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MacIntyre CR, de Sousa JC, Heininger U, Kardos P, Konstantopoulos A, Middleton D, Nolan T, Papi A, Rendon A, Rizzo A, Sampson K, Sette A, Sobczyk E, Tan T, Weil-Olivier C, Weinberger B, Wilkinson T, von König CHW. Public health management of pertussis in adults: Practical challenges and future strategies. Hum Vaccin Immunother 2024; 20:2377904. [PMID: 39016172 PMCID: PMC11259069 DOI: 10.1080/21645515.2024.2377904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024] Open
Abstract
A panel of 24 international experts met in July 2022 to discuss challenges associated with pertussis detection, monitoring, and vaccination in adults; conclusions from this meeting are presented. There has been a shift in the epidemiology of pertussis toward older children and adults. This shift has been attributed to the waning of infection- or vaccine-induced immunity, newer detection techniques causing detection bias, and possibly the replacement of whole-cell pertussis with acellular vaccines in high-income countries, which may lead to immunity waning more quickly. The burden of adult pertussis is still likely under-ascertained due to widespread under-recognition by healthcare professionals (HCPs), under-diagnosis, and under-reporting in this age group. Non-standardized testing guidance and varied case definitions have contributed to under-reporting. Key barriers to HCP engagement with the tetanus, diphtheria, and pertussis (Tdap) vaccine include low awareness, lack of time/funding, and lack of motivation due to low prioritization of Tdap.
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Affiliation(s)
| | | | | | - Peter Kardos
- Group Practice & Center, Allergy, Respiratory and Sleep Medicine, Maingau Hospital of The Red Cross, Frankfurt am Main, Germany
| | | | - Donald Middleton
- Department of Pediatrics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Terry Nolan
- Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Alberto Papi
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Adrian Rendon
- Universidad Autonoma de Nuevo Leon, Hospital Universitario “Dr. Jose Eleuterio Gonzalez”, CIPTIR, Monterrey, Mexico
| | | | - Kim Sampson
- Immunisation Coalition, Melbourne, Australia
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, San Diego, CaliforniaUSA
| | - Elizabeth Sobczyk
- AMDA – The Society for Post-Acute and Long-Term Care Medicine, Columbia, SC, USA
| | - Tina Tan
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Birgit Weinberger
- Institute for Biomedical Aging Research, Universität Innsbruck, Innsbruck, Austria
| | - Tom Wilkinson
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
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Gómez-Acebo I, Barquín-Ruiz A, Llorente S, Alonso-Molero J, Llorca J, Cabero-Perez MJ, Dierssen-Sotos T. The impact of the COVID-19 pandemic on childhood vaccination rates and the role of sociodemographic factors: A cohort study. Vaccine 2024; 42:126207. [PMID: 39121696 DOI: 10.1016/j.vaccine.2024.126207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 08/01/2024] [Accepted: 08/03/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE This study examines the impact of the COVID-19 pandemic on both routine and non-routine vaccinations in infants during their initial 18 months of life, concurrently exploring the complex influence of sociodemographic factors. METHODS A cohort study was conducted, involving 2007 children in two distinct periods: pre-pandemic (January-June 2018) and pandemic (March 2020-May 2021). Participants were classified into two cohorts: 962 children in the 2018 group and 1045 children in the 2020-21 group. Utilizing unconditional logistic regression, the association between vaccination (complete or non-routine) and socioeconomic factors was examined, with adjustments for potential confounding variables such as age, breastfeeding, gestational age, and twins. RESULTS The study's analysis reveals that in the post-pandemic period, mothers were three times more likely to opt for non-routine vaccines (95% CI 2.25-4.23). However, no significant alterations were observed in routine vaccination rates. Protective factors for complete vaccination included having an employed mother, higher education, and a medium-to-high income. Conversely, a higher income was associated with a reduced likelihood of complete vaccination (OR 0.34, 95% CI 0.20-0.59). CONCLUSION Contrary to initial expectations, this study concludes that the COVID-19 pandemic did not have a substantial impact on childhood complete vaccination rates. Nevertheless, a noticeable increase in the choice of non-routine vaccination was observed. Sociodemographic factors, such as maternal education, income, and employment status, emerged as key influencers, particularly in the context of deciding on non-routine vaccinations.
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Affiliation(s)
- Inés Gómez-Acebo
- Preventive Medicine Group, University of Cantabria, Santander, Spain, IDIVAL-Valdecilla Health Research Institute, Santander, Spain, CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Ana Barquín-Ruiz
- Preventive Medicine Group, University of Cantabria, Santander, Spain
| | - Sandra Llorente
- Department of Pediatrics, Marqués de Valdecilla University Hospital, Santander, Spain. IDIVAL-Valdecilla Health Research Institute, Santander, Spain
| | - Jéssica Alonso-Molero
- Preventive Medicine Group, University of Cantabria, Santander, Spain, IDIVAL-Valdecilla Health Research Institute, Santander, Spain, CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Javier Llorca
- Preventive Medicine Group, University of Cantabria, Santander, Spain; Retired Professor, University of Cantabria, Santander, Spain
| | - María J Cabero-Perez
- Department of Pediatrics, Marqués de Valdecilla University Hospital, Santander, Spain. IDIVAL-Valdecilla Health Research Institute, Santander, Spain
| | - Trinidad Dierssen-Sotos
- Preventive Medicine Group, University of Cantabria, Santander, Spain, IDIVAL-Valdecilla Health Research Institute, Santander, Spain, CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Burgaya-Subirana S, Balaguer M, Miró Catalina Q, Sola L, Ruiz-Comellas A. Influenza Vaccination Coverage in Children: How Has COVID-19 Influenced It? A Review of Five Seasons (2018-2023) in Central Catalonia, Spain. Vaccines (Basel) 2024; 12:925. [PMID: 39204048 PMCID: PMC11358914 DOI: 10.3390/vaccines12080925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 09/03/2024] Open
Abstract
Influenza vaccination is the main method of preventing influenza. Vaccination is recommended for certain individuals with diseases that could cause complications in the case of flu infection. The objective of this retrospective observational study was to examine influenza vaccination coverage in patients with risk factors, to describe the characteristics of those vaccinated and to study the influence of COVID-19. The study population was children under 14 years old with risk factors between 2018/19 and 2022/23 in Central Catalonia, sourced through the electronic database of the Catalan Institute of Health. The association of influenza vaccination data with sociodemographic data and risk factors was performed by bivariate and multivariate analysis. A total of 13,137 children were studied. Of those, 4623 had received the influenza vaccine in at least one season. The average influenza vaccination rate was 28.8%. The statistically significant factors associated with vaccination were age and having certain risk factors: asthma, diabetes, haemoglobinopathies and clotting disorders. In all seasons, the immigrant population was vaccinated more than the native population p < 0.05, except for the COVID-19 season (2020/21), where no differences were observed. Of those vaccinated, 7.1% had been vaccinated for 5 consecutive years. Influenza vaccination coverage in the paediatric age group was low. Vaccination promotion measures must be implemented. COVID-19 meant an increase in vaccination of the native population to the same level as that of the immigrant population.
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Affiliation(s)
- Sílvia Burgaya-Subirana
- Pediatrics Department, EAP Manlleu, Institut Català de la Salut, Gerència d’Atenció Primària i a la Comunitat de la Catalunya Central, C/Castellot, 17, 08560 Manlleu, Barcelona, Spain;
- Faculty of Medicine, Universitat de Vic-Universitat Central de Catalunya, Cta/Roda, 70, 08500 Vic, Barcelona, Spain;
| | - Mònica Balaguer
- Faculty of Medicine, Universitat de Vic-Universitat Central de Catalunya, Cta/Roda, 70, 08500 Vic, Barcelona, Spain;
- Pediatric Intensive Care Unit, Hospital Sant Joan de Déu Barcelona, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Queralt Miró Catalina
- Research Department, Institut Català de la Salut, Gerència d’Atenció Primària i a la Comunitat de la Catalunya Central, C/Pica d’Estats, 13-15, 08272 Sant Fruitós de Bages, Barcelona, Spain
| | - Laia Sola
- Research Department, Institut Català de la Salut, Gerència d’Atenció Primària i a la Comunitat de la Catalunya Central, C/Pica d’Estats, 13-15, 08272 Sant Fruitós de Bages, Barcelona, Spain
| | - Anna Ruiz-Comellas
- Faculty of Medicine, Universitat de Vic-Universitat Central de Catalunya, Cta/Roda, 70, 08500 Vic, Barcelona, Spain;
- Research Department, Institut Català de la Salut, Gerència d’Atenció Primària i a la Comunitat de la Catalunya Central, C/Pica d’Estats, 13-15, 08272 Sant Fruitós de Bages, Barcelona, Spain
- Medicine Department, EAP Sant Joan de Vilatorrada, Institut Català de la Salut, Gerència d’Atenció Primària i a la Comunitat de la Catalunya Central, Avinguda del Torrent del Canigó, 0, 08250 Sant Joan de Vilatorrada, Catalonia, Spain
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4
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Castillo-Rodenas M, Vicente Gómez JÁ, Fuster-Casanovas A, Miró Catalina Q, Vidal-Alaball J, López Seguí F. Impact of COVID-19 on the Pediatric Primary Care Model in Catalonia: Analysis of Changes in the Number and Type of Face-to-Face and Remote Visits. JMIR Pediatr Parent 2024; 7:e49943. [PMID: 38532544 PMCID: PMC11004613 DOI: 10.2196/49943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 03/28/2024] Open
Abstract
Background The outbreak of COVID-19 has turned the care model of health systems around the world upside down. The health care crisis has led to opportunities for digital health to deliver quality care, and the system has been redirected toward telemedicine. In Catalonia, Spain, as of March 2020, the pattern of visits in primary care pediatric consultations changed, such that face-to-face visits decreased in favor of non-face-to-face visits. Objective This study aimed to analyze variations in the types of pediatric visits in primary care centers in Catalonia before and after the onset of COVID-19. Methods This was a descriptive observational study based on administrative data. The number and type of visits to primary care pediatric services in Catalonia between January 2019 and December 2022 were studied. Results A drop of more than 80% in face-to-face visits and an increase of up to 15 times in remote visits were observed as of March 2020 compared to the previous year. Subsequently, the face-to-face attendance rate began to recover, although it did not reach the same rate as before COVID-19. Non-face-to-face visits were maintained, representing more than 20% of the total after more than 2 years of the pandemic. Conclusions COVID-19 has been the trigger for a transition in the types of visits to primary care pediatric services. The COVID-19 pandemic was a clear catalyst for the integration of telemedicine in Catalan pediatric health care. In this context, although face-to-face consultations have recovered in absolute numbers, after the pandemic period, the weight of telemedicine has increased.
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Affiliation(s)
- Marta Castillo-Rodenas
- Centre d'Atenció Primària Cardona, Gerència d'Atenció Primària i a la Comunitat Catalunya Central, Institut Català de la Salut, Cardona, Spain
| | | | - Aïna Fuster-Casanovas
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Queralt Miró Catalina
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència d'Atenció Primària i a la Comunitat Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| | - Josep Vidal-Alaball
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Health Promotion in Rural Areas Research Group, Gerència d'Atenció Primària i a la Comunitat Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Faculty of Medicine, University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Francesc López Seguí
- Chair in ICT and Health, Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
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Tan LLJ, Safadi MAP, Horn M, Regojo Balboa C, Moya E, Schanbaum J, Pimenta P, Lambert E, Soumahoro L, Sohn WY, Bruce T, Ruiz García Y. Pandemic's influence on parents' attitudes and behaviors toward meningococcal vaccination. Hum Vaccin Immunother 2023; 19:2179840. [PMID: 36883777 PMCID: PMC10026861 DOI: 10.1080/21645515.2023.2179840] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Invasive meningococcal disease is a life-threatening infection preventable through vaccination. Pediatric vaccination rates have declined during the coronavirus disease 2019 (COVID-19) pandemic. This survey aimed to understand how parents' attitudes and behaviors have changed during the pandemic with regard to immunization and, more specifically, meningococcal vaccination. An online survey was emailed to parents of eligible children 0-4 years, following the selection process from UK, France, Germany, Italy, Brazil, Argentina, and Australia; and of adolescents 11-18 years from US. Data collection took place 19 January-16 February 2021. Quotas were set to ensure a representative sample. Eleven questions relating to general perceptions around vaccination and attitudes and behaviors toward meningitis vaccination were displayed. On 4,962 parents (average 35 years) participating in the survey, most (83%) believed important for their child to continue receiving recommended vaccines during the COVID-19 pandemic. Nearly half of routine vaccine appointments were delayed or canceled due to the pandemic, and 61% of respondents were likely to have their children catch up once COVID-19 restrictions were lifted. 30% of meningitidis vaccination appointments were canceled or delayed during the pandemic, and 21% of parents did not intend to reschedule them because of lockdown/stay at home regulations, and fear of catching COVID-19 in public places. It is crucial to communicate clear instructions to health workers and the general population and to provide appropriate safety precautions in vaccination centers. This will help to maintain vaccination rates and limit infections to prevent future outbreaks.
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Affiliation(s)
| | | | | | | | - Elena Moya
- Asociación Española contra la meningitis, Madrid, Spain
| | | | - Pedro Pimenta
- Meningitis Survivor, Santana de Parnaíba, São Paulo, Brazil
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6
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Zhang C, Hu W, Li Y, Lv Y, Zhang S. Impact of the COVID-19 pandemic on routine vaccination services in Shaanxi province, Northwest China: Non-pharmaceutical intervention period and mass COVID-19 vaccination period. Hum Vaccin Immunother 2023; 19:2251826. [PMID: 37665634 PMCID: PMC10478737 DOI: 10.1080/21645515.2023.2251826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 09/06/2023] Open
Abstract
To better understand the impact of COVID-19 epidemic on routine vaccination, a cross-sectional study was carried out during non-pharmaceutical intervention period (2020) and mass COVID-19 vaccination period (2021) in Shaanxi province. Data on NIP (National Immunization Program, Free), nNIP (non-National Immunization Program, Paid), and COVID-19 vaccines inoculated and vaccination clinics were collected. At the beginning of the COVID-19 epidemic, the rate of routine vaccination clinics providing vaccination services was only 20.0%, rabies vaccination clinics was 89.9% and obstetric vaccination clinics was 95.9%. Compared with 2019 (as baseline), NIP vaccines inoculated in 2020 and 2021 decreased by 3.5% and 19.2%, respectively, on the contrary, nNIP vaccines increased by 25.8% and 34.7%, respectively. In 2021, 74.9% of vaccination clinics were involved in mass COVID-19 vaccination, and there was not a significant impact of mass COVID-19 vaccination on the number of other vaccines inoculated. Vaccination coverage of all NIP vaccines was not different from that in previous years. COVID-19 epidemic had a short-term impact on routine vaccination at beginning. The impact of mass COVID-19 vaccination on routine vaccination could even be ignored. The COVID-19 epidemic has once again made people realize the great harm of infectious diseases, and has improved everyone's willingness to receive routine vaccines.
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Affiliation(s)
- Chao Zhang
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Weijun Hu
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Yajun Li
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Yake Lv
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Shaobai Zhang
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
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Marvila Garcia É, Lima de Souza E, Penido Matozinhos F, Moreira Ribeiro da Silva T, Alves Waldman E, Sato APS. Associated factors with vaccine hesitancy in mothers of children up to two years old in a Brazilian city. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002026. [PMID: 37289722 DOI: 10.1371/journal.pgph.0002026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 05/15/2023] [Indexed: 06/10/2023]
Abstract
This study aims to evaluate maternal vaccine hesitancy and its associated factors. This is a cross-sectional study of a probabilistic sample of 450 mothers of children born in 2015, living in a Brazilian city, and who was, at the time of data collection, more than two years old. We used the tool proposed by the World Health Organization (10-item Vaccine Hesitancy Scale). To assess its structure, we performed, exploratory and confirmatory factor analyses. We performed linear regression models to evaluate the factors associated with vaccine hesitancy. The factor analysis showed two components for the vaccine hesitancy scale: lack of confidence in vaccines and risk perception of vaccines. High family income was associated with lower vaccine hesitancy (greater confidence in vaccines and lower risk perception of vaccines), while the presence of other children, regardless of birth order, in the family was associated with lower confidence in vaccines. A good rapport with health professionals, willingness to wait for the vaccination and the getting vaccinated through campaigns were associated with greater confidence in vaccines. The deliberate delay or decision not to vaccinate their children and previous experience with adverse reactions to the vaccine were associated with lower confidence in vaccines and greater risk perception of vaccines. Health care providers, especially nurses, play a relevant role to address vaccine hesitancy, guiding vaccination through a trustworthy rapport.
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8
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Lucinde RK, Karia B, Ouma N, Amadi D, Nyundo C, Mataza C, Nyaguara A, Scott JAG, Gallagher KE, Kagucia E. The impact of the COVID-19 pandemic on vaccine coverage in Kilifi, Kenya: A retrospective cohort study. Vaccine 2023; 41:666-675. [PMID: 36543684 PMCID: PMC9622384 DOI: 10.1016/j.vaccine.2022.10.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic caused unprecedented disruption in health service delivery, globally. This study sought to provide evidence on the impact of the pandemic on vaccine coverage in Kilifi County, Kenya. We conducted a vaccine coverage survey between April and June 2021 within the Kilifi Health and Demographic Surveillance System (KHDSS). Simple random sampling was used to identify 1500 children aged 6 weeks-59 months. Participants were grouped into three retrospective cohorts based on when they became age-eligible for vaccination: before the pandemic, during the first year, or during the second year of the pandemic. Survival analysis with Cox regression was used to evaluate the association between the time-period at which participants became age-eligible for vaccination and the rate of vaccination within a month of age-eligibility for the third dose of pentavalent vaccine (Pentavalent-3) and within three months of age-eligibility for the first dose of Measles vaccine (MCV-1). A total of 1,341 participants were included in the survey. Compared to the pre-COVID-19 baseline period, the rate of vaccination within a month of age-eligibility for Pentavalent-3 was not significantly different in the first year of the pandemic (adjusted hazard ratio [aHR] 1.03, 95 % confidence interval [CI] 0.90-1.18) and was significantly higher during the second year of the pandemic (aHR 1.33, 95 % CI 1.07-1.65). The rate of vaccination with MCV-1 within three months of age-eligibility was not significantly different among those age-eligible for vaccination during the first year of the pandemic (aHR 1.04, 95 % CI 0.88-1.21) and was 35 % higher during the second year of the pandemic (95 % CI 1.11-1.64), compared to those age-eligible pre-COVID-19. After adjusting for known determinants of vaccination, the COVID-19 pandemic did not adversely affect the rate of vaccination within the KHDSS.
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Affiliation(s)
- R K Lucinde
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya.
| | - B Karia
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya
| | - N Ouma
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya
| | - D Amadi
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya
| | - C Nyundo
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya
| | - C Mataza
- Kilifi County, Department of Health, Kilifi, Kenya
| | - A Nyaguara
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya
| | - J A G Scott
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK
| | - K E Gallagher
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK
| | - E Kagucia
- KEMRI-Wellcome Trust Research Programme (KWTRP) Centre for Geographic Medical Research - Coast (CGMRC), Kilifi, Kenya
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Castrejon MM, Leal I, de Jesus Pereira Pinto T, Guzmán-Holst A. The impact of COVID-19 and catch-up strategies on routine childhood vaccine coverage trends in Latin America: A systematic literature review and database analysis. Hum Vaccin Immunother 2022; 18:2102353. [PMID: 36084255 DOI: 10.1080/21645515.2022.2102353] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Globally, an estimated 23 million children missed vaccination in 2020 due to the coronavirus disease 2019 (COVID-19) pandemic. We analyzed vaccination coverage trends and catch-up strategies/recommendations implemented in Latin America during the pandemic. We performed a national administrative database analysis and a systematic literature review to evaluate vaccination coverage data and identify catch-up strategies for missed vaccinations in selected countries in Latin America (Argentina, Brazil, Chile, Colombia, Mexico and Peru). Data were extracted from national health ministry vaccination coverage and supranational databases to identify coverage of rotavirus (RV), pentavalent/hexavalent, measles, Bacillus Calmette-Guérin (BCG) and pneumococcal conjugate vaccines (PCV) at country level before and during the COVID-19 pandemic. A systematic literature review of published papers was conducted to identify vaccination catch-up strategies published in January 2020-June 2021. National administrative database-reported data showed that vaccination coverage trends were declining prior to 2020. The change in vaccination coverage before and during the COVID-19 pandemic ranged from 2.5% to -11.5% (RV), -3.0% to -11.0% (measles), 1.5% to -7.5% (PCV), 9.0% to -14.0% (pentavalent/hexavalent), and 3.0% to -18.5% (BCG). Among 696 identified studies, 14 studies were included in this review. Catch-up vaccination strategies included prioritizing routine vaccinations as per the national immunization schedule. Overall vaccination coverage declined by varying degrees among the countries investigated. This trend was observed prior to 2020, suggesting multifactorial reasons for declining vaccination rates in Latin America.
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Affiliation(s)
- María M Castrejon
- Scientific and Medical Affairs in Emerging Markets, GSK, Ciudad de Panamá, Panamá
| | - Ingrid Leal
- Regional Publications - Global Medical, GSK, Ciudad de Panamá, Panamá
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Falope O, Nyaku MK, O'Rourke C, Hermany LV, Plavchak B, Mauskopf J, Hartley L, Kruk ME. Resilience learning from the COVID-19 pandemic and its relevance for routine immunization programs. Expert Rev Vaccines 2022; 21:1621-1636. [PMID: 36063485 DOI: 10.1080/14760584.2022.2116007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The COVID-19 pandemic represents a threat that has posed a challenge to public health response and threatens immunization programs globally. Despite recommendations to continue routine immunization services, disruptions have been observed to these and mass vaccination campaigns. This may result in setbacks to immunization initiative successes and a rise in cases of vaccine-preventable diseases. AREAS COVERED We conducted a systematic literature review to identify studies globally that described how indicators of health system resilience, defined using the Resilient Health System Framework, enabled routine immunizations to continue during the COVID-19 pandemic. A systematic search was conducted in Embase, Web of Science, PsychInfo, medRxiv, bioRxiv, and the gray literature between 1 January 2020, and 12 November 2021. Information was extracted from the studies identified describing how the specific elements of resiliency (being aware, diverse, self-regulating, integrated, and adaptive) were applied to their routine immunization programs. EXPERT OPINION Our study demonstrates the use of tools that contributed to immunization program resilience during the COVID-19 pandemic in all geographic regions and for countries with different income levels. These tools may help inform preparations for other immunization programs to catch up from the COVID-19 pandemic or mitigate the impact of future threats.
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Affiliation(s)
| | | | | | | | | | | | | | - Margaret E Kruk
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Arcos González P, Zabibdullah A, Cernuda Martínez J, Castro Delgado R. Exploring COVID-19 pandemic side effects: The case of routine immunization in Afghanistan. J Glob Health 2022; 12:03039. [PMID: 35861477 PMCID: PMC9302038 DOI: 10.7189/jogh.12.03039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Routine Immunization Programs for Children during the COVID-19 Pandemic in Ecuador, 2020-Hidden Effects, Predictable Consequences. Vaccines (Basel) 2022; 10:vaccines10060857. [PMID: 35746465 PMCID: PMC9227181 DOI: 10.3390/vaccines10060857] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic has led to a global disruption of several services, including routine immunizations. This effect has been described in several countries, but there are few detailed studies in Latin America and no reports in Ecuador. Therefore, this work aims to quantify the reduction in routine immunizations for infants during the 2020 COVID-19 pandemic in Ecuador. 2018, 2019, and 2020 data were obtained from the Ministry of Health, Ecuador. The number of doses and the extent of immunization coverage was descriptively compared for four vaccines: rotavirus (ROTA), poliovirus (PV), pneumococcal (PCV), and pentavalent (PENTA) vaccines. There was no significant difference in doses applied during the 2018 and 2019 years. However, a significant (p < 0.05) drop of 137,000 delivered doses was observed in 2020 compared to the pre-pandemic years. Reductions in the percentage of coverage were more pronounced for the PENTA vaccine (17.7%), followed by PV (16.4%), ROTA (12%), and PCV vaccines (10.7%). Spatial analysis shows a severe impact on vaccination coverage on provinces from the Coast and Highland regions of the country. The pandemic has significantly impacted the immunization programs for infants across Ecuador. This retrospective analysis shows an urgent need to protect vulnerable zones and populations during public health emergencies.
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Abid Z, Castro Delgado R, Cernuda Martinez JA, Arcos González P. The Impact of COVID-19 Pandemic Lockdown on Routine Immunization in the Province of Laghman, Afghanistan. Risk Manag Healthc Policy 2022; 15:901-908. [PMID: 35547645 PMCID: PMC9084504 DOI: 10.2147/rmhp.s352567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background The COVID-19 pandemic, declared by the World Health Organization as a public health international emergency concern in March 2020, has caused serious impacts on individuals, families, communities, and societies across the globe. The COVID-19 pandemic not only disrupted the health systems and the economy, but also significantly impacted routine immunization programs. Aim To study the impact of the COVID-19 pandemic lockdown on the routine immunization coverage program in the province of Laghman, Afghanistan. Methods A comparative cross-sectional quantitative study was conducted to understand the impact of COVID-19 on routine childhood immunization during the study period. Secondary data was used from the Ministry of Health from April to July 2020 and compared with the historical data of the same period in 2019. Student t-test was used to test the association between the mean changes in the daily immunization coverage. A p-value<0.05 was considered as statistically significant with 95% confidence interval. Results There was a 21.4% significant (p<0.01) decline in the total immunization coverage during April–July 2020 compared to April–July 2019. This reduction was diverse across all districts and all vaccine antigens. The most affected district was Alingar, and the most affected vaccines were measles and OPV4, with 28% declines, followed by PCV3 at 26%, and DPT3, IPV, OPV3, PCV2 and rotavirus at 23%. The outreach vaccination coverage declined by 56.1% compared to the fixed, at 13.4%. Conclusion The COVID-19 pandemic seriously affected the routine immunization in Afghanistan. On average, 325 children per day missed out on a lifesaving vaccine in Laghman province which put them at risk of getting preventable diseases. To provide access to routine immunization during pandemics, the study suggests a set of customized interventions to strengthen and sustain routine immunization.
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Affiliation(s)
- Zabihulah Abid
- Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Rafael Castro Delgado
- Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
| | | | - Pedro Arcos González
- Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
- Correspondence: Pedro Arcos González, Unit for Research in Emergency and Disaster, Faculty of Medicine, 7th Floor, Campus del Cristo, Oviedo, 33006, Spain, Tel +34 985103545, Email
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Moura C, Truche P, Sousa Salgado L, Meireles T, Santana V, Buda A, Bentes A, Botelho F, Mooney D. The impact of COVID-19 on routine pediatric vaccination delivery in Brazil. Vaccine 2022; 40:2292-2298. [PMID: 35287987 PMCID: PMC8885307 DOI: 10.1016/j.vaccine.2022.02.076] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 11/10/2021] [Accepted: 02/23/2022] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Childhood vaccination rates have decreased significantly during the COVID-19 pandemic. The Brazilian immunization program, Programa Nacional de Imunização (PNI), is a model effort, achieving immunization rates comparable to high-income countries. This study aimed to evaluate the impact of the COVID-19 pandemic in pediatric vaccinations administered by the PNI, as a proxy of adherence to vaccinations during 2020. METHODS Data on the number of vaccines administered to children under 10 years of age nationally and in each of Brazil's five regions were extracted from Brazil's federal health delivery database. Population adjusted monthly vaccination rates from 2015 through 2019 were determined, and autoregressive integrated moving average (ARIMA) models were used to forecast expected vaccinated rates in 2020. We compared the forecasts to reported vaccine administrations to assess adequacy of pediatric vaccine delivery during the COVID-19 pandemic. RESULTS From January 2015 to February 2020, the average rate of vaccine administration to children was 53.4 per 100,000. After February 2020, this rate decreased to 50.4, a 9.4% drop compared to 2019 and fell outside of forecasted ranges in December 2020. In Brazil's poorest region, the North, vaccine delivery fell outside of the forecasted ranges earlier in 2020 but subsequently rebounded, meeting expected targets by the end of 2020. However, in Brazil's wealthiest South and Southeast regions, initial vaccine delivery fell and remained well below forecasted rates through the end of 2020. CONCLUSION In Brazil, despite a model national pediatric vaccination program with an over 95% national coverage, vaccination rates decreased during the COVID-19 pandemic. Coordinated governmental efforts have ameliorated some of the decrease, but more efforts are needed to ensure continued protection from preventable communicable diseases for children globally.
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Affiliation(s)
- Carolina Moura
- Faculdade da Saúde e Ecologia Humana, FASEH, Vespasiano, MG, Brazil
| | - Paul Truche
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Lucas Sousa Salgado
- União Educacional do Vale do Aço, UNIVAÇO, Departamento de Medicina, Ipatinga, MG, Brazil
| | - Thiaro Meireles
- Faculdade de Medicina da Universidade de São Paulo, FMUSP, São Paulo, SP, Brazil
| | - Vitor Santana
- Faculdade de Medicina da Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brazil
| | - Alexandra Buda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Aline Bentes
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Departamento de Infectologia Pediátrica, Belo Horizonte, MG, Brazil
| | - Fabio Botelho
- Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, Montreal, Canada
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15
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Del Cura-González I, Polentinos-Castro E, Fontán-Vela M, López-Rodríguez JA, Martín-Fernández J. [What have we missed because of COVID-19? Missed diagnoses and delayed follow-ups. SESPAS Report 2022]. GACETA SANITARIA 2022; 36 Suppl 1:S36-S43. [PMID: 35781146 PMCID: PMC9244613 DOI: 10.1016/j.gaceta.2022.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022]
Abstract
The COVID-19 pandemic and the associated public health emergency have affected patients and health services in non-COVID-19 pathologies. Several studies have shown its dissociation from health services, with a decrease in emergency department visits, in hospital admissions for non-COVID-19 pathologies, as well as in the reported weekly incidence of acute illnesses and new diagnoses in primary care. In parallel, the pandemic has had direct and indirect effects on people with chronic diseases; the difficulties in accessing health services, the interruption of care, the saturation of the system itself and its reorientation towards non-face-to-face formats has reduced the capacity to prevent or control chronic diseases. All this has also had an impact on the different areas of people's lives, creating new social and economic difficulties, or aggravating those that existed before the pandemic. All these circumstances have changed with each epidemic wave. We present a review of the most relevant studies that have been analyzing this problem and incorporate as a case study the results of a retrospective observational study carried out in Primary Care in the Madrid Health Service, which provides health coverage to a population of more than 6 million people, and whose objective was to analyze the loss of new diagnoses in the most prevalent pathologies such as common mental health problems, cardiovascular and cerebrovascular diseases, type 2 diabetes, chronic obstructive pulmonary disease, and breast and colon tumors, in the first and second waves. Annual incidence rates with their confidence interval were calculated for each pathology and the monthly frequency of new codes recorded between 1/01/2020 and 12/31/2020 was compared with the monthly mean of observed counts for the same months between 2016 and 2019. The annual incidence rate for all processes studied decreased in 2020 except for anxiety disorders. Regarding the recovery of lost diagnoses, heart failure is the only diagnosis showing an above-average recovery after the first wave. To return to pre-pandemic levels of diagnosis and follow-up of non-COVID-19 pathology, the healthcare system must reorganize and contemplate specific actions for the groups at highest risk.
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Affiliation(s)
- Isabel Del Cura-González
- Unidad de Investigación, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) - Instituto de Salud Carlos III, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España.
| | - Elena Polentinos-Castro
- Unidad de Investigación, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) - Instituto de Salud Carlos III, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
| | - Mario Fontán-Vela
- Servicio de Medicina Preventiva, Hospital Infanta Leonor, Madrid, España; Grupo de Investigación en Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - Juan A López-Rodríguez
- Unidad de Investigación, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) - Instituto de Salud Carlos III, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Centro de Salud General Ricardos, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, España
| | - Jesús Martín-Fernández
- Departamento de Especialidades Médicas y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) - Instituto de Salud Carlos III, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Oeste, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, España
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Ramírez M, de la Fuente J, Andía D, Hernández JJ, Fiol G, Torné A. "HPV vaccination coverage in women between 15-55 years in Spain. Temporal trend during the period 2007-2020". Int J Gynaecol Obstet 2021; 158:705-713. [PMID: 34905216 DOI: 10.1002/ijgo.14067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/26/2021] [Accepted: 12/12/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Mar Ramírez
- Gynecology Oncology Unit. Institute of Women's Health José Botella Llusiá. Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC), Complutense University, Madrid, Spain
| | - Jesús de la Fuente
- Gynecology and Obstetrics Department, University Hospital Infanta Leonor, Madrid, Spain
| | - Daniel Andía
- Gynecology and Obstetrics Department, Basurto University Hospital, Bilbao, Spain
| | - Juan José Hernández
- Gynecology and Obstetrics Department, University Hospital Infanta Leonor, Madrid, Spain
| | - Gabriel Fiol
- Gynecology Oncology Unit, Torrecárdenas University Hospital, Almeria, Spain
| | - Aureli Torné
- Gynecology Oncology Unit, Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Spain
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Marchetti F, Verazza S, Brambilla M, Restivo V. Rotavirus and the web: analysis of online conversations in Italy during 2020. Hum Vaccin Immunother 2021; 18:2002087. [PMID: 34856884 PMCID: PMC8966986 DOI: 10.1080/21645515.2021.2002087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Rotavirus is the most common cause of severe diarrhea among children worldwide. In 2017, Italy included rotavirus vaccination in its National Immunization Program. The use of social media monitoring, an efficient tool to understand vaccine hesitancy, has increased in recent years; however, only a few examples of such monitoring are available for Italy. Present study analyzed content on online sources, including social media, to identify factors contributing to Italian parents’ decisions to vaccinate or not their children against rotavirus. Blogmeter Suite was used to search and analyze conversations related to rotavirus in Italian on online sources during 2020. These data were compared with data from 2019. There were 2250 mentions of “rotavirus” recorded; 1080 were related to the rotavirus vaccine. Terms and hashtags used were similar in both years. Facebook was the main source of influence, Instagram dominated the engagement (the sum of interactions related to a post), and Google Trends showed a 5-year upward trend in searches for rotavirus vaccine. Of 1270 sentiment opinions, 60.7% were negative. More parents were familiar with the disease and the vaccine in 2020 compared with 2019. Pediatricians were the most influential healthcare professionals (59.2% of mentions), followed by vaccination staff (33.4%). The most relevant factors for vaccine hesitancy were fear of adverse events, concerns about the vaccination schedule, and COVID-19. Present study represents the first web listening analysis of online discussions about rotavirus. The results can be used to inform targeted communication to counteract misinformation and raise awareness about rotavirus vaccination among parents.
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Affiliation(s)
| | | | | | - Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
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18
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Silveira MM, Conrad NL, Leivas Leite FP. Effect of COVID-19 on vaccination coverage in Brazil. J Med Microbiol 2021; 70. [PMID: 34845982 DOI: 10.1099/jmm.0.001466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
During the COVID-19 pandemic, recommendations for maintaining physical distance, restricted mobility measures, as well as fear of mass transmission by going to health centers have significantly contributed to the general vaccination coverage, which by and large is decreasing worldwide; thus, favoring the potential re-emergence of vaccine-preventable diseases. In this study, we have used the existing data on vaccination coverage during the pre-pandemic (2019) as well as the pandemic (2020) period to evaluate the impact of coronavirus outbreaks during the vaccination drive in Brazil. Furthermore, we have accumulated data since 2015 among the different regions of the country to acquire more consistent information. The various vaccines analyzed in our study were meningococcal C conjugate, Triple antigen vaccine, 10-valent pneumococcal conjugate, and BCG; subsequently, the data were obtained from the National Disease Notification System. This study revealed that the ongoing immunization drive saw a steep decline of around 10 to 20% during the (2019-2020) pandemic period in Brazil. These results provide strong evidence towards the decreasing trends following the vaccination programs during the COVID-19 pandemic period in Brazil. Furthermore, our results also highlight the importance of adopting widespread multi-component interventions to improve vaccination uptake rates.
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Affiliation(s)
| | - Neida Lucia Conrad
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, Brazil
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19
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Ota MOC, Badur S, Romano-Mazzotti L, Friedland LR. Impact of COVID-19 pandemic on routine immunization. Ann Med 2021; 53:2286-2297. [PMID: 34854789 PMCID: PMC8648038 DOI: 10.1080/07853890.2021.2009128] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/16/2021] [Indexed: 11/04/2022] Open
Abstract
The current COVID-19 global pandemic continues to impact healthcare services beyond those directly related to the management of SARS-CoV-2 transmission and disease. We reviewed the published literature to assess the pandemic impact on existing global immunization activities and how the impact may be addressed. Widespread global disruption in routine childhood immunization has impacted a majority of regions and countries, especially in the initial pandemic phases. While data indicate subsequent recovery in immunization rates, a substantial number of vulnerable people remain unvaccinated. The downstream impact may be even greater in resource-limited settings and economically poorer populations, and consequently there are growing concerns around the resurgence of vaccine-preventable diseases, particularly measles. Guidance on how to address immunization deficits are available and continue to evolve, emphasizing the importance of maintaining and restoring routine immunization and necessary mass vaccination campaigns during and after pandemics. In this, collaboration between a broad range of stakeholders (governments, industry, healthcare decision-makers and frontline healthcare professionals) and clear communication and engagement with the public can help achieve these goals.Key messagesThe COVID-19 pandemic has a substantial impact on essential immunization activities.Disruption to mass vaccination campaigns increase risk of VPD resurgence.Catch-up campaigns are necessary to limit existing shortfalls in vaccine uptake.Guidance to mitigate these effects continues to evolve.
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Chiappini E, Parigi S, Galli L, Licari A, Brambilla I, Angela Tosca M, Ciprandi G, Marseglia G. Impact that the COVID-19 pandemic on routine childhood vaccinations and challenges ahead: A narrative review. Acta Paediatr 2021; 110:2529-2535. [PMID: 34028088 PMCID: PMC8222862 DOI: 10.1111/apa.15949] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 12/23/2022]
Abstract
Aim To document the decline in vaccination coverage in the first months of 2020 as an indirect effect of the COVID‐19 pandemic. Methods We performed a literature review in medical databases. Overall, 143 articles were initially retrieved, out of which 48 were selected and included in the review. Results Our review retrieved similar data in many countries worldwide, and, globally, preliminary data from the first 4 months of 2020 indicate a decline in diphtheria‐tetanus‐pertussis coverage, generally considered the marker of vaccination coverage across countries. World Health Organization recommends maintaining vaccination services, prioritising primary series vaccinations especially for measles‐rubella or poliomyelitis, but it also lets each country decide whether to maintain the immunisation services evaluating the current epidemiology of vaccine‐preventable diseases and the COVID‐19 local transmission scenario. Successively, recovering of vaccinations should be planned. Moreover, during the pandemic, influenza vaccination should be promoted as a central public health measure. Conclusion Future challenges will be to maintain the vaccination programmes, especially in children younger than 2 years old and adolescents, to plan the recovery of vaccinations for subjects who postponed them during the lockdown, and to early identify any vaccine‐preventable disease outbreak.
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Affiliation(s)
- Elena Chiappini
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Sara Parigi
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Luisa Galli
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Amelia Licari
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
| | - Ilaria Brambilla
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
| | | | | | - Gianluigi Marseglia
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
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The Impact of the COVID-19 Pandemic on Immunization Campaigns and Programs: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030988. [PMID: 33499422 PMCID: PMC7908591 DOI: 10.3390/ijerph18030988] [Citation(s) in RCA: 136] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/07/2021] [Accepted: 01/20/2021] [Indexed: 02/08/2023]
Abstract
The COVID-19 pandemic has had an impact on health service delivery, including immunization programs, and this review assesses the impact on vaccine coverage across the globe and identifies the potential underlying factors. A systematic search strategy was employed on PubMed, Embase, MedRxiv, BioRxiv, and WHO COVID-19 databases from December 2019 till 15 September 2020. Two review authors independently assessed studies for inclusion, assessed quality, and extracted the data (PROSPERO registration #CRD42020182363). A total of 17 observational studies were included. The findings suggest that there was a reduction in the vaccination coverage and decline in total number of vaccines administered, which led to children missing out on their vaccine doses. An approximately fourfold increase was also observed in polio cases in polio endemic countries. Factors contributing to low vaccine coverage included fear of being exposed to the virus at health care facilities, restriction on city-wide movements, shortage of workers, and diversion of resources from child health to address the pandemic. As the world re-strategizes for the post-2020 era, we should not let a crisis go to waste as they provide an opportunity to establish guidelines and allocate resources for future instances. High-quality supplementary immunization activities and catch-up programs need to be established to address gaps during the pandemic era.
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22
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Torner N. Collateral effects of Covid-19 pandemic emergency response on worldwide immunizations. ACTA ACUST UNITED AC 2020; 21:73-75. [PMID: 32840247 PMCID: PMC7334912 DOI: 10.1016/j.vacun.2020.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- N Torner
- CIBER Epidemiology and Public Health CIBERESP, University of Barcelona, Barcelona, Spain
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