Search

ABSTRACT Hepatitis A is a vaccine‐preventable disease that typically causes mild illness. Hepatitis A outbreaks associated with person‐to‐person transmission have been widespread in the United States since 2016. We used public‐use US Multiple Cause of Death data to compare characteristics and listed comorbidities among decedents with hepatitis A‐listed deaths during non‐outbreak (2011–2015) and outbreak (2017–2021) periods and assessed the median age at death among decedents with and without hepatitis A‐listed deaths during the outbreak period. From the non‐outbreak period to the outbreak period, hepatitis A‐listed deaths more than doubled (from 369 to 801), while the hepatitis A‐listed age‐adjusted mortality rate increased 150% (p < 0.001). When compared with the non‐outbreak period, hepatitis A‐listed decedents during the outbreak period were more frequently male, aged 18–49 years, non‐Hispanic White, died in an inpatient setting, and had hepatitis A listed as their underlying cause of death. The median age at death for hepatitis A‐listed decedents was significantly younger during the outbreak period overall and among females (62 and 66 years, respectively) compared with the non‐outbreak period (64 and 72 years, respectively, p < 0.001). During the outbreak period, median age at death for hepatitis A‐listed decedents was 14 years younger than decedents without hepatitis A listed. Compared with the general US population, decedents with hepatitis A listed on the death certificate died at younger ages during 2017–2021. Efforts are needed to improve hepatitis A vaccination coverage among adults recommended for hepatitis A vaccination to prevent additional premature hepatitis A deaths. [ABSTRACT FROM AUTHOR]

Objectives Design Results Conclusions This study aims to study the impact of sociodemographic (SD), health status and resources (HSR), macroeconomic (ME), and Environmental (EV) factors on the infant mortality rate (IMR) in Qatar, Kingdom of Saudi Arabia (KSA), and the United Arab Emirates (UAE) and from 1990 to 2022.A retrospective time‐series study employing yearly data was conducted. A generalized least squares model was utilized to construct an exploratory model of IMR determinants for each country.In SD, the risk of IMR may be increased with a higher crude birth rate, adolescent fertility rate, and married women percentage. In HSR, immunization coverage shows a significant effect in preventing neonatal diseases and reducing IMR. In ME, the effect of parents’ employment seems contradicted among the three countries. In EV, greenhouse emissions have also had contradictory effects among the three countries, suggesting a complex relationship with IMR. Some were consistent with global findings, whereas others contradicted the prevailing narrative.This study highlights the need for tailored public health interventions addressing socio‐demographic, healthcare, and environmental contexts to effectively reduce IMR and enhance infant health outcomes. [ABSTRACT FROM AUTHOR]

Background: Multiple factors, such as less complex U.S. adult pneumococcal recommendations that could increase vaccination rates, childhood pneumococcal vaccination indirect effects that decrease adult vaccination impact, and increased vaccine hesitancy (particularly in underserved minorities), could diminish the cost‐effectiveness of programs to increase pneumococcal vaccination in older adults. Prior analyses supported the economic favorability of these programs. Methods: A Markov model compared no vaccination and current recommendations (either 20‐valent pneumococcal conjugate vaccine [PCV20] alone or 15‐valent pneumococcal conjugate vaccine plus the 23‐valent pneumococcal polysaccharide vaccine [PCV15/PPSV23]) without or with programs to increase vaccine uptake in Black and non‐Black 65‐year‐old cohorts. Pre‐pandemic population‐ and serotype‐specific pneumococcal disease risk and illness/vaccine costs came from U.S. databases. Program costs were $2.19 per vaccine‐eligible person and increased absolute vaccination likelihood by 7.5%. Delphi panel estimates and trial data informed vaccine effectiveness values. Analyses took a healthcare perspective, discounting at 3%/year over a lifetime time horizon. Results: Uptake programs decreased pneumococcal disease overall. In Black cohorts, PCV20 without program cost $216,805 per quality‐adjusted life year (QALY) gained compared with no vaccination; incremental cost‐effectiveness was $245,546/QALY for PCV20 with program and $425,264/QALY for PCV15/PPSV23 with program. In non‐Black cohorts, all strategies cost >$200,000/QALY gained. When considering the potential indirect effects from childhood vaccination, all strategies became less economically attractive. Increased vaccination with less complex strategies had negligible effects. In probabilistic sensitivity analyses, current recommendations with or without programs were unlikely to be favored at thresholds <$200,000/QALY gained. Conclusion: Current U.S. pneumococcal vaccination recommendations for older adults were unlikely to be economically reasonable with or without programs to increase vaccine uptake. Alternatives to current pneumococcal vaccines that include pneumococcal serotypes associated with adult disease should be considered. See related Editorial by Melissa K. Andrew in this issue. [ABSTRACT FROM AUTHOR]

Background: Community pharmacists have become flu vaccine immunisers in several countries to increase vaccine uptake. Aim: This study aimed to perform a scoping review to evaluate the pharmacist's role and contribution to flu immunisation coverage, satisfaction and promotion as vaccine providers. Design: The framework proposed by Arksey and O'Malley and the PRISMA Extension for Scoping Reviews (PRISMA‐ScR) were considered for this analysis. Two electronic databases (PubMed and Cochrane Library) were used to search for relevant peer‐reviewed quantitative, qualitative and mixed‐method studies published between 1990 and 2022. Results: A total of 37 studies were included. These studies suggested that, over time, there was an increase in the rate of vaccine administration within community pharmacies across the various countries examined. Moreover, patients have consistently expressed their satisfaction with the convenience and accessibility of pharmacy‐based vaccine services, with some expressing a preference for pharmacies over traditional visits to their general practitioner′s office. Conclusion: Several initiatives aimed at promoting flu vaccination have been rolled out in pharmacy settings, and a number of these initiatives have demonstrated positive outcomes. The flu vaccination service provided by pharmacists has proven to be an asset in public health by improving accessibility to immunisation services. Pharmacists should continue to take part in yearly flu vaccination programs as flu vaccine providers as they contribute to an increased uptake of immunisations by the population. Extending these services to other vaccines should be further considered. [ABSTRACT FROM AUTHOR]

Advancements in vaccination technologies mitigate disease transmission risks but may inadvertently suppress the behavioral immune system, an evolved disease avoidance mechanism. Applying behavioral immune system theory and utilizing robust big data analytics, we examined associations between rising vaccination coverage and government policies, public mobility, and online information seeking regarding disease precautions. We tested whether cultural tightness–looseness moderates the relationship between mass immunization and disease prevention vigilance. Comprehensive time series analyses were conducted using American data (Study 1) and international data (Study 2), employing transfer function modeling, cross‐correlation function analysis, and meta‐regression analysis. Across both the US and global analyses, as vaccination rates rose over time, government COVID‐19 restrictions significantly relaxed, community mobility increased, and online searches for prevention information declined. The relationship between higher vaccination rates and lower disease prevention vigilance was stronger in culturally looser contexts. Results provide initial evidence that mass immunization may be associated with attenuated sensitivity and enhanced flexibility of disease avoidance psychology and actions. However, cultural tightness–looseness significantly moderates this relationship, with tighter cultures displaying sustained vigilance amidst immunization upticks. These findings offer valuable perspectives to inform nuanced policymaking and public health strategies that balance prudent precautions against undue alarm when expanding vaccine coverage worldwide. [ABSTRACT FROM AUTHOR]

This article discusses the resurgence of circulating vaccine-derived poliovirus type 2 (cVDPV2) in Indonesia, which has become a setback in the global efforts to eradicate polio. The article provides details on six cases of cVDPV2 in Indonesia, including the age, gender, district, province, vaccination history, and genetic sequencing findings of each case. It highlights the challenges faced in eradicating polio in Indonesia, such as suboptimal vaccine coverage, vaccine hesitancy, and disruptions caused by the COVID-19 pandemic. The article emphasizes the need for comprehensive management strategies, including active case finding, environmental surveillance, and targeted vaccination campaigns, to control the spread of cVDPV2 and achieve polio eradication. [Extracted from the article]

Introduction: Nigeria adopted the expanded program on immunization (EPI) in 1978, which aimed at offering children under 2 years old routine immunization (RI). Early accomplishments with the program resulted in a decrease in childhood mortality. As of 2018, Nigeria accounted for about 4.3 million out of over 13 million unvaccinated children globally. Therefore, this study revealed the challenges and efforts associated with RI program in Nigeria and the way forward. Methods: In this perspective article, I conducted searches and extracted relevant information from publicly available sources such as Google Scholar, Pubmed, and grey literature. I employed RI, challenges, efforts, and Nigeria as the keywords. Results: The 2021 Multiple Indicator Cluster Survey/National Immunization Coverage Survey reports revealed weaknesses in the program, with a national average coverage of 36%. The primary barrier to EPI across various zones is the challenge of reaching marginalized areas that were cut off from vaccination services due to operational and sociocultural issues. Some of the obstacles, such as restricted access to medical facilities, weak cold chain systems, and COVID‐19 containment strategies had a great impact on the RI program. To scale up the RI program, the Nigerian government, through the National Primary Health Care Development Agency (NPHCDA), collaborated with the World Health Organization (WHO) and Gavi, the Vaccine Alliance, to optimize the "Big Catch‐up campaign" and increase immunization coverage nationwide. By 2028, 80% of the projected zero‐dose populace is expected to be covered, reaching these eligible children with life‐saving vaccines. Conclusion: Nigeria still has a long way to go in making significant progress in the RI program. To further strengthen the immunization coverage, the country needs to maintain data on their achievements, as this will help identify gaps that need to be addressed in the immunization program. [ABSTRACT FROM AUTHOR]

Purpose: Childhood immunizations have proven to be one of the most beneficial interventions to promote public health and prevent childhood deaths due to disease. However, global coverage of childhood immunization has decreased throughout the world due to guardians' growing hesitancy towards immunizations. This study aims to describe how specialist nurses promote legal guardians to adhere to national childhood immunization programmes. Design and Methods: This study had a qualitative design. Semistructured interviews with 11 specialist nurses, who were paediatric primary care nurses or nurse practitioners, were conducted. Data were analysed using qualitative content analysis. Results: The findings, with four main categories including four subcategories, showed nurses using both local guidelines and national guidelines to promote guardians to adhere to the childhood immunization programme. The main intervention the nurses did to promote childhood immunization coverage was giving legal guardians general information about the programme. With hesitant guardians, adopting a person‐centred approach towards the legal guardian improved adherence. Practice Implications: Further research should focus on how specialist nurses can respond to guardians who decline immunization for their children, as this study identified difficulties in this area. Furthermore, research on guardians' perspectives towards childhood immunization may also help generate further effective guidance on how to promote immunization coverage among children. [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]

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]

At the 2023 EUROGIN workshop scientific basis for strategies to accelerate the elimination of cervical cancer and its causative agent, human papillomavirus (HPV) were reviewed. Although some countries have reached key performance indicators toward elimination (>90% of girls HPV vaccinated and >70% of women HPV screened), most are yet to reach these targets, implying a need for improved strategies. Gender‐neutral vaccination, even with moderate vaccination coverage was highlighted as a strategy to achieve elimination more rapidly. It is more resilient against major disturbances in vaccination delivery, such as what happened during the coronavirus pandemic. Further, an analysis of ethical/legal issues indicated that female‐restricted vaccination is problematic. Extended catch‐up of vaccination with concomitant screening, and outreach to vulnerable groups were highlighted. Although birth cohorts with high coverage of HPV vaccination at school are protected against HPV, and HPVs have a very low reproductive rate in women above age 35, adult women below age 30 have inadequate direct protection. In addition to herd protection from gender‐neutral vaccination, this group can be protected by offering concomitant catch‐up HPV vaccination and HPV screening. Furthermore, hepatitis B vaccination experiences indicate that elimination cannot be achieved without prioritizing vulnerable/migrant populations. The long‐lasting durability of vaccination‐induced antibody responses suggests prolonged protection with HPV vaccines when adequately administrated. Finally, cost‐effectiveness modelling suggests that high‐coverage HPV vaccination in multiple population segments will be resource‐saving due to reduced need for screening. In summary, the workshop found that strategically optimal deployment of vaccination will accelerate elimination of HPV and cervical cancer. [ABSTRACT FROM AUTHOR]

Copyright of European Policy Analysis is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although the World Health Organization has declared that the COVID‐19 pandemic no longer qualifies as a global public health emergency, it still needs to explore the response of society to the COVID‐19 pandemic. Socio‐economic status (SES) was proven to be linearly associated with the COVID‐19 pandemic, although this relationship may be more complex due to regional differences. In the study, we analyzed and revealed the effects and mechanisms of SES on infections among low, lower‐middle, upper‐middle and high SES group (LSG, LMSG, UMSG, and HSG, respectively). The results showed that the relationship between SES and infections was inverted U‐shaped, especially in the first three phases. In Phase I, UMSG had the highest number of infections, with an average of 238.31/1M people (95%CI: 135.47–341.15/1M people). In Phases II and III, infections decreased insignificantly with increasing SES (r = −0.01, p = 0.92; r = −0.11, p = 0.22) and the highest number of infections were found in the LMSG. In Phase IV, SES was positively related to the number of infections (r = 0.54, p < 0.001). Furthermore, the nonlinear impact of multiple factors related to SES on the infections explains the complex relationships between SES and infections. SES affected infections mainly through medical resources, demographics and vaccination, and differed across the SES groups. Particularly, demographics could exert an impact on population mobility, subsequently influencing infections in LMSG, with an indirect effect of 0.01 (p < 0.05) in Phase II. This study argues for greater attention to countries with middle SES and the need for future targeted measures to cope with infectious diseases. Plain Language Summary: As the virulence of SARS‐CoV‐2 diminishes and vaccination coverage rises, countries around the world are gradually returning to normal development like the pre‐COVID‐19 period. However, the COVID‐19 pandemic crisis of the past three years calls for thoughtful reflection, presenting us with experiences and lessons to learn from. Previous studies suggested that the infections were linearly associated with socio‐economic status (SES). Nevertheless, SES was related with multiple factors (such as vaccination), leading to the complex relationship between infections and SES. Therefore, it still needs to analyze the impacts and mechanisms of SES on infections. Empirical results show the relationship between SES and infections was an inverted U‐shape in the progress of the COVID‐19 pandemic, and the infections in lower‐middle and upper‐middle SES countries was the highest in the first three phases. SES affected infections through multiple factors and the mechanisms differed across SES groups. This work emphasizes the need to be attentive to the further prevalence of infectious diseases in middle‐SES countries and implementing the target measures in different SES countries in the future. Key Points: The response of society to the COVID‐19 pandemic was exploredSocio‐economic status had an inverted U‐shaped relationship with infections during the COVID‐19 pandemicSES affected infections mainly through action time, demographics, medical resources and vaccination [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]

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]

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]

Background and Aims: Poliomyelitis is an acute neurologic condition that causes muscle weakness, permanent flaccid paralysis, and even death. The world has seen a drastic fall in the number of poliovirus cases owing to effective immunization programs and preventive measures. Pakistan and Afghanistan still remain the two endemic countries for poliovirus, particularly, the WPV1 strain. Global Polio Eradication Initiative (GPEI) has set a target to eradicate all WPV1 cases by the end of 2023. However, the re‐emergence of WPV1 cases has posed a serious setback for the achievement of this target. This article aims to discuss the public health challenges that contribute to resurgence of poliovirus cases. Methods: A comprehensive literature search was conducted using various databases including Cochrane, Google Scholar, PubMed, Science Direct, MEDLINE. Only articles written in English were considered. All the articles reporting the incidence of poliovirus and WPV1 cases in Pakistan, surveillance data and global context of poliovirus outbreak were evaluated to write this correspondence. In addition, references from the selected articles were also examined to ensure a comprehensive review of the literature. Results: This article highlights the factors contributing to the re‐emergence of WPV1 cases in Pakistan. Low vaccine coverage, attacks on frontline polio health workers, misinformation, and reluctance to vaccine acceptance pose a daunting challenge for polio eradication. Further, gaps in AFP surveillance and sensitivity may underestimate the true extent of the emerging genetic clusters. The Covid‐19 pandemic and subsequent flooding in the affected area have further worsened the underdeveloped public health infrastructure. Conclusion: Despite the challenges, the country has observed a significant decline in the number of cases in the past 2 years. It is high time to capitalize on the decrease in WPV1 cases by intensifying the efforts to mitigate and limit the spread of the disease. [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]

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]

Cell‐based influenza vaccines avoid egg‐adaptive mutations, potentially improving vaccine effectiveness. We assessed the one‐season cost‐effectiveness of cell‐based quadrivalent influenza vaccine (QIVc) against that of egg‐derived quadrivalent influenza vaccines (QIVe) in children (6 months to 17 years of age) from payer and societal perspectives in Taiwan using an age‐stratified static model. Base case and high egg adaptation scenarios were assessed. Deterministic and probabilistic sensitivity analyses were performed. The incremental cost‐effectiveness ratio (ICER) threshold in Taiwan was assumed to be USD 99 177/quality‐adjusted life year (QALY). Compared to QIVe, QIVc would prevent 15 665 influenza cases, 2244 complicated cases, and 259 hospitalizations per year. The base case ICER was USD 68 298/QALY and USD 40 085/QALY from the payer and societal perspective, respectively. In the high egg adaptation scenario, the ICER was USD 45 782/QALY from the payer's perspective and USD 17 489/QALY from the societal perspective. Deterministic sensitivity analyses indicated that infection incidence rate, vaccination coverage, and prevalence of the A/H3N2 strain were the main drivers of ICER. In conclusion, switching the immunization strategy from QIVe to QIVc is predicted to reduce the influenza‐associated disease burden and be cost‐effective for the pediatric population in Taiwan. The potential benefits of QIVc would be even higher during influenza seasons with high levels of egg adaptation. [ABSTRACT FROM AUTHOR]

A recent meta-analysis published in the Journal of Medical Virology evaluated the effectiveness of the oral antiviral nirmatrelvir-ritonavir (NR) in high-risk COVID-19 patients. The analysis included 32 studies and found that NR was significantly effective in reducing mortality, hospitalizations, and disease progression compared to standard care, even in highly vaccinated populations with the Omicron variant. However, subgroup analysis indicated that NR was less effective against mortality in vaccinated/boosted patients. Additional meta-regression analyses showed that variations in vaccination coverage did not significantly affect the effectiveness of NR on these outcomes. These findings support the use of NR as a treatment option for high-risk patients. [Extracted from the article]

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: 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]

In May 2019, a measles outbreak occurred in the French subregion of Loire‐Atlantique, particularly affecting Roma settlements. Various obstacles hindered the implementation of postexposure measures among Roma population, resulting in the spread of the cases to other settlements. Suspected cases of measles were immediately investigated and concerned settlements were visited for measles–mumps–rubella (MMR) vaccination. From July 1 to September 3, 2019, a first and then a second Health Reserve team helped for vaccination on the affected and then also the measles‐free settlements. Vaccination uptake was monitored with the use of the department's vaccination center immunization registry. Genotyping of selected samples was performed for comparison with viruses circulating at the same time in France and Romania. As of September 16 2019, 109 cases of measles were confirmed among Roma population, including 99 (91%) children under 15 years. Of the 85 people eligible for vaccination, 60 (71%) had not been vaccinated and 23 (27%) had an unknown vaccination status. Sequence comparison revealed that 28/29 sequenced D8 strains were 100% identical to the strain responsible for a large number of cases throughout France in 2019, and to two sequences reported in Romania among sporadic cases. The vaccination campaign resulted in 1136 people on 35 settlements receiving at least one dose of MMR vaccine and in the increase of one‐dose MMR vaccine coverage at 24 months from 43% (23/53) to 91% (48/53). With measles transmission continuing in Europe, efforts must be made to meet immunization coverage targets, particularly in hard‐to‐reach communities where outbreaks may be difficult to control. [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]

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]

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]

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]

We aimed to estimate self‐reported vaccine coverage and SARS‐CoV‐2 anti‐N and anti‐S seroprevalence in Mexico overall and for five vaccine types. We used a nationally representative survey with 7236 dried blood spot samples for adults 18 years and older collected from August to November 2021. Anti‐N and anti‐S seroprevalence were estimated adjusting for the sensitivity and specificity of the immunoassay test. A multivariate Poisson regression model was used to estimate seroprevalence by vaccine type and by age group adjusting for confounders and test performance. Vaccination coverage was 74%, being higher in women compared to men, high socioeconomic status (SES) compared to low and middle SES, graduates compared to people with high school, and formal workers compared to other employment statuses. Anti‐N seroprevalence was 59.2%, compared to 84.1% anti‐S seroprevalence. Anti‐S seroprevalence was higher for vaccinated than unvaccinated participants. All vaccines were associated with more than 70% anti‐S seroprevalence, with the lowest being observed for CoronaVac and Ad5‐nCoV. Fully vaccinated participants over 60 years presented a lower seroprevalence (77.6%) compared to younger adults (91.1%), with larger differences for ChAdOx1 and CoronaVac vaccines. Between August and November 2021, three out of four Mexican adults had been vaccinated. Vaccination was associated with a higher positivity to anti‐S antibodies. While antibodies do not reflect immunity, our results suggest that booster doses should be offered to people over 60 years of age and to adults who received Ad5‐nCoV or CoronaVac as primary vaccination schemes. [ABSTRACT FROM AUTHOR]

Rotavirus (RV) infection is a leading cause of severe diarrhea among children younger than 5 years old and a considerable cause of RV gastroenteritis (RVGE) hospitalization. This study aimed to evaluate the impact of vaccination in Italy in the reduction of the burden of RV‐related disease, estimating the relation between vaccination coverage and hospitalization rates. RVGE‐related hospitalizations that occurred in Italy from 2008 to 2018 among children aged 0−35 months were assessed by consulting the Hospital Discharge Record database and including records whose ICD‐9‐CM diagnosis code was 008.61 in the first or in any diagnosis position. In the 2008−2018 period, a total of 17 535 791 at‐risk person‐years were considered and 74 211 (423.2 cases × 100 000 per year) RVGE hospitalizations were observed. Higher hospitalization rates occurred in males (456.6 vs. 387.9 × 100 000 per year) and in children aged 1 year (507.8 × 100 000 per year). Poisson regression analysis showed a decrease of −1.25% in hospitalization rates (−1.19% to −1.31%, p < 0.001) per unit increase in vaccination coverage. This is the first study that correlates hospitalization rate reduction with a percentage increase in vaccination coverage. Our findings strongly support RV vaccination as an effective public health strategy for reducing RVGE‐related hospitalizations. [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]

With the rapid increase in the incidence of cervical cancer, anal cancer and other cancers, human papillomavirus (HPV) infection has become a growing concern. Persistent infection with high‐risk HPV is a major cause of malignant tumors. In addition, microbiota and viruses such as human immunodeficiency virus, herpes simplex virus, and Epstein–Barr virus are closely associated with HPV infection. The limited effectiveness of existing treatments for HPV‐associated tumors and the high rates of recurrence and metastasis in patients create an urgent need for novel and effective approaches. In recent years, HPV vaccine coverage has increased and can reduce the incidence of serious adverse events. Overall, this article provides a comprehensive overview of HPV biology, microbiome, and other viral interactions in cancer development, highlighting the need for a more comprehensive approach to cancer prevention and treatment. Current and emerging HPV‐related cancer control and treatment strategies are also further explored. [ABSTRACT FROM AUTHOR]

The article discusses the role of childhood immunization coverage in the increase of pyogenic infections in children after the COVID-19 pandemic. The authors suggest that the relaxation of social distancing measures, along with the emergence of more virulent bacterial serotypes and the immunosuppressive effect of COVID-19 infection, may have contributed to the increase in pediatric bacterial complicated infections. The article emphasizes the importance of vaccination coverage, particularly against S. pneumoniae, in preventing the emergence of pyogenic infections in children. It calls for healthcare professionals to consider the impact of vaccination coverage and implement adequate public health policies. [Extracted from the article]

This article discusses two studies conducted in Southern and Northern Rwanda that report a high prevalence of epilepsy. While the studies provide valuable data on the epilepsy burden in Sub-Saharan Africa, there are methodological issues that may affect the generalizability of the findings. The choice of study areas appears biased, and the selection of villages based on the absence of an epilepsy awareness campaign may introduce bias as well. Additionally, the exceptionally high participation rate in the Southern Rwanda study and the higher prevalence among women raise questions about the study's methodology and potential factors contributing to the high prevalence. The authors emphasize the need for prevalence studies to include large, heterogeneous populations and investigate local risk factors. [Extracted from the article]

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]

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: Vaccination in pregnancy is the best strategy to reduce complications from influenza or pertussis infection in infants who are too young to be protected directly from vaccination. Pregnant women are also at risk of influenza complications preventable through antenatal vaccination. Both vaccines are funded under the National Immunisation Program for pregnant women in Australia, but coverage is not routinely reported nationally.We reviewed all reported Australian maternal influenza and pertussis vaccine coverage data for the period 2016–2021, to identify gaps and information needs.Maternal influenza vaccine coverage was suboptimal at < 58% for 2016–2018, with higher coverage of 62–75% reported in two states (Victoria and Western Australia) for 2019–2021. Maternal pertussis vaccine coverage from 2016 was generally higher than for influenza at > 70%, with the highest jurisdictional coverage of 89% reported in Western Australia in 2020.Vaccination rates were often suboptimal among First Nations pregnant women and up to 20% lower than among non‐First Nations Australian women; while data were limited, coverage was low among culturally and linguistically diverse women and among women of lower socio‐economic status.Jurisdictional perinatal data collections were the best source of information on antenatal vaccine coverage but were only available for a minority of the population; a nationally consistent systematic approach is lacking.Timely and comprehensive data are needed to provide feedback to improve maternal vaccination coverage, particularly among groups with higher risk and/or low uptake, and as new vaccines are recommended, including COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

Several vaccines have been produced in 2 years of the COVID‐19 pandemic to control the infection outbreak. This study demonstrated the success of vaccination in controlling COVID‐19 cases and deaths in a small city (41 424 people) with a low population density in Brazil. This study was based on a 1‐year dataset since the application of the first dose in January 2021. The results show a reduction in positive cases and deaths as the vaccination coverage increased in the city, mainly after 15 000 inhabitants were vaccinated (35.21% of the population) in July 2021. At the time, 49.06% of administered vaccines were ChAdOx1‐S recombinant, 39.80% inactivated SARS‐CoV‐2 virus (CZ02 strain), 9.70% Tozinameran, and 1.44% Ad26.COV2‐S recombinant. From August 2021, a marked reduction in daily positive cases and deaths was observed, and incidence (≤2.49 per 1000 inhabitants) and mortality (≤0.02 per 1000 inhabitants) rates remained stabilized until January 2022, when a new outbreak occurred upon the emergence of the Omicron variant. However, the mortality rate (0.07 per 1000 inhabitants) remained low regardless of the Omicron high incidence rate (68.41 per 1000 inhabitants). These data demonstrate the COVID‐19 vaccination effectiveness with a threshold of 35.21% of the population vaccinated in this city model. [ABSTRACT FROM AUTHOR]

Objective: The study objective was to prioritize topics for future patient‐centered research to increase uptake of common vaccines, such as for pneumococcal pneumonia, influenza, herpes zoster, human papillomavirus, and severe acute respiratory syndrome coronavirus 2, among adults living with autoimmune conditions. Methods: A steering committee (SC) was formed that included clinicians, patients, patient advocates, and researchers associated with rheumatic diseases (psoriatic arthritis, rheumatoid arthritis, vasculitis), inflammatory bowel disease, and multiple sclerosis. Through a scoping review and discussions, SC members identified research topics regarding vaccine uptake and/or hesitancy for prioritization. A larger multistakeholder alliance that included patients and patient advocates, clinicians, researchers, policy makers, regulators, and vaccine manufacturers conducted a modified Delphi exercise online with three rating rounds and one ranking round. Frequency analysis and comparisons across stakeholder groups were conducted. A weighted ranking score was generated for each item in the ranking round for final prioritization. Results: Through the Delphi process, 33 research topics were identified, of which 13 topics were rated as critical by more than 70% of all stakeholders (n = 31). The two highest ranked critical topics per the full stakeholder group were "How well a vaccine works for adults with autoimmune conditions" and "How beliefs about vaccine safety affect vaccine uptake." Conclusion: A multistakeholder group identified key topics as critically important priorities for future research to decrease vaccine hesitancy and improve uptake of vaccines for adults with autoimmune conditions. [ABSTRACT FROM AUTHOR]

Bluetongue (BT) causes an economic loss of $3 billion every year in the world. After two serious occurrences of BT (bluetongue virus [BTV] occurrence in 2006 and 2015), France has been controlling for decades, but it has not been eradicated. As the largest live cattle export market in the world, France is also one of the major exporters of breeding animals and genetic materials in the world. The biosafety of its exported cattle and products has always been a concern. The scenario tree quantitative model was used to analyze the risk of BTV release from French exported live cattle and bovine semen. The results showed that with the increase in vaccination coverage rates, the risk decreased. If the vaccine coverage is 0%, the areas with the highest average risk probability of BTV‐4 and BTV‐8 release from exported live cattle were Haute‐Savoie and Puy‐de‐Dôme, and the risk was 2.96 × 10–4 and 4.25 × 10–4, respectively. When the vaccine coverage was 90%, the risk probability of BTV‐4 and BTV‐8 release from exported live cattle was 2.96 × 10–5 and 4.24 × 10–5, respectively. The average probability of BTV‐8 release from bovine semen was 1.09 × 10–10. Sensitivity analysis showed that the probability of false negative polymerase chain reaction (PCR) test and the probability of BT infection in the bull breeding station had an impact on the model. The identification of high‐risk areas and the discovery of key control measures provide a reference for decision makers to assess the risk of French exports of live cattle and bovine semen. [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]

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: 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]