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Doherty TM, Di Pasquale A, Finnegan G, Lele J, Philip RK. Sustaining the momentum for adult vaccination post-COVID-19 to leverage the global uptake of life-course immunisation: A scoping review and call to action. Int J Infect Dis 2024; 142:106963. [PMID: 38354849 DOI: 10.1016/j.ijid.2024.02.006] [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: 10/12/2023] [Revised: 01/22/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES The COVID-19 pandemic changed the adult vaccination landscape, possibly permanently. This review attempts to quantitate the magnitude of those changes. METHODS PubMed was searched for studies on adult / life-course vaccination between 1 January 2020 until 8 November 2022. RESULTS Twenty-one articles were identified and observations summarised as positive developments/impediments to life-course immunisation, and areas needing policy and structural reform. Unprecedented funding, international co-operation and technical advances led to COVID-19 vaccines authorised in record time. Investments in infrastructure and an expanded healthcare workforce streamlined vaccine delivery to adults. Constant media coverage and targeted messaging have improved health literacy. Conversely, the speed of vaccine development was perceived as a safety risk, and an 'infodemic' of misinformation propagated through social media negatively influenced vaccine uptake. Vaccine access and affordability remains inequitable among older adults and minority groups. CONCLUSIONS The COVID pandemic led to an opportunity to permanently change policies, attitudes, and systems for vaccine delivery to adults to establish a global life-course approach to immunisation. This is a call for action to sustain the momentum triggered by the COVID-19 pandemic. Addressing inequalities, improving health literacy and optimally using social media are critical to sustain adult vaccinations in post-COVID-19 era.
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Affiliation(s)
| | - Alberta Di Pasquale
- Takeda Pharmaceuticals International AG Singapore Branch, Singapore, Singapore
| | | | - Jayesh Lele
- Indian Medical Association, National Hospital Board of India, Mumbai, India
| | - Roy K Philip
- University Maternity Hospital Limerick, University of Limerick School of Medicine, Limerick, Ireland
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2
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Soto-Moreno JA, Coe M, Parellada C, Tantri A, Angarita-Contreras MC, Acosta P. Socioeconomic and fiscal returns of expanded investment in immunization: a case for life-course vaccination in Colombia. HEALTH AFFAIRS SCHOLAR 2024; 2:qxae042. [PMID: 38756168 PMCID: PMC11044964 DOI: 10.1093/haschl/qxae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/24/2024] [Accepted: 04/03/2024] [Indexed: 05/18/2024]
Abstract
Despite the health, societal, and economic benefits of immunization, many countries focus primarily on childhood immunizations and lack robust policies and sufficient resources for immunizations that can benefit populations across the life course. While the benefits of childhood vaccination are well documented, there is limited evidence on the financial and social return on investment that policymakers can use to inform decisions around administering a life-course immunization program. We developed a cost-benefit model from a societal perspective to evaluate the inclusion of 5 vaccines across the life course in Colombia's national immunization program. This model estimated a return of US$1.3 per US$1.0 invested in the first 2 decades, increasing to US$3.9 after 60 years. Primary benefits were productivity gains, followed by fiscal savings and household averted expenditure on health care. Furthermore, vulnerable households are predicted to receive 3.2 times greater income protection than formally employed households under a life-course immunization program. Consequently, there is a potential to reduce Colombia's income inequality and poverty rate by increasing access to immunization for all ages.
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Affiliation(s)
| | - Martha Coe
- ThinkWell, Lutherville, MD 21093, United States
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Gaviola GC, McCarville M, Shendale S, Goodman T, Lomazzi M, Desai S. A review of health worker vaccination programs in low, middle and upper middle-income countries. PUBLIC HEALTH IN PRACTICE 2023; 6:100415. [PMID: 37547811 PMCID: PMC10400463 DOI: 10.1016/j.puhip.2023.100415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives Health workers (HW) are at risk of contracting vaccine preventable diseases when caring for patients and communities. This study aims to evaluate the existing literature on the routine vaccination of health workers against a variety of antigens in low and middle income countries, focusing on facilitators, barriers, and considerations in the implementation of immunization programs and campaigns. Study design A PubMed Literature search. Methods A PubMed search was conducted to find articles that addressed vaccination programs and policies for HW in low-income countries (LIC), lower middle-income countries (LMIC), and upper middle-income countries (UMIC). Original articles, meta-analyses, and reviews published in English between January 2000 and July 2022 were included in the search. Inductive content analysis was used to identify themes that illustrate facilitators, barriers, and considerations in the implementation of immunization programs and campaigns. Results The search identified 4240 studies, 90 were used for analysis as they provided antigen specific details on immunization policies or programs. Hepatitis B was the most frequently discussed antigen, followed by Influenza, then Measles, Rubella and Mumps. With considerable variability by vaccine and country, in most cases the vaccination was not offered free to HW or included in a regular vaccination schedule. Utilizing existing immunization infrastructure such as the Expanded Programme on Immunization (EPI) and having effective management of vaccination programs were found to be key facilitators to vaccinate HW. Conclusions The low vaccination coverage of health workers in LMIC is of concern; attention towards the key considerations, barriers and facilitators of immunization implementation is central to the advancement of health worker vaccination coverage in LMIC's. The COVID-19 pandemic necessitated the swift vaccination of HW. Many LIC countries lacking established HW immunization infrastructure are now administering COVID-19 vaccines. As we move beyond the pandemic's acute phase, there is a chance for those countries to enhance their immunization initiatives and policies for HW concerning other antigens, even if it is not a standard practice currently.
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Affiliation(s)
- Gabriel C. Gaviola
- Department of Occupational Medicine, Cambridge Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | - Maddison McCarville
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
- World Federation of Public Health Associations, Geneva, Switzerland
| | - Stephanie Shendale
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Tracey Goodman
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Marta Lomazzi
- World Federation of Public Health Associations, Geneva, Switzerland
- University of Geneva, Institute of Global Health, Geneva, Switzerland
| | - Shalini Desai
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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Patel C, Rendell N, Sargent GM, Ali A, Morgan C, Fields R, Sheel M. Measuring National Immunization System Performance: A Systematic Assessment of Available Resources. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e220055. [PMID: 37348935 PMCID: PMC10285727 DOI: 10.9745/ghsp-d-22-00555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/16/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Vaccination coverage is widely used to assess immunization performance but, on its own, provides insufficient information to drive improvements. Assessing the performance of underlying components of immunization systems is less clear, with several monitoring and evaluation (M&E) resources available for use in different operational settings and for different purposes. We studied these resources to understand how immunization system performance is measured. METHODS We reviewed peer-reviewed and gray literature published since 2000 to identify M&E resources that include national-level indicators measuring the performance of immunization systems or their components (governance, financing, regulation, information systems, vaccine logistics, workforce, service delivery, and demand generation). We summarize indicators by the system components or outcomes measured and describe findings narratively. RESULTS We identified 20 resources to monitor immunization program objectives and guide national strategic decision-making, encompassing 631 distinct indicators. Indicators for immunization program outcomes comprised the majority (124/631 [19.7%]), largely vaccination coverage (110/124 [88.7%]). Almost all resources (19/20 [95%]) included indicators for vaccine logistics (83/631 [13.2%]), and those for regulation (19/631 [3.0%]) and demand generation (28/631 [4.4%]) were least common. There was heterogeneity in how information systems (92/563 [14.6%]) and workforce (47/631 [7.4%]) were assessed across resources. Indicators for vaccination coverage in adults, data use in decision-making, equity and diversity, effectiveness of safety surveillance, and availability of a public health workforce were notably lacking. CONCLUSIONS Between the resources identified in this review, we identified considerable variability and gaps in indicators assessing the performance of some immunization system components. Given the multitude of indicators, policymakers may be better served by tailoring evaluation resources to their specific context to gain useful insight into health system performance and improve data use in decision-making for immunization programs.
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Affiliation(s)
- Cyra Patel
- National Centre for Epidemiology and Population Health, Australian National University, Acton, Australia.
| | - Nicole Rendell
- National Centre for Epidemiology and Population Health, Australian National University, Acton, Australia
| | - Ginny M Sargent
- National Centre for Epidemiology and Population Health, Australian National University, Acton, Australia
| | - Akeem Ali
- World Health Organization, Seoul, Republic of Korea
| | - Christopher Morgan
- Jhpiego, Baltimore, MD, USA
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
| | - Rebecca Fields
- JSI Research & Training Institute, Inc., Arlington, VA, USA
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Australian National University, Acton, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
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5
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Laufer RS, Baral R, Buchwald AG, Campbell JD, Coulibaly F, Diallo F, Doumbia M, Driscoll AJ, Galvani AP, Keita AM, Neuzil KM, Sow S, Pecenka C, Ortiz JR, Fitzpatrick MC. Optimizing next-generation RSV prevention in Mali: A cost-effectiveness analysis of pediatric vaccination, maternal vaccination, and extended half-life monoclonal antibody immunoprophylaxis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001432. [PMID: 37145993 PMCID: PMC10162555 DOI: 10.1371/journal.pgph.0001432] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/05/2023] [Indexed: 05/07/2023]
Abstract
Respiratory syncytial virus (RSV) is the most common cause of early childhood lower respiratory tract infection (LRTI) in low- and middle-income countries (LMICs). Maternal vaccines, birth-dose extended half-life monoclonal antibodies (mAbs), and pediatric vaccines are under development for prevention of respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) in young children. We analyzed the health and economic impact of RSV interventions used alone or in combinations in Mali. We modeled age-specific and season-specific risks of RSV LRTI in children through three years, using WHO Preferred Product Characteristics and data generated in Mali. Health outcomes included RSV LRTI cases, hospitalizations, deaths, and disability-adjusted life-years (DALYs). We identified the optimal combination of products across a range of scenarios. We found that mAb delivered at birth could avert 878 DALYs per birth cohort at an incremental cost-effectiveness ratio (ICER) of $597 per DALY averted compared to no intervention if the product were available at $1 per dose. Combining mAb with pediatric vaccine administered at 10/14 weeks, 1947 DALYs would be prevented. The ICER of this combination strategy is $1514 per DALY averted compared to mAb alone. Incorporating parameter uncertainty, mAb alone is likely to be optimal from the societal perspective at efficacy against RSV LRTI above 66%. The optimal strategy was sensitive to economic considerations, including product prices and willingness-to-pay for DALYs. For example, the combination of mAb and pediatric vaccine would be optimal from the government perspective at a willingness-to-pay above $775 per DALY. Maternal vaccine alone or in combination with other interventions was never the optimal strategy, even for high vaccine efficacy. The same was true for pediatric vaccine administered at 6/7 months. At prices comparable to existing vaccine products, extended half-life RSV mAbs would be impactful and efficient components of prevention strategies in LMICs such as Mali.
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Affiliation(s)
- Rachel S. Laufer
- Center for Vaccine Development & Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | | | - Andrea G. Buchwald
- Center for Vaccine Development & Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - James D. Campbell
- Department of Pediatrics, Center for Vaccine Development & Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Flanon Coulibaly
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | - Fatoumata Diallo
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | - Moussa Doumbia
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | - Amanda J. Driscoll
- Center for Vaccine Development & Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Alison P. Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, United States of America
| | - Adama M. Keita
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | - Kathleen M. Neuzil
- Center for Vaccine Development & Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Samba Sow
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | | | - Justin R. Ortiz
- Center for Vaccine Development & Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Meagan C. Fitzpatrick
- Center for Vaccine Development & Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
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Abdullahi YAM. COVID-19 Mass Vaccination Campaign: An International Comparison of Qatar With GCC Nations and Other Global Groups. Int J Public Health 2023; 68:1605614. [PMID: 37139243 PMCID: PMC10150879 DOI: 10.3389/ijph.2023.1605614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/13/2023] [Indexed: 04/07/2023] Open
Abstract
Objectives: Mass vaccination has been a key component in the effort to control the COVID-19 pandemic. Different countries have formulated their mass vaccination campaigns in different ways and with different priorities, with varying results. This study focuses on the case of Qatar in comparison with regional neighbors in the Gulf Cooperation Community (GCC) and with global benchmarks (G7 and OECD nations) in terms of the deployment of its mass vaccination program.Methods: Data on national vaccine administration and policy were obtained from Our World in Data and the Oxford COVID-19 Government Response Tracker for the period of 25 November 2020, when public vaccination first began to be implemented within the GCC, and June 2021, when Qatar’s mass vaccination campaign concluded. Factors compared cross-nationally included the total number of vaccine doses administered, doses administered per 100 population, the time taken to reach certain vaccination thresholds (5, 10, 25, 50, and 100 doses per 100 population), and policy regarding administration to specific priority groups. Cumulative vaccination rates were also compared graphically by date.Results: A descriptive comparison of vaccination rates illustrated that there were similar aggregate patterns among the GCC, G7, and OECD groups of countries, and that there was a great deal of heterogeneity in the patterns of vaccination between countries within each of these groups. The mass vaccination program in Qatar outpaced the aggregate GCC, G7, and OECD groups.Conclusion: There were large between-country differences in the speed of mass vaccination progress which did not appear to be directly explained by national wealth. It is suggested that administrative and program management factors could account for some of these differences.
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Chaves SS, Nealon J, Burkart KG, Modin D, Biering-Sørensen T, Ortiz JR, Vilchis-Tella VM, Wallace LE, Roth G, Mahe C, Brauer M. Global, regional and national estimates of influenza-attributable ischemic heart disease mortality. EClinicalMedicine 2023; 55:101740. [PMID: 36425868 PMCID: PMC9678904 DOI: 10.1016/j.eclinm.2022.101740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Influenza virus infection is associated with incident ischemic heart disease (IHD) events. Here, we estimate the global, regional, and national IHD mortality burden attributable to influenza. METHODS We used vital registration data from deaths in adults ≥50 years (13.2 million IHD deaths as underlying cause) to assess the relationship between influenza activity and IHD mortality in a non-linear meta-regression framework from 2010 to 2019. This derived relationship was then used to estimate the global influenza attributable IHD mortality. We estimated the population attributable fraction (PAF) of influenza for IHD deaths based on the relative risk associated with a given level of weekly influenza test positivity rate and multiplied PAFs by IHD mortality from the Global Burden of Disease study. FINDINGS Influenza activity was associated with increased risk of IHD mortality across all countries analyzed. The mean PAF of influenza for IHD mortality was 3.9% (95% uncertainty interval [UI] 2.5-5.3%), ranging from <1% to 10%, depending on country and year. Globally, 299,858 IHD deaths (95% UI 191,216-406,809) in adults ≥50 years could be attributed to influenza, with the highest rates per 100,000 population in the Central Europe, Eastern Europe and Central Asia Region (32.3; 95% UI 20.6-43.8), and in the North Africa and Middle East Region (26.7; 95% UI 17-36.2). INTERPRETATION Influenza may contribute substantially to the burden of IHD. Our results suggest that if there were no influenza, an average of 4% of IHD deaths globally would not occur. FUNDING Collaborative study funded by Sanofi Vaccines.
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Affiliation(s)
- Sandra S. Chaves
- Modelling, Epidemiology and Data Science Department, Sanofi Vaccine, Lyon, France
- Corresponding author.
| | - Joshua Nealon
- Modelling, Epidemiology and Data Science Department, Sanofi Vaccine, Lyon, France
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
- Corresponding author.
| | - Katrin G. Burkart
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Daniel Modin
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tor Biering-Sørensen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Justin R. Ortiz
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Lindsey E. Wallace
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Gregory Roth
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Cedric Mahe
- Modelling, Epidemiology and Data Science Department, Sanofi Vaccine, Lyon, France
| | - Michael Brauer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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Soeters HM, Doshi RH, Fleming M, Adegoke OJ, Ajene U, Aksnes BN, Bennett S, Blau EF, Carlton JG, Clements S, Conklin L, Dahlke M, Duca LM, Feldstein LR, Gidudu JF, Grant G, Hercules M, Igboh LS, Ishizumi A, Jacenko S, Kerr Y, Konne NM, Kulkarni S, Kumar A, Lafond KE, Lam E, Longley AT, McCarron M, Namageyo-Funa A, Ortiz N, Patel JC, Perry RT, Prybylski D, Reddi P, Salman O, Sciarratta CN, Shragai T, Siddula A, Sikare E, Tchoualeu DD, Traicoff D, Tuttle A, Victory KR, Wallace A, Ward K, Wong MKA, Zhou W, Schluter WW, Fitter DL, Mounts A, Bresee JS, Hyde TB. CDC's COVID-19 International Vaccine Implementation and Evaluation Program and Lessons from Earlier Vaccine Introductions. Emerg Infect Dis 2022; 28:S208-S216. [PMID: 36502382 DOI: 10.3201/eid2813.212123] [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] [Indexed: 12/15/2022] Open
Abstract
The US Centers for Disease Control and Prevention (CDC) supports international partners in introducing vaccines, including those against SARS-CoV-2 virus. CDC contributes to the development of global technical tools, guidance, and policy for COVID-19 vaccination and has established its COVID-19 International Vaccine Implementation and Evaluation (CIVIE) program. CIVIE supports ministries of health and their partner organizations in developing or strengthening their national capacities for the planning, implementation, and evaluation of COVID-19 vaccination programs. CIVIE's 7 priority areas for country-specific technical assistance are vaccine policy development, program planning, vaccine confidence and demand, data management and use, workforce development, vaccine safety, and evaluation. We discuss CDC's work on global COVID-19 vaccine implementation, including priorities, challenges, opportunities, and applicable lessons learned from prior experiences with Ebola, influenza, and meningococcal serogroup A conjugate vaccine introductions.
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Braunfeld JB, Carson HN, Williams SR, Schwartz LM, Neuzil KM, Ortiz JR. Clinical endpoints to inform vaccine policy: A systematic review of outcome measures from pediatric influenza vaccine efficacy trials. Vaccine 2022; 40:4339-4347. [PMID: 35717265 DOI: 10.1016/j.vaccine.2022.06.028] [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: 12/15/2021] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION We conducted a systematic review of pediatric influenza vaccine efficacy trials to assess clinical outcome measures and whether the trials defined important public health endpoints. MATERIAL AND METHODS We systematically identified phase 3 or 4 influenza vaccine randomized controlled trials among children ≤18 years of age with laboratory-confirmed influenza outcomes since 1980. We recorded countries, age groups, vaccine formulations, specimen collection criteria, laboratory diagnostics, primary and secondary outcome measures, and funders, and we determined income category for study countries. We used descriptive statistics to summarize study characteristics. We analyzed the studies overall and a subset of studies conducted in at least one low- and middle-income country (LMIC). RESULTS From 6455 potentially relevant articles, we identified 41 eligible studies. Twenty-one studies (51%) were conducted in at least one LMIC, while the remaining studies (49%) were conducted in high-income countries only. Thirty-one studies (76%) included children younger than six years. We found 40 different primary outcome measures among the 41 eligible studies. Thirty-three studies (80%) reported standardized symptoms or findings which defined a primary outcome or triggered specimen collection. One study defined a primary outcome which captured more severe illness; however, cases were mostly due to high body temperature without other severity criteria. Of the 21 studies from at least one LMIC, 15 (71%) were published since 2010 and 17 (81%) enrolled children younger than six years. Eighteen (86%) studies from at least one LMIC reported standardized symptoms or findings which defined a primary outcome or triggered specimen collection. CONCLUSIONS Among pediatric influenza vaccine efficacy trials, primary outcome measures and clinical specimen collection criteria were highly variable and, with one exception, focused on capturing any influenza illness. As most LMICs do not have influenza vaccination programs, our study highlights a potential data limitation affecting policy and implementation decisions in these settings.
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Affiliation(s)
- Jordan B Braunfeld
- Division of Infectious Diseases, University of Utah School of Medicine, 30 N 1900 E Room 4B319, Salt Lake City, UT 84132, USA.
| | - Heather N Carson
- Carson Law Firm, PLLC 717 Texas Ave 12th Floor, Houston, TX 77002, USA.
| | - Sarah R Williams
- Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St., Baltimore, MD, USA.
| | - Lauren M Schwartz
- Department of Epidemiology, School of Public Health, University of Washington, 3980 15th Ave NE, Seattle, WA 98195, USA.
| | - Kathleen M Neuzil
- Center for Vaccine Development & Global Health, University of Maryland School of Medicine, 685 W. Baltimore St., Baltimore, MD 21201, USA.
| | - Justin R Ortiz
- Center for Vaccine Development & Global Health, University of Maryland School of Medicine, 685 W. Baltimore St., Baltimore, MD 21201, USA.
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10
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Liu L, Wang X, Li X, Li N. COVID-19 Vaccines and Public Anxiety: Antibody Tests May Be Widely Accepted. Front Public Health 2022; 10:819062. [PMID: 35602124 PMCID: PMC9120666 DOI: 10.3389/fpubh.2022.819062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background More than 200 countries are experiencing the coronavirus disease (COVID-19) pandemic. COVID-19 vaccination strategies have been implemented worldwide, and repeat COVID-19 outbreaks have been seen. The purpose of this study was to investigate the impact of COVID-19 vaccination on the reduction of perceived anxiety and the association between public anxiety and antibody testing intention during the COVID-19 pandemic. Methods Chinese adults aged 18 and over were surveyed using an anonymous online questionnaire in April and May 2021. The questionnaire collected sociodemographic characteristics, vaccination characteristics, perceived anxiety due to COVID-19, and attitudes toward future antibody testing after COVID-19 vaccination. Perceived anxiety was assessed on a visual analog scale (VAS). Multivariate logistic regression analysis was used to determine the factors influencing future antibody detection. Results A total of 3,233 people were investigated, 3,209 valid questionnaires were collected, and the response rate was 99.3%. Of the 3,209 respondents, 2,047 were vaccinated, and 1,162 were unvaccinated. There was a significant difference in anxiety levels between vaccinated and unvaccinated respondents (24.9±25.4 vs. 50.0±33.1, respectively). With the local spread of COVID-19 in mainland China, the public anxiety VAS scores increased by 15.4±25.6 (SMD=120%) and 33.8±31.7 (SMD=49%) among vaccinated and unvaccinated respondents, respectively. Of the 2,047 respondents who were vaccinated, 1,626 (79.4%) thought they would accept antibody testing. Those who displayed more anxiety about acquiring COVID-19 disease were more likely to accept COVID-19 antibody testing. If the antibody test results showed protective antibodies, 1,190 (58.1%) were more likely to arrange travel plans in China, while 526 (25.7%) thought they would feel safer traveling abroad. Conclusion COVID-19 vaccination strategies help reduce public anxiety. However, public anxiety may be elevated as the local transmission of COVID-19 occurs in mainland China, which is usually caused now by imported cases. Those who display more anxiety choose to have antibody testing. Improving the accessibility of COVID-19 antibody tests can help ease public anxiety and enhance the confidence of some people to participate in social activities.
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Affiliation(s)
- Leyuan Liu
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Xiaoxiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Xiaoguang Li
- Department of Infectious Diseases, Peking University Third Hospital, Beijing, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
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11
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Persistent serotype 3 and 19A invasive pneumococcal diseases in adults in vaccine era: Serotype-dependent difference in ceftriaxone susceptibility. Vaccine 2022; 40:2258-2265. [DOI: 10.1016/j.vaccine.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/10/2022] [Accepted: 03/02/2022] [Indexed: 11/23/2022]
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Kalmar CL, Park BC, Patrinely JR, Drolet BC. COVID-19 Booster Vaccination Has Not Decreased Access for Low-Income Countries. Public Health 2022; 205:e18-e20. [PMID: 35232581 PMCID: PMC8810347 DOI: 10.1016/j.puhe.2022.01.029] [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] [Received: 12/09/2021] [Revised: 01/05/2022] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Affiliation(s)
- C L Kalmar
- Vanderbilt University Medical Center, Nashville, TN, USA.
| | - B C Park
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - J R Patrinely
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - B C Drolet
- Vanderbilt University Medical Center, Nashville, TN, USA
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Tantawichien T, Hsu LY, Zaidi O, Bernauer M, Du F, Yamada E, Kim JO, Sukarom I. Systematic literature review of the disease burden and vaccination of pneumococcal disease among adults in select Asia-Pacific areas. Expert Rev Vaccines 2021; 21:215-226. [PMID: 34894996 DOI: 10.1080/14760584.2022.2016399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Pneumococcal diseases are common and cause significant morbidity and mortality, with higher rates especially in developing areas including many in the Asia-Pacific (AP) region. However, current strategies to prevent pneumococcal disease in adults are quite complicated and not well implemented among many AP areas, and vaccination coverage rates among adults are generally low or perceived as low in the region. Thus, this literature review's purpose was to summarize the disease burden and vaccination against pneumococcal diseases among adults in select AP areas (Australia, Hong Kong, India, Indonesia, South Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam). AREAS COVERED This systematic review included published articles from January 2010 to August 2020 using MEDLINE/Embase. Grey literature websites were searched for national immunization programs and medical society vaccination recommendations from areas of interest. A total of 69 publications were identified. EXPERT OPINION In the AP region, pneumococcal disease burden and serotype prevalence are variable among adult populations, particularly among older adults. Data was provided primarily from countries with established national immunization programs (NIPs). Further research on the disease burden and emphasis on the benefits of vaccination in AP areas lacking pneumococcal vaccination programs is warranted.
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Affiliation(s)
- Terapong Tantawichien
- Department of Medicine, Faculty of Medicine and Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Omer Zaidi
- Evidence & Access, OPEN Health, Newton, MA, USA
| | | | - Frieda Du
- Evidence & Access, OPEN Health, Shanghai, China
| | - Eriko Yamada
- Global Medical and Scientific Affairs, MSD Singapore, Singapore
| | - Jin Oh Kim
- Global Medical and Scientific Affairs, MSD Korea, Seoul, Republic of Korea
| | - Isaya Sukarom
- Center for Observational and Real-world Evidence, MSD Thailand, Bangkok, Thailand
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Ayenigbara IO, Adegboro JS, Ayenigbara GO, Adeleke OR, Olofintuyi OO. The challenges to a successful COVID-19 vaccination programme in Africa. Germs 2021; 11:427-440. [PMID: 34722365 DOI: 10.18683/germs.2021.1280] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 vaccination campaign is an ongoing worldwide effort to vaccinate large numbers of people against COVID-19 in order to ensure protection from the disease, control the rate of infection, reduce severe outcomes, and get back to normal life. Most African countries had a delay in the initiation of their COVID-19 vaccine national rollout compared to other regions in the world, and the goal of the immunization exercise in the continent is to vaccinate over 60% of the African population to attain herd immunity. Over the years, vaccination programmes are usually faced with challenges in Africa because of numerous factors. So far, some of the major challenges threatening the success of the COVID-19 vaccination rollout in most African countries includes the slow onset of the vaccination exercise, limited funds, concerns around vaccine safety and uncertainties, storage requirements and regulatory hurdles for vaccines, limited shelf life of COVID-19 vaccines, inability to access vulnerable communities in a timely fashion, problems around the use of different vaccines, and wars and conflicts. The solutions and other imperative recommendations to these challenges were provided so as to optimize the vaccination programme and to achieve an appreciable success in the COVID-19 vaccination programme on the continent. In conclusion, a holistic and timely planning, fast execution of plans, rigorous community involvement, and a robust multi-sectoral partnership will ensure a successful COVID-19 vaccination campaign in Africa.
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Affiliation(s)
- Israel Oluwasegun Ayenigbara
- M Ed, PhD Student, School and Community Health Education Unit, Department of Health Education, University of Ibadan, post office street number 022, postal code 200284, Ibadan, Nigeria
| | - Joseph Sunday Adegboro
- PhD, Department of Human Kinetics and Health Education, Adekunle Ajasin University Akungba-Akoko, Adefarati street number 001, postal address 342111, Ondo State, Nigeria
| | - George Omoniyi Ayenigbara
- PhD, Department of Human Kinetics and Health Education, Adekunle Ajasin University Akungba-Akoko, Adefarati street number 001, postal address 342111, Ondo State, Nigeria
| | - Olasunkanmi Rowland Adeleke
- M Ed, PhD Student, Department of Human Kinetics and Health Education, Adekunle Ajasin University Akungba-Akoko, Adefarati street number 001, postal address 342111, Ondo State, Nigeria
| | - Oluwaseyi Oye Olofintuyi
- M Ed, Department of Human Kinetics and Health Education, Adekunle Ajasin University Akungba-Akoko, Adefarati street number 001, postal address 342111, Ondo State, Nigeria
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Aemro A, Amare NS, Shetie B, Chekol B, Wassie M. Determinants of COVID-19 vaccine hesitancy among health care workers in Amhara region referral hospitals, Northwest Ethiopia: a cross-sectional study. Epidemiol Infect 2021; 149:e225. [PMID: 34645533 PMCID: PMC8548232 DOI: 10.1017/s0950268821002259] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 11/09/2022] Open
Abstract
Vaccine hesitancy remains a serious global threat to achieve herd immunity, and this study aimed to assess the magnitude and associated factors of coronavirus disease-19 (COVID-19) vaccine hesitancy among healthcare workers (HCWs) in Amhara regional referral hospitals. A web-based anonymised survey was conducted among 440 HCWs in the Amhara region referral hospitals. The questionnaire was designed using Google Forms and distributed using telegram and e-mail from 15 May to 10 June 2021 to the randomly selected participants in each hospital. The data were analysed with Stata 14.0 and described using frequency tables. A multivariable binary logistic regression model was fitted and model fitness was checked with the Hosmer-Lemeshow goodness of fit test. Out of 440 participants, 418 were willing to participate in the study and the mean age was about 30 years. Overall, 45.9% (n = 192) of participants reported vaccine hesitancy. After applying multivariate analysis, age ≤25 years (adjusted odds ratio (aOR) = 5.6); do not wear a mask (aOR = 2.4); not compliance with physical distancing (aOR = 3.6); unclear information by public health authorities (aOR = 2.5); low risk of getting COVID-19 infection (aOR = 2.8); and not sure about the tolerability of the vaccine (aOR = 3.76) were associated with COVID-19 vaccine hesitancy. A considerable proportion of HCWs were hesitant towards COVID-19 vaccine, and this can be tackled with the provision of clear information about the vaccine.
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Affiliation(s)
- Agazhe Aemro
- Department of Medical nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | - Belayneh Shetie
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Basazinew Chekol
- Department of Anesthesiology, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mulugeta Wassie
- Department of Medical nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Johansen K, Nohynek H. No country or continent is on its own in the ongoing COVID-19 pandemic. Euro Surveill 2021; 26:2100430. [PMID: 33928901 PMCID: PMC8086248 DOI: 10.2807/1560-7917.es.2021.26.17.2100430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
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