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Flanagan P, Dowling M, Sezgin D, Mereckiene J, Murphy L, Giltenane M, Carr P, Gethin G. The effectiveness of interventions to improve the seasonal influenza vaccination uptake among nurses: A systematic review. J Infect Prev 2023; 24:268-277. [PMID: 37969468 PMCID: PMC10638950 DOI: 10.1177/17571774231208115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 09/30/2023] [Indexed: 11/17/2023] Open
Abstract
Background Seasonal influenza is a significant cause of mortality and morbidity worldwide. Despite annual recommendations, influenza vaccination uptake rates are disproportionately lower among nurses compared to other health care professionals, especially when compared to physicians. Nurses have an additional risk of exposure to influenza infection due to the nature of their work. Aim To determine the effectiveness of interventions in increasing seasonal influenza vaccination uptake among nurses. Methods Evidence on the effectiveness of interventions to improve seasonal influenza vaccination uptake among nurses was systematically reviewed. A comprehensive search of six electronic databases and grey literature was undertaken. A minimum of two reviewers completed study selection, data extraction and risk of bias assessment independently. Results One hundred and thirty-four studies were identified of which one cluster randomised trial met the inclusion criteria. The results of the included study found the implementation of an intervention with multiple components increased nurses' seasonal influenza vaccination rates during a single influenza season in geriatric healthcare settings in France. As the evidence in this review was very limited, it was not possible to make recommendations regarding which interventions were effective at increasing the seasonal influenza vaccination rate for nurses. Conclusion This systematic review highlights a lack of high-quality studies that assessed interventions to improve the seasonal influenza vaccination of nurses. In view of the likelihood of influenza and the coronavirus (COVID-19) pandemic occurring together, it is imperative to have evidence on effective interventions for the nursing workforce and for policy decision makers.
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Affiliation(s)
- Paula Flanagan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Duygu Sezgin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | | | - Louise Murphy
- School of Nursing and Midwifery, University of Limerick, Galway, Ireland
| | - Martina Giltenane
- School of Nursing and Midwifery, University of Limerick, Galway, Ireland
| | - Peter Carr
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Georgina Gethin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
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Pijpers J, van Roon A, van Roekel C, Labuschagne L, Smagge B, Ferreira JA, de Melker H, Hahné S. Determinants of COVID-19 Vaccine Uptake in The Netherlands: A Nationwide Registry-Based Study. Vaccines (Basel) 2023; 11:1409. [PMID: 37766087 PMCID: PMC10537724 DOI: 10.3390/vaccines11091409] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
By September 2022, the uptake of at least one dose of COVID-19 vaccine in the Dutch adult population was 84%. Ecological studies have indicated a lower uptake in certain population groups. We aimed to investigate determinants of COVID-19 vaccine uptake in the Netherlands at individual level to evaluate and optimize implementation of the vaccination program and generate hypotheses for research on drivers of, and barriers to, vaccination. A retrospective database study was performed including the entire Dutch population ≥ 18. Vaccination data (5 January 2021-18 November 2021) were at individual levels linked to sociodemographic data. Random forest analyses ranked sociodemographic determinants of COVID-19 vaccine uptake. The most important determinant was age; uptake increased until the age of 80 (67% in 18-35 years, 92% in 67-79 years, and 88% in those > 80). Personal income and socioeconomic position ranked second and third, followed by migration status. Uptake was lower among individuals in the lowest income group (69%), those receiving social benefits (56%), and individuals with two parents born abroad (59%). Our finding that age is the most important determinant for uptake likely reflects the prioritisation of elderly in the programme and the general understanding of their increased vulnerability. However, our findings also reveal important other disparities in vaccine uptake. How to best address this inequity in future vaccination campaigns requires further research.
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Affiliation(s)
- Joyce Pijpers
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, 3721 MA De Bilt, The Netherlands
| | - Annika van Roon
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, 3721 MA De Bilt, The Netherlands
| | - Caren van Roekel
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, 3721 MA De Bilt, The Netherlands
| | - Lisanne Labuschagne
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, 3721 MA De Bilt, The Netherlands
| | - Bente Smagge
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, 3721 MA De Bilt, The Netherlands
| | - José A. Ferreira
- Statistics and Modelling, National Institute for Public Health and the Environment, 3721 MA De Bilt, The Netherlands
| | - Hester de Melker
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, 3721 MA De Bilt, The Netherlands
| | - Susan Hahné
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, 3721 MA De Bilt, The Netherlands
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3
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Martínez-Marcos M, Zabaleta-del-Olmo E, Gómez-Durán EL, Reñé-Reñé A, Cabezas-Peña C. Impact of the COVID-19 lockdown on routine childhood-vaccination coverage rates in Catalonia (Spain): a public health register-based study. Public Health 2023; 218:68-74. [PMID: 36972643 PMCID: PMC9968620 DOI: 10.1016/j.puhe.2023.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/12/2023] [Accepted: 02/20/2023] [Indexed: 03/01/2023]
Abstract
Objective The aim of this study was to determine the impact of the lockdown measures adopted during the COVID-19 pandemic on routine childhood-vaccination coverage rates in Catalonia (Spain) and to estimate its recovery once the progressive return to ”normalcy” had begun. Study design We carried out a public health register-based study. Methods Routine childhood-vaccination coverage rates were analysed in three periods, a first pre-lockdown period (from January 2019 to February 2020), a second lockdown period with full restrictions (from March 2020 to June 2020), and, lastly, a third post-lockdown period with partial restrictions (from July 2020 to December 2021). Results During the lockdown period, most of the coverage rates remained stable, concerning the pre-lockdown period; however, when comparing the vaccination coverage rates in the post-lockdown period to the pre-lockdown period, we observed decreases in all types of vaccines and doses analysed, except for coverage with the PCV13 vaccine in two-year-olds, which experienced an increase. The most relevant reductions were observed in MMR and DTaP vaccination coverage rates. Conclusions Since the beginning of the COVID-19 pandemic, there has been an overall decline in routine, childhood vaccine-coverage rates, and the pre-pandemic rates have not yet been recovered. Immediate and long-term support strategies must be maintained and strengthened to restore, and sustain routine childhood-vaccination.
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Affiliation(s)
- Montse Martínez-Marcos
- Preventive Medicine Service, Sub-directorate General for Health Promotion, Secretariat of Public Health, Department of Health, Generalitat de Catalunya, Roc Boronat Street 81-95, 08005 Barcelona, Spain,School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Edurne Zabaleta-del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587, 08007 Barcelona, Spain,Gerència Territorial de Barcelona, Institut Català de la Salut, Balmes Street 22, 08007 Barcelona, Spain,Nursing Department, Faculty of Nursing, Universitat de Girona, Emili Grahit Street 77, 17003 Girona, Spain,Corresponding author. . Tel.: +34 934 824 105
| | - Esperanza-Luisa Gómez-Durán
- Vice-Deanship of Teaching Staff, Faculty of Medicine, Universitat Internacional de Catalunya, Josep Trueta Street, 08195 Sant Cugat del Vallès, Spain
| | - Anna Reñé-Reñé
- Central Vaccine Registry Management Team, Institut Català de la Salut, Santa Clara Street 33, 17001 Girona, Spain
| | - Carmen Cabezas-Peña
- Secretariat of Public Health, Department of Health, Generalitat de Catalunya, Roc Boronat Street 81-95, 08005 Barcelona, Spain
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4
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Young B, Sarwar G, Hossain I, Mackenzie G. Risk factors associated with non-vaccination in Gambian children: a population-based cohort study. Trans R Soc Trop Med Hyg 2022; 116:1063-1070. [PMID: 35696088 PMCID: PMC9623738 DOI: 10.1093/trstmh/trac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND We determined the risk factors associated with unvaccinated children in rural Gambia. METHODS We conducted prospective demographic surveillance and recorded immunisations in real time in the Upper River Region, The Gambia. Analysis included residents born from 1 January 2012 to 31 December 2016. Data included age, sex, household members and relationships, migrations, births, deaths, ethnicity, residential location and birth type. Children were defined as unvaccinated at 10, 15 and 24 mo of age if they missed all primary series doses (pentavalent, oral polio and pneumococcal conjugate vaccines), secondary series (first dose measles and yellow fever vaccines) or both vaccination series, respectively. Logistic regressions measured the association between risk factors and being unvaccinated. RESULTS In total, 5% (1567/30 832) of infants born during the study period and who were residents at the age of 10 mo were unvaccinated. Being unvaccinated at 10 mo of age was associated with children; who did not reside with either parent (adjusted OR 2.26, 95% CI 1.60 to 3.19), whose parents were not the head of household (1.29, 1.09 to 1.52), who had experienced immigration (2.78, 1.52 to 5.08) or who were not of Mandinka ethnicity (between 1.57 and 1.85 for other ethnicities). CONCLUSIONS Family characteristics are associated with unimmunised children in rural Gambia. Our findings may inform strategies to increase vaccine coverage.
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Affiliation(s)
- Benjamin Young
- Corresponding author: Present address: School of Public Health, University of Hong Kong, 7 Sassoon Road, Sandy Bay, Hong Kong SAR. Tel: +852-3917 9055; E-mail:
| | - Golam Sarwar
- MRC Unit The Gambia at LSHTM, Fajara, 00000, The Gambia,London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Ilias Hossain
- MRC Unit The Gambia at LSHTM, Fajara, 00000, The Gambia,London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Grant Mackenzie
- MRC Unit The Gambia at LSHTM, Fajara, 00000, The Gambia,London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom,Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia,Department of Paediatrics, University of Melbourne, Melbourne, VIC 3010, Australia
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5
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Intusoma U, Thewamit R, Thamcharoenvipas T, Khantee P. Epidemiology and burden of Haemophilus influenzae disease in Thai children before implementation of the routine immunisation programme: A National Health Data Analysis. Trop Med Int Health 2022; 27:546-552. [PMID: 35477947 DOI: 10.1111/tmi.13755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To conduct the first pre-Haemophilus influenzae (Hi) type b (Hib) immunisation programme-based epidemiological study using national health data. METHODS We analysed National Health Security Office data, which cover 72% of the Thai population. The study population included children aged <18 years admitted for Hi disease from 2015 to 2019. Hi disease diagnosis and death were based on the International Statistical Classification of Diseases and Related Health Problems (10th revision) hospital discharge summary codes. We estimated the hospital cost per admission using diagnosis-related grouping with a global budget. RESULTS A total of 1125 children aged <18 years were admitted for Hi disease. During the 5-year-study, the annual incidence of Hi disease varied from 1.5 to 1.9 per 100,000 children, with an overall case fatality rate (CFR) of 2%. Pneumonia was the most common clinical form, followed by meningitis and sepsis. The incidence, clinical forms and severity of Hi disease were age specific. Infant CFR was higher than that of other age groups. The incidence of Hi disease in children aged <5 years was 4.9 per 100,000 (CFR = 2.0%). Sepsis was the primary cause of infant death, whereas pneumonia was the cause of death in children aged >5 years. The hospital cost ranged from 25,000 to 30,000 THB per admission. CONCLUSIONS This analysis provided epidemiological data of Hi in Thai children before the Hib routine immunisation programme. The incidence of Hi disease was lower than that previously speculated. Our results could facilitate an assessment of the impact of Hib immunisation programme in Thailand.
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Affiliation(s)
- Utcharee Intusoma
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Rapeepat Thewamit
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Titaporn Thamcharoenvipas
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Puttichart Khantee
- Division of Infectious Disease, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Odone A, Gianfredi V, Sorbello S, Capraro M, Frascella B, Vigezzi GP, Signorelli C. The Use of Digital Technologies to Support Vaccination Programmes in Europe: State of the Art and Best Practices from Experts' Interviews. Vaccines (Basel) 2021; 9:1126. [PMID: 34696234 PMCID: PMC8538238 DOI: 10.3390/vaccines9101126] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/22/2022] Open
Abstract
Digitalisation offers great potential to improve vaccine uptake, supporting the need for effective life-course immunisation services. We conducted semi-structured in-depth interviews with public health experts from 10 Western European countries (Germany, Greece, Italy, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, and the United Kingdom) to assess the current level of digitalisation in immunisation programmes and retrieve data on interventions and best practices. Interviews were performed using an ad hoc questionnaire, piloted on a sample of national experts. We report a mixed level of digital technologies deployment within vaccination services across Europe: Some countries are currently developing eHealth strategies, while others have already put in place robust programmes. Institutional websites, educational videos, and electronic immunisation records are the most frequently adopted digital tools. Webinars and dashboards represent valuable resources to train and support healthcare professionals in immunisation services organisation. Text messages, email-based communication, and smartphone apps use is scattered across Europe. The main reported barrier to the implementation of digital-based programmes is the lack of resources and shared standards. Our study offers a comprehensive picture of the European context and shows the need for robust collaboration between states and international institutions to share best practices and inform the planning of digital intervention models with the aim of countering vaccine hesitancy and increasing vaccine uptake.
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Affiliation(s)
- Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Vincenza Gianfredi
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Sebastiano Sorbello
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Michele Capraro
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Beatrice Frascella
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Giacomo Pietro Vigezzi
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (V.G.); (M.C.); (B.F.); (G.P.V.); (C.S.)
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Koliou M, Kasapi D, Mazeri S, Maikanti P, Demetriou A, Skordi C, Agathocleous M, Tzanakaki G, Constantinou E. Epidemiology of invasive meningococcal disease in Cyprus 2004 to 2018. ACTA ACUST UNITED AC 2020; 25. [PMID: 32734853 PMCID: PMC7393851 DOI: 10.2807/1560-7917.es.2020.25.30.1900534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Despite progress in the management of invasive meningococcal disease (IMD) it causes significant mortality and sequelae. Aim This study aims to describe the epidemiology and clinical characteristics of IMD in Cyprus and discuss the current immunisation programmes. Methods This is a retrospective study of all cases of IMD notified to the Ministry of Health between 2004 and 2018. Demographic, epidemiological, clinical and microbiological data were collected when a new case was notified. Risk factors associated with mortality were investigated using univariable logistic regression. Results 54 cases of IMD were recorded, an overall incidence of 0.4 cases per 100,000 population. The incidence rate was highest among infants (7.2/100,000) and adolescents (1.4/100,000). Case fatality rate was 10.4%. Serogroup B accounted for 24 of 40 cases caused by known serogroup. Serogroups W and Y comprised nine cases and were responsible for most fatal cases. Serogroup C was the cause in only four cases. There was an increase in the odds of death with increasing age, while the presence of meningitis in the clinical picture was found to be associated with lower odds of death. Conclusion Despite the low incidence of IMD in Cyprus, it remains an important cause of morbidity and mortality. Serogroup B is the most frequent serogroup, while incidence of serogroups W and Y is rising. Monitoring new cases and yearly evaluation of the immunisation programmes by the National Immunization Technical Advisory Group (NITAG) is essential for successful control of the disease.
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Affiliation(s)
- Maria Koliou
- Unit for Surveillance and control of Communicable diseases, Medical and Public Health Services, Ministry of Health, Nicosia, Cyprus.,Medical School, University of Cyprus, Nicosia, Cyprus
| | | | - Stella Mazeri
- The Roslin Institute, Division of Genetics and Genomics, Easter Bush Veterinary Centre, Roslin, United Kingdom.,The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom
| | | | - Anna Demetriou
- Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | | | | | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
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Antommaria AH, Prows CA. Content analysis of requests for religious exemptions from a mandatory influenza vaccination program for healthcare personnel. J Med Ethics 2018; 44:389-391. [PMID: 29463693 DOI: 10.1136/medethics-2017-104271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 01/24/2018] [Accepted: 02/06/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Having failed to achieve adequate influenza vaccination rates among employees through voluntary programmes, healthcare organisations have adopted mandatory ones. Some programmes permit religious exemptions, but little is known about who requests religious objections or why. METHODS Content analysis of applications for religious exemptions from influenza vaccination at a free-standing children's hospital in Cincinnati, Ohio, USA during the 2014-2015 influenza season. RESULTS Twelve of 15 260 (0.08%) employees submitted applications requesting religious exemptions. Requestors included both clinical and non-clinical employees. All requestors voluntarily identified their religious affiliation, and most were Christian (n=9). Content analysis identified six categories of reasons used to justify an exemption: risks/benefits, ethical/political, lack of direct patient contact, providence, purity and sanctity of life. Individuals articulated reasons in 1-5 (mean 2.6) categories. The most frequently cited category (n=9) was purity; the vaccine and/or its mode of administration were impure, or receiving the vaccine would make the individual impure. Two individuals asserted that the vaccine contained cells derived from aborted human fetuses. Individuals (n=6) also volunteered information supporting the sincerity of their beliefs including distress over previous vaccination and examples of behaviour consistent with their specific objection or their general religious commitment. All requests were approved. CONCLUSIONS Less than 0.1% of employees requested religious exemptions. Partnering with religious leaders and carefully correcting erroneous information may help address requestors' concerns.
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Affiliation(s)
- Armand H Antommaria
- Ethics Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Cynthia A Prows
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Division of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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9
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Phillips A, Beard F, Macartney K, Chan J, Gilmour R, Saravanos G, McIntyre P. Vaccine-preventable child deaths in New South Wales from 2005 to 2014: How much is preventable? J Paediatr Child Health 2018; 54:356-364. [PMID: 29322575 DOI: 10.1111/jpc.13835] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/29/2017] [Accepted: 10/03/2017] [Indexed: 11/28/2022]
Abstract
AIM To identify and describe potentially vaccine-preventable child deaths in New South Wales (NSW). METHODS Child deaths in NSW from 2005 to 2014 potentially preventable by vaccination were identified from the NSW Child Death Register (maintained by the NSW Ombudsman) and the Notifiable Conditions Information Management System (NSW Health). Medical and post-mortem records were reviewed. Cases were classified as vaccine-preventable based on the strength of evidence for the relevant infection causing death and likelihood that death was preventable through vaccination. A two-source capture-recapture method was used to estimate the true number of deaths. Age-specific mortality rate and number of deaths by disease, area of residence and comorbidity were analysed. Deaths were classified as preventable based on vaccine availability, eligibility under the National Immunisation Program, age and presence of any contraindications. RESULTS Fifty-four deaths were identified as definitely or probably due to diseases for which a vaccine was available, with a total average annual mortality rate of 0.33 per 100 000 children and 2.1 per 100 000 infants. Two thirds of deaths occurred in children with no identified comorbidities. Twenty-three deaths were classified as preventable or potentially preventable by vaccination, with influenza (12 deaths) and meningococcal disease (five deaths) most common. An additional 15 deaths would be potentially preventable as of August 2016 due to immunisation recommendation changes including maternal vaccination. CONCLUSION Maternal vaccination along with increased uptake of childhood influenza vaccination could reduce child deaths, particularly from influenza.
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Affiliation(s)
- Anastasia Phillips
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Frank Beard
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Jocelyn Chan
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Robin Gilmour
- Communicable Diseases Branch, Health Protection NSW, Sydney, New South Wales, Australia
| | - Gemma Saravanos
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Peter McIntyre
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
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10
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Madsen LB, Ustrup M, Hansen KS, Nyasulu PS, Bygbjerg IC, Konradsen F. Estimating the costs of implementing the rotavirus vaccine in the national immunisation programme: the case of Malawi. Trop Med Int Health 2013; 19:177-85. [PMID: 24314006 DOI: 10.1111/tmi.12233] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Worldwide, rotavirus infections cause approximately 453,000 child deaths annually. Two licensed vaccines could be life- and cost-saving in low-income countries where the disease burden is highest. The aim of our study was to estimate the total cost of implementing the rotavirus vaccine in the national immunisation programme of a low-income country. Furthermore, the aim was to examine the relative contribution of different components to the total cost. METHODS Following the World Health Organization guidelines, we estimated the resource use and costs associated with rotavirus vaccine implementation, using Malawi as a case. The cost analysis was undertaken from a governmental perspective. All costs were calculated for a 5-years period (2012-2016) and discounted at 5%. The value of key input parameters was varied in a sensitivity analysis. RESULTS The total cost of rotavirus vaccine implementation in Malawi amounted to US$ 18.5 million over a 5-years period. This translated into US$ 5.8 per child in the birth cohort. With GAVI Alliance financial support, the total cost was reduced to US$ 1.4 per child in the birth cohort. Approximately 83% of the total cost was attributed to vaccine purchase, while 17% was attributed to system costs, with personnel, transportation and cold chain as the main cost components. CONCLUSION The total cost of rotavirus vaccine implementation in Malawi is high compared with the governmental health budget of US$ 26 per capita per year. This highlights the need for new financing opportunities for low-income countries to facilitate vaccine implementation and ensure sustainable financing.
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Affiliation(s)
- Lizell B Madsen
- Department of International Health, Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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11
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Friederichs V, Cameron JC, Robertson C. Impact of adverse publicity on MMR vaccine uptake: a population based analysis of vaccine uptake records for one million children, born 1987-2004. Arch Dis Child 2006; 91:465-8. [PMID: 16638784 PMCID: PMC2082791 DOI: 10.1136/adc.2005.085944] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To determine the impact of adverse publicity on MMR uptake and measles susceptibility, including whether vaccination is delayed and the role of deprivation. METHODS A population database for all Scotland containing immunisation records for over one million children (n = 1,079,327) born 1987-2004 was analysed. MMR uptake was determined by birth cohort and deprivation category. "Final" uptake (at approx age 6 years) was predicted by linear regression by birth cohort. Measles susceptibility in 1998 and 2003 was determined by postcode sector and district for cohorts combined to construct nursery and primary school age groups. RESULTS There is evidence of a slight rise in late uptake, but insufficient to compensate for underlying declines. Late vaccination continues to be associated with deprivation, while the most affluent tend to be vaccinated promptly, or not at all. Predicted figures for "final" MMR1 uptake are over 90%, but under 95%. Measles susceptibility has increased significantly in nursery children, with an eightfold rise in the number of districts with greater than 20% susceptibility in this group (from 3 to 25). CONCLUSIONS Increased measles susceptibility in nursery children is concerning, particularly in the most vulnerable areas. These figures are likely to increase in the future, as MMR uptake has not yet returned to the previous higher level. Increased susceptibility levels can also be expected in primary schools in the future, as levels of late uptake are insufficient to compensate. Predicted figures for "final" MMR1 uptake are under the herd immunity threshold and campaigns may be required to increase uptake among future primary school children.
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Abstract
Risk factors for invasive pneumococcal disease (IPD) include young and old age, comorbidities (such as splenic dysfunction, immunodeficiencies, chronic renal disease, chronic heart or lung disease or cerebral spinal fluid leak), crowded environments or poor socioeconomic conditions. Universal use of the 7-valent pneumococcal conjugate (7vPncCRM) vaccine for infants and young children has led to significant decreases in IPD in the vaccinated population (direct protection), and there has also been a decrease in the incidence of IPD among the nonvaccinated population (indirect immunity; herd protection). While 7vPncCRM vaccine is administered universally to children in USA, many countries of the European Union have chosen to target children with comorbidities. This review aims to highlight individual risk factors for IPD, describe studies that evaluated pneumococcal conjugate vaccines in at-risk groups and estimate the proportion of at-risk children who may have been vaccinated in the European Union since the 7vPncCRM vaccine was introduced, using UK as an example. Although immunisation targeting only children with comorbidities may achieve satisfactory results for a few, many otherwise healthy children at risk simply because of their age will be neglected, and herd protection might not be established.
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