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Introduction: Group B arbovirus is the cause of Japanese encephalitis (JE), with a 20–40% case fatality rate, is spread by the culicine mosquito.¹ Due to the rise in incidence reported in Karnataka, JE immunization campaign with inactivated JENVAC vaccine was conducted in December 2022 in 10 Karnataka districts including Kalaburagi, an undeveloped district vaccinating children aged 1-15 years.² Objectives: To evaluate vaccine coverage and the challenges faced among children in Kalaburagi city, following the campaign. Materials & Methods: 210 children were chosen using 30*7 cluster sample method.3 Eligible children residing at Kalaburagi city were included, although recently immigrated and immunized residents of surrounding talukas were not. This survey was conducted two months following the campaign. JE vaccination status was assessed using a pretested, semi-structured questionnaire from reliable informants.SPSS software version 16 was used for analysis after the data were entered into an Excel sheet. Statistical tests like Chisquare, frequency and percentage were used. Results: Of the 210 children, the majority were younger than five years old. Estimated vaccine coverage was 68.6% with the major reason being unawareness followed by hesitancy for vaccination with no significant association with sociodemographic factors. Conclusion: Raising awareness through the media and medical professionals contributes to the vaccination’s ability to lower the prevalence of JE and vaccinating nonvaccinators unless contraindicated. [ABSTRACT FROM AUTHOR]

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Introduction Effective and safe vaccines against COVID-19 are essential to achieve global control of the coronavirus (SARS-CoV-2). Using faith centres may offer a promising route for promoting higher vaccine uptake from certain minority ethnic groups known to be more likely to be vaccine hesitant. Methods This cross-sectional study explored attendees' perceptions, experiences of being offered, and receiving COVID-19 vaccination in a local mosque in Woking, Surrey, UK. About 199 attendees completed a brief questionnaire on experiences, views, motivations about attending the mosque and vaccination on site. Results The most common ethnic groups reported were White British (39.2%) and Pakistani (22.6%); 36.2% identified as Christian, 23.6% as Muslim, 5.5% as Hindu, and 17.1% had no religion. Genders was relatively equal with 90 men (45.2%) and 98 women (49.2%), and 35–44-year-olds represented the most common age group (28.1%). Views and experiences around receiving vaccinations at the mosque were predominantly positive. Primary reasons for getting vaccinated at the mosque included convenience, accessibility, positive aspects of the venue's intercultural relations, and intentions to protect oneself against COVID-19, regardless of venue type. Negative views and experiences in regards to receiving the vaccination at the mosque were less common (7% expressed no intention of recommending the centre to others), and disliked aspects mostly referred to the travel distance and long waiting times. Conclusions Offering COVID-19 vaccination in faith centres appears acceptable for different faith groups, ensuring convenient access for communities from all religions and ethnic backgrounds. Key message What is already known on this topic Effective and safe vaccines against COVID-19 are essential to achieve global control of the coronavirus Using faith centres for providing access to health services may offer a promising route for promoting higher vaccine uptake from certain minority ethnic groups known to be more likely to be vaccine hesitant. What this study adds Convenience, accessibility, positive aspects of the venue, the importance of promoting intercultural relations, and getting vaccinated to protect oneself against COVID-19 appear to be major influencers relevant for the specific type of venue where the vaccine was offered, i.e. a mosque. Long travel distance and waiting times were barriers to recommending the centre to others. How this study might affect research, practice or policy Offering COVID-19 vaccination in faith centres appears acceptable for different faith groups. Vaccine uptake can be maximized by ensuring convenient access to the centre for communities from all religions and ethnic backgrounds. Future research should continue to explore COVID-19 vaccination behaviours and underlying beliefs in larger ethnic minority samples. Faith centres could provide an alternative location for preventative healthcare offers, such as vaccines, in local communities, therefore representing a promising approach to maximize public health impacts. [ABSTRACT FROM AUTHOR]

Background: Although important information concerning COVID-19 vaccination is available, the effects of the CoronaVac and ChadOx-1 vaccines on immunity and the redox balance in the upper airway mucosa of the aged population are not fully understood. Therefore, the aim of this study was to investigate the impacts of two doses of the CoronaVac or ChadOx-1 vaccine on immune/inflammatory responses and oxidative stress in the airway mucosa of older adults. Methods: Seventy-six older adults of both sexes, with a mean age of 75.1 ± 6.4 years, were separated according to vaccination status into the CoronaVac (n = 52) and ChadOx-1 (n = 24) groups. Saliva samples were collected before (pre) and 30 days after (post) the administration of the second dose of the CoronaVac or ChadOx-1 vaccine to assess the levels of antibodies (sIgA and IgG), antimicrobial peptides, cytokines, and oxidant/antioxidant agents. Results: The immunogenicity in the ChadOx-1 group was 37.5% for sIgA and 25% for IgG, while that in the CoronaVac group was 18.9% for sIgA and 13.2% for IgG. Intergroup analysis revealed that (1) lower levels of IFN-α, IFN-γ, and IL-10 and a greater IFN-γ/IL-10 ratio, in addition to a greater IL-6/IL-10 ratio, were found in both the pre- and postvaccination periods, and (2) lower levels of total sIgA, IL-12p70, IL-17A, TNF-α, and the IL-12p70/IL-10 ratio, in addition to higher levels of specific sIgA for SARS-CoV-2 antigens and lysozyme, were observed only in the postvaccination period in the ChadOx-1 group than in the CoronaVac group. Intragroup analysis revealed (1) a significant increase in the salivary levels of total peroxides in the postvaccination period compared to those in the prevaccination period in both volunteer groups; (2) a decrease in the levels of lysozyme and the ratio between total antioxidant capacity (TAC) and total peroxides in the postvaccination period in the CoronaVac group compared with those in the prevaccination period; and (3) decreases in the TNF-α, IL-6, and IL-12p70 levels, and the IL-12p70/IL-10 ratio in the ChadoX-1 group, as well as a higher lactoferrin concentration in the postvaccination period than in the prevaccination period. Several positive and negative correlations between the parameters assessed here were found. Conclusions: In general, the ChadOx-1 group exhibited improvements in both immune/inflammatory responses and redox balance and greater immunogenicity than did the CoronaVac group. [ABSTRACT FROM AUTHOR]

The Human Papillomavirus (HPV) vaccine can prevent 90% of cancers caused by HPV. Health care provider recommendations affect vaccine uptake, yet there are a lack of studies examining the impact of the school nurse (SN) in vaccine recommendations. The purpose of this study was to evaluate the impact of adding a SN HPV recommendation to the standard vaccination letter sent to parents/guardians. The rate of vaccination between the intervention and control schools was not statistically significant (Estimate (Std. Error) = −0.3066 (0.2151), p = 0.154). After controlling for age, sex, race, insurance type, and medical practice type, there was no significant difference in the likelihood to receive the HPV vaccine (OR = 1.53, 95% CI: 0.563–4.19 in 2018; OR = 1.34, 95% CI: 0.124–14.54 in 2019. Further work is needed to clarify how school nurses can better promote HPV vaccine, and which adolescent demographic groups (e.g., race, insurance type, provider type) face barriers to HPV vaccine uptake. [ABSTRACT FROM AUTHOR]

Introduction: Group B arbovirus is the cause of Japanese encephalitis (JE), with a 20–40% case fatality rate, is spread by the culicine mosquito.1 Due to the rise in incidence reported in Karnataka, JE immunization campaign with inactivated JENVAC vaccine was conducted in December 2022 in 10 Karnataka districts including Kalaburagi, an undeveloped district vaccinating children aged 1-15 years.2 Objectives: To evaluate vaccine coverage and the challenges faced among children in Kalaburagi city, following the campaign. Materials & Methods: 210 children were chosen using 30*7 cluster sample method.3 Eligible children residing at Kalaburagi city were included, although recently immigrated and immunized residents of surrounding talukas were not. This survey was conducted two months following the campaign. JE vaccination status was assessed using a pretested, semi-structured questionnaire from reliable informants.SPSS software version 16 was used for analysis after the data were entered into an Excel sheet. Statistical tests like Chisquare, frequency and percentage were used. Results: Of the 210 children, the majority were younger than five years old. Estimated vaccine coverage was 68.6% with the major reason being unawareness followed by hesitancy for vaccination with no significant association with sociodemographic factors. Conclusion: Raising awareness through the media andmedical professionals contributes to the vaccination’s ability to lower the prevalence of JE and vaccinating nonvaccinators unless contraindicated. [ABSTRACT FROM AUTHOR]

Background: Although vaccination is the most effective and specific approach for prevention of infectious diseases, but in a small percentage of vaccinated person's breakthrough infections can occur. This study aimed to determine the effectiveness of different common coronavirus vaccines in this area. Methods: 109 COVID-19 vaccinated patients were enrolled, with different types of vaccines (Sinopharm, AstraZeneca, Sputnic, Bharath, CovIran Barkat and Pasto-CoV) and time of administration in 2021 in Babol, Iran. Patients after 14 days of administration of the final dose of corona vaccines with positive COVID-19 RT-PCR test entered to study. Patients' data such as RT-PCR, type of vaccine, age, sex and outcome were collected using electronic medical records. Results: 47 patients were not fully vaccinated, 62 had two vaccine doses and 51 were fully vaccinated and considered to a breakthrough infection. Although, most of the patients with SARS-CoV-2 infection were either mild (n=18 [16.56%]), or moderate (n=86 [78.9%]), 5 (4.6%) patients had severe or critical illness, of whom 3 admitted in intensive care unit, 3 intubated, and 4 died. The average age of the participants with COVID-19 infections was 61.23 ± 19.91 years. Conclusion: Based on our results, the COVID-19 breakthrough occurring with two doses of current vaccines were mild and moderate. [ABSTRACT FROM AUTHOR]

Background: People with Substance Use Disorder have higher adverse outcomes associated with COVID-19 infection that can be reduced with COVID-19 vaccines. Various factors influence the acceptability of COVID-19 vaccines. We assessed COVID-19 vaccine-related knowledge, attitude, and beliefs in patients on Opioid Agonist Treatment (OAT) from a community clinic in an urban impoverished area in Delhi, India. Methods: Cross-sectional design. We interviewed 200 adult males using a structured questionnaire. Results: The participants' mean age was 27.4 (SD 6.8) years; majority (68%, n = 136) had less than 10 years of schooling. While family members of 77% (n = 154) of the participants were vaccinated for COVID-19, only 32% (n = 64) of the participants had been vaccinated with at least a single dose. 43% (n = 86) felt they are ineligible for vaccine due to their addiction or their ongoing addiction treatment (46.5%, n = 93). Though the majority (78.5%, n = 157) were willing to get vaccinated, they had not done so due to concerns, such as fear of vaccine-related adverse-effects (35%). Conclusions: COVID-19 vaccination rates in individuals with opioid dependence are much lower compared to the general population. There are several misconceptions related to COVID-19 vaccinations in this population that needs to be addressed to achieve universal vaccination against COVID-19 infection. [ABSTRACT FROM AUTHOR]

We quantify the impact of county‐level vaccination rates on vaccine uptake. While the marginal effect at current vaccination rates is modest, the overall impact is large. Moving from a 0% to 15% vaccination rate in a county is associated with an increase in the daily uptake of over 10 fold. Our results shed light on the rise and decline of vaccine hesitancy and imply an externality of vaccination programs. For Ohio's Vax‐A‐Million lottery, a back‐of‐the‐envelope calculation finds that there were an additional 30,000 vaccinations immediately following the lottery as a result of the increased vaccinations from the lottery. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions The contribution of SARS‐CoV‐2 infection on lung damage and the effect of vaccination on either containing the number of deaths or mitigating lung damage has not been systematically investigated.Post‐mortem analysis was performed among consecutive in‐patients with COVID‐19 deceased in the Province of Trieste (2020–2022). The outcomes of the study were (i) rates of in‐hospital mortality, (ii) contribution of COVID‐19 to death, (iii) histological extent of lung injury and (iv) impact of vaccination.A total of 1038 consecutive hospitalized patients who died with SARS‐CoV‐2 infection were autopsied and deep histological analysis of the lungs was performed in a randomly selected sample of 508 cases. Among them, SARS‐CoV‐2 infection was (a) the cause of death (n = 90), (b) contributing to death (n = 304) and (c) an accompanying feature (n = 114). The incidence of SARS‐CoV‐2 infection as the primary cause of mortality decreased over time (23.8% in 2020, 20.9% in 2021 and 7.9% in 2022). On multivariable analysis, vaccination (any dose) was independently associated with lower rates of death related to SARS‐CoV‐2 infection (HR .15, p < .001), after adjusting for other independent predictors. A total of 172 patients were vaccinated at least with two doses at the time of death: 93% triple‐vaccinated, 7% double‐vaccinated. On histological analysis, vaccinated patients had a greater frequency of pneumonia severity score 0 and 1 (20.3% vs. 5.4% and 20.9% vs. 7.7%, p < .001, respectively), and a substantially lower proportion of pneumonia severity score 3 (26.2% vs. 55.1%, p < .001) compared to unvaccinated patients.COVID‐19 vaccination has substantially reduced rates of death related to SARS‐CoV‐2 infection over time and may have the ability to mitigate lung damage. [ABSTRACT FROM AUTHOR]

Malnutrition is responsible for over one-third of deaths among children under the age of five in low-and middle-income countries, including Ethiopia, and is largely preventable. The objective of this study was to determine the prevalence of undernutrition and its contributing factors among children aged 6–59 months in the Gedio zone of Southern Ethiopia. A community-based cross-sectional study design was used, and data were collected from 403 children and their mothers selected through random sampling technique. Anthropometric measures were converted to Z-scores using WHO-Anthro version 3.2.2 software. The prevalence of underweight, wasting, and stunting were 19.7% (95% CI 16-24%), 10% (95% CI 7–13%), and 49% (95% CI 44–54%) respectively. Low birth weight (AOR = 2.8, 95% CI (1.585–4.895), feeding non-diversified diet (AOR = 1.9, 95% CI (1.036–3.497), and being unvaccinated (AOR: 2.0; 95%CI (1.013–4.197) were significantly associated with being underweight. Family size of ≥ 5 (AOR = 4.4, CI (1.274–5.059), meal frequency of < 3 times per a day (AOR = 2.3, CI (1.037–5.024), and index birth interval of < 24 months (AOR = 2.2, CI (1.015–4.843) were significantly associated with wasting. Similarly, children aged ≥ 24 months (AOR = 2.8, CI (1.769–4.474), feeding non-diversified diet (AOR = 1.8, CI (1.153–2.894), total duration of breast-feeding < 12 months (AOR = 4.0, CI (2.547–6.429), and mothers BMI below 18.5 (AOR = 2.2, CI (1.328–3.718) were identified as a predictors of stunting. The study revealed significant levels of undernutrition, including underweight, wasting, and stunting, among children in the study area. Factors such as birth weight, dietary diversity score, and vaccine status were found to be strongly linked to underweight. Additionally, living in a large family, meal frequency, and birth interval were significantly associated with wasting. The age of the child, duration of breastfeeding, dietary diversity score, and maternal BMI status were also significantly linked to stunting. To address this issue, the study recommends promoting healthier feeding practices, dietary diversification, optimal breastfeeding, complete vaccination, wider birth intervals, and improving maternal nutrition to reduce undernutrition among children aged 6–59 months in the area. Implementing these measures could significantly improve the health of children in the study area. [ABSTRACT FROM AUTHOR]

Background: In Yemen, diphtheria has become an important health problem since 2017 when diphtheria re-emergence as a consequence of war and the collapse of the health system. In 2023, there has been a 57% increase in diphtheria cases compared to 2021 and 2022. Damt district of Al Dhalea Governorate had the highest reported cases for year 2023. The study aims to determine the risk factors associated with diphtheria outbreak in Damt District. Methods: A retrospective matched case–control (1:2) was used. All confirmed cases based on the WHO case definition reported from Damt district during 2023 were considered cases. Two age-matched (± 5years) neighborhood controls were recruited per case. A pretested questionnaire was used for collecting data during household interviews including demographic and household characteristics, knowledge of diphtheria, vaccination status, contact with a case of diphtheria, and travel history. Frequency and proportion for quantitative and median with interquartile range (IQR) for quantitative variables. Chi-square and Mann–Whitney tests to compare the distribution of categorical and numerical variables between cases and controls. Univariate and multivariate conditional binary logistic regression, and Adjusted Odds ratio (AOR) with a 95% confidence interval at P < 0.05 were used to identify risk factors. Results: A total of 118 cases and 236 controls were enrolled, 56% were females (63% of cases vs. 53% of controls). The median (IQR) age was 14 (9,22) years for cases vs 12(7,23) of control, it was significantly higher for females than males in the case group: (16(10,29) Vs 10(6,18), P < 0.001) and control group: (15(8,25) vs 12(7,18), p-value = 0.022). Partial vaccination status AOR = 13.7(6.1–31.1), P-value < 0.001), contacts with a case of diphtheria AOR = 8.5(2.3–31.0), P value < 0.001) and Female gender, AOR = 3.3(CI; 1.1–9.5, P value = 0.029), were the main risk factors. Conclusions: Poor vaccination and contact with a case of diphtheria were the main contributors to diphtheria in the Damt district particularly among adult females. Increasing the vaccination coverage with a diphtheria-containing vaccine through routine immunization as well as tetanus-diphtheria vaccine for childbearing age females along with community awareness regarding protection measures during home care of diphtheria cases. Vaccination services as well as gender barriers related to Td vaccination should be investigated. [ABSTRACT FROM AUTHOR]

Background: COVID-19 vaccines effectively prevent infection and hospitalization. However, few population-based studies have compared the clinical characteristics and outcomes of patients hospitalized for COVID-19 using advanced statistical methods. Our objective is to address this evidence gap by comparing vaccinated and unvaccinated patients hospitalized for COVID-19. Methods: This retrospective cohort included adult COVID-19 patients admitted from March 2021 to August 2022 from 27 hospitals. Clinical characteristics, vaccination status, and outcomes were extracted from medical records. Vaccinated and unvaccinated patients were compared using propensity score analyses, calculated based on variables associated with vaccination status and/or outcomes, including waves. The vaccination effect was also assessed by covariate adjustment and feature importance by permutation. Results: From the 3,188 patients, 1,963 (61.6%) were unvaccinated and 1,225 (38.4%) were fully vaccinated. Among these, 558 vaccinated individuals were matched with 558 unvaccinated ones. Vaccinated patients had lower rates of mortality (19.4% vs. 33.3%), invasive mechanical ventilation (IMV-18.3% vs. 34.6%), noninvasive mechanical ventilation (NIMV-10.6% vs. 22.0%), intensive care unit admission (ICU-32.0% vs. 44.1%) vasoactive drug use (21.1% vs. 32.6%), dialysis (8.2% vs. 14.7%) hospital length of stay (7.0 vs. 9.0 days), and thromboembolic events (3.9% vs.7.7%), p < 0.05 for all. Risk-adjusted multivariate analysis demonstrated a significant inverse association between vaccination and in-hospital mortality (adjusted odds ratio [aOR] = 0.42, 95% confidence interval [CI]: 0.31–0.56; p < 0.001) as well as IMV (aOR = 0.40, 95% CI: 0.30–0.53; p < 0.001). These results were consistent in all analyses, including feature importance by permutation. Conclusion: Vaccinated patients admitted to hospital with COVID-19 had significantly lower mortality and other severe outcomes than unvaccinated ones during the Delta and Omicron waves. These findings have important implications for public health strategies and support the critical importance of vaccination efforts, particularly in low-income countries, where vaccination coverage remains suboptimal. [ABSTRACT FROM AUTHOR]

Individuals with mental illness are at higher risk of severe COVID-19 outcomes. However, previous studies on the uptake of COVID-19 vaccination in this population have reported conflicting results. Using data from seven cohort studies (N = 325,298) included in the multinational COVIDMENT consortium, and the Swedish registers (N = 8,080,234), this study investigates the association between mental illness (defined using self-report measures, clinical diagnosis and prescription data) and COVID-19 vaccination uptake. Results from the COVIDMENT cohort studies were pooled using meta-analyses, the majority of which showed no significant association between mental illness and vaccination uptake. In the Swedish register study population, we observed a very small reduction in the uptake of both the first and second dose of a COVID-19 vaccine among individuals with vs. without mental illness; the reduction was however greater among those not using psychiatric medication. Here we show that uptake of the COVID-19 vaccine is generally high among individuals both with and without mental illness, however the lower levels of vaccination uptake observed among subgroups of individuals with unmedicated mental illness warrants further attention. Monitoring COVID-19 vaccine uptake in those at risk of severe disease, such as people with mental illness, is important. Here, the authors use cohort and/or health registry data from five countries in northern Europe and investigate vaccine uptake by mental illness and treatment status. [ABSTRACT FROM AUTHOR]

Introduction: In May 2022, the Centers for Disease Control and Prevention disseminated an alert advising that "a few" persons with Nirmatrelvir/ritonavir (NM/R)-associated rebound of COVID-19 infection had been identified. Three case reports appearing as pre-print postings described the first cases. Analyses in March 2023 by NM/R's manufacturer and the Food and Drug Administration (FDA) reported no association between NM/R and COVID-19 rebound in a large phase 3 randomized clinical trial. Our study evaluated if social media databases or electronically disseminated new articles might provide insights related to the putative new toxicity, NM/R-associated COVID-19 rebound. Methods: Information on NM/R-associated COVID-19 rebound cases was abstracted from preprint postings of non-peer-reviewed manuscripts, social media websites, electronically disseminated print and television media reports, a new FDA adverse event database for drugs that received Emergency Use Approval, and news articles in scientific journals. Results: Thirty-five persons experienced presumed or documented NM/R-associated COVID-19 rebound, based on information described in preprint services (n = 27), Twitter postings and related news articles (n = 7), and news articles without related Twitter reports (n = 1). These reports included information on dates of initial COVID-19 illness and rebound onset, COVID-19 testing, vaccine status, presentation, and outcome. A new FDA safety database identified 12,500 possible cases of this toxicity, but the quality of these data was poor. Preprint postings preceded peer-reviewed publications describing the same cases by four months. Social media websites including Instagram, Reddit, YouTube, the Center for Disease Control and Prevention's (CDC) Health Alert Network, CDC Twitter, and Facebook did not provide clinically meaningful information on individual cases. Conclusion: Preprint services and Twitter facilitated identification of the largest case series of NM/R-associated COVID-19 rebound. The cases were reported in non-peer-reviewed media several weeks prior to the first peer-reviewed electronically disseminated publication of one person with this diagnosis. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsData on the outcomes of COVID-19 in people living with HIV (PLHIV), specifically in relation to vaccination status, are lacking during the Omicron era.This nationwide registry-based study included all resident in Sweden ≥18 years with a positive SARS-CoV-2 PCR test during January 2021–February 2023. We estimated adjusted odds ratios (adjOR) for COVID-19 hospitalisation and severe COVID-19 (ICU admission and 90-day mortality), categorised by SARS-CoV-2 vaccination status (0–1, 2, and ≥3 doses), and HIV-status. Analyses were then categorised by time periods of pre-Omicron, Omicron during public testing, and Omicron after public testing.1348 PLHIV and 1 669 389 people without HIV (PWoH) were included. PLHIV were older, more migrant (65 vs. 22%) and male (59 vs. 46%). Of PLHIV, 96% were on antiretroviral treatment and 94% virally suppressed. AdjORs of COVID-19 hospitalisation were similar irrespective of HIV-status, controlled for demographics, calendar month of infection, comorbidities, and income. PLHIV were more likely to be hospitalised than PWoH during Omicron and public testing (adjOR 2.3, 95% CI 1.1–4.2), but not after public testing. The odds of severe COVID-19 were three times higher in PLHIV compared to PWoH vaccinated with 2 doses (adjOR 3.2, 95% CI 1.3–6.9), but not when vaccinated with ≥3 doses (adjOR 0.7, 95% CI 0.2–1.6). Migrant and low nadir CD4+ T-cells were associated with higher odds of hospitalisation in unvaccinated PLHIV.This nationwide study, including mostly well-treated PLHIV, highlights the importance of vaccination with booster dose/s for effective protection against severe COVID-19 in PLHIV.KEY POINTPeople living with HIV compared to people without HIV did not have higher odds of COVID-19 hospitalisation irrespective of SARS-CoV-2 vaccination status (0–1 dose, 2 doses, ≥3 doses) when adjusting for known risk factors including comorbidities and socioeconomic status.People living with HIV compared to people without HIV did not have higher odds of COVID-19 hospitalisation irrespective of SARS-CoV-2 vaccination status (0–1 dose, 2 doses, ≥3 doses) when adjusting for known risk factors including comorbidities and socioeconomic status. [ABSTRACT FROM AUTHOR]

Globally, cases of children's coronavirus disease 2019 (COVID-19) have been reported since the pandemic started. Most children have an asymptomatic or mild infection. Therefore, the incidence rate of COVID-19 in children might have been underestimated. This study aimed to determine (1) the seroprevalence (and seroconversion rates) of COVID-19, including associated risk factors, in pediatric patients visiting hospitals; and (2) the immunological responses to COVID-19. This was a prospective, cross-sectional study. Patients aged 0–18 years who visited the hospital from September 2020 to February 2022 were included. Demographic, clinical, and laboratory data were reviewed. A total of 1,443 pediatric patients were enrolled. Of these, 323 (22.6%) had a history of COVID-19. In the pre-Delta period, the seroprevalence increased from 4.1% to 70.6% in all included patients and from 0.5% to 10% in patients without a known history of COVID-19 compared with the Delta-Omicron period. The seroconversion rate was 6.8% (19 per 100 person-years) in pediatric patients with COVID-19. Risk factors for COVID-19 seropositivity were respiratory symptoms, being in an outpatient department setting, and infection during the Delta-Omicron period. Exposure to household members with confirmed COVID-19 was a risk factor for seropositivity and seroconversion. Infection during the Delta-Omicron period and testing conducted >2 weeks after the onset of symptoms was associated with spike immunoglobulin (Ig) M and spike and nucleocapsid IgG, respectively. High nucleocapsid IgG levels were associated with pneumonia in pediatric patients with COVID-19. Pediatric patients exposed to household members with COVID-19 and respiratory symptoms should be tested for COVID-19. Nucleocapsid IgG can be used as a surrogate marker to identify patients who may have experienced pneumonia from COVID-19 and as a screening tool for the COVID-19 outbreak, regardless of COVID-19 vaccination status. [ABSTRACT FROM AUTHOR]

During the coronavirus disease 2019 (COVID‐19) pandemic, many nations relied on unprecedented amounts of health‐sector aid to efficiently vaccinate their populations. These vaccines and supporting materials came from a variety of traditional and nontraditional donors, with the majority donor differing by recipient country. Previous research has examined the political benefits to donor states of providing health aid before and during the COVID‐19 pandemic. Less is known, however, about how recipients view health aid based on the donor and whether this impacts health aid resource use. This research aims to investigate whether recipient preferences over the source of health assistance affects the efficacy of aid, while using a novel vax‐score method to account for existing trends and predictors of vaccine uptake. Using COVID‐19 vaccine donation and uptake statistics collected by the Duke Global Health Innovation Center, the IMF, and the World Health Organization, we compare vaccine uptake across many vaccine recipient countries to investigate the impact of vaccine origin (Chinese vs. non‐Chinese source). We find that while increased donated vaccines per capita significantly raises the proportion of the population vaccinated at 12 months, the source of the donated vaccines has no impact. Previously reported recipient‐side concerns over vaccine origin have no impact on population‐level uptake at 12 months. Additionally, we observe that a vax‐score metric derived from vaccine uptake of a suite of childhood vaccines predicts COVID‐19 vaccine uptake beyond differences in GDP and GDP per capita. These results have implications for health aid policy and future research into foreign aid efficacy. [ABSTRACT FROM AUTHOR]

Background: Limited data are available describing the effects of SARS-CoV-2 breakthrough infections on the plasma proteome. Methods: PCR-positive SARS-CoV-2 patients, enrolled in a natural history study, underwent analysis of the plasma proteome. A prospective cohort of 66 unvaccinated and 24 vaccinated persons with different degrees of infection severity were evaluated acutely (within 40 days of symptom onset), and at three and ten months. Comparisons based on vaccination status alone and unsupervised hierarchical clustering were performed. A second cohort of vaccinated Omicron patients were evaluated acutely and at ten months. Results: Acutely, unvaccinated patients manifested overexpression of proteins involved in immune and inflammatory responses, while vaccinated patients exhibited adaptive immune responses without significant inflammation. At three and ten months, only unvaccinated patients had diminished but sustained inflammatory (C3b, CCL15, IL17RE) and immune responses (DEFA5, TREM1). Both groups had underexpression of pathways essential for cellular function, signaling, and angiogenesis (AKT1, MAPK14, HSPB1) across phases. Unsupervised clustering, based on protein expression, identified four groups of patients with variable vaccination rates demonstrating that additional clinical factors influence the plasma proteome. The proteome of vaccinated Omicron patients did not differ from vaccinated pre-Omicron patients. Conclusions: Vaccination attenuates the inflammatory response to SARS-CoV-2 infection across phases. However, at ten months after symptom onset, changes in the plasma proteome persist in both vaccinated and unvaccinated individuals, which may be relevant to post-acute sequelae of SARS-CoV-2 and other viral infections associated with post-acute infection syndromes. [ABSTRACT FROM AUTHOR]

Introduction: Reinfection with SARS-Cov-2 after recovery can occur that most of them don't require hospitalization. The aim of this study is estimation of out-patient COVID-19 reinfection and recurrence rates and its associated factors among Iranian patients with history of confirmed SARS-Cov-2 infection and hospitalization. Methods: This study is a retrospective cohort conducted from May 2021 to May 2022 in Iran. The national Medical Care Monitoring Center (MCMC) database, obtained from the Ministry of Health and Medical Education, includes all information about confirmed COVID-19 patients who are hospitalized and diagnosed during the pandemic. Using probability proportional to size sampling from 31 provinces, 1,532 patients over one years of age with a history of hospitalization in the MCMC data are randomly selected. After that, interviews by phone are performed with all of the selected patients using a researcher-made questionnaire about the occurrence of overall reinfection without considering the time of infection occurrence, reinfection occurring at least 90 days after the discharge and recurrence (occurring within 90 days after discharge). Univariate and multivariable Cox regression analyses are performed to assess the factors associated with each index. All of the analyses are performed using Stata software version 16. Results: In general, 1,532 phone calls are made, out of which 1,095 individuals are willing to participate in the study (response rate ≃ 71%). After assessing the 1,095 patients with a positive history of COVID-19, the rates of non-hospitalized overall SARS-Cov-2 reinfection, reinfection and recurrence are 122.64, 114.09, and 8.55 per 1,000 person-years, respectively. The age range of 19–64 years (aHR:3.93, 95%CI : 1.24–12.41) and COVID-19-related healthcare worker (aHR: 3.67, 95%CI: 1.77–7.61) are identified as risk factors for reinfection, while having comorbidity, being fully vaccinated, and having a partial pressure of oxygen (PaO2) ≥ 93 mmHg during the initial infection are identified as factors that reduce the risk of non-hospitalized reinfection. Conclusion: Reinfection due to COVID-19 is possible because of the weakened immune system for various reasons and the mutation of the virus. Vaccination, timely boosters, and adherence to preventive measures can help mitigate this risk. [ABSTRACT FROM AUTHOR]

Background: COVID-19 vaccine uptake among individuals with disabilities is crucial for safeguarding their health and well-being. However, the extent of vaccine uptake among this group remains largely unknown in low- and middle-income countries. This study aims to assess the COVID-19 vaccine uptake among persons with functional difficulty, disability and/or comorbidity in Bangladesh and their associated factors. Methods: Data from 9,370 respondents extracted from the 2021 National Household Survey on Persons with Disability were analysed. The outcome variable was the uptake of at least one dose of the COVID-19 vaccine (yes, no). Key explanatory variables included the presence of disability (yes, no), comorbidity (yes, no), and both comorbidity and disability (yes, no) among persons with functional difficulty. The relationship between the outcome and explanatory variables was determined using mixed-effects multilevel logistic regressions adjusted for covariates. Results: The overall uptake of at least one dose of the COVID-19 vaccine among persons with functional difficulty was 57.37%, among persons with functional difficulty and disability was 48.63% and among persons with functional difficulty and single (57.85%) or multi-comorbidity (60.37%). Compared to the respondents with functional difficulty only, the adjusted odds ratio (aOR) of not receiving any dose of the COVID-19 vaccine for individuals with both functional difficulty and disability was 1.37 (95% CI, 1.22–1.53), and for individuals with functional difficulty, disability and one or more comorbid conditions was 1.30 (95% CI, 1.15–1.47). The aOR of receiving at least one dose of the COVID-19 vaccine among individuals with functional difficulty and one or more comorbid conditions was significantly higher than among those with functional difficulty only. Conclusion: In Bangladesh, COVID-19 vaccine uptake was relatively low among individuals with disabilities. The existing COVID-19 vaccine rollout programs and similar future programs should prioritise individuals with disabilities and include targeted strategies to reach them. [ABSTRACT FROM AUTHOR]

Background Nirmatrelvir-ritonavir is recommended for persons at risk for severe coronavirus disease 2019 (COVID-19) but remains underutilized. Information on which eligible groups are likely to benefit from treatment is needed. Methods We conducted a target trial emulation study in the Veterans Health Administration comparing nirmatrelvir–ritonavir treated versus matched untreated veterans at risk for severe COVID-19 who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from April 2022 through March 2023. We measured incidence of any hospitalization or all-cause mortality at 30 days. Outcomes were measured for the entire cohort, as well as among subgroups defined by 30-day risk of death or hospitalization, estimated using an ensemble risk prediction model. Results Participants were 87% male with median age 66 years and 16% unvaccinated. Compared with matched untreated participants, those treated with nirmatrelvir-ritonavir (n = 24 205) had a lower 30-day risk for hospitalization (1.80% vs 2.30%; risk difference [RD], −0.50% points [95% confidence interval {CI}: −.69 to −.35]) and death (0.11% vs 0.30%; RD, −0.20 [95% CI: −.24 to −.13]). The greatest reductions in combined hospitalization or death were observed in the highest risk quartile (RD −2.85 [95% CI: −3.94 to −1.76]), immunocompromised persons (RD −1.91 [95% CI: −3.09 to −.74]), and persons aged ≥75 years (RD −1.16 [95% CI: −1.73 to −.59]). No reductions were observed in the 2 lowest risk quartiles or persons younger than 65 years. Conclusions Nirmatrelvir-ritonavir was effective in reducing 30-day hospitalization and death in older veterans, those at highest predicted risk for severe outcomes, and immunocompromised groups. Benefit was not observed in younger veterans or groups at lower predicted risk for hospitalization and death. [ABSTRACT FROM AUTHOR]

Background: We investigated the expression of inflammation, placental development, and function markers, including cluster of differentiation 44 (CD44), osteopontin (OPN), and cyclooxygenase-2 (COX-2), to shed light on the controversy regarding the impact of the COVID-19 epidemic on fetal development and pregnancy outcomes. Methods: We immunohistochemically analyzed placental tissue from 170 patients (65 COVID-positive and unvaccinated women; 35 Pfeizer-vaccinated and COVID-negative women; and 70 COVID-negative and unvaccinated women, without any other associated pathology) for particularities in the expression of these three molecules. Results: CD44 expression was highest in COVID-negative and unvaccinated women, moderate in COVID-positive cases, and lowest in vaccinated and COVID-negative women. OPN expression was highest in COVID-negative and Pfeizer-vaccinated cases, moderate in COVID-negative and unvaccinated cases, and lowest in COVID-positive cases. COX-2 expression was increased in COVID-negative and unvaccinated women, modestly elevated in COVID-positive and unvaccinated cases, and lowest in vaccinated cases. Conclusions: These findings reflected an alteration in the placental structure and consequent function due to altered expression of the three studied molecules. [ABSTRACT FROM AUTHOR]

Background: Even though the disease has spread throughout the world, with millions killed, global COVID-19 vaccination coverage remains low, particularly in developing countries. However, epidemiological data is lacking in the area. Hence, this study aimed to assess COVID-19 uptake, willingness for vaccination, and associated factors. Method: A hospital-based cross-sectional study was conducted from May 1 to June 30, 2022, among patients attending chronic follow-up clinics in the two comprehensive specialized hospitals in Bahir Dar. The total sample size was 423. Participants were selected by a systematic random sampling technique. Data was gathered using a pre-tested questionnaire and analyzed using SPSS version 23. A descriptive analysis was performed. A binary logistic regression analysis was done to assess the association between variables. Variables with a p-value < 0.05 in the multi-variable logistic regression with a 95% confidence interval were considered statistically significant. Results: The analysis included 400 out of 423 participants, representing a 95% response rate. The COVID-19 vaccination uptake was 46.8%, while the acceptance was 60.5%. About 56% and 68% of the respondents had good knowledge and a favorable attitude, respectively. Elderly people were 2.7 times more likely to be vaccinated. Similarly, urban residents were 3.94 times more vaccinated. The probability of being vaccinated among respondents with good knowledge and favorable attitudes was 70% and 79%, respectively. The willingness for vaccination increased among those individuals with favorable attitudes (AOR: 1.82). Urban people were less likely to accept vaccination (AOR: 0.46). Some participants misunderstood that vaccination may aggravate their disease condition. Conclusion: The overall COVID-19 vaccine uptake and acceptance for vaccination were low compared to what was estimated by the WHO. Age, residence, knowledge, and attitude were associated with COVID-19 vaccine uptake and acceptance of vaccination. Besides, there was a high level of rumor about the status of the vaccine and risk factors. Hence, special emphasis is warranted to deliver centrally trusted information. Moreover, further nationwide studies are warranted in the future. [ABSTRACT FROM AUTHOR]

Background: Coronavirus Disease 2019 (COVID–19) has been associated with adverse effects and death among people with low immunity, including pregnant women. Despite introducing the vaccine as the proper means to curb the spread of the pandemic, vaccine uptake is still low. This study assessed the influence of perception, attitude, and trust toward COVID-19 vaccine uptake among pregnant women attending Antenatal Care Clinics. Methods: A cross-sectional study design was used, utilizing a quantitative approach with a cross-sectional analytical design conducted in Mbeya urban, distribution of sample size during data collection based on client's volume at three government health facilities (one tertiary health facility, one secondary health facility, and one primary health facility) in Mbeya Urban, Tanzania. Data were collected from 333 pregnant women who attended ANC during the data collection period using a questionnaire with closed-ended questions administered to respondents face-to-face. Data cleaning and analysis were done using Excel and Stata/SE 14.1 software for bivariate and multivariate data; Pearson's chi-squire and Fisher's test were used to analyze the independent determinants of COVID-19 vaccine uptake. Results: The proportion of pregnant women vaccinated with the COVID-19 vaccine was 27%. There was a statistically significant association between the respondents' vaccine uptake with primary education and < 5 work experience to vaccine uptake P = 0.015 (AOR = 6.58; 95% CI; 1.45–29.85), and P = 0.046 (AOR = 2.45; 95% CI; 1.02–5.89) respectively. The association of attitude influence to COVID-19 vaccine uptake was statistically significant (acceptance of vaccine due to its availability, vaccine acceptance for protection against COVID-19 pandemic to respondent and her baby, experience from other vaccines) was statistically significant at P = 0.011 (AOR = 4.43; 95% CI; 1.41–13.93), P = 0.001 (AOR = 45.83; 95% CI; 18.6-112.89) respectively. The level of trust in the COVID-19 vaccine influenced respondents' association with vaccine uptake in the 2nd and 3rd trimesters of pregnancy (P = 0.633 (AOR = 1.23; 95% CI; 0.53–2.48), respectively. Conclusion: Pregnant women's positive attitude and trust in the COVID-19 vaccine influenced them to uptake it; our conclusion supports the WHO guidelines that the COVID-19 vaccine should be administered to pregnant women since it is a safer means to curb COVID-19 pregnancy-related complications. [ABSTRACT FROM AUTHOR]

Background: Premature infants have less physiologic reserve and often delayed vaccination compared to full-term infants. The birth dose of hepatitis B vaccine (HepB-BD) is an essential measure to achieve the goal of "zero infections" of hepatitis B virus in all newborns. However, there are few investigations of hepatitis B vaccination of preterm infants, leading to uncertainty of coverage and insufficient knowledge of factors influencing timely vaccination of this important population. Methods: We obtained hepatitis B vaccine (HepB) vaccination histories of premature infants born during 2019–2021 in three provinces from the respective provincial immunization information systems. Extracted data included date of birth, sex, region, and dates of HepB administration. We conducted descriptive analyses that included basic characteristics of the study subjects, HepB-BD administration, and full-series HepB vaccination. Factors potentially influencing HepB-BD and full series vaccination were analyzed by logistic regression. Results: There were 1623 premature infants included in the analytic data set. Overall HepB-BD coverage was 71.41%; coverage among premature infants born to mothers with unknown hepatitis B surface antigen (HBsAg) status was 69.57%; coverage was higher at county-level-and-above hospitals (72.02%) than hospitals below county level (61.11%). Full-series HepB coverage was 94.15%; full-series coverage among preterm infants weighing less than 2000 g at birth was 76.92%. Logistic regression showed that the HepB-BD vaccination rate was positively associated with being born to an HBsAg-positive mother and being preterm with high birth weight. Regression analysis for factors influencing full-series HepB coverage showed that being born prematurely was positively associated with full-series coverage and being premature with a very low birth weight was negatively associated with full-series coverage. Conclusions: HepB-BD coverage levels in three provinces of China were less than the target of 90%, especially among premature infants born to mothers with unknown HBsAg status and at hospitals below the county level. Screening of pregnant women should be a universal normal standard. Hepatitis B vaccination training should be strengthened in hospitals to improve the HepB-BD vaccination rate of premature infants and to effectively prevent mother-to-child transmission of hepatitis B virus. [ABSTRACT FROM AUTHOR]

Background: Measles remains a major public health burden worldwide. Parents often hesitate to vaccinate children with chronic diseases. We investigated the association between the percentage of vaccination and chronic diseases and explore hospital infections' role in the 2017–2019 measles outbreak across northern Vietnam provinces. Methods: A total of 2,064 children aged 0–15 years old admitted for measles to the National Children's Hospital during the outbreak were included in the study. Demographic information, clinical characteristics, vaccination statuses and laboratory examination were extracted from electronic medical records, vaccination records, or interviews with parents when other sources were unavailable. Results: The incidence rate that provincial hospitals sent to the National Children's Hospital was proportional to the population density of their provinces of residence. Early nosocomial transmission of measles was observed before community-acquired cases emerged in many provinces. Among patients aged over 18 months, those with chronic diseases had a proportion of vaccination of 9.4%, lower than patients without chronic diseases at 32.4%. Unvaccinated patients had a higher proportion of hospital-acquired infections with aOR = 2.42 (1.65–3.65), p < 0.001 relative to vaccinated patients. The proportion of hospital-acquired infections was higher among children with chronic diseases compared to those without, with aOR = 3.81 (2.90–5.02), p < 0.001. Conclusion: Measles spread in healthcare settings prior to community cases that occurred in several provinces. We recommend enhancing hospital infection control by increasing staff training and improving early detection and isolation during non-outbreak periods. Measles patients with chronic diseases exhibited lower proportions of vaccination and faced a higher risk of hospital-acquired infections. It is crucial to establish comprehensive vaccination guidelines and enhance parental awareness regarding the significance and safety of measles vaccination to protect these vulnerable individuals. [ABSTRACT FROM AUTHOR]

Anti-vaccine sentiment during the COVID-19 pandemic grew at an alarming rate, leaving much to understand about the relationship between people's vaccination status and the information they were exposed to. This study investigated the relationship between vaccine behavior, decision rationales, and information exposure on social media over time. Using a cohort study that consisted of a nationally representative survey of American adults, three subpopulations (early adopters, late adopters, and nonadopters) were analyzed through a combination of statistical analysis, network analysis, and semi-supervised topic modeling. The main reasons Americans reported choosing to get vaccinated were safety and health. However, work requirements and travel were more important for late adopters than early adopters (95% CI on OR of [0.121, 0.453]). While late adopters' and nonadopters' primary reason for not getting vaccinated was it being too early, late adopters also mentioned safety issues more often and nonadopters mentioned government distrust (95% CI on OR of [0.125, 0.763]). Among those who shared Twitter/X accounts, early adopters and nonadopters followed a larger fraction of highly partisan political accounts compared to late adopters, and late adopters were exposed to more neutral and pro-vaccine messaging than nonadopters. Together, these findings suggest that the decision-making process and the information environments of these subpopulations have notable differences, and any online vaccination campaigns need to consider these differences when attempting to provide accurate vaccine information to all three subpopulations. [ABSTRACT FROM AUTHOR]

To better understand the impact of Long COVID on an individual, we explored changes in daily wearable data (step count, resting heart rate (RHR), and sleep quantity) for up to one year in individuals relative to their pre-infection baseline among 279 people with and 274 without long COVID. Participants with Long COVID, defined as symptoms lasting for 30 days or longer, following a SARS-CoV-2 infection had significantly different RHR and activity trajectories than those who did not report Long COVID and were also more likely to be women, younger, unvaccinated, and report more acute-phase (first 2 weeks) symptoms than those without Long COVID. Demographic, vaccine, and acute-phase sensor data differences could be used for early identification of individuals most likely to develop Long COVID complications and track objective evidence of the therapeutic efficacy of any interventions. Trial Registration: https://classic.clinicaltrials.gov/ct2/show/NCT04336020. [ABSTRACT FROM AUTHOR]

Recent studies suggest an increased risk of reinfection with the SARS-CoV-2 Omicron variant compared with previous variants, potentially due to an increased ability to escape immunity specific to older variants, high antigenic divergence of Omicron from earlier virus variants as well as its altered cell entry pathway. The present study sought to investigate epidemiological evidence for differential SARS-CoV-2 reinfection intervals and incidence rates for the Delta versus Omicron variants within Wales. Reinfections in Wales up to February 2022 were defined using genotyping and whole genome sequencing. The median inter-infection intervals for Delta and Omicron were 226 and 192 days, respectively. An incidence rate ratio of 2.17 for reinfection with Omicron compared to Delta was estimated using a conditional Poisson model, which accounted for several factors including sample collection date, age group, area of residence, vaccination and travel status. These findings are consistent with an increased risk of reinfection with the Omicron variant, and highlight the value of monitoring emerging variants that have the potential for causing further waves of cases. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) have suffered considerable morbidity and mortality during the COVID-19 pandemic. Few data on COVID-19 vaccine effectiveness (VE) are available from middle-income countries in the WHO European Region. We evaluated primary series COVID-19 VE against laboratory-confirmed COVID-19 among HCWs in Georgia. Methods: HCWs in six hospitals in Georgia were invited to enroll in a prospective cohort study conducted during March 19–December 5, 2021. Participants completed weekly symptom questionnaires. Symptomatic HCWs were tested by RT-PCR and/or rapid antigen test (RAT), and participants were routinely tested for SARS-CoV-2 by RT-PCR or RAT, regardless of symptoms. Serology was collected at enrolment, and quarterly thereafter, and tested by electrochemiluminescence immunoassay for SARS-CoV-2 antibodies. We defined primary series vaccination as two doses of COVID-19 vaccine received ≥14 days before symptom onset. We estimated VE as (1-hazard ratio)*100 using a Cox proportional hazards model with vaccination status as a time-varying covariate. Estimates were adjusted by potential confounders that changed the VE estimate by more than 5%, according to the change-in-estimate approach. Results: Overall, 1561/3849 (41%) eligible HCWs enrolled and were included in the analysis. The median age was 40 (IQR: 30–53), 1318 (84%) were female, and 1003 (64%) had laboratory evidence of prior SARS-Cov-2 infection. At enrolment, 1300 (83%) were unvaccinated; By study end, 1082 (62%) had completed a primary vaccine series (69% BNT162b2 (Pfizer-BioNTech); 22% BBIBP-CorV (Sinopharm); 9% other). During the study period, 191(12%) participants had a new PCR- or RAT-confirmed symptomatic SARS-CoV-2 infection. VE against PCR- or RAT- confirmed symptomatic SARS-CoV-2 infection was 58% (95%CI: 41; 70) for all primary series vaccinations, 68% (95%CI: 51; 79) for BNT162b2, and 40% (95%CI: 1; 64) for BBIBP-CorV vaccines. Among previously infected HCWs, VE was 58% (95%CI: 11; 80). VE against medically attended COVID-19 was 52% (95%CI: 28; 68), and VE against hospitalization was 69% (95% CI: 36; 85). During the period of predominant Delta variant circulation (July-December 2021), VE against symptomatic COVID-19 was 52% (95%CI: 30; 66). Conclusions: Primary series vaccination with BNT162b2 and BBIBP-CorV was effective at preventing COVID-19 among HCWs, most of whom had previous infection, during a period of mainly Delta circulation. Our results support the utility of COVID-19 primary vaccine series, and the importance of increasing coverage, even among previously infected individuals. [ABSTRACT FROM AUTHOR]

Background: Pregnant women, fetuses, and neonates are particularly vulnerable to vaccine-preventable diseases (VPDs). These VPDs are associated with high morbidity and mortality among expectant mothers and their fetuses and neonates. Vaccination during pregnancy can protect the expectant mother from VPDs to which she may be especially vulnerable while pregnant. In addition, the passive transfer of maternal neutralizing immunoglobulin G (IgG) and secretory immunoglobulin A (IgA) also protects the fetus against congenital infections and may further protect the neonate from infection during the first few months of life. Despite this, coverage of recommended maternal vaccines remains suboptimal globally, especially in resource-constrained settings. Determinants of vaccine acceptance and uptake are frequently understudied in low- and middle-income countries (LMICs) and among specific groups such as pregnant and postpartum women. This proposed systematic review will assess the acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in LMICs. Methods: A Boolean search strategy employing common and medical subject heading (MeSH) terms for tetanus, influenza, pertussis, and COVID-19 vaccines, as well as vaccine acceptance, hesitancy, together with uptake, pregnancy, and postpartum, will be used to search electronic databases for relevant literature published between 2009 and 2024. Only studies conducted in LMICs that investigated determinants of acceptance, hesitancy, and uptake of tetanus, influenza, pertussis, and COVID-19 vaccines among pregnant and postpartum women will be eligible for inclusion in the review. The quality and the risk of bias of all eligible full-text articles will be assessed using the Joanna Briggs Institute's (JBI) critical appraisal tools. Discussion: This protocol proposes a systematic review and meta-analysis that aims to assess the uptake of maternal vaccines and to systematically appraise and quantify determinants of the acceptance and uptake of recommended vaccines during pregnancy and postpartum in LMICs. A better understanding of these factors and how they influence maternal vaccine decision-making will enable public health practitioners as well as global and national policymakers to design more effective interventions as we look towards expanding the scope and reach of maternal immunization programs. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is associated with severe outcomes of coronavirus disease (COVID-19), including death. COVID-19 vaccination is crucial for preventing infection and severe disease in the general population, but most importantly, among high-risk populations such as persons with DM. However, while COVID-19 vaccination uptake in the general population is regularly tracked, information on vaccination behavior specific to persons with DM is scarce. This study aimed to identify factors associated with the uptake of full COVID-19 vaccination among persons living with DM at Kiruddu National Referral Hospital (KRH). Methods: We employed a cross-sectional study design and administered a structured questionnaire on a systematically selected random sample of 340 people with DM attending Kiruddu National Referral Hospital from March 08 to May 25, 2023. We used a Modified Poisson Regression model to identify the factors associated with full COVID-19 vaccination and present adjusted prevalence ratios, along with their 95% confidence intervals. Full COVID-19 vaccination in this study was defined as having completed the last dose in the primary series of a COVID-19 vaccine. Results: We administered the questionnaire to 340 participants, with 75% (255 of 340) being female. The mean age of the participants was 52 years (± 12 years) and their median duration with diabetes mellitus was 5 years (± 7.3 years). Overall, 195 out of 340 participants (57.35%, 95% CI: 52-63%) completed the last dose in the primary series of a COVID-19 vaccine. The likelihood of receiving full vaccination was higher when a health provider advised one to receive a vaccine (aPR = 1.91, 95% CI: 1.20–3.02), when one reported having a comorbidity (aPR = 1.26, 95% CI: 1.06–1.53), and when one had a strong perceived benefit of vaccination (aPR = 1.76, 95% CI: 1.23–2.53). However, having a strong perceived barrier to vaccination was negatively associated with the likelihood of being fully vaccinated (aPR = 0.71, 95% CI: 0.60–0.84). Conclusion: The uptake of COVID-19 vaccines among persons with DM at KRH is low, with only 57% having a full COVID-19 vaccination status. This underscores the progress in meeting the WHO recommendation of having a 100% COVID-19 vaccination uptake among people with underlying health conditions, including diabetes mellitus. At the policy level, the Ugandan Ministry of Health (MoH) may implement a provider-initiated vaccination strategy where healthcare providers who attend to DM patients during their routine clinic visits initiate the idea of vaccinating, sensitize, and spearhead myth-bursting around COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

In pandemic mitigation, strategies such as social distancing and mask-wearing are vital to prevent disease resurgence. Yet, monitoring adherence is challenging, as individuals might be reluctant to share behavioral data with public health authorities. To address this challenge and demonstrate a framework for conducting observational research with sensitive data in a privacy-conscious manner, we employ a privacy-centric epidemiological study design: the federated cohort. This approach leverages recent computational advances to allow for distributed participants to contribute to a prospective, observational research study while maintaining full control of their data. We apply this strategy here to explore pandemic intervention adherence patterns. Participants (n = 3808) were enrolled in our federated cohort via the "Google Health Studies" mobile application. Participants completed weekly surveys and contributed empirically measured mobility data from their Android devices between November 2020 to August 2021. Using federated analytics, differential privacy, and secure aggregation, we analyzed data in five 6-week periods, encompassing the pre- and post-vaccination phases. Our results showed that participants largely utilized non-pharmaceutical intervention strategies until they were fully vaccinated against COVID-19, except for individuals without plans to become vaccinated. Furthermore, this project offers a blueprint for conducting a federated cohort study and engaging in privacy-preserving research during a public health emergency. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the relationship between parent and child COVID-19 immunization series completion using vaccine records. Methods: A cross-sectional chart review was performed on parent and child patients at the Albany Medical Center Internal Medicine and Pediatrics practice. Patient and parent demographic data, COVID-19 immunization status, and health care worker status was collected. Patient data was further separated into 2 cohorts to account for vaccine eligibility among child age groups, with 5–11 years and 6 months-4 years cohorts. Chi square or Fisher's exact test was used where appropriate. Results: Across both cohorts, 371 child patients were identified and cross-matched with corresponding parents. Neither cohort offered evidence linking child immunization series completion with the child's race, ethnicity, or county of residence. However, rates of series completion were higher for children with private insurance versus public options in both the 5–11 years and 6 months-4 years cohorts (both p < 0.001). Children were more likely to be immunized against COVID-19 if their parents were fully immunized against COVID-19 (both p < 0.05). Children aged 6 months-4 years were more likely to be immunized against COVID-19 if their parent was a health care worker (p = 0.038). Conclusions: This study demonstrates a significance between child insurance status, as well as between parental vaccination status and child vaccination status. Only children under 5 years were more likely to be vaccinated against COVID-19 if their parent was a health care worker. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionsTo investigate the association between the retinal vascular occlusion and vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).This nationwide population-based cohort study included 2,742,065 individuals aged ≥ 20 years who were vaccinated against SARS-CoV-2 from March 1, 2021, to December 31, 2021, and unvaccinated individuals matched at a ratio of approximately 1:10 by gender and age, all without a history of retinal vascular occlusion. The occurrence of retinal vascular occlusion was observed up to 60 days after the 1st vaccination date in the vaccination group, while 60 days from January 1, 2021, in the non-vaccination group. The risk of developing retinal vascular occlusion was compared between vaccinated and unvaccinated subjects. Risks were also compared among the different types of vaccines.Vaccination lowered the risk of retinal vascular occlusion, with an odds ratio (OR) of 0.80 (95% confidence interval (CI), 0.64–0.99; p = 0.039). For individuals aged < 40 years, the vaccination lowered the risk of retinal vascular occlusion occurrence significantly compared with those over the age of 40 (OR, 0.35 for age 20–39, 0.83 for age 40–64, 0.81 for age ≥ 65; P for interaction = 0.028). There was a significant difference in the ORs for retinal vascular occlusion among the four vaccine types (p < 0.001).SARS-CoV-2 vaccination did not increase the risk of retinal vascular occlusion. However, the risk levels differed depending on the type of vaccine used. Considering the ongoing evolution of SARS-CoV-2 vaccines, it is imperative to conduct additional assessments of the recently introduced vaccines [ABSTRACT FROM AUTHOR]

Background: Mobile Integrated Health-Community Paramedicine (MIH-CP) is a novel approach that may reduce the rural-urban disparity in vaccination uptake in the United States. MIH-CP providers, as physician extenders, offer clinical follow-up and wrap-around services in homes and communities, uniquely positioning them as trusted messengers and vaccine providers. This study explores stakeholder perspectives on feasibility and acceptability of community paramedicine vaccination programs. Methods: We conducted semi-structured qualitative interviews with leaders of paramedicine agencies with MIH-CP, without MIH-CP, and state/regional leaders in Indiana. Interviews were audio recorded, transcribed verbatim, and analyzed using content analysis. Results: We interviewed 24 individuals who represented EMS organizations with MIH-CP programs (MIH-CP; n = 10), EMS organizations without MIH-CP programs (non-MIH-CP; n = 9), and state/regional administrators (SRA; n = 5). Overall, the sample included professionals with an average of 19.6 years in the field (range: 1–42 years). Approximately 75% (n = 14) were male, and all identified as non-Hispanic white. MIH-CPs reported they initiated a vaccine program to reach underserved areas, operating as a health department extension. Some MIH-CPs integrated existing services, such as food banks, with vaccine clinics, while other MIH-CPs focused on providing vaccinations as standalone initiatives. Key barriers to vaccination program initiation included funding and vaccinations being a low priority for MIH-CP programs. However, participants reported support for vaccine programs, particularly as they provided an opportunity to alleviate health disparities and improve community health. MIH-CPs reported low vaccine hesitancy in the community when community paramedics administered vaccines. Non-CP agencies expressed interest in launching vaccine programs if there is clear guidance, sustainable funding, and adequate personnel. Conclusions: Our study provides important context on the feasibility and acceptability of implementing an MIH-CP program. Findings offer valuable insights into reducing health disparities seen in vaccine uptake through community paramedics, a novel and innovative approach to reduce health disparities in rural communities. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 cell-mediated immunity remains understudied during pregnancy in unvaccinated Black African women living with HIV (WLWH) from low- and middle-income countries. We investigated SARS-CoV-2-specific T-cell responses 1 month following infection in 24 HIV-uninfected women and 15 WLWH at any stage during pregnancy or postpartum. The full-length spike (FLS) glycoprotein and nucleocapsid (N) protein of wild-type (WT) SARS-CoV-2, as well as mutated spike protein regions found in the Omicron variant (B.1.1.529) were targeted by flow cytometry. WT-specific CD4+ and CD8+ T cells elicited similar FLS- and N-specific responses in HIV-uninfected women and WLWH. SARS-CoV-2-specific T-lymphocytes were predominantly TNF-α monofunctional in pregnant and postpartum women living with and without HIV, with fever cells producing either IFN-γ or IL-2. Furthermore, T-cell responses were unaffected by Omicron-specific spike mutations as similar responses between Omicron and the ancestral virus were detected for CD4+ and CD8+ T cells. Our results collectively demonstrate comparable T-cell responses between WLWH on antiretroviral therapy and HIV-uninfected pregnant and postpartum women who were naïve to Covid-19 vaccination. Additionally, we show that T cells from women infected with the ancestral virus, Beta variant (B.1.351), or Delta variant (B.1.617.2) can cross-recognize Omicron, suggesting an overall preservation of T-cell immunity. [ABSTRACT FROM AUTHOR]

Background: The current survey describes the seroprevalence, history of coronavirus disease 2019 (COVID-19), and vaccination status among predominantly aboriginal residents on a tourist island in southern Thailand. This information can be translated into COVID-19 vaccination and control plans for this population. Methods: We implemented questionnaire interviews and collected blood samples from 249 residents of Lipe Island, Satun Province, in January 2022. We measured the anti-nucleocapsid protein and anti-spike (anti-S) receptor-binding protein levels of immunoglobulin (Ig) M and IgG. The differences in antibody levels among participants with different histories of vaccination and infection were analyzed using one-way analysis of variance with multiple comparisons. Results: During the 2-year pandemic period, no island residents with COVID-19 required hospitalization despite the high prevalence of hypertension (33.3%) and diabetes mellitus (21.7%). Approximately 18.8% of the participants reported a history of COVID-19 diagnosis. In total, 95.1% of the participants had a history of complete vaccination, of which 93.5% were seropositive. The anti-S IgG geometric means (geometric standard deviation) were 3945.8 (2.0), 829.8 (9.7) AU/mL, 789.9 (5.3) AU/mL, and 22.7 (7.1) AU/mL, respectively, in participants with a history of both COVID-19 diagnosis and complete vaccination (group 1), incomplete vaccination and subsequent COVID-19 diagnosis (group 2), complete vaccination but no previous infection (group 3), or neither previous COVID-19 and complete vaccination (group 4). Significant pairwise differences in anti-S IgG levels were found between certain groups (1 vs 3, 1 vs 4, 2 vs 4, and 3 vs 4). Conclusions: The high coverage of vaccination, high levels of population antibody titers, variable antibody levels among completely vaccinated non-infected residents, and high prevalence of non-communicable diseases (NCDs) suggested that the local health systems could control the pandemic. However, continuing surveillance, booster vaccinations, and NCD prevention programs were still required. [ABSTRACT FROM AUTHOR]

Introduction The World Health Organization identified vaccine hesitancy as one of the top 10 threats to global health. Vaccine hesitancy is defined as a delay in acceptance or refusal of vaccination despite the availability of vaccination services. Because vaccine safety concerns are important contributors to hesitancy, people who have experienced adverse events following immunization (AEFI) may be at especially high risk for subsequent vaccine hesitancy. The Defense Health Agency Immunization Healthcare Division (DHA IHD) provides specialized vaccine care to persons who have experienced AEFI. The impact of this specialized vaccine care on subsequent vaccine hesitancy has not been fully explored. Materials and Methods A cohort of patients (n = 146) was identified among those who received consultative care from DHA IHD clinicians for AEFI concerns between April 2017 and September 2022. Analyses were restricted to non-uniformed beneficiaries of the Military Health System (MHS). Uniformed beneficiaries of the MHS were excluded from this analysis since vaccination mandates preclude the use of vaccine uptake as a measure of vaccine hesitancy. Outcomes were evaluated by reviewing MHS vaccination records after initial AEFI consultation through January 2023. Vaccine acceptance was considered the inverse of hesitancy, and was defined by: (a) receipt of any subsequent vaccination, (b) receipt of seasonal influenza vaccine, (c) receipt of subsequent doses of the AEFI-associated vaccine, if clinically recommended, and (d) receipt of COVID-19 vaccine. Results A diverse group of patients with a wide range of AEFI concerns received specialized vaccine care from DHA IHD clinicians during this period. Among the cohort, 78% of patients received any subsequent vaccination, 55.2% received seasonal influenza vaccine, 57.8% received a subsequent dose of their AEFI-associated vaccine when the vaccine was clinically recommended, and 48.9% received COVID-19 vaccine. The proportion of patients who received influenza vaccine exceeded the reported rate of influenza vaccine uptake by the general population during this time period. Conclusion Specialized vaccine care after AEFI concerns was associated with relatively high acceptance of subsequent vaccinations. The experiences of DHA IHD clinicians, in providing specialized vaccine care to AEFI patients, may serve as a model for other organizations that are working to reduce vaccine hesitancy, even beyond the MHS. [ABSTRACT FROM AUTHOR]

Introduction: The impact of coronavirus disease 2019 (COVID-19) on diabetic kidney disease (DKD) patients in China is not fully understood. This study aimed to investigate infection status in a DKD cohort post-renal biopsy and analyze vaccination and infection rates, as well as symptom severity, across various renal pathologies in DKD patients. Methods: This epidemiological survey, centered on COVID-19, employed a Chinese DKD and renal puncture follow-up cohort. A customized questionnaire enabled standardized data gathering. It collected data on clinical characteristics, vaccination and infection statuses, and diverse pathological types. The study analyzed the relationship between vaccination and infection statuses across various pathological types, evaluating characteristics and treatment outcomes in patients with infections. Results: In total, 437 patients with DKD from26 Chinese provinces were followed up for amedian of 44.6 ± 20 months. COVID-19 infection, vaccination, and novel coronavirus pneumonia (NCP) rates were 73.68%, 59.3%, and 6.63%, respectively. Ten patients with NCP had severe pneumonia or died of COVID-19. Renal pathology revealed that 167 (38.22%) patients had diabetic nephropathy (DN), 171 (39.13%) had non-diabetic renal disease (NDRD), and 99 had DN and NDRD (22.65%). The DN group had the lowest vaccination (54.5%), highest all-cause mortality (3.6%), and highest endpoint rates (34.10%). Compared to patients who were not vaccinated pre-infection (117 cases), vaccinated patients (198 cases) had reduced NCP (6.6% vs. 13.7%), severity (1.0% vs. 3.4%), and endpoint (9.10% vs. 31.60%) rates. Conclusion: Vaccination can prevent infection and diminish COVID-19 severity in patients with DKD; therefore, increasing vaccination rates is particularly important. Clinical Trial registration: ClinicalTrails.gov, NCT05888909. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease patients, especially those on hemodialysis, are at increased risk of developing hepatitis B virus (HBV) infection. Guidelines suggest that all patients with chronic kidney disease patients should be vaccinated against HBV, but these guidelines are sub-optimally implemented. Notably, there is a lack of studies in Ethiopia examining the hepatitis B vaccination status among patients with end-stage renal disease. Objective: To assess the vaccination status of hepatitis B and associated factors among people with end-stage renal disease who were on hemodialysis. Methods: A multi-center cross-sectional observational study was conducted in six randomly selected dialysis centers in Ethiopia, from May 2023 to September 2023. Logistic regression analysis was used to evaluate factors associated with vaccination status. A person is considered to be vaccinated against hepatitis B if he/ she has taken at least one dose of HBV. Vaccination status was determined by patient's recall and verification from medical record. Results: Only 16% of patients with end-stage renal disease on hemodialysis were vaccinated against hepatitis B virus (16.6%; with CI = 12.18, 21.83), of which 30% had received one dose, 57.5% had two doses, 12.5% had three doses, and only five had a booster dose. Post-secondary education (AOR = 5.47; 95% CI = 1.41, 21.2; P < 0.014) and dialysis for more than three years (AOR = 19.75; 95% CI = 4.06, 96.1; P < 0.001) were significant factors associated with having received hepatitis B vaccination. Conclusion: Only a small minority of Ethiopian hemodialysis patients have received hepatitis B vaccination. The level of education of patients and the duration of time on dialysis were significant associated factors that affected the vaccination status of patients with end-stage renal disease. So, strong intervention is needed according to the identified factors to raise the vaccination status of patients. [ABSTRACT FROM AUTHOR]

Background: Bovine genital campylobacteriosis (BGC) is a globally important venereal disease of cattle caused by Campylobacter fetus subspecies venerealis. Diagnosis of BGC is highly challenging due to the lack of accurate diagnostic tests. Methods: To characterise the biomarkers for C. fetus venerealis infection, a total of twelve cycling heifers were selected and categorised as vaccinated (n = 6) with Vibrovax® (Zoetis™) and unvaccinated (n = 6). All heifers were oestrous synchronised with a double dose of prostaglandin (PGF2α) 11 days apart and when in oestrous intravaginally challenged with 2.7 x 109 CFU live C. fetus venerealis. DNA extracted from vaginal mucus samples was screened using a C. fetus qPCR and 16S rRNA was characterised using Illumina sequencing (V5-V8 region). Relative abundances of serum proteins were calculated using sequential window acquisition of all theoretical fragment ion spectra coupled to tandem mass spectrometry (SWATH-MS) for all heifers at three timepoints: pre-challenge, post-challenge and post-recovery. Results: In 16S rRNA sequencing of vaginal mucus, Campylobacter spp. appeared two days following challenge in unvaccinated compared to 14 days in vaccinated animals, consistent with the qPCR results. Increased relative abundances of Firmicutes and Campylobacterota were identified after C. fetus venerealis challenge and were associated with C. fetus venerealis in vaccinated and unvaccinated heifers. Greater relative abundance of Streptococcus spp. was observed during oestrous rather than dioestrous. In both vaccinated and unvaccinated heifers, Acinetobacter spp. increased after challenge with higher abundance of Corynebacterium spp. in the vaccinated group. A total of 130 unique proteins were identified in SWATH analysis of the serum samples, and the number of differentially abundant proteins found was higher in the vaccinated group after recovery from infection compared to pre-and post-challenge (adjusted P < 0.05 and Log2FC > 0.2). Conclusion: Coglutinin, clusterin, HP homologs, vitamin D binding protein and fetuin B were identified as potential biomarkers for C. fetus venerealis infection and need further study to validate their efficiency as immune biomarkers for BGC. [ABSTRACT FROM AUTHOR]

Objectives: This study assessed the risk perception of COVID-19 and the uptake of the COVID-19 vaccine among patients with chronic illnesses in a tertiary health facility. Design: A hospital-based cross-sectional study. Setting: The outpatient clinics in a tertiary health facility in Ilorin, North-Central Nigeria Participants: Patients with chronic diseases attending outpatient clinics in UITH, Ilorin from November-December 2022, excluding patients under 18 years of age, using simple random sampling by balloting for outpatient clinics, proportional allocation for participants from each clinic, and systematic sampling method for eligible respondents. Main outcome measure: Risk perception of COVID-19 and vaccine uptake among patients with chronic illnesses in Nigeria Results: Respondents believed that older people were most at risk of COVID-19. Over two-thirds, 278 (69.5%) of the respondents had received the COVID-19 vaccine. Fear of the unknown (36.0%) and fear of side effects 30 (24.6%) were the most common reasons for not taking the vaccine. Those married were more likely to have received at least one dose of the vaccine (p=0.007). Conclusion: COVID-19 risk perception and COVID-19 vaccine uptake were relatively above average. Fear of the unknown and side effects were significant reasons for not taking the vaccines. [ABSTRACT FROM AUTHOR]

Background: Long COVID is a common condition lacking consensus definition; determinants remain incompletely understood. Characterizing immune profiles associated with long COVID could support the development of preventive and therapeutic strategies. Methods: We used a survey to investigate blood donors' infection/vaccination history and acute/persistent symptoms following COVID‐19. The prevalence of long COVID was evaluated using self‐report and an adapted definition from the RECOVER study. We evaluated factors associated with long COVID, focusing on anti‐spike and anti‐nucleocapsid SARS‐CoV‐2 antibodies. Lastly, we investigated long COVID clinical subphenotypes using hierarchical clustering. Results: Of 33,610 participants, 16,003 (48%) reported having had COVID‐19; 1853 (12%) had self‐reported long COVID, 685 (4%) met an adapted RECOVER definition, and 2050 (13%) met at least one definition. Higher anti‐nucleocapsid levels measured 12–24 weeks post‐infection were associated with higher risk of self‐reported and RECOVER long COVID. Higher anti‐spike IgG levels measured 12–24 weeks post‐infection were associated with lower risk of self‐reported long COVID. Higher total anti‐spike measured 24–48 weeks post‐infection was associated with lower risk of RECOVER long COVID. Cluster analysis identified four clinical subphenotypes; patterns included neurological and psychiatric for cluster 1; neurological and respiratory for cluster 2; multi‐systemic for cluster 3; and neurological for cluster 4. Discussion: Long COVID prevalence in blood donors varies depending on the adopted definition. Anti‐SARS‐CoV‐2 antibodies were time‐dependently associated with long COVID; higher anti‐nucleocapsid levels were associated with higher risk; and higher anti‐spike levels were associated with lower risk of long COVID. Different underlying pathophysiologic mechanisms may be associated with distinct clinical subphenotypes. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to examine the trend in human papillomavirus (HPV) vaccination rates in Japan before and after a policy change in 2022, involving resumption of active recommendation and start of catch‐up vaccination. Methods: From 2021 to 2023, a web‐based questionnaire survey was administered to newly enrolled female college students in Yokohama, Japan. The questionnaire included items such as age, HPV vaccination status, HPV vaccine awareness, and awareness of catch‐up vaccination. We compared knowledge about the HPV vaccine and cervical cancer in 2021 and 2023, before and after resumption of the national vaccination program. Results: The HPV vaccination rates were 5.4% in 2021, 7.5% in 2022, and 35.3% in 2023, with a significant upward trend (p < 0.001). A similar upward trend was observed for HPV vaccine awareness (p < 0.001). Comparing 2022 and 2023 after the start of catch‐up vaccination, there was no significant difference in awareness of catch‐up vaccination (p = 0.669), but there was a significant increase in awareness of free vaccination tickets (p < 0.001). After resumption of the national vaccination program with adoption of the catch‐up vaccination program, there was no difference in knowledge of cervical cancer, but there was a difference in knowledge of the HPV vaccine. Conclusions: Although the HPV vaccination rate has increased after the policy change, it has not recovered to the level before the suspension of active recommendation. It is important for healthcare providers and school educators to actively communicate the safety and effectiveness of the HPV vaccine. [ABSTRACT FROM AUTHOR]

Introduction: Despite people with haematological malignancies being particularly vulnerable to severe COVID-19 infection and complications, vaccine hesitancy may be a barrier to optimal vaccination. This study explored attitudes towards COVID-19 vaccination in people with haematological malignancies. Methods: People with haematological malignancies at nine Australian health services were surveyed between June and October 2021. Sociodemographic and clinical characteristics were collected. Attitudes towards COVID-19 vaccination were explored using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale, and the Disease Influenced Vaccine Acceptance Scale-Six. Open-ended comments were qualitatively analysed. Results: A total of 869 people with haematological malignancies (mean age 64.2 years, 43.6% female) participated. Most participants (85.3%) reported that they had received at least one COVID-19 vaccine dose. Participants who were younger, spoke English as a non-dominant language, and had a shorter time since diagnosis were less likely to be vaccinated. Those who were female or spoke English as their non-dominant language reported greater vaccine side-effect concerns. Younger participants reported greater concerns about the vaccine impacting their treatment. Conclusion: People with haematological malignancies reported high vaccine uptake; however, targeted education for specific participant groups may address vaccine hesitancy concerns, given the need for COVID-19 vaccine boosters. [ABSTRACT FROM AUTHOR]

Background Uncertainty exists regarding the effectiveness of COVID-19 vaccine to prevent postacute sequelae of COVID-19 (PASC) following a breakthrough infection. While most studies based on symptom surveys found an association between preinfection vaccination status and PASC symptoms, studies of medically attended PASC are less common and have reported conflicting findings. Methods In this retrospective cohort of patients with an initial SARS-CoV-2 infection who were continually empaneled for primary care in a large US health system, the electronic health record was queried for preinfection vaccination status, demographics, comorbidity index, and diagnosed conditions. Multivariable logistic regression was used to model the outcome of a medically attended PASC diagnosis within 6 months of SARS-CoV-2 infection. Likelihood ratio tests were used to assess the interaction between vaccination status and prevalent variant at the time of infection and between vaccination status and hospitalization for SARS-CoV-2 infection. Results During the observation period, 6.9% of patients experienced medically attended and diagnosed PASC. A diagnosis of PASC was associated with older age, female sex, hospitalization for the initial infection, and an increased severity-weighted comorbidity index and was inversely associated with infection during the Omicron period. No difference in the development of diagnosed PASC was observed between unvaccinated patients and those vaccinated with either 2 doses of an mRNA vaccine or >2 doses. Conclusions We found no association between vaccination status at the time of infection and development of medically diagnosed PASC. Vaccine remains an important measure to prevent SARS-CoV-2 infection and severity. Further research is needed to identify effective measures to prevent and treat PASC. [ABSTRACT FROM AUTHOR]

Objective To understand the influenza vaccination status of permanent residents in Macao and analyze the influencing factors. Methods A stratified cluster sampling method was employed to conduct a questionnaire survey of permanent residents in Macao from November 16 to 22, 2020. The survey primarily included basic knowledge of influenza, individual vaccination behavior, and vaccination status of family members. Chi-square tests and univariate and multivariate logistic regression models were utilized to explore the factors influencing public vaccination against influenza. Results A total of 2 207 residents participated in the survey, with males accounting for 45.3% and females accounting for 54.7%. In total, 62.1% of respondents reported having received the influenza vaccine in the past 12 months, and 61.0% of respondents exhibited a low level of knowledge regarding influenza. Multivariate logistic regression analysis indicated that the likelihood of receiving the influenza vaccine was higher among older individuals (aged over 50, OR=3.064, 95%CI: 1.114-7.814), those with fewer family members (1-2 members, OR=1.752, 95%CI: 1.323-2.320), those with a moderate monthly household income (40 000-60 000 yuan, OR=1.126, 95%CI: 1.852-1.489), individuals with higher educational attainment (higher education, OR=1.167, 95%CI: 1.949-1.434), those in high-risk professions (healthcare workers compared to civil servants, OR=2.730, 95%CI: 1.700-4.383), individuals in poorer health who were not pregnant (healthy individuals compared to pregnant patients, OR=2.060, 95%CI: 1.634-1.772; chronic disease patients, OR=2.623, 95%CI: 1.948-2.779), and those with a higher level of vaccine knowledge (OR=1.531, 95%CI: 1.069-2.194). Conclusion The influenza vaccination rate in Macao is relatively high on a global scale. However, there is still a need to strengthen educational outreach regarding influenza vaccination, encourage residents to get vaccinated, and actively promote collective vaccination activities in schools and institutions to fully utilize the role of community immunity. [ABSTRACT FROM AUTHOR]

This study examines the links between vaccination status, fear of vaccination (cognitive and somatic symptoms), anxiety, alexithymia, and type D personality (negative affect and social inhibition), to propose policies to increase vaccination rates. A sample of university students (n = 2535; mean age = 20.59, SD = 2.04; male: 26.75%, female: 73.25%) from Spain, Italy, Lebanon, Nigeria, Turkey, and Ukraine completed the Vaccination Fear Scale (VFS-6), the Generalised Anxiety Disorder scale (GAD-7), the Perth Alexithymia Questionnaire—Short Form (PAQ-S), the Type D Scale (DS14), and also a question on vaccination status. Correlation, regression, and network analyses were applied. Cognitive symptoms of fear of vaccination and negative affect were the most significant in the correlation and regression analyses. In the network analysis, negative affect showed the highest values in all centrality indices and positive relationships with other nodes. Vaccination status showed negative relationships with fear of vaccination, alexithymia, and social inhibition. The network structure is similar between the sexes but varies between cultures and sexes within cultures. The relationship between vaccination status and cognitive symptoms of fear of vaccination was the most consistent, allowing for interventions at this level to be advised across cultures. For more specific interventions, cultural context must be considered for optimal results. [ABSTRACT FROM AUTHOR]