Influenza vaccination coverage among persons ages six months and older in the Vaccine Safety Datalink in the 2017-18 through 2022-23 influenza seasons

Impact of caregiver vaccination status on child influenza vaccination hesitancy: A time-to-vaccination analysis for 2023-2024 season in the Republic of Korea

Children face heightened risks of severe influenza compared to healthy adults. Republic of Korea provides free influenza vaccinations to children aged 6 months to 13 years. Global vaccine hesitancy has surged amidst the COVID-19 pandemic. This study assesses how caregivers' vaccination status influences childhood influenza vaccination hesitancy using national data from the 2023-2024 period. Analyzing data from the Korea Disease Control and Prevention Agency's Immunization Registry Information System, focusing on 2-year-old children, 93.0 % were eligible after excluding those who didn't complete the initial two-dose schedule. 'Time to Vaccination' spanned from the program's inception to inoculation. Cox proportional hazards regression found children were 1.53 times more likely to get vaccinated if their caregiver had been, with significance (Exp(B) = 1.531, p < .001). Female gender and text message reminders were also influential. These results underscore caregiver vaccination's pivotal role in curbing childhood influenza vaccination hesitancy.

Successful Implementation of Nirsevimab and Factors Influencing Uptake in Neonatal Care

OBJECTIVE

To describe the implementation of nirsevimab for the prevention of respiratory syncytial virus-associated lower respiratory tract disease in a pediatric hospital, focusing on strategies to ensure equitable access and address logistic challenges. Additionally, we aimed to identify predictors of nirsevimab deferral among eligible infants.

METHODS

Our hospital implemented a universal immunization campaign to all eligible infants, including those discharged from the newborn nursery, intermediate care nursery, and neonatal intensive care unit. We identified key drivers and barriers, formed a multidisciplinary team, and applied a systematic approach for integration of nirsevimab orders into existing workflows. We developed and disseminated educational resources for staff and caregivers. After the implementation, we conducted univariable and multivariable analyses to identify predictors of nirsevimab deferral to evaluate implementation success and possible gaps.

RESULTS

Despite challenges, we offered nirsevimab to 99% of eligible infants prior to discharge from the newborn nursery, intermediate care nursery, and neonatal intensive care unit with 71% receiving the immunization. On the multivariable analysis, independent predictors of nirsevimab deferral included preferred language of English, deferral of hepatitis B vaccine, discharge from the newborn nursery, and public insurance.

CONCLUSIONS

Our implementation strategy ensured equitable access to nirsevimab for newborns with both our high uptake and acceptance rate underscoring the effectiveness of our approach. Key strategies for success included early stakeholder engagement, multidisciplinary collaboration, and proactive logistic planning. Our approach serves as a model for other institutions to offer nirsevimab prior to hospital discharge and highlights the importance of addressing both clinical and socioeconomic barriers.

Vaccinations in children of non-European origin: The Vax4globe survey

BACKGROUND

An equitable immunization coverage to "leave no one behind" is one of the World Health Organization Sustainable Development Goals. However, disparities in vaccination coverage exist. The present study aims to investigate vaccine attitude of non-European parents living in Italy and those factors affecting vaccine uptake and equity.

METHODS

A cross sectional survey, named Vax4globe, on knowledge and immunization compliance in childhood and pregnancy of non-European (non-EU) parents was carried out among general pediatrician and Vaccine Centers located in Lazio Region, between February and July 2023. Logistic regression models were used in univariate and multivariate analyses to examine the socio-demographic parameters mainly associated with the vaccination status.

RESULTS

A total of 310 parent/child pair were included in the study. Most children were born in Italy (262/310; 86.5 %), while while 40/310 (13.2 %) migrated from country of origin and 1/310 (0.3 %) was adopted. Mandatory vaccines were perfomed by 270/306 (88 %) children, however flu, papillomavirus and meningococcal group B were vaccines most commonly refused by 208/289 (72 %), 11/36 (31 %) and 9/36 (25 %) parents, respectively. A lower educational degree of parents (p = 0.040) and the migration status of children (p < 0.001) were associated to incomplete or missed immunization. As to maternal immunization 164/310 (53 %) non-EU women decided not to vaccinate and received less information (155/297;52 %) compared to childhood immunization (268/305; 88 %) (p < 0.0001). The educational degree (p = 0.017), the origin from non-EU European countries (p = 0.008) and the age 25-40 years (p = 0.036) and > 40 years (p = 0.007) were associated to lack of immunization during pregnancy. Finally, while 279/310 (90 %) parents were vaccinated against Sars-CoV-2, only 60/199 (30 %) children had been immunized with this vaccine mainly due to the non-mandatory vaccine request at pediatric age and to the doubts about its value according to 39/127 (31 %) and 29/127 (23 %) parents, respectively.

CONCLUSION

Our study highlights the need for targeted strategies to improve vaccine uptake both in childhood and in pregnancy among non-EU individuals living in Italy. Further, to achieve vaccination equity the role of institutions and healthcare personnel is pivotal to overcome vaccine hesitancy.

COVID-19 pandemic interventions reshaped the global dispersal of seasonal influenza viruses

The global dynamics of seasonal influenza viruses inform the design of surveillance, intervention, and vaccination strategies. The COVID-19 pandemic provided a singular opportunity to evaluate how influenza circulation worldwide was perturbed by human behavioral changes. We combine molecular, epidemiological, and international travel data and find that the pandemic's onset led to a shift in the intensity and structure of international influenza lineage movement. During the pandemic, South Asia played an important role as a phylogenetic trunk location of influenza A viruses, whereas West Asia maintained the circulation of influenza B/Victoria. We explore drivers of influenza lineage dynamics across the pandemic period and reasons for the possible extinction of the B/Yamagata lineage. After a period of 3 years, the intensity of among-region influenza lineage movements returned to pre-pandemic levels, with the exception of B/Yamagata, after the recovery of global air traffic, highlighting the robustness of global lineage dispersal patterns to substantial perturbation.

Vaccine Effectiveness Against Pediatric Influenza-A-Associated Urgent Care, Emergency Department, and Hospital Encounters During the 2022-2023 Season: VISION Network

BACKGROUND

During the 2022-2023 influenza season, the United States experienced the highest influenza-associated pediatric hospitalization rate since 2010-2011. Influenza A/H3N2 infections were predominant.

METHODS

We analyzed acute respiratory illness (ARI)-associated emergency department or urgent care (ED/UC) encounters or hospitalizations at 3 health systems among children and adolescents aged 6 months-17 years who had influenza molecular testing during October 2022-March 2023. We estimated influenza A vaccine effectiveness (VE) using a test-negative approach. The odds of vaccination among influenza-A-positive cases and influenza-negative controls were compared after adjusting for confounders and applying inverse-propensity-to-be-vaccinated weights. We developed overall and age-stratified VE models.

RESULTS

Overall, 13 547 of 44 787 (30.2%) eligible ED/UC encounters and 263 of 1862 (14.1%) hospitalizations were influenza-A-positive cases. Among ED/UC patients, 15.2% of influenza-positive versus 27.1% of influenza-negative patients were vaccinated; VE was 48% (95% confidence interval [CI], 44-52%) overall, 53% (95% CI, 47-58%) among children aged 6 months-4 years, and 38% (95% CI, 30-45%) among those aged 9-17 years. Among hospitalizations, 17.5% of influenza-positive versus 33.4% of influenza-negative patients were vaccinated; VE was 40% (95% CI, 6-61%) overall, 56% (95% CI, 23-75%) among children ages 6 months-4 years, and 46% (95% CI, 2-70%) among those 5-17 years.

CONCLUSIONS

During the 2022-2023 influenza season, vaccination reduced the risk of influenza-associated ED/UC encounters and hospitalizations by almost half (overall VE, 40-48%). Influenza vaccination is a critical tool to prevent moderate-to-severe influenza illness in children and adolescents.