africa. Methods: We searched six electronic databases: MEDLINE, Embase, Web of Science, Global Health, MathSciNet and Africa‐Wide NiPAD, using keywords to identify articles focused on the use of mathematical modelling studies of COVID‐19 vaccination in Africa that were published as of October 2022. We extracted the details on the country, author affiliation, characteristics of models, policy intent and heterogeneity factors. We assessed quality using 21‐point scale criteria on model characteristics and content of the studies. Results: The literature search yielded 462 articles, of which 32 were included based on the eligibility criteria. Nineteen (59%) studies had a first author affiliated with an African country. Of the 32 included studies, 30 (94%) were compartmental models. By country, most studies were about or included South Africa (n = 12, 37%), followed by Morocco (n = 6, 19%) and Ethiopia (n = 5, 16%). Most studies (n = 19, 59%) assessed the impact of increasing vaccination coverage on COVID‐19 burden. Half (n = 16, 50%) had policy intent: prioritising or selecting interventions, pandemic planning and response, vaccine distribution and optimisation strategies and understanding transmission dynamics of COVID‐19. Fourteen studies (44%) were of medium quality and eight (25%) were of high quality. Conclusions: While decision‐makers could draw vital insights from the evidence generated from mathematical modelling to inform policy, we found that there was limited use of such models exploring vaccination impacts for COVID‐19 in Africa. The disparity can be addressed by scaling up mathematical modelling training, increasing collaborative opportunities between modellers and policymakers, and increasing access to funding. [ABSTRACT FROM AUTHOR]

Aims: Anthrax is reported with frequency but poorly understood in Southeast Asian countries including Vietnam. In Vietnam, anthrax surveillance is national. However, case detection, prevention, and control are implemented locally at the provincial level. Here, we describe the epidemiological characteristics, identify spatial clusters of human anthrax, and compare the variation in livestock anthrax vaccine coverage to disease incidence in humans and livestock using historical data in Son La province, Vietnam (2003–2020). Methods and Results: Most human cases occurred between April and September. Most of the patients were male, aged 15–54 years old. The human cases were mainly reported by public district hospitals. There was a delay between disease onset and hospitalization of ~5 days. We identified spatial clusters of high–high incidence communes in the northern communes of the province using the local Moran's I statistic. The vaccine coverage sharply decreased across the study period. The province reported sporadic human anthrax outbreaks, while animal cases were only reported in 2005 and 2022. Conclusions: These results suggest underreporting for human and livestock anthrax in the province. Intersectoral information sharing is needed to aid livestock vaccination planning, which currently relies on reported livestock cases. The spatial clusters identify areas for targeted surveillance and livestock vaccination, while the seasonal case data suggest prioritizing vaccination campaigns for February or early March ahead of the April peak. A regional approach for studying the role of livestock trading between Son La and neighbouring provinces in anthrax occurrence is recommended. [ABSTRACT FROM AUTHOR]

Age heterogeneity in influenza transmission leads to significant differences in infection risk among different age groups. In this paper, an influenza model with vaccination and discrete age structure is constructed. First, we obtain the basic reproduction number R0$$ {R}_0 $$ and prove that the disease‐free equilibrium E0$$ {E}_0 $$ is globally stable at R0<1$$ {R}_0<1 $$. When R0>1$$ {R}_0>1 $$, the disease will persist uniformly, and there is a unique positive equilibrium, which is globally asymptotically stable under certain conditions. The model is used to analyze influenza data from 2016 to 2017 in China. By comparing various prevention and control measures, it can be found that by wearing masks to reduce contact between different age groups, while increasing vaccine coverage and reducing vaccine failure rates, the prevention and control goals can be achieved in the shortest time. However, if only the vaccine coverage rate is increased and the vaccine protection rate is strengthened, the time to reach the control target is 8 months later than the above case, and the cost is the lowest. [ABSTRACT FROM AUTHOR]

In this paper, we study nontrivial periodic solutions for seasonal epidemiological models with information‐dependent vaccination. Using Leray–Schauder degree theory, we establish new results concerning the existence of at least one nontrivial periodic solution for the SIS$$ SIS $$ and SIR$$ SIR $$ models with seasonality, state‐dependent vaccination coverage and delayed information. Some numerical simulations are presented to illustrate the effect of such vaccination coverage. [ABSTRACT FROM AUTHOR]

Worldwide inequalities in vaccine availability are expected to affect the spread and spatial distribution of infectious diseases. It is unclear, however, how spatial variation in vaccination coverage can affect the long-term evolution of pathogens. Here we use an analytical model and numerical simulations to analyse the influence of different imperfect vaccines on the potential evolution of pathogen virulence in a two-population model where vaccination coverage varies between populations. We focus on four vaccines, with different modes of action on the life cycle of a pathogen infecting two host populations coupled by migration. We show that, for vaccines that reduce infection risk or transmissibility, spatial heterogeneity has little effect on pathogen prevalence and host mortality, and no effect on the evolution of pathogen virulence. In contrast, vaccines that reduce pathogen virulence can select for more virulent pathogens and may lead to the coexistence of different pathogen strains, depending on the degree of spatial heterogeneity in the metapopulation. This heterogeneity is driven by two parameters: pathogen migration and the difference in the vaccination rate between the two populations. We show that vaccines that only reduce pathogen virulence select mainly for a single pathogen strategy in the long term, while vaccines that reduce both transmission and virulence can favor the coexistence of two pathogen genotypes. We discuss the implications and potential extensions of our analysis. [ABSTRACT FROM AUTHOR]

Objective: Governments use vaccination mandates, of different degrees of coerciveness, to encourage or require childhood vaccination. We elicited the views of well‐informed community members on the public acceptability of using childhood vaccination mandates in Australia. Methods: Four community juries were conducted in Canberra, Launceston, Cairns and Melbourne, Australia between 2021 and 2022. We recruited 51 participants from diverse backgrounds, genders and ages through random digit dialling and social media. Two juries were held in metropolitan areas, and two in regional/rural settings. Outcome measures included jury verdicts and reasons in response to structured questions. Results: All juries were concerned about collective protection and individual rights but prioritised the former over the latter. A majority in all juries supported mandates but juries disagreed with respect to the appropriate mandate types. All juries endorsed using the least restrictive or coercive means to encourage vaccination (providing incentives or education, e.g.) before imposing penalties such as financial losses and school exclusions. The overriding view was that it is fairer to place a direct burden on parents rather than children and that mandates should be designed to avoid inequitable impacts on less advantaged groups in society. Many jurors found conscientious objection acceptable as a controlled option for resolute refusers, provided that overall vaccination coverage remains high. Conclusion: This paper gives policymakers access to the reasons that Australians have for supporting or opposing different mandates under conditions of high knowledge, understanding and deliberation regarding policy options. Sustaining high rates of vaccination requires high levels of co‐operation between governments, public health actors and the public. Our findings highlight the importance of considering public values in the design and implementation of vaccination mandates. Patient and Public Involvement: We sought input from individuals who did and did not vaccinate during the study design. The views and perspectives of nonvaccinating parents were presented in the evidence to juries. We deliberately excluded nonvaccinating individuals from participating, as the divisive and often hostile nature of the topic, and their minority status, made it difficult to ensure they would feel safe as members of the jury without overrepresenting their perspective in the sample. Two related projects engaged directly with these parents. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer has been considered as one of the most common cancers in women (15–44 years) globally, but the advent of the human papilloma virus (HPV) vaccine has raised the anticipation that eradication of cervical carcinoma might be achieved in the near future as several prophylactic cervical carcinoma vaccines have already been currently licensed in various countries. Countries should devise strategies, practices and policies to attain and sustain higher levels of HPV immunization coverage as still 68% countries have introduced HPV vaccine in their national immunization programs even after 17 years following the licensure of the first prophylactic HPV vaccine. Methodology: A comprehensive literature analysis was conducted using various databases and search engines, to include the most relevant research articles and data available and critically discussed the operational gaps that need to be answered to achieve adequate coverage of HPV vaccination. Results: The present review highlights the existing HPV vaccination strategies, unmet needs and challenges needed to be addressed for proper implementation framework as well as the collaborations required to achieve decent vaccination coverage. Well‐coordinated vaccination strategy with focus on adolescent girls and if possible, boys can lead to dramatic impact on disease reduction around the world. [ABSTRACT FROM AUTHOR]

Objectives: Viral hepatitis co‐infection among people living with HIV is known to accelerate the progression of liver disease and AIDS. An increased prevalence and incidence of hepatitis B virus (HBV) infection among people living with HIV demands continuous monitoring to adapt targeted prevention strategies to reach the global goals of eliminating viral hepatitis as a public health threat. Methods: We determined the prevalence and incidence of HBV for the years 1996–2019 from yearly blood sample testing and questionnaire reports among people living with HIV belonging to a nationwide, multicentre observational, prospective cohort study. Results: Among this study population of 3479 participants, the majority (87%) indicated that being men who have sex with men (MSM) was their likely HIV transmission route; 51% were recruited from Berlin. HBV prevalence for acute/chronic and resolved infections decreased from 4.1% and 45% in 1996–1999 to 1.3% and 16% in 2019, respectively. Simultaneously, participants with a serological status indicating HBV vaccination increased from 25% in 1996–1999 to 69% in 2019. Among vaccinated participants with relevant information (n = 1135), 38% received their first HBV vaccination after HIV infection. The HBV incidence rate in 565 eligible participants decreased from 6.9/100 person‐years in 2004–2007 to 0.45/100 person‐years in 2015. Conclusion: Increasing vaccination coverage because of a general HBV vaccination recommendation and catch‐up vaccination efforts among risk groups decreased HBV infection prevalence over time among this study population of people living with HIV, primarily MSM and from Berlin. Despite this success, the prevalence and incidence of HBV remains higher than in the general population in Germany. This emphasizes the need for continued HBV prevention by promoting HBV vaccination and HBV screening at regular intervals based on the individual risk behaviour. [ABSTRACT FROM AUTHOR]

Aim: To investigate the current status of COVID‐19 vaccination in maintenance hemodialysis (MHD) patients and its influencing factors. Methods: In total, 585 patients undergoing regular hemodialysis in Sichuan Province of China from January to March 2022 were selected to complete a questionnaire survey on their knowledge, attitudes and practices regarding COVID‐19 vaccination. Independent t tests and logistic multivariate analysis were used to analyze the influencing factors of COVID‐19 vaccination in hemodialysis patients. Results: The survey showed that 37.44% of MHD patients had been vaccinated with the COVID‐19 vaccine. Being married was associated with COVID‐19 vaccination in patients with MHD (odds ratio [OR] = 1.969 95% CI 0.870 ~ 4.453). MHD patients living in county areas have higher rates of COVID‐19 vaccination (OR = 0.572 95% CI 0.301 ~ 1.087). Family /relatives/friends who are healthcare workers are associated with COVID‐19 vaccination for MHD patients (OR = 1.840 95% CI 1.140 ~ 2.970). Other vaccination history within 5 years was a factor in COVID‐19 vaccination for MHD patients (OR = 5.592 95% CI 2.997 ~ 10.434). Attitude (OR = 0.885 95% CI 0.808 ~ 0.905), and practice (OR = 0.756 95% CI 0.697 ~ 0.819) scores on the COVID‐19 vaccination knowledge and practice questionnaire were related to the vaccination status of MHD patients. Conclusions: MHD patients had lower rates of COVID‐19 vaccination. Marital status, living environment, whether family/relatives/friends were medical workers, and the score of the COVID‐19 vaccine knowledge and practice questionnaire were the factors influencing their vaccination status. Clinical attention should be given to the adverse reactions of COVID‐19 vaccination in MHD patients to improve the awareness of primary medical staff on hemodialysis, and families and society should pay more attention to COVID‐19 vaccination in MHD patients. [ABSTRACT FROM AUTHOR]

Objective: Cervical Cancer (CC) lingers as a severe public health issue due to low vaccination coverage and poor screening addressability. Hence, this systematic review explored psychological factors influencing the Human Papilloma Virus (HPV) vaccination uptake in European women. Methods: As of September 2022, PubMed, EMBASE, Scopus, and Web of Science were systematically searched to include English studies assessing diverse factors influencing vaccination uptake in European women. Only studies comparing vaccinated with unvaccinated women were included. Quality assessment, publication attrition assessment, and sensitivity analyses were performed. Results: Eighteen studies were included, totaling a population of 18,611 participants. Results indicated that knowledge about HPV infection could positively influence vaccination rates with an Odds Ratio (OR) of 1.82 and a confidence interval (CI) between 1.27 and 2.61, showing statistical significance at a Z value of 3.24 with a p‐value of 0.001. Neither knowledge about HPV vaccination (OR = 1.39, CI: 0.73–2.65, Z = 1.01, p = 0.31) nor knowledge about CC screening (OR = 1.05, CI: 0.55–1.98, Z = 0,14, p = 0.89) seem to affect vaccination rates. Regardless, intention to undertake CC screening (CCS) showed an OR = 1.68 in favor of the group intending to perform it, with a CI between 1.37 and 2.07, showing statistical significance at a Z = 4.94 and p = 0.00001. Other aspects affecting vaccination uptake were fear of side effects, insufficient information, and belief that chances of being infected are low. Conclusions: Results demonstrated that diverse aspects could affect the vaccination intent, while personalized interventions focusing on population and country characteristics need to be assembled to mitigate vaccination coverage. [ABSTRACT FROM AUTHOR]

Background: The global COVID‐19 pandemic presented an immense obstacle to public health, with vaccination emerging as a crucial measure to curb transmission. This study aimed to evaluate the willingness, hesitancy, and coverage of SARS‐CoV‐2 vaccines among healthcare workers (HCWs) in Tanzania and reveal their concerns about SARS‐CoV‐2 vaccines and the reasons that might prevent them from getting vaccinated. Methods: We conducted a cross‐sectional study using an anonymous online survey from October to November 2022. The multivariate logistic regression model explored the factors associated with SARS‐CoV‐2 vaccine willingness, hesitancy, and coverage. Results: The study included 560 HCWs, with the largest group being doctors (47.9%), followed by nurses (26.9%) and other HCWs (25.2%). A total of 70.5% of HCWs reported being vaccinated against SARS‐CoV‐2. The primary driver for SARS‐CoV‐2 vaccination was collective responsibility. A total of 81.4% of HCWs reported being willing to accept SARS‐CoV‐2 vaccines, while 62.5% of HCWs reported vaccine hesitancy. HCWs with higher educational qualifications were likelier to take the vaccine, while the respondents aged 18–30 years had the highest SARS‐CoV‐2 vaccination refusal (71.9%). We also investigated the role of HCWs as a source of information to promote COVID‐19 vaccine uptake. 79.4% of HCWs provided information and advice on SARS‐CoV‐2 vaccines. Conclusion: To increase vaccine acceptance among HCWs and the general population, targeted messaging is needed to deliver transparent information on vaccine safety, efficacy, and development. [ABSTRACT FROM AUTHOR]

Summary: Accurate estimates of subnational health and demographic indicators are critical for informing policy. Many countries collect relevant data using complex household surveys, but when data are limited, direct weighted estimates of small area proportions may be unreliable. Area level models treating these direct estimates as response data can improve precision but often require known sampling variances of the direct estimators for all areas. In practice, the sampling variances are estimated, so standard approaches do not account for a key source of uncertainty. To account for variability in the estimated sampling variances, we propose a hierarchical Bayesian spatial area level model for small area proportions that smooths both the estimated proportions and sampling variances to produce point and interval estimates of rates of interest. We demonstrate the performance of our approach via simulation and application to vaccination coverage and HIV prevalence data from the Demographic and Health Surveys. [ABSTRACT FROM AUTHOR]

Background: There is considerable variation in vaccination practices between pediatric transplant centers. This study aims to evaluate active immunization attitudes and practices among ERN‐TransplantChild centers and identify potential areas of improvement that could be addressed by shared evidence‐based protocols. Methods: A cross‐sectional questionnaire of attitudes and practices toward immunization of pediatric SOT and HSCT candidates and recipients was sent to a representative member of multidisciplinary teams from 27 European centers belonging to the ERN‐TransplantChild. Results: A total of 28/62 SOT programs and 6/12 HSCT programs across 21 European centers participated. A quarter of centers did not have an on‐site protocol for the immunizations. At the time of transplantation, pediatric candidates were fully immunized (80%–100%) in 57% and 33% of the SOT and HSCT programs. Variations in the time between vaccine administration and admission to the waiting list were reported between the centers, with 2 weeks for inactivated vaccines and variable time (2–4 weeks) for live‐attenuated vaccines (LAVs). Almost all sites recommended immunization in the post‐transplant period, with a time window of 4–8 months for the inactivated vaccines and 16–24 months for MMR and Varicella vaccines. Only five sites administer LAVs after transplantation, with seroconversion evaluated in 80% of cases. Conclusions: The immunization coverage of European pediatric transplant recipients is still inconsistent and far from adequate. This survey is a starting point for developing shared evidence‐based immunization protocols for safe vaccination among pediatric transplant centers and generating new research studies. [ABSTRACT FROM AUTHOR]

Issue Addressed: COVID‐19 vaccination is the cornerstone of managing Australia's COVID‐19 pandemic and the success of the vaccination program depends on high vaccination coverage. This paper examined differences in COVID‐19 vaccination coverage and vaccine hesitancy for people with disability, long‐term health conditions, and carers – subgroups that were prioritised in Australia's vaccination program. Methods: Using data from 2400 Australians who participated in two waves of the Taking the Pulse of the Nation survey in April and May 2021, we described vaccination coverage and hesitancy among people with disability, severe mental health conditions, severe long‐term health conditions, frequent need for assistance with everyday activities, and carers. Results: Vaccination coverage was estimated to be 8.2% in the population overall and was similar for people with disability, those with frequent need for assistance, and carers. It was higher for people with severe long‐term health conditions (13.4%) and lower for people with severe mental health conditions (4.3%). Vaccine hesitancy was high overall (35.6%) and was similarly high across the priority groups, with only small differences for people with disability, severe long‐term health conditions and frequent need for assistance. Conclusions: This study highlights a lack of difference in vaccination coverage for people with disability, long‐term health conditions, and carers compared to the general population. So what?: Sub‐optimal vaccination coverage for people in the priority groups leaves many people at significant risk of serious disease or death if exposed to COVID‐19, particularly in light of easing of disease‐control restrictions across Australia and the emergence of new variants. [ABSTRACT FROM AUTHOR]

Introduction: Despite various efforts to improve human papillomavirus (HPV) vaccine coverage in France, it has always been lower than in most other high‐income countries. The health authorities launched in 2018 the national PrevHPV research programme to (1) co‐develop with stakeholders and (2) evaluate the impact of a multicomponent complex intervention aimed at improving HPV vaccine coverage amongst French adolescents. Objective: To describe the development process of the PrevHPV intervention using the GUIDance for rEporting of intervention Development framework as a guide. Methods: To develop the intervention, we used findings from (1) published evidence on effective strategies to improve vaccination uptake and on theoretical frameworks of health behaviour change; (2) primary data on target populations' knowledge, beliefs, attitudes, preferences, behaviours and practices as well as the facilitators and barriers to HPV vaccination collected as part of the PrevHPV Programme and (3) the advice of working groups involving stakeholders in a participatory approach. We paid attention to developing an intervention that would maximise reach, adoption, implementation and maintenance in real‐world contexts. Results: We co‐developed three components: (1) adolescents' and parents' education and motivation using eHealth tools (web conferences, videos, and a serious video game) and participatory learning at school; (2) general practitioners' e‐learning training on HPV using motivational interviewing techniques and provision of a decision aid tool and (3) easier access to vaccination through vaccination days organised on participating middle schools' premises to propose free of charge initiation of the HPV vaccination. Conclusion: We co‐developed a multicomponent intervention that addresses a range of barriers and enablers of HPV vaccination. The next step is to build on the results of its evaluation to refine it before scaling it up if proven efficient. If so, it will add to the small number of multicomponent interventions aimed at improving HPV vaccination worldwide. Patient or Public Contribution: The public (adolescents, their parents, school staff and health professionals) participated in the needs assessment using a mixed methods approach. The public was also involved in the components' development process to generate ideas about potential activities/tools, critically revise the successive versions of the tools and provide advice about the intervention practicalities, feasibility and maintenance. [ABSTRACT FROM AUTHOR]

Children require accessible, affordable health care to support health and education outcomes. Health care access is affected by children's social determinants of health. School‐based health centers (SBHC) bypass larger social structures and social determinants of health, providing accessible health care to children. New SBHC development should consider university collaboration partnerships to establish funding sustainability. University interprofessional health programs allow for high‐quality, advanced practice nurse care models to staff SBHCs. When developing an SBHC, founders should utilize access theory to ensure conformity between the targeted population's needs and health services. The dimensions of the theory assist in building and evaluating access. As the pandemic continues to cause health care access barriers for children, advocates, and policymakers should focus efforts on sustaining and expanding SBHCs. [ABSTRACT FROM AUTHOR]

Observing the relationship between COVID‐19 vaccination and the neurological side‐effect of worsening seizure frequency, this case series offers insight into the impact of vaccine administration on seizure frequency in three individuals with intellectual disabilities and epilepsy. With questions still remaining with regard to vaccine safety, this article provides an example of the unique challenges faced by this patient population. It is hoped that the publication will stimulate further investigation into related issues and will also help to further inform vaccination strategies. [ABSTRACT FROM AUTHOR]

The emergence of COVID‐19 pandemic has been a major social as well as economic challenges around the globe. Infections from the infected surfaces have also been identified as drivers of COVID‐19 transmission, but most of the epidemic models do not include the effect of environmental contamination to account for the indirect transmission of the disease. The present study is devoted to the investigation of the effect of environmental contamination on the spread of the coronavirus pandemic by means of a mathematical model. We also consider the impact of vaccination coverage as an effective control measure against COVID‐19. The proposed model is analyzed to discuss the feasibility as well as stability of the disease‐free and endemic equilibria; an epidemic threshold in the form of basic reproduction number is obtained. Further, we incorporate the effect of seasonal periodic changes by letting the rate of direct transmission of disease as time dependent, and find sufficient conditions for the global attractivity of the positive periodic solution. We employ sophisticated techniques of sensitivity analysis to identify model parameters which significantly alter the epidemic threshold and the disease prevalence. We find that by enhancing the vaccination of the susceptible population and hospitalization of the symptomatic/asymptomatic individuals, the basic reproduction number can be lowered to a value less than unity. The findings show that the prevalence of disease can be potentially suppressed by increasing the vaccination of susceptible population, hospitalization of infected people and depletion of environmental contamination. Moreover, we observe that seasonal pattern in the disease transmission causes persistence of the pandemic in the population for a longer period. [ABSTRACT FROM AUTHOR]

Objective: To report on vaccination status by 12 months of age among tribal children from nine districts of India. Methods: Cross‐sectional study of 2631 tribal women having a child aged 12 months or below from nine Indian districts with a considerable proportion of the tribal population. Socio‐demographic details, reception of various vaccines by 12 months of age, mother's antenatal care utilisation and health system‐related details were collected through a pre‐tested, interviewer‐administered questionnaire from mothers. Multiple logistic regression analysis was used to identify the factors associated with complete vaccination by 12 months of age. Results: Only 52% of children were fully vaccinated by the age of 12 months among the tribal populations; 11% did not receive any vaccine, and 37% of the tribal children received some vaccines. The age‐appropriate vaccination was unsatisfactory as only 75% of the infants received all birth dose vaccines, and only 60.5% received all doses by 14 weeks. Only 73% were vaccinated against measles. Illness of the child, home births and communication gaps concerning vaccination were the main reasons for an infant not being vaccinated appropriately. Frequency of health worker's visits to the village, hospital birth, reception of advice on vaccination and educational status of the head of the households were significantly associated with full vaccination status. Conclusion: A relatively low proportion of children were fully vaccinated among the tribal populations. Health systems factors, mainly the outreach services and advice by the health workers, were positively and significantly associated with a child being fully vaccinated by 12 months of age. Improving outreach services is crucial to improve vaccination coverage in tribal areas, and there is a need to address the social determinants in the long run. [ABSTRACT FROM AUTHOR]

Objectives: To assess influenza and Tdap (tetanus, diphtheria, pertussis) vaccine coverage during pregnancy, explore key socioeconomic and maternity pathway‐related predictors of vaccination, and detect specific patterns of vaccination uptake. Methods: The authors cross‐sectionally analyzed self‐reported data obtained from the systematic survey on the maternity pathways of Tuscany. They selected all pregnant women that completed from March 2019 to June 2022 the third‐trimester questionnaire (n = 25 160), which included two dichotomous items on influenza and Tdap vaccination, as well as socioeconomic and pathway‐related questions. Multilevel logistic models were performed to assess vaccination predictors and cluster analysis to identify vaccination patterns. Results: Vaccination coverage was higher for pertussis (56.5%) than for influenza (18.9%). The main predictors of vaccination were high socioeconomic status, attending private gynecologists, and receiving vaccine information. Three clusters were identified: cluster 1 included women receiving both Tdap and influenza vaccines; cluster 2 included women receiving no vaccinations; and cluster 3 included women receiving only the pertussis vaccine. Although women from cluster 3 were of middle to low education status, vaccine information was the main adherence determinant also in this group. Conclusions: Health workers and policymakers should focus on groups of pregnant women less prone to vaccination to promote vaccination information and encourage wider uptake and coverage. Synopsis: Patient‐reported data from a systematic survey involving pregnant women from Tuscany revealed specific vaccination patterns during pregnancy and the main predictors of vaccination uptake. [ABSTRACT FROM AUTHOR]

Objectives: The authors aimed to assess the characteristics and integration of immunization services into the prenatal care provided by maternity care units (MCUs) in Italy. Methods: A cross‐sectional nationwide study using a web‐based survey was conducted from June to August 2021. The study population consisted of 342 obstetricians/gynecologists (OB/GYNs), members of the Italian Society of Gynecology and Obstetrics, and heads of MCUs. The main outcome was to assess the performance of several vaccine‐related services among the surveyed MCUs. Results: Overall, 112 of 342 MCUs completed the survey, for an overall response rate of 32.7%. Almost all MCUs (96.4%) provided vaccine information, but only 22% had an onsite vaccination clinic. Less than half (43.8%) offered vaccines during prenatal visits and 75% of those sites required women to set up an extra appointment for vaccination. Although 68% MCUs recorded vaccines administered, only 20% of them managed to record vaccines in their own medical records. The institutional‐logistic issues were the most voted vaccination barrier (40.2%). Conclusions: Institutional barriers and lack of certain vaccine‐related services offered during prenatal care in Italian MCUs might be responsible for many missed vaccination opportunities. Embedding maternal immunization programs within the current prenatal care services might optimize vaccine coverage. Synopsis: The lack of integration between maternal immunization programs and prenatal care services might represent a significant barrier that prevents maternal care providers from recommending and offering vaccines to pregnant women. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients are frail individuals, thus the prevention of SARS‐CoV‐2 infection is essential. To date, vaccination is the most effective tool to prevent COVID‐19. In a previous study, we evaluated the immunogenicity of two doses of mRNA‐based vaccines (BNT162b2 or mRNA‐1273) in solid cancer patients. We found that seroconversion rate in cancer patients without a previous exposure to SARS‐CoV‐2 was lower than in healthy controls (66.7% vs. 95%, p = 0.0020). The present study aimed to evaluate the clinical efficacy of the vaccination in the same population. Methods: This is a single‐institution, prospective observational study. Data were collected through a predefined questionnaire through phone call in the period between the second and third vaccine dose. The primary objective was to describe the clinical efficacy of the vaccination, defined as the percentage of vaccinated subjects who did not develop symptomatic COVID‐19 within 6 months after the second dose. The secondary objective was to describe the clinical features of patients who developed COVID‐19. Results: From January to June 2021, 195 cancer patients were enrolled. Considering that 7 (3.59%) patients tested positive for SARS‐CoV‐2 and 5 developed symptomatic disease, the clinical efficacy of the vaccination was 97.4%. COVID‐19 disease in most patients was mild and managed at home; only one hospitalization was recorded and no patient required hospitalization in the intensive care unit. Discussion: Our study suggests that increasing vaccination coverage, including booster doses, could improve the prevention of infection, hospitalization, serious illness, and death in the frail population of cancer patients. [ABSTRACT FROM AUTHOR]

Summary: Splenectomy/asplenia is a condition associated with immune‐compromission and specific vaccines are recommended for these patients, including the anti‐COVID‐19 vaccine. Among the high‐risk group for which vaccination was prioritized in Italy, the immunocompromised patients after therapies or treatments were included. The Apulian regional archive of hospital discharge forms was used to define the list of splenectomized Apulian inhabitants, considering data from 2015 through 2020. The overall vaccination status of asplenic patients was assessed via data collected from the Regional Immunization Database. The history of SARS‐CoV‐2 infection and the infectious disease outcomes were extracted from the Italian Institute of Health platform "Integrated surveillance of COVID‐19 cases in Italy". 1219 Apulian splenectomized inhabitants were included; the incidence rate of SARS‐CoV‐2 infection was 15.0 per 100 persons‐year with a proportion of re‐infection equal to 6.4%; the proportion of hospitalization was 2.9%, with a case‐fatality rate of 2.6%. The vaccine coverage (VC) for the anti‐COVID‐19 vaccine basal routine was 64.2%, for the first booster dose was 15.4%, and for the second booster dose was 0.6%. A multifactorial approach is needed to increase the vaccination uptake in this sub‐group population and to increase the awareness of the asplenia‐related risks to patients and health personnel. [ABSTRACT FROM AUTHOR]

Aim: To compare the clinical outcomes among women diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection during pregnancy, and their neonates, during the period when the Omicron variant predominated in Japan with those of the pre‐Omicron variant period. Methods: We conducted a retrospective single‐center cohort study between August 1, 2020, and June 30, 2022. The cohort was divided into pre‐Omicron group (August 1, 2020 to November 30, 2021) and Omicron group (December 1, 2021 to June 30, 2022). The primary outcome was maternal intensive care unit (ICU) admission during the perinatal period. The secondary outcomes were maternal oxygen administration before and after delivery, preterm birth (PTB), and low birth weight (LBW). Results: During the study period, 81 pregnant women were admitted to the hospital with SARS‐CoV‐2 infection (pre‐Omicron period, n = 28; Omicron period, n = 53). SARS‐CoV‐2 infection during the Omicron period was associated with lower risk of maternal ICU admission (adjusted‐odds ratio [aOR]: 0.10, 95% confidence interval [CI]: 0.01–1.23, p = 0.072), oxygen administration via a nasal cannula or mask (aOR: 0.18, 95% CI: 0.03–0.96, p = 0.045), PTB (aOR: 0.15, 95% CI: 0.04–0.51, p = 0.002), and LBW (aOR: 0.13, 95% CI: 0.03–0.55, p = 0.005). Conclusion: Among pregnant women, SARS‐CoV‐2 infection during the Omicron period was associated with reduced risk of maternal ICU admission, requiring supplemental oxygen, PTB, and LBW. This can be attributable to lower virulence of the Omicron variant and higher vaccination coverage during the Omicron period. [ABSTRACT FROM AUTHOR]

Background: Despite the introduction of cervical cancer screening and human papillomavirus (HPV) vaccines, the utilization pattern was not standardized. The aim of this study was to elicit the current prevention care in Asia‐Oceania. Methods: An online questionnaire was circulated to different countries/cities in Asia‐Oceania. The primary objective was to evaluate the coverage of HPV vaccination and cervical screening programs. The secondary objectives were to study the structures of these programs. Five case scenarios were set to understand how the respondents manage the abnormal screening results. Results: Fourteen respondents from 10 countries/cities had participated. Cervical cancer ranked the first in Myanmar and Nepal. About 10%–15% did not have national vaccination or screening program. The estimated coverage rate for vaccination and screening varied from less than 1% to 70%, which the coverage ran in parallel with the incidence and mortality rates of cervical cancer. All regions approved HPV vaccines, although only four provided free or subsidized programs for nonavalent vaccine. Cervical cytology remained the most common screening tool, and 20%–30% relied heavily on visual inspection using acetic acid. The screening age groups varied in different regions. From the case scenarios, it was noted that some respondents tended to offer more frequent screening tests or colposcopy than recommended by international guidelines. Conclusion: This study revealed discrepancy in the practice of cervical cancer prevention in Asia‐Oceania especially access to HPV vaccines. There is an urgent need for a global collaboration to eliminate cervical cancer by public education, reforming services, and medical training. [ABSTRACT FROM AUTHOR]

The Covid‐19 vaccine has been recommended for pregnant people (hapū māmā) in Aotearoa New Zealand since June 2021. We surveyed people birthing in a tertiary hospital regarding their vaccination status and reasons for this. There were 74% (142/191) of pregnant people who were fully vaccinated. Motivators for vaccination included protection against Covid‐19 and antibody transfer to the baby (pēpē). Unvaccinated participants worried about vaccine safety. Concerns were raised about the change in official advice without well‐communicated reasons for the change. Future vaccine and booster rollouts must be delivered equitably and hapū māmā must be a priority group. [ABSTRACT FROM AUTHOR]

Background: Although there has been an effective seasonal influenza vaccine available for more than 60 years, influenza continues to circulate and cause illness. The Eastern Mediterranean Region (EMR) is very diverse in health systems capacities, capabilities, and efficiencies, which affect the performance of services, especially vaccination, including seasonal influenza vaccination. Aims: The aim of this study is to provide a comprehensive overview on country‐specific influenza vaccination policies, vaccine delivery, and coverage in EMR. Materials and Methods: We have analyzed data from a regional seasonal influenza survey conducted in 2022, Joint Reporting Form (JRF), and verified their validity by the focal points. We also compared our results with those of the regional seasonal influenza survey conducted in 2016. Results: Fourteen countries (64%) had reported having a national seasonal influenza vaccine policy. About (44%) countries recommended influenza vaccine for all SAGE recommended target groups. Up to 69% of countries reported that COVID‐19 had an impact on influenza vaccine supply in the country, with most of them (82%) reporting increases in procurement due to COVID‐19. Discussion: The situation of seasonal influenza vaccination in EMR is varied, with some countries having well established programs while others having no policy or program; these variances may be due to resources inequity, political, and socioeconomic dissimilarities. Few countries have reported wide vaccination coverage over time with no clear trend of improvement. Conclusion: We suggest supporting countries to develop a roadmap for influenza vaccine uptake and utilization, assessment of barriers, and burden of influenza, including measuring the economic burden to enhance vaccine acceptance. [ABSTRACT FROM AUTHOR]

Rabies is a lethal zoonotic disease mainly transmitted to humans by dog bites. The purpose of this study was to assess the efficacy of rabies control policies in Japan, which resulted in the elimination of the disease from the country in 1957. Using historical records from the Kanto region (Chiba, Kanagawa, Saitama and Tokyo Prefectures) between 1947 and 1956 where the final canine cases were recorded, we undertook a descriptive epidemiological study, applying spatio‐temporal scan statistics using SaTScan and estimating the effective reproduction number (Rt) for the clusters and each prefecture using the growth rates. There were 1,567 dog rabies and 161 human rabies cases recorded during this period. Vaccination coverage in registered dogs was over 70% after 1951, with much lower coverage in free‐roaming and unregistered dogs. Eight clusters of dog rabies cases were identified: the first appeared in 1947 in Tokyo and was linked to three further clusters in peripheral prefectures between 1947 and 1951. Three more clusters occurred in Tokyo again between 1952 and 1954, and the last cluster was in Tokyo and Kanagawa between 1955 and 1956. Rt in the first cluster was 1.68, and Rt values in the others ranged between 1.18 and 1.86, with an exception of 4.05 in the smallest cluster in Tokyo in 1952 (10 cases). The moving average of Rt coincided with the clusters. As dog vaccination and dog management progressed, and the number of dog rabies cases declined, the moving average of Rt declined to below 1. Delays in the implementation of dog management policies in Kanagawa may have prolonged this last outbreak. These results demonstrate the effectiveness of coordinated control policy involving dog vaccination and management of free‐roaming dog populations for rabies elimination. [ABSTRACT FROM AUTHOR]

Aim: Maternal vaccination is a promising strategy for protecting pregnant women and newborns against severe infections. This review aims to describe the current status and challenges associated with maternal vaccination against seasonal influenza, tetanus‐diphtheria‐pertussis (Tdap/DTaP), and novel coronavirus disease of 2019 (COVID‐19) in Japan and other countries, mainly the United States and the United Kingdom. Methods: A literature search was conducted in PubMed and other public websites (e.g., Centers for Disease Control and Prevention) to obtain information on maternal vaccination. Results: Inactivated vaccines are recommended for pregnant women by gynecologic societies in Japan, the United States, and the United Kingdom. Among pregnant Japanese women, the influenza and COVID‐19 (two doses) vaccine coverage rates were 27.0%–53.5% (six studies) and 73.6% (one study), respectively; there are no studies on maternal vaccination with DTaP. Concerns regarding vaccine safety are a major barrier to maternal vaccination across countries. Maternal vaccination is effective in preventing severe disease in pregnant women and protecting infants aged <6 months, is generally safe, and does not increase the risk of adverse maternal and fetal outcomes. Providing accurate information regarding vaccination through healthcare providers and the government and government funding for vaccines may help improve maternal vaccination rates in Japan. Conclusion: Current coverage for maternal vaccination is still low globally mainly because of vaccine hesitancy among pregnant women. The government, drug‐regulatory authorities, and healthcare professionals must educate pregnant women about the effectiveness and safety of maternal vaccines and encourage vaccination when the benefits outweigh the risks. [ABSTRACT FROM AUTHOR]

Background: A dengue vaccine, dengvaxia, was licensed for the first time in 2015. It was approved for use in 11 countries where dengue infection is endemic, including the Philippines. In November 2017, controversy arose in the Philippines regarding the dengvaxia vaccine. We hypothesized that the dengvaxia controversy might be correlated with immunization coverage in the Philippines. Methods: We performed an analytical and infodemiological study on web‐based interest in dengvaxia, both globally and in 18 dengue endemic countries, from 2015 to 2020 using Google Trends™. Comparisons were made with search trends for the components of the National Immunization Program (NIP) and vaccine coverage by computing the Pearson product–moment correlation coefficient (r) between each variable. Results: Among the 18 countries included, the Philippines had the highest search volume index for dengvaxia, with peaks in searches coinciding with that of worldwide search trends. There was no correlation between the relative search volume for dengvaxia with that of vaccines included in the NIP in the Philippines from 2015 to 2020. There was no significant correlation between web‐based interest in dengvaxia and the estimated immunization coverage from 2015 to 2019. Conclusion: There was no significant correlation between web‐based interest in dengvaxia, the vaccines in the NIP, and national immunization coverage. [ABSTRACT FROM AUTHOR]

Background: The significant annual burden caused by seasonal influenza has led to global calls for increased influenza vaccination coverage rates (VCRs). We aimed to estimate the proportion of the German population at high risk of serious illness from influenza due to chronic conditions and to estimate age‐specific VCRs of people with/without chronic conditions. Methods: Using health insurance claims data covering nine influenza seasons (2010–2019), we assessed up to 7 million insured individuals per season across all German regions. Individuals were classified according to age and presence of chronic health conditions. VCRs were estimated using outpatient healthcare utilization documentation. Results: In the 2018–2019 influenza season, 47.3% of individuals had ≥1 chronic condition. Most common were circulatory disorders, accounting for more than a third of individuals with ≥1 condition. Prevalence of chronic diseases, and therefore the proportion of high‐risk individuals, increased slightly over time across most age groups. A downward trend in influenza VCRs was observed in all age groups until the 2017–2018 season, followed by a noticeable increase in the 2018–2019 season. Highest VCRs occurred among individuals of ≥60 years, with a 38.5% VCR for this age group in the 2018–2019 season. Several factors, including age, chronic condition type, and geographical location, affected VCRs. Conclusions: Influenza VCRs in individuals at high risk of severe complications from influenza infection are insufficient. Our results suggest that intensified public health efforts are necessary to reach the World Health Organization vaccination coverage target of 75%. [ABSTRACT FROM AUTHOR]

The overabundant populations of wildlife have caused many negative impacts, such as human‐wildlife conflicts and ecological degradation. The existing approaches like injectable immunocontraceptive vaccines and lethal methods have limitations in many aspects, which has prompted the advancement of oral immunocontraceptive vaccine. There is growing interest in oral immunocontraceptive vaccines for reasons including high immunization coverage, easier administration, frequent boosting, the ability to induce systemic and mucosal immune responses, and cost‐effectiveness. Delivery systems have been developed to protect oral antigens and enhance the immunogenicity, including live vectors, microparticles and nanoparticles, bacterial ghosts, and mucosal adjuvants. However, currently, no effective oral immunocontraceptive vaccine is available for field trials because of the enormous development challenges, including biological and physicochemical barriers of the gastrointestinal tract, mucosal tolerance, pre‐existing immunity, antigen residence time in the small intestine, species specificity and other safety issues. To overcome these challenges, this article summarizes achievements in delivery systems and contraceptive antigens in oral immunocontraceptive vaccines and explores the potential barriers for future vaccine design and application. [ABSTRACT FROM AUTHOR]

Many vaccines are often administered in multiple doses to boost their effectiveness. In the case of childhood vaccines, the coverage maps of the doses and the differences between these often constitute an evidence base to guide investments in improving access to vaccination services and health system performance in low and middle‐income countries. A major problem often encountered when mapping the coverage of multi‐dose vaccines is the need to ensure that the coverage maps decrease monotonically with successive doses. That is, for doses i$$ i $$ and j$$ j $$, i

Objective: This study aims to examine the factors influencing COVID‐19 vaccine uptake among healthcare professionals (HCPs) and the general population in Cyprus. Methods: A web‐based cross‐sectional study was conducted (November 2021–January 2022), using a self‐administered, anonymous questionnaire to collect information covering a wide range of potential determinants including sociodemographic and health‐related characteristics, trust in the healthcare system, satisfaction with it, utilization of preventive healthcare services, COVID‐19 vaccination information and general vaccination knowledge. Results: A total of 2582 participants completed the survey. Overall, 53.5% of participants representing the general population, and 70.0% of the HCPs received the COVID‐19 vaccination. We found that as the age increases by 1 year among the general population, the odds of being vaccinated against COVID‐19 increase by 1.02 units (95% 1.00, 1.03, p= 0.035). In addition, participants among the general population with increased trust in national healthcare authorities' guidelines (OR = 3.96, 95% CI: 3.41, 4.61), and increased vaccination knowledge scores (OR = 1.11, 95% CI: 1.05, 1.18) were significantly more likely to be vaccinated, while those who had underage children living in the household were significantly less likely to be vaccinated against COVID‐19 (OR = 0.68, 95% CI: 0.50, 0.91). Furthermore, male HCPs (OR = 1.91, 95% CI: 1.01, 3.59), and those who reported increased trust in national healthcare authorities' guidelines (OR = 5.38, 95% CI: 3.65, 7.95) were significantly more likely to be vaccinated. Conclusion: Public health policymakers can use national campaigns and long‐term planning to build public trust in national healthcare authorities and raise awareness about the benefits of vaccination. Such strategies could pave the way for adequate vaccine uptake and prepare the public for unfavourable scenarios, such as future pandemics. [ABSTRACT FROM AUTHOR]

Objective: To analyze factors associated with vaccination delay in children up to 2 years of age. Methods: Cross‐sectional study with primary data from a probabilistic sample of 388 children born in 2015. The data were described using absolute and relative frequencies. For the analysis of factors associated with vaccination delay, Cox proportional risk regression was performed, considering the time from birth to the first vaccination delay as a dependent variable and as sociodemographic, economic, behavioral aspects related to health services as independent variables. Results: The delayed vaccination rate was 88.66%. Variables associated with delayed vaccination were: mother's health problems during delivery or in the first 7 days (HR: 0.68; 95% CI: 0.48–0.96); hospitalization of the child in the first 2 years of life (HR: 1.52; 95% CI: 1.10–2.11); mother's poor bond with health professionals at the health unit (HR: 1.75; 95% CI: 1.01–3.03); purposeful decision to delay or not to vaccinate the child (HR: 1.56; 95% CI: 1.14–2.13). Conclusions: The factors associated with health care, such as the mother's health problems, the child's hospitalization in the first 2 years of life, and the bond between the mother and the health professionals affect the timeliness of vaccine doses. [ABSTRACT FROM AUTHOR]

Introduction: People with substance use disorders are considered a priority group for SARS‐CoV‐2 vaccination as they are at elevated risk of COVID‐19 and its severe complications. However, data are scarce about vaccination coverage in a real‐world setting. Methods: A descriptive study was conducted in people with opioid use disorder (OUD) from three public centres for outpatient drug addiction treatment in Barcelona, Spain, who received brief medical advice and were referred to vaccination clinic sites. Results: Three hundred and sixty‐two individuals were included: 277 (77%) were men with a mean age of 48.1 ± 8.9 years and 77% were Spanish. Most (90%) participants engaged in polysubstance use and all individuals were on opioid agonist therapy. Psychiatric comorbidity was present in 56% subjects and 32% individuals had ≥1 chronic disease, 30% had HIV and 13% hepatitis C. There were 258 fully vaccinated individuals (71%; 95% confidence interval [CI] 67, 76). Age (odds ratio [OR] 1.04; 95% CI 1.01, 1.08; P < 0.01) and Charlson Comorbidity Index (OR 1.67; 95% CI 1.11, 2.5; P < 0.01) were associated with full vaccination. The vaccination hesitancy causes cited were complacency (53, 51%), convenience (40, 39%) and confidence (11, 10%). Discussion and Conclusions: More than two‐thirds of our sample of people with OUD were fully vaccinated. Complacency and convenience represented a significant barrier to complete vaccination among people with OUD on opioid agonist therapy referred to vaccination clinic sites. Additional measures are necessary to increase vaccination, especially for younger individuals and those with less medical comorbidity. Integrating vaccination services in drug outpatient centres could be a useful alternative. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to analyse the temporal trend of HPV vaccination coverage (VC) in Spain in women aged 15‐55 years not included in systematic vaccination programmes during the period 2007‐2020. Methods: We assessed the vaccine coverage rate in this population based on three estimations: 1) annual vaccination coverage with at least one dose (VCR ≥ 1d), 2) annual VC for the full schedule (VCR3d), and 3) cumulative VC for the full schedule (aVCR). Results: Annual VCR ≥ 1d and VCR3d were highest in 2008 (2.40% and 0.66% respectively) and subsequently decreased drastically in 2011 (0.55% and 0.15%). From 2017 to 2019 there was an increase from 1.4‐fold to 1.6‐fold, respectively, which decreased in 2020. In relation to aVCR, there was an increasing trend throughout the study period with approximately 4.03% of the study population having been vaccinated against HPV in 2020. Conclusion: In Spain, the cumulative vaccination coverage against HPV in women between 15‐55 years old not included in current vaccination programmes remains very low. Nonetheless, the temporal trend has shown a slight increase in recent years. Despite the COVID‐19 pandemic in 2020, no significant negative impact on vaccination coverage has been observed in this population. In Spain, cumulative vaccination coverage against HPV in women aged 15–55 years remains very low, but temporal trend has increased slightly in recent years. [ABSTRACT FROM AUTHOR]

People who inject drugs may be at higher risk of COVID‐19 transmission and more severe negative health outcomes following COVID‐19 infection. Early research on hypothetical COVID‐19 vaccines suggests this population may be less likely to accept vaccination. This commentary extends this research by presenting vaccine intention data from Illicit Drug Reporting System interviews conducted in June–July 2021, in the early stages of vaccine rollout, with people in Australia who inject drugs (N = 888). Half the sample (48%, n = 419) reported that they were hesitant to receive the COVID‐19 vaccine, with key barriers relating to vaccine safety and side effect concerns. This level of hesitancy is substantially higher than that of the general population at a similar time. While we note that the subsequent Delta variant‐driven third wave of cases in Australia and efforts to increase population vaccination coverage may have altered intent in this group, this level of hesitancy warrants a targeted strategy to mitigate vaccine‐related concerns and maximise uptake. Ideally, this should comprise an inclusive health response that is peer‐led, with peer‐based organisations ideally positioned to direct immunisation service delivery and provide vaccine‐related messaging. [ABSTRACT FROM AUTHOR]

Background: Individuals in contact with persons with COVID‐19 are at high risk of developing COVID‐19; protection offered by COVID‐19 vaccines in the context of known exposure is poorly understood. Methods: Symptomatic outpatients aged ≥12 years reporting acute onset of COVID‐19‐like illness and tested for SARS‐CoV‐2 between February 1 and September 30, 2021 were enrolled. Participants were stratified by self‐report of having known contact with a COVID‐19 case in the 14 days prior to illness onset. Vaccine effectiveness was evaluated using the test‐negative study design and multivariable logistic regression. Results: Among 2229 participants, 283/451 (63%) of those reporting contact and 331/1778 (19%) without known contact tested SARS‐CoV‐2‐positive. Adjusted vaccine effectiveness was 71% (95% confidence interval [CI], 49%–83%) among fully vaccinated participants reporting a known contact versus 80% (95% CI, 72%–86%) among those with no known contact (p‐value for interaction = 0.2). Conclusions: This study contributes to growing evidence of the benefits of vaccinations in preventing COVID‐19 and support vaccination recommendations and the importance of efforts to increase vaccination coverage. [ABSTRACT FROM AUTHOR]

Introduction: To contain the COVID‐19 pandemic, higher vaccination rates are essential. However, as vaccine hesitancy is a reality, it is important to understand what drives health professionals to refuse getting vaccinated against COVID‐19, who have been in the frontline of this pandemic since its beginning and may be key actors to improve vaccine coverage among their patients. Purpose: This study aims to assess the factors associated with vaccine hesitancy (VH) among health professionals (physicians, nurses, pharmacists and dentists). Methods: A nationwide cross‐sectional study was conducted through an online survey, with 890 Portuguese health professionals. A logistic regression analysis was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge and attitudes) per 1‐point increase in the Likert scale and VH. Results: Complacency, communications, confidence and convenience were strongly associated with VH probability. Concerns about vaccines' efficacy (ORPhysicians = 8.33, 95% CI: 4.51–15.36) and safety (ORNurses = 11.07, 95% CI: 4.12–29.77) increase the risk of VH on all health professional groups. A reduction of VH probability is associated with higher risk perceptions of getting infected (1/ORNurses = 2.76, 95% CI: 1.52–5.02) and suffering complications (1/ORNurses = 33.72, 95% CI: 8.48–134.13), higher confidence in the effectiveness of COVID‐19 vaccines (1/ORDentists = 12.29, 95% CI: 2.91–51.89), risk perception of getting infected if vaccinated (1/ORPhysicians = 14.92, 95% CI: 6.85–32.50), risk of suffering from complications after getting vaccinated, and higher trust levels on the information transmitted by competent authorities (1/ORDentists = 17.76, 95% CI: 3.83–82.22). Conclusions: To reduce COVID‐19 VH, which appears to be highly influenced by perceptions, knowledge and attitudes, it is essential to promote interventions directed to transforming these potentially modifiable determinants. [ABSTRACT FROM AUTHOR]

A stochastic Markovian Susceptible‐Infectious‐Susceptible (SIS) model, with infection reintroduction is considered to represent the evolution of an epidemic process within a finite population. Disease is assumed to be a contact disease whose effect can be prevented by a vaccine. Before the epidemic process emerges, v0$v_0$ individuals got vaccinated to assure that the population is protected by herd immunity. In consequence, we formulate the model by adding a new compartment for vaccine protected individuals. The administered vaccine is not a perfect one and consequently it fails in a proportion of vaccinated individuals that are not protected against the vaccine preventable communicable disease. Hence, while the infectious process is in progress, the initial vaccine coverage declines and herd immunity could be lost. A threshold on the size of the vaccinated group is included as a warning measure on the protection of the community. Our objective is to define and study random characteristics, depending on the vaccination eligible group, that could advise health authorities when to launch a new vaccination program to recover the initial immunity level. [ABSTRACT FROM AUTHOR]

Background: Children with comorbidities are at greater risk of severe influenza outcomes compared with healthy children. In Australia, influenza vaccination was funded for those with comorbidities from 2010 and all children aged <5 years from 2018. Influenza vaccine coverage remains inadequate in children with and without comorbidities. Methods: Children ≤16 years admitted with acute respiratory illness and tested for influenza at sentinel hospitals were evaluated (2010–2019). Multivariable regression was used to identify predictors of severe outcomes. Vaccine effectiveness was estimated using the modified incidence density test‐negative design. Results: Overall, 6057 influenza‐confirmed hospitalized cases and 3974 test‐negative controls were included. Influenza A was the predominant type (68.7%). Comorbidities were present in 40.8% of cases. Children with comorbidities were at increased odds of ICU admission, respiratory support, longer hospitalizations, and mortality. Specific comorbidities including neurological and cardiac conditions increasingly predisposed children to severe outcomes. Influenza vaccine coverage in influenza negative children with and without comorbidities was low (33.5% and 17.9%, respectively). Coverage improved following introduction of universal influenza vaccine programs for children <5 years. Similar vaccine effectiveness was demonstrated in children with (55% [95% confidence interval (CI): 45; 63%]) and without comorbidities (57% [(95%CI: 44; 67%]). Conclusions: Comorbidities were present in 40.8% of influenza‐confirmed admissions and were associated with more severe outcomes. Children with comorbidities were more likely experience severe influenza with ICU admission, mechanical ventilation, and in‐hospital morality. Despite demonstrated vaccine effectiveness in those with and without comorbidities, vaccine coverage was suboptimal. Interventions to increase vaccination are expected to reduce severe influenza outcomes. [ABSTRACT FROM AUTHOR]

Aim: Childhood immunisation is an important preventive measure. However, care givers may delay routine immunisations or seek exemptions from state vaccine mandates. Vaccine refusal creates barriers on vaccine coverage and leads to morbidity and mortality. Methods: Our study reviews morbidity and mortality from vaccine preventable diseases (VPDs) in a large paediatric intensive care unit in Greece over a 10‐year period. Results: During the study period, 73 cases of VPDs were recorded, corresponding to 3.5% of total paediatric intensive care unit admissions. Influenza was the most prevalent VPD, followed by pneumococcal disease, measles, pertussis and meningococcal disease. Most patients (83.3%) were unvaccinated for the admission's VPD. Outcome was unfavourable for 31.9% of the patients (17 children died, 6 developed chronic impairment). Conclusion: Absent or incomplete vaccination may result in serious morbidity and mortality from preventable diseases. Strengthening vaccination strategies are needed to improve individual protection as well as herd immunity. [ABSTRACT FROM AUTHOR]

Only an estimated 62% of Indian children under the age of 2 years are fully immunized. We examined the association between India's Mission Indradhanush (MI)—a periodic intensification of the routine immunization program—which was implemented in phases across districts between March 2015 and July 2017, and routine vaccination coverage and timeliness among children. We used data from a 2015 to 2016 national survey of children (n = 29,532) and employed difference‐in‐difference regressions to examine binary indicators of receipt of 11 vaccines and whether vaccines were received at recommended ages. The full immunization rate was 27% higher among children under 2 years old residing in MI phase 1 and 2 districts (intervention group) as compared with those residing elsewhere (control group). The rate of receiving all vaccines at recommended ages was 8% higher in the intervention group. Receiving doses of oral polio vaccine (OPV) birth dose, OPV dose 1 (OPV1), OPV2, OPV3, bacillus Calmette–Guérin, and hepatitis B birth dose vaccines were 9%, 9%, 11%, 16%, 5%, and 19% higher in the intervention group than the control group, respectively. More research is required on the cost‐effectiveness of investing in MI‐type programs as compared with routine immunization. [ABSTRACT FROM AUTHOR]

Background: To characterize level and predictors of influenza and pneumococcal vaccine uptake among Danish kidney transplant recipients (KTR) and kidney transplant waiting list patients (WLP). Methods: A cross‐sectional survey based on self‐reported vaccine uptake including WLP and KTR ≤ 1½ years post transplantation. Descriptive statistics and logistic regression analyses identifying factors associated with influenza vaccine uptake in the latest season were performed. Results: A total of 220 participants were included in the study, 54% KTR and 46% WLP. Self‐reported influenza vaccine uptake in the latest season was overall 41.8%. Uptake of influenza vaccine on any prior season apart from the latest season was 53.2% and significantly higher among WLP than KTR (P =.007). Pneumococcal vaccine uptake was only 4% overall. The only factor positively associated with influenza vaccine uptake in the latest season was any prior influenza vaccine uptake (OR 5.79, CI95 2.44‐13.76) (P <.001). Recommendations given by other persons (non‐physician) were negatively associated with receiving the influenza vaccination in the latest season (OR 0.34, CI95 0.13‐0.92) (P =.03). Reasons for not being vaccinated were primarily lack of information, perception of own good health, and fear of adverse reactions. Conclusions: Influenza and pneumococcal vaccine uptakes were suboptimal among Danish WLP and KTR. Increased awareness about guidelines and physicians´ education are warranted. [ABSTRACT FROM AUTHOR]

Health and development indicators (HDIs) such as vaccination coverage are regularly measured in many low‐ and middle‐income countries using household surveys, often due to the unreliability or incompleteness of routine data collection systems. Recently, the development of model‐based approaches for producing subnational estimates of HDIs using survey data, particularly cluster‐level data, has been an active area of research. This is mostly driven by the increasing demand for estimates at certain administrative levels, for example, districts, at which many development goals are set and evaluated. In this study, we explore spatial modeling approaches for producing district‐level estimates of vaccination coverage. Specifically, we compare discrete spatial smoothing models which directly model district‐level data with continuous Gaussian process (GP) models that utilize geolocated cluster‐level data. We adopt a fully Bayesian framework, implemented using the INLA and SPDE approaches. We compare the predictive performance of the models by analyzing vaccination coverage using data from two Demographic and Health Surveys (DHS), namely the 2014 Kenya DHS and the 2015‐16 Malawi DHS. We find that the continuous GP models performed well, offering a credible alternative to traditional discrete spatial smoothing models. Our analysis also revealed that accounting for between‐cluster variation in the continuous GP models did not have any real effect on the district‐level estimates. Our results provide guidance to practitioners on the reliability of these model‐based approaches for producing estimates of vaccination coverage and other HDIs. [ABSTRACT FROM AUTHOR]

A cholera outbreak in Ethiopia's Amhara region has resulted in the deaths of 76 people since July, with over 4,000 people infected. The outbreak is occurring amidst drought and conflict between the army and local militia groups. In Sudan, outbreaks of cholera and dengue fever have claimed the lives of over 100 people since August. The UN has warned that months of conflict in Sudan have left millions of people at risk of various diseases. Zimbabwe is also struggling to contain a cholera outbreak, with over 100 deaths and 5,000 infections since February. The government has implemented restrictions to curb the spread of the disease. Guinea is experiencing a diphtheria outbreak, with 58 deaths and hundreds of reported cases, many of them affecting babies and toddlers. The disease can be prevented through vaccination, but immunization coverage in Guinea has remained low. Burkina Faso has successfully eliminated 700,000 mosquito-breeding sites in an effort to combat diseases such as dengue, chikungunya, and malaria. Malaria remains a public health problem in Burkina Faso, with a high number of recorded cases and deaths in 2021. [Extracted from the article]

Aim: Our objectives were to measure the vaccine coverage rates for children with chronic diseases as well as the prevalence of potentially harmful delays for generally recommended vaccines. We also identified the factors influencing non-adherence to vaccines specifically recommended for chronic conditions.Methods: Three non-interventional point-prevalence surveys were performed in 2014 in all paediatric units at Lille University Hospital among children aged 2 months-18 years with chronic diseases and vaccination data. Vaccine coverage and delays for generally recommended vaccines were studied. The children who were up-to-date and those under-vaccinated for specifically indicated vaccines were compared and the factors potentially associated with under-vaccination were studied with multivariable analysis.Results: We screened 682 patients: of 207 with chronic diseases, mainly neurological, muscular and respiratory disorders, 146 had vaccination data. Only 47% (95% confidence interval 39-55) were up-to-date for all generally recommended vaccinations; potentially harmful vaccination delays were high (26%-75%). Only 11% of the 81% of patients for whom some vaccines were specifically recommended were up-to-date. Low maternal education level was significantly associated with under-vaccination (adjusted odds ratio 10.5, 95% confidence interval 1.3-86.9, P = .03).Conclusion: This study showed inadequate vaccine coverage rates and significant delays among children with chronic diseases. [ABSTRACT FROM AUTHOR]

Two conundrums puzzle COVID‐19 investigators: 1) morbidity and mortality is rare among infants and young children and 2) rates of morbidity and mortality exhibit large variances across nations, locales, and even within cities. It is found that the higher the rate of pneumococcal vaccination in a nation (or city) the lower the COVID‐19 morbidity and mortality. Vaccination rates with Bacillus Calmette–Guerin, poliovirus, and other vaccines do not correlate with COVID‐19 risks, nor do COVID‐19 case or death rates correlate with number of people in the population with diabetes, obesity, or adults over 65. Infant protection may be due to maternal antibodies and antiviral proteins in milk such as lactoferrin that are known to protect against coronavirus infections. Subsequent protection might then be conferred (and correlate with) rates of Haemophilus influenzae type B (Hib) (universal in infants) and pneumococcal vaccination, the latter varying widely by geography among infants, at‐risk adults, and the elderly. Also see the video abstract here https://youtu.be/GODBYRbPL00. [ABSTRACT FROM AUTHOR]