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Doherty TM, Ecarnot F, Gaillat J, Privor-Dumm L. Nonstructural barriers to adult vaccination. Hum Vaccin Immunother 2024; 20:2334475. [PMID: 38629573 PMCID: PMC11028002 DOI: 10.1080/21645515.2024.2334475] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024] Open
Abstract
Adult vaccination coverage remains low, despite vaccine recommendations, improved access, and reimbursement. Low vaccination coverage and an aging population at higher risk from vaccine-preventable diseases lead to preventable disability and deaths, straining healthcare systems. An Advisory Board meeting was, therefore, held to identify non-structural barriers to adult vaccination and discuss potential solutions to increase uptake. Many non-structural factors can influence vaccine uptake, such as heterogeneity in the population, (fear of) vaccine shortages, incentives, or mandates for vaccination, understanding of disease burden and personal risks, time and opportunity for healthcare providers (HCPs) to discuss and deliver vaccines during general practice or hospital visits, trust in the health system, and education. To address these barriers, push-pull mechanisms are required: to pull patients in for vaccination and to push HCP performance on vaccination delivery. For patients, the focus should be on lifelong prevention and quality of life benefits: personal conversations are needed to increase confidence and knowledge about vaccination, and credible communication is required to build trust in health services and normalize vaccination. For providers, quality measurements are required to prioritize vaccination and ensure opportunities to check vaccination status, discuss and deliver vaccines are not missed. Financial and quality-based incentives may help increase uptake.
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Affiliation(s)
| | | | | | - Lois Privor-Dumm
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Franklin D, Barbre K, Rowe TA, Reses HE, Massey J, Meng L, Dollard P, Dubendris H, Stillions M, Robinson L, Clerville JW, Slifka KJ, Benin A, Bell JM. COVID-19 Vaccination Coverage, and Rates of SARS-CoV-2 Infection and COVID-19-Associated Hospitalization Among Residents in Nursing Homes - National Healthcare Safety Network, United States, October 2023-February 2024. MMWR Morb Mortal Wkly Rep 2024; 73:339-344. [PMID: 38635474 PMCID: PMC11037435 DOI: 10.15585/mmwr.mm7315a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Nursing home residents are at increased risk for developing severe COVID-19. Nursing homes report weekly facility-level data on SARS-CoV-2 infections, COVID-19-associated hospitalizations, and COVID-19 vaccination coverage among residents to CDC's National Healthcare Safety Network. This analysis describes rates of incident SARS-CoV-2 infection, rates of incident COVID-19-associated hospitalization, and COVID-19 vaccination coverage during October 16, 2023-February 11, 2024. Weekly rates of SARS-CoV-2 infection ranged from 61.4 to 133.8 per 10,000 nursing home residents. The weekly percentage of facilities reporting one or more incident SARS-CoV-2 infections ranged from 14.9% to 26.1%. Weekly rates of COVID-19-associated hospitalization ranged from 3.8 to 7.1 per 10,000 residents, and the weekly percentage of facilities reporting one or more COVID-19-associated hospitalizations ranged from 2.6% to 4.7%. By February 11, 2024, 40.5% of nursing home residents had received a dose of the updated 2023-2024 COVID-19 vaccine that was first recommended in September 2023. Although the peak rate of SARS-CoV-2 infection among nursing home residents was lower during the 2023-24 respiratory virus season than during the three previous respiratory virus seasons, nursing home residents continued to be disproportionately affected by SARS-CoV-2 infection and related severe outcomes. Vaccination coverage remains suboptimal in this population. Ongoing surveillance for SARS-CoV-2 infections and COVID-19-associated hospitalizations in this population is necessary to develop and evaluate evidence-based interventions for protecting nursing home residents.
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Medeni V, Altıner ÖT, Medeni İ. Measles vaccination coverage and immunization status of nurses: An interventional study in Türkiye. Vaccine 2024; 42:2716-2721. [PMID: 38503662 DOI: 10.1016/j.vaccine.2024.03.037] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/02/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Healthcare workers are more likely to contract measles than the general population. Our study aimed to assess measles vaccination and immunization levels among nurses, examine the influencing factors and implement an intervention program to increase immunization coverage. MATERIALS AND METHODS Our study was conducted in a university hospital in Türkiye. The study included 1012 nurses. It was an intervention study, continued between 01/11/2021 and 30/10/2023. Measles IgG and vaccination status of the participants were evaluated. Participants with negative measles IgG results who had not been vaccinated against measles or received a single dose of the vaccine were invited to the outpatient clinic to receive two doses. Participants who had received two doses of the measles vaccine and had negative measles IgG results were invited to the outpatient clinic for one dose of the measles vaccine. Nine hundred seventy-eight people participated in our study. The access frequency was 96.6%. RESULTS Among the participants aged 21-30, 68.4 % were Measles IgG (+). Measles IgG (+) prevalence was higher in women than men (85.3 % vs. 61.0 %). The department with the lowest measles IgG positivity was intensive care (75.8 %). Measles IgG (+) prevalence became higher as the duration of employment increased. The measles seropositivity in total population rose from 83.1 % before the intervention to 94.3 % after, to 91.8 % in the 21-30 age group, and to 90.2 % in male. Sixteen people had never received measles vaccination. Of the 37 participants who had previously received two doses of measles vaccine, 22 received a single dose and after the intervention 16 (72.7 %) were positive. Only 1 person was found to have vaccine refusal during the intervention. CONCLUSION Expanding the immunization scope in hospitals by screening for measles antibodies among healthcare personnel and vaccinating those who are seronegative can be considered an effective public health strategy.
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Affiliation(s)
- Volkan Medeni
- Department of Public Health, Faculty of Medicine, Gazi University, Ankara, Türkiye.
| | | | - İrem Medeni
- Employee Health Department, General Directorate of Public Health, Ministry of Health, Ankara, Türkiye
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Mathis AD, Raines K, Masters NB, Filardo TD, Kim G, Crooke SN, Bankamp B, Rota PA, Sugerman DE. Measles - United States, January 1, 2020-March 28, 2024. MMWR Morb Mortal Wkly Rep 2024; 73:295-300. [PMID: 38602886 PMCID: PMC11008791 DOI: 10.15585/mmwr.mm7314a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Measles is a highly infectious febrile rash illness and was declared eliminated in the United States in 2000. However, measles importations continue to occur, and U.S. measles elimination status was threatened in 2019 as the result of two prolonged outbreaks among undervaccinated communities in New York and New York City. To assess U.S. measles elimination status after the 2019 outbreaks and to provide context to understand more recent increases in measles cases, CDC analyzed epidemiologic and laboratory surveillance data and the performance of the U.S. measles surveillance system after these outbreaks. During January 1, 2020-March 28, 2024, CDC was notified of 338 confirmed measles cases; 97 (29%) of these cases occurred during the first quarter of 2024, representing a more than seventeenfold increase over the mean number of cases reported during the first quarter of 2020-2023. Among the 338 reported cases, the median patient age was 3 years (range = 0-64 years); 309 (91%) patients were unvaccinated or had unknown vaccination status, and 336 case investigations included information on ≥80% of critical surveillance indicators. During 2020-2023, the longest transmission chain lasted 63 days. As of the end of 2023, because of the absence of sustained measles virus transmission for 12 consecutive months in the presence of a well-performing surveillance system, U.S. measles elimination status was maintained. Risk for widespread U.S. measles transmission remains low because of high population immunity. However, because of the increase in cases during the first quarter of 2024, additional activities are needed to increase U.S. routine measles, mumps, and rubella vaccination coverage, especially among close-knit and undervaccinated communities. These activities include encouraging vaccination before international travel and rapidly investigating suspected measles cases.
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Affiliation(s)
- Adria D. Mathis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Kelley Raines
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Nina B. Masters
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Thomas D. Filardo
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Gimin Kim
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen N. Crooke
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Bettina Bankamp
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Paul A. Rota
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - David E. Sugerman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
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Doshi RH, Nsasiirwe S, Dahlke M, Atagbaza A, Aluta OE, Tatsinkou AB, Dauda E, Vilajeliu A, Gurung S, Tusiime J, Braka F, Bwaka A, Wanyoike S, Brooks DJ, Blanc DC, Alexander JP, Dahl BA, Lindstrand A, Wiysonge CS. COVID-19 Vaccination Coverage - World Health Organization African Region, 2021-2023. MMWR Morb Mortal Wkly Rep 2024; 73:307-311. [PMID: 38602879 PMCID: PMC11008790 DOI: 10.15585/mmwr.mm7314a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
With the availability of authorized COVID-19 vaccines in early 2021, vaccination became an effective tool to reduce COVID-19-associated morbidity and mortality. Initially, the World Health Organization (WHO) set an ambitious target to vaccinate 70% of the global population by mid-2022. However, in July 2022, WHO recommended that all countries, including those in the African Region, prioritize COVID-19 vaccination of high-risk groups, including older adults and health care workers, to have the greatest impact on morbidity and mortality. As of December 31, 2023, approximately 860 million doses of COVID-19 vaccine had been delivered to countries in the African Region, and 646 million doses had been administered. Cumulatively, 38% of the African Region's population had received ≥1 dose, 32% had completed a primary series, and 21% had received ≥1 booster dose. Cumulative total population coverage with ≥1 dose ranged by country from 0.3% to 89%. Coverage with the primary series among older age groups was 52% (range among countries = 15%-96%); primary series coverage among health care workers was 48% (range = 13%-99%). Although the COVID-19 public health emergency of international concern was declared over in May 2023, current WHO recommendations reinforce the need to vaccinate priority populations at highest risk for severe COVID-19 disease and death and build more sustainable programs by integrating COVID-19 vaccination into primary health care, strengthening immunization across the life course, and improving pandemic preparedness.
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de Oliveira Andrade R. After years of decline, Brazil sees vaccination coverage rise in 2023. BMJ 2024; 385:q668. [PMID: 38565254 DOI: 10.1136/bmj.q668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
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Basa JE, Clemens R, Clemens SAC, Nicholson M. Landscaping analysis of immunization progress and program structures in selected middle income Southeast Asian countries. Vaccine 2024; 42:2326-2336. [PMID: 38448324 DOI: 10.1016/j.vaccine.2024.02.047] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/28/2024] [Accepted: 02/14/2024] [Indexed: 03/08/2024]
Abstract
This study examined the performance and structures of national immunization program in five middle-income Southeast Asian countries - Malaysia, Thailand, Philippines, Viet Nam, and Myanmar, and analyzed how the different structures relate to the difference in program performance to identify effective strategies in the study countries that facilitated good immunization performance. Data were derived from published literature, and WHO/UNICEF/Gavi databases, with 2010 as the baseline year. UMICs Malaysia and Thailand maintained ≥90 % coverage from 2010 to 2020 and even during the COVID-19 pandemic in 2021. LMICs Viet Nam and donor-supported Myanmar also achieved 80-90 % coverage for most routine vaccines in 2020. The Philippines have not reached ≥90 % coverage since 2010, with the maximum only 72 % (MCV1 and Polio3) in 2020. All study countries prioritize immunization and increased government financing since 2010 by minimum 91 % in Malaysia and 1897 % in Myanmar. However, Myanmar still largely depended on donor support with government financing only 32 % of immunization costs in 2021. The Philippines funds 100 % of immunization costs and ensures sustainable financing for the NIP through earmarked "sin tax" revenues from alcohol and tobacco. Donor support influenced new vaccine introductions among the study countries, with Gavi countries Myanmar and Viet Nam introducing more new vaccines, compared to Gavi-ineligible Malaysia and Thailand. The Philippines reported vaccine stock-outs every year amounting to 28 stock-outs events from 2010 to 2019, compared to only 1-4 stockouts in the other study countries. Donor support, innovative financing, and domestic vaccine manufacturing all play an important role in the efficient delivery of immunization services as demonstrated by the several new vaccine introductions and high immunization rates in Myanmar though Gavi and UNICEF support, additional annual $1.2 billion budget for health and immunization from "sin taxes" in the Philippines, and lack of stockouts for vaccines sourced at affordable prices from domestic manufacturers in Viet Nam.
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Affiliation(s)
- Jessabelle E Basa
- Research Institute for Tropical Medicine, Department of Health, Philippines; Institute for Global Health, University of Siena, Siena, Italy.
| | - Ralf Clemens
- Institute for Global Health, University of Siena, Siena, Italy; International Vaccine Institute (IVI), Seoul, Republic of Korea
| | - Sue Ann Costa Clemens
- Institute for Global Health, University of Siena, Siena, Italy; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
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von der Schulenburg P, Herting A, Harberts A, Lütgehetmann M, Jahnke‐Triankowski J, Pischke S, Piecha F, Drolz A, Jörg V, Hübener P, Wehmeyer M, Addo MM, Fischer L, Lohse AW, Schulze Zur Wiesch J, Sterneck M. High vaccination coverage and infection rate result in a robust SARS-CoV-2-specific immunity in the majority of liver cirrhosis and transplant patients: A single-center cross-sectional study. United European Gastroenterol J 2024; 12:339-351. [PMID: 38279837 PMCID: PMC11017769 DOI: 10.1002/ueg2.12528] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/09/2023] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND In the third year of the SARS-CoV-2 pandemic, little is known about the vaccine- and infection-induced immune response in liver transplant recipients (LTR) and liver cirrhosis patients (LCP). OBJECTIVE This cross-sectional study assessed the vaccination coverage, infection rate, and the resulting humoral and cellular SARS-CoV-2-specific immune responses in a cohort of LTR and LCP at the University Medical Center Hamburg-Eppendorf, Germany between March and May 2023. METHODS Clinical and laboratory data from 244 consecutive patients (160 LTR and 84 LCP) were collected via chart review and a patient survey. Immune responses were determined via standard spike(S)- and nucleocapsid-protein serology and a spike-specific Interferon-gamma release assay (IGRA). RESULTS On average, LTR and LCP were vaccinated 3.7 and 3.3 times, respectively and 59.4% of patients received ≥4 vaccinations. Altogether, 68.1% (109/160) of LTR and 70.2% (59/84) of LCP experienced a SARS-CoV-2 infection. Most infections occurred during the Omicron wave in 2022 after an average of 3.0 vaccinations. Overall, the hospitalization rate was low (<6%) in both groups. An average of 4.3 antigen contacts by vaccination and/or infection resulted in a seroconversion rate of 98.4%. However, 17.5% (28/160) of LTR and 8.3% (7/84) of LCP demonstrated only low anti-S titers (<1000 AU/ml), and 24.6% (16/65) of LTR and 20.4% (10/59) of LCP had negative or low IGRA responses. Patients with hybrid immunity (vaccination plus infection) elicited significantly higher anti-S titers compared with uninfected patients with the same number of spike antigen contacts. A total of 22.2% of patients refused additional booster vaccinations. CONCLUSION By spring 2023, high vaccination coverage and infection rate have resulted in a robust, mostly hybrid, humoral and cellular immune response in most LTR and LCP. However, booster vaccinations with vaccines covering new variants seem advisable, especially in patients with low immune responses and risk factors for severe disease.
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Affiliation(s)
- P. von der Schulenburg
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - A. Herting
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - A. Harberts
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - M. Lütgehetmann
- German Center for Infection Research (DZIF)Partner Site Hamburg‐Lübeck‐Borstel‐RiemsBraunschweigGermany
- Institute of Medical Microbiology, Virology and HygieneUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - J. Jahnke‐Triankowski
- Department of Visceral Transplant SurgeryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- University Transplant CenterUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - S. Pischke
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- German Center for Infection Research (DZIF)Partner Site Hamburg‐Lübeck‐Borstel‐RiemsBraunschweigGermany
| | - F. Piecha
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - A. Drolz
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - V. Jörg
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - P. Hübener
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - M. Wehmeyer
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - M. M. Addo
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- German Center for Infection Research (DZIF)Partner Site Hamburg‐Lübeck‐Borstel‐RiemsBraunschweigGermany
- Department for Clinical Immunology of Infectious DiseasesBernhard‐Nocht‐Institute for Tropical MedicineHamburgGermany
- University Medical Center Hamburg‐EppendorfInstitute for Infection Research and Vaccine Development (IIRVD)HamburgGermany
| | - L. Fischer
- Department of Visceral Transplant SurgeryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- University Transplant CenterUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - A. W. Lohse
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- German Center for Infection Research (DZIF)Partner Site Hamburg‐Lübeck‐Borstel‐RiemsBraunschweigGermany
| | - J. Schulze Zur Wiesch
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- German Center for Infection Research (DZIF)Partner Site Hamburg‐Lübeck‐Borstel‐RiemsBraunschweigGermany
| | - M. Sterneck
- I. Department of Internal MedicineUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- University Transplant CenterUniversity Medical Center Hamburg‐EppendorfHamburgGermany
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Nguyen KH, McChesney C, Rodriguez C, Vasudevan L, Bednarczyk RA, Corlin L. Child and adolescent COVID-19 vaccination coverage by educational setting, United States. Public Health 2024; 229:126-134. [PMID: 38430658 PMCID: PMC10961195 DOI: 10.1016/j.puhe.2024.01.029] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/20/2024] [Accepted: 01/27/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES The COVID-19 pandemic changed the setting of education for many children in the U.S. Understanding COVID-19 vaccination coverage by educational setting is important for developing targeted messages, increasing parents' confidence in COVID-19 vaccines, and protecting all children from severe effects of COVID-19 infection. STUDY DESIGN/METHODS Using data from the Household Pulse Survey (n = 25,173) collected from December 9-19, 2022, January 4-16, 2023, and February 1-13, 2023, this study assessed factors associated with COVID-19 vaccination and reasons for non-vaccination among school-aged children 5-11 and adolescents 12-17 by educational setting. RESULTS Among children 5-11 years, COVID-19 vaccination coverage was higher among those who received in-person instruction (53.7%) compared to those who were homeschooled (32.5%). Furthermore, among adolescents 12-17 years, COVID-19 vaccination coverage was higher among those who received in-person instruction (73.5%) or virtual/online instruction (70.1%) compared to those who were homeschooled (51.0%). Children and adolescents were more likely to be vaccinated if the parental respondent had been vaccinated compared to those who had not. Among children and adolescents who were homeschooled, main reasons for non-vaccination were concern about side effects (45.4-51.6%), lack of trust in COVID-19 vaccines (45.0-50.9%), and lack of trust in the government (32.7-39.2%). CONCLUSIONS Children and adolescents who were home-schooled during the pandemic had lower vaccination coverage than those who attended school in person, and adolescents who were home-schooled had lower vaccination coverage than those who received virtual instruction. Based on the reasons for non-vaccination identified in this study, increasing parental confidence in vaccines, and reducing barriers to access are important for supporting COVID-19 vaccination for school-age children.
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Affiliation(s)
- K H Nguyen
- Department of Epidemiology, George Washington University School of Public Health, Washington, DC, 20037, USA; Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - C McChesney
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - C Rodriguez
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - L Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - R A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - L Corlin
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA
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Lanza-León P, Cantarero-Prieto D, Pascual-Sáez M. Exploring trends and determinants of basic childhood vaccination coverage: Empirical evidence over 41 years. PLoS One 2024; 19:e0300404. [PMID: 38512892 PMCID: PMC10956826 DOI: 10.1371/journal.pone.0300404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children's Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.
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Affiliation(s)
- Paloma Lanza-León
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
| | - David Cantarero-Prieto
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
| | - Marta Pascual-Sáez
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
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Jabbar F, Kadhim KA, Alhilfi RA, Chitheer A, Rahi A, Hipgrave DB. Intensification of integrated immunization services to recover routine vaccination coverage and bring COVID-19 vaccine to the population of Iraq in 2022. Vaccine 2024; 42:2036-2043. [PMID: 38418341 DOI: 10.1016/j.vaccine.2024.02.038] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 03/01/2024]
Abstract
INTRODUCTION COVID-19 seriously impacted routine immunization (RI) in Iraq. Coverage declined to a 6-year low in 2021, and COVID-19 vaccination uptake was slow. In response, government implemented intensification of integrated immunization services (3IS), a nationwide approach comprising regular outreach sessions of COVID-19 vaccination and RI for children who had either missed doses or never commenced scheduled vaccination (zero-dose children). We describe the 3IS and its impact on vaccination coverage in Iraq. METHODS 3IS comprised new outreach sessions for urban and rural communities where administrative data suggested there were gaps in coverage. Groups of six personnel from each of 1,321 primary healthcare centres implemented six outreach sessions per month during February-November 2022. Community engagement was an integral component. We compared RI administrative data (2019-2022) and data reported during 3IS activities to assess its impact. RESULTS In total 4,189,859 vaccine doses were administered during 72,495 3IS outreach sessions, over one-fifth of 19,106,849 vaccine doses administered in Iraq over these 10 months. Among them, 957,874 (22.9 %) were COVID-19 vaccines, adding slightly to national coverage, and 3,231,985 (77.1 %) were RI vaccines, dramatically reducing zero-dose children, adding 18 %, 25 %, 21 %, and 31 % to 2022 penta1, penta3, measles first-dose and MMR1 vaccine coverage, and contributing to national coverage of 102.2 %, 94.5 %, 91.8 % and 96.3 % for these vaccines during February-November, respectively. Moreover, 3IS sessions delivered 133,528 doses of tetanus toxoid, 16,353 doses of adult HepB vaccine, and 315,032 vitamin A doses to eligible individuals. CONCLUSION In the context of global encouragement to integrate vaccination services, Iraq's 3IS approach enabled dramatic improvements in RI coverage, virtual elimination of zero-dose status among children born during the pandemic, and small improvements in COVID-19 and adult vaccination. Our findings provide lessons for future integrated primary care towards universal health coverage in Iraq, and for other countries yet to undertake integration.
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Affiliation(s)
- Firas Jabbar
- Expanded Programme on Immunization, Ministry of Health, Baghdad, Iraq
| | - Kamal A Kadhim
- Expanded Programme on Immunization, Ministry of Health, Baghdad, Iraq
| | | | - Abdulaal Chitheer
- Expanded Programme on Immunization, Ministry of Health, Baghdad, Iraq
| | - Alaa Rahi
- Health and Nutrition Section, UNICEF, Baghdad, Iraq.
| | - David B Hipgrave
- Health and Nutrition Section, UNICEF, Baghdad, Iraq; Saw Swee Hock School of Public Health, National University of Singapore; SingHealth Duke-NUS Global Health Institute, Singapore.
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Rockson Adjei M, Longsignikuu A, Saeed Iddris I, Nang Suuri T, Asamoah B, Okoye M, Vanessa Baafi J, Kubio C, Ohene SA, Grobusch MP. Trend of measles-rubella vaccination coverage and impact on measles epidemiology in the Savannah Region, Ghana; 2018-2022: A secondary data analysis. Vaccine 2024; 42:1910-1917. [PMID: 38365480 PMCID: PMC11080765 DOI: 10.1016/j.vaccine.2024.02.024] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Ghana witnessed an outbreak of measles in 2022 following the COVID-19 pandemic, and Savannah Region was among the regions severely impacted. The objective of this study was to conduct trend analysis of measles case incidence and measles-rubella (MR) vaccination coverage in the Savannah Region to identify gaps and propose remedial actions to mitigate future outbreaks of vaccine preventable diseases (VPDs). METHODS Analysis of measles surveillance and measles-rubella vaccination data for 2018-2022 was conducted to assess relationship between immunization coverage and measles case incidence. Data were extracted from the District Health Information Management System (DHIMS) platform and loaded into Microsoft Excel 16.0 spreadsheet for analysis. Coverages for first (MR1) and second (MR2) doses of measles-rubella vaccination, dropout rates, and measles incidence (per 100,000) were calculated. RESULTS The coverage trend for both vaccine doses followed similar trajectories, increasing from 2018 to a peak in 2019, and declining sequentially thereafter to the lowest (for the study period) in 2022. Generally, MR1/MR2 dropout rate was high across all districts during the entire study period. The regional incidence of confirmed measles rose sharply from less than 1/1,000,000 in 2018-2021 to 94 in 2022. Wide variations in vaccination coverage and dropout rates were observed among the districts. There was moderate to fairly strong negative correlation between MR vaccination coverage and measles case incidence. CONCLUSIONS The MR vaccination coverage in the Savannah Region declined probably due to pre-existing weaknesses in the immunization programme accentuated by impact of the COVID-19 pandemic. The lowered population immunity likely contributed to occurrence of the measles outbreak in 2022. Pragmatic actions are needed to catch-up on missed children, restore coverage to pre-pandemic levels, and strengthen the immunization programme as part of global efforts towards achieving the Immunization Agenda 2030 (IA2030) trajectory.
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Affiliation(s)
- Michael Rockson Adjei
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Iocation AMC, University of Amsterdam, Amsterdam, the Netherlands; World Health Organization, Country Office, Accra, Ghana.
| | - Amos Longsignikuu
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | - Ibrahim Saeed Iddris
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | - Thomas Nang Suuri
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | | | | | - Janet Vanessa Baafi
- Ghana Health Service, District Health Directorate, Sunyani West, Odumase, Ghana
| | - Chrysantus Kubio
- Ghana Health Service, Regional Health Directorate, Savannah Region, Damongo, Ghana
| | | | - Martin Peter Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Iocation AMC, University of Amsterdam, Amsterdam, the Netherlands; Institute of Tropical Medicine, and German Center of Infectious Diseases (DZIF), University of Tuebingen, Tuebingen, Germany; Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa; Centre de Recherches Médicales En Lambaréné (CERMEL), Lambaréné, Gabon; Masanga Medical Research Unit, Masanga, Sierra Leone
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Souza JFA, da Silva TPR, Oliveira TM, Vimieiro AM, Teixeira AMDS, Soares AC, Ribeiro EEN, de Freitas GL, Gaspar ED, Matozinhos FP. Impact of a research-action on vaccination indicators in the state of Minas Gerais, Brazil. Rev Saude Publica 2024; 58:09. [PMID: 38477780 PMCID: PMC10926982 DOI: 10.11606/s1518-8787.2024058005484] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/23/2023] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE Analyze the impact of the state research-action project on immunization indicators (vaccination coverage - VC, homogeneity of vaccination coverage - HVC, dropout rate - DR, and risk rating) before and after the intervention in municipalities and priority Regional Health Administrations/Regional Health Superintendencies (RHA/RHS). METHODS The state research-action project was a before-after community clinical trial conducted in 212 municipalities belonging to eight RHA/RHS in the state of Minas Gerais, Brazil. The study sample comprised RHA/RHS with a decreasing trend for routine vaccination coverage in children under one year from 2015 to 2020. This study used secondary VC and DR data from 10 immunobiologicals recommended for children younger than two years from January to December 2021 (pre-intervention period, prior to the state research-action project) and from January to December 2022 (post-intervention period). The categorical variables were presented in proportions, and initially, a comparison was made between those of DR, HVC, and the risk rating for the transmission of vaccine-preventable diseases, according to the two periods (2021 and 2022), using the McNemar test. RESULTS All immunization indicators increased after conducting the research-action project. In 2021, 80.66% of the state's municipalities had a risk rating for the transmission of vaccine-preventable diseases as "high and very high." In 2022, the value reduced to 68.40%. CONCLUSIONS Risk rating for the transmission of vaccine-preventable diseases is an important mechanism to assist managers in defining priorities. The state research-action project used a method that enabled the construction and execution of unique action plans for each municipality, directing the improvement of immunization indicators in the state.
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Affiliation(s)
- Janaina Fonseca Almeida Souza
- Universidade Federal de Minas GeraisEscolas de EnfermagemPrograma de Pós-graduação em Saúde e EnfermagemBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escolas de Enfermagem. Programa de Pós-graduação em Saúde e Enfermagem. Belo Horizonte, MG, Brasil
- Secretária de Estado da Saúde de Minas GeraisBelo HorizonteMGBrasil Secretária de Estado da Saúde de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Thales Philipe Rodrigues da Silva
- Universidade Federal de Minas GeraisEscolas de EnfermagemPrograma de Pós-graduação em Saúde e EnfermagemBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escolas de Enfermagem. Programa de Pós-graduação em Saúde e Enfermagem. Belo Horizonte, MG, Brasil
- Universidade Federal de São PauloEscola Paulista de EnfermagemDepartamento de Enfermagem na Saúde da MulherSão PauloSPBrasilUniversidade Federal de São Paulo. Escola Paulista de Enfermagem. Departamento de Enfermagem na Saúde da Mulher. São Paulo, SP, Brasil
| | - Thais Moreira Oliveira
- Santa Casa de Belo HorizonteBelo HorizonteMGBrasil Santa Casa de Belo Horizonte. Belo Horizonte, MG, Brasil
| | - Aline Mendes Vimieiro
- Secretária de Estado da Saúde de Minas GeraisBelo HorizonteMGBrasil Secretária de Estado da Saúde de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Adriana Coelho Soares
- Secretária de Estado da Saúde de Minas GeraisBelo HorizonteMGBrasil Secretária de Estado da Saúde de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Elice Eliane Nobre Ribeiro
- Secretária de Estado da Saúde de Minas GeraisBelo HorizonteMGBrasil Secretária de Estado da Saúde de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Giselle Lima de Freitas
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Eduarda Dantas Gaspar
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Fernanda Penido Matozinhos
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
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Senjam SS, Manna S, Goel G, Balhara YPS, Ray A, Gupta Y, Lomi N, Gupta V, Vashist P, Titiyal JS, Kashyap N, Kumar R. Vaccination coverage against COVID-19 among rural population in Haryana, India: A cross-sectional study. PLoS One 2024; 19:e0299564. [PMID: 38457391 PMCID: PMC10923481 DOI: 10.1371/journal.pone.0299564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/13/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Conducting a study in rural pre-dominant areas will help to understand the penetration of the vaccination campaign during the COVID-19 health crisis. This study aimed to investigate vaccination coverage against COVID-19 among the rural adult population in India and to identify factors associated with vaccination coverage. METHODS A population-based cross-sectional study was conducted among the rural population in one district of north India from January to February 2023. A semi-structured questionnaire was designed on the SurveyMonkey digital platform for interviewing the participants, which consisted of questions related to socio-demographic profile, health problems, vaccination status, types of vaccine, re-infection after vaccination, and functional difficulties. The data regarding infection with COVID-19 was collected based on self-reported positive testing for SARS-CoV 2 on RT-PCR. FINDINGS A total of 3700 eligible individuals were enumerated for the survey, out of which 2954 (79.8%) were interviewed. The infection rate of past COVID-19 infection, based on self-report of testing positive, was 6.2% (95%CI: 5.3-7.1). Covishield vaccine was received by most participants (81.3%, 2380) followed by Covaxin (12.3%, 361) and Pfizer manufactured vaccine (0.03,1). The coverage for first, second, and booster doses of the vaccine was 98.2% (2902), 94.8% (2802), and 10.7% (315) respectively. The risk of reinfection at 12 months or more among participants with two doses of vaccine was 1.6% (46/2802, 95%CI: 1.2-2.1). The coverage among those with severe functional difficulties was lesser as compared to those with some or no difficulties. INTERPRETATION Vaccination coverage against COVID-19 in rural Haryana, India is not dependent on factors like gender or occupation but is dependent on age and education. Although the full and partial vaccination coverage is high, the booster dose coverage is poor. In addition, the presence of severe disability was significantly associated with reduced vaccination coverage.
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Affiliation(s)
- Suraj Singh Senjam
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Souvik Manna
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Goel
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Yatan Pal Singh Balhara
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Animesh Ray
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Yashdeep Gupta
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Neiwete Lomi
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Vashist
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jeewan Singh Titiyal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Nitin Kashyap
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Nguyen KH, Chen S, Zhao R, Vasudevan L, Beninger P, Bednarczyk RA. Vaccination patterns and up-to-date status of children 19-35 months, 2011-2021. Vaccine 2024; 42:1617-1629. [PMID: 38341291 DOI: 10.1016/j.vaccine.2024.01.096] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Being up-to-date with all recommended vaccines is needed to protect children from vaccine preventable diseases. Understanding vaccination patterns is needed to develop messaging and strategies to increase vaccination uptake and confidence. METHODS Data from the 2011 to 2021 National Immunization Surveys was used to assess trends and disparities in vaccination patterns, zero vaccination status, and up-to-date status of U.S. children by 19-35 months. RESULTS From 2011 to 2021, adherence to the recommended schedule using the stringent definition increased from 35.7 % to 52.2 % (p < 0.01), adherence to the alternate schedule decreased from 28.2 % to 15.1 % (p < 0.01), and proportion of children who were not up-to-date decreased from 49.0 % to 33.3 % (p < 0.01). However, the proportion of children who had zero vaccinations did not change from 2011 (0.9 %) to 2021 (0.9 %; p = 0.08). In 2021, children 19-23 months were less likely to follow the recommended schedule than children 24-29 months (49.2 % compared to 56.4 %, p < 0.01). Adherence to the recommended schedule among children 19-23 months decreased in 2021 compared to 2020 overall and for some subpopulations (e.g. those with non-Hispanic (NH) Black parents (33.2 % compared to 44.9 %, p < 0.01). Furthermore, it was lowest among children of NH Black parents living at or below the federal poverty level (31.2 %) compared to their respective NH White counterparts (43.6 %, p < 0.01). CONCLUSIONS While there were overall increases in adherence to the recommended schedule from 2011 to 2021, a sustained catch-up program is needed to prevent missed vaccinations and achieve equitable vaccination coverage for all children.
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Affiliation(s)
- Kimberly H Nguyen
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA; Department of Epidemiology, George Washington University School of Public Health, Washington, DC 20037, USA.
| | - Siyu Chen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Ruitong Zhao
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA, USA
| | - Lavanya Vasudevan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Paul Beninger
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA; Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA; Emory Vaccine Center, Emory University, Atlanta, GA, USA
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Zemariam AB, Abebe GK, Kassa MA, Alamaw AW, Molla RW, Abate BB, Tilahun BD, Wondie WT, Shimelash RA, Fentanew M. Immunization coverage and its associated factors among children aged 12-23 months in Ethiopia: An umbrella review of systematic review and meta-analysis studies. PLoS One 2024; 19:e0299384. [PMID: 38451961 PMCID: PMC10919590 DOI: 10.1371/journal.pone.0299384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/09/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Immunization estimated to prevent 2 to 3 million children deaths every year from vaccine preventable disease. In Ethiopia, limited and inconclusive studies have been conducted on immunization coverage so far. Therefore, this umbrella review was intended to estimate the pooled national immunization coverage and its associated factors among children age 12-23 months in Ethiopia. METHODS This umbrella review included five systematic reviews and meta-analyses through literature search from PubMed, Science direct, and web of science, CINHALE, and data bases specific to systematic reviews such as the Cochrane Database of Systematic Reviews and Prospero, the International Prospective Register of Systematic Reviews from May 1 to 30/ 2023. Only systematic reviews and meta-analyses published in English from inception to May 1, 2023, were included. The quality of each study was assessed using Assessment of Multiple Systematic Reviews. Data were extracted using Microsoft excel 2016 and analyzed using STATA 17.0 statistical software. Heterogeneity among studies was assessed using the Cochran Q statistics and I2 test. The pooled effect sizes were determined using pooled proportion for the full vaccination coverage and odds ratios for the associated factors with the corresponding 95% confidence interval were used to declare statically significance. RESULTS Five studies with 77,161 children aged 12-23 months were included. The overall pooled full vaccination coverage was 57.72% (95% CI 50.17, 65.28). Institutional delivery (OR: 2.12, 95% CI: 1.78-2.52), travel to vaccination site for <2 hours (OR: 2.43, 95%CI: 1.97-3.00), received at least one antenatal (ANC) visit (OR: 3.2, 95%CI: 2.46-4.1), good maternal knowledge of immunization (OR: 3.63, 95%CI: 2.82-4.67), being informed on immunization schedule (OR: 2.54, 95%CI: 2.02-3.2), living in urban areas (OR: 2, 95% CI: 1.54-2.6), and a household visit by health-care providers (HCP) during the postnatal period (OR: 2.23, 95%CI: 1.22-4.09) were the independent predictors of immunization coverage. CONCLUSION This study showed the full immunization coverage in Ethiopia was lower compared to the WHO-recommended level. Besides, the current umbrella review identifies several factors that contribute to higher immunization coverage. These includes; institutional delivery, near to vaccination site, having ANC visit, being urban residence, household visited by HCP, having good knowledge and informed on immunization schedule. Thus, the government should intensify the growth of immunization services by emphasizing outreach initiatives to reach remote areas and professionals must combine child immunization service with other medical services offered by health institutions.
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Affiliation(s)
- Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Gebremeskel Kibret Abebe
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Mulat Awoke Kassa
- Department of Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Addis Wondemagegn Alamaw
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Rediet Woldesenbet Molla
- Department of Midwifery, School of Midwifery, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Biruk Beletew Abate
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Befekad Deresse Tilahun
- Department of Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Wubet Tazeb Wondie
- Departments of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Rahel Asres Shimelash
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, DebreMarkos University, DebreMarkos, Ethiopia
| | - Molla Fentanew
- Departments of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Williams SV, Akande T, Abbas K. Systematic review of social determinants of childhood immunisation in low- and middle-income countries and equity impact analysis of childhood vaccination coverage in Nigeria. PLoS One 2024; 19:e0297326. [PMID: 38446836 PMCID: PMC10917251 DOI: 10.1371/journal.pone.0297326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 12/22/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Nigeria has a high proportion of the world's underimmunised children. We estimated the inequities in childhood immunisation coverage associated with socioeconomic, geographic, maternal, child, and healthcare characteristics among children aged 12-23 months in Nigeria using a social determinants of health perspective. METHODS We conducted a systematic review to identify the social determinants of childhood immunisation associated with inequities in vaccination coverage among low- and middle-income countries. Using the 2018 Nigeria Demographic and Health Survey (DHS), we conducted multiple logistic regression to estimate the association between basic childhood vaccination coverage (1-dose BCG, 3-dose DTP-HepB-Hib (diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type B), 3-dose polio, and 1-dose measles) and socioeconomic, geographic, maternal, child, and healthcare characteristics in Nigeria. RESULTS From the systematic review, we identified the key determinants of immunisation to be household wealth, religion, and ethnicity for socioeconomic characteristics; region and place of residence for geographic characteristics; maternal age at birth, maternal education, and household head status for maternal characteristics; sex of child and birth order for child characteristics; and antenatal care and birth setting for healthcare characteristics. Based of the 2018 Nigeria DHS analysis of 6,059 children aged 12-23 months, we estimated that basic vaccination coverage was 31% (95% CI: 29-33) among children aged 12-23 months, whilst 19% (95% CI:18-21) of them were zero-dose children who had received none of the basic vaccines. After controlling for background characteristics, there was a significant increase in the odds of basic vaccination by household wealth (AOR: 3.21 (2.06, 5.00), p < 0.001) for the wealthiest quintile compared to the poorest quintile, antenatal care of four or more antenatal care visits compared to no antenatal care (AOR: 2.87 (2.21, 3.72), p < 0.001), delivery in a health facility compared to home births (AOR 1.32 (1.08, 1.61), p = 0.006), relatively older maternal age of 35-49 years compared to 15-19 years (AOR: 2.25 (1.46, 3.49), p < 0.001), and maternal education of secondary or higher education compared to no formal education (AOR: 1.79 (1.39, 2.31), p < 0.001). Children of Fulani ethnicity in comparison to children of Igbo ethnicity had lower odds of receiving basic vaccinations (AOR: 0.51 (0.26, 0.97), p = 0.039). CONCLUSIONS Basic vaccination coverage is below target levels for all groups. Children from the poorest households, of Fulani ethnicity, who were born in home settings, and with young mothers with no formal education nor antenatal care, were associated with lower odds of basic vaccination in Nigeria. We recommend a proportionate universalism approach for addressing the immunisation barriers in the National Programme on Immunization of Nigeria.
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Affiliation(s)
| | - Tanimola Akande
- Department of Epidemiology & Community Health, University of Ilorin, Ilorin, Nigeria
| | - Kaja Abbas
- Department of Infectious Disease Epidemiology and Dynamics, London School of Hygiene & Tropical Medicine, London, United Kingdom
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Cunningham-Erves J, George W, Sanderson M, Stewart E, Jin SW, Davis J, Brandt HM. Predictors of seasonal influenza and COVID-19 vaccination coverage among adults in Tennessee during the COVID-19 pandemic. Front Public Health 2024; 12:1321173. [PMID: 38500722 PMCID: PMC10945017 DOI: 10.3389/fpubh.2024.1321173] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/06/2024] [Indexed: 03/20/2024] Open
Abstract
Background The COVID-19 pandemic has convoluted hesitancy toward vaccines, including the seasonal influenza (flu) vaccine. Because of COVID-19, the flu season has become more complicated; therefore, it is important to understand all the factors influencing the uptake of these vaccines to inform intervention targets. This article assesses factors related to the uptake of influenza and COVID-19 vaccines among adults in Tennessee. Methods A cross-sectional, secondary data analysis of 1,400 adults was conducted in Tennessee. The adult sample came from two data sources: Data source 1 completed a baseline survey from January to March 2022, and data source 2 was completed from May to August 2022. Data on vaccine attitudes, facilitators and barriers, and communication needs were collected via random digit dial by Scientific Telephone Samples (STS). Two multivariable logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to predict sociodemographic and overall vaccine-related factors associated with receipt or non-receipt (referent) of COVID-19 and influenza vaccines. Results Approximately 78% of the adult sample had received the COVID-19 vaccination. A significant positive association for COVID-19 vaccine uptake was seen among those who were older (aged 50-65) (aOR = 1.9; 95% CI: 1.2-3.2), Black (aOR = 2.0; 95% CI:1.3-2.8), and had a college education and higher (aOR = 2.3; 95% CI: 1.5-3.6). However, there was a significant negative association for persons reporting they were extremely religious (aOR = 0.5; 95% CI:0.3-0.9). Over 56% of the adult sample had received the influenza vaccination this season. Those who had a higher annual household income ($80,000+) (aOR = 1.9; 95% CI: 1.3-2.6) and had health insurance (aOR = 2.6; 95% CI: 1.4-4.8) had a significant positive association with influenza vaccine receipt. However, those who were employed part-time or were unemployed had a significant negative association for influenza vaccine receipt (aOR = 0.7; 95% CI: 0.5-0.9). Both COVID-19 and influenza vaccine receipt had strongly significant positive trends with increasing belief in effectiveness and trust (p < 0.0001) and strongly significant negative trends with higher levels of overall vaccine hesitancy (p < 0.0001). Conclusion Strategies to increase COVID-19 and influenza vaccination should be age-specific, focus on increasing geographical and financial access, and offer tailored messages to address concerns about these vaccines.
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Affiliation(s)
- J Cunningham-Erves
- Department of Internal Medicine, School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - W George
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, United States
| | - M Sanderson
- Department of Family and Community Medicine, School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - E Stewart
- Department of Internal Medicine, School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - S W Jin
- School of Social Work, The University of Memphis, Memphis, TN, United States
| | - J Davis
- Department of Biochemistry and Cancer Biology, School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - H M Brandt
- St. Jude Children's Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN, United States
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Schott E, Schaller K, Mons U, Ouédraogo N. Inventory of projects promoting HPV vaccination coverage in Germany. Z Evid Fortbild Qual Gesundhwes 2024; 184:3-6. [PMID: 38199939 DOI: 10.1016/j.zefq.2023.11.005] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024]
Abstract
Since the first recommendation for HPV vaccination in Germany (2007), a rising number of projects aiming to increase HPV vaccination coverage in Germany have been conducted. From October 2019 to February 2020, we systematically searched for data (project description, evaluation reports) on projects in Germany that aimed to increase HPV vaccination rates. The aim was to provide a comprehensive overview of these projects (duration, implementing organisation, target group/addressees, setting, strategies, reach) and to gain insights for optimising future projects. The inventory of these projects shows that most of the projects focused on the education of children, adolescents and parents, as well as on the training of medical staff. The school was the main setting for education. Rarely were the recorded projects conducted on a long-term and comprehensive basis. It was not possible to make a statement about the impact of the different projects within the framework of this review, as evaluation reports were not available for most of the projects. To optimise the impact on increasing HPV vaccination rates, future projects should be planned on a long-term and nationwide basis. They should also be evaluated to improve the quality and effectiveness of the projects.
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Affiliation(s)
- Evelyn Schott
- Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Katrin Schaller
- Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ute Mons
- Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nobila Ouédraogo
- Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Kortsmit K, Oduyebo T, Simeone RM, Kahn KE, Razzaghi H, Galang RR, Ellington S, Ruffo N, Barfield WD, Warner L, Cox S. Influenza and Tetanus, Diphtheria, and Acellular Pertussis Vaccination Coverage During Pregnancy: Pregnancy Risk Assessment Monitoring System, 2020. Public Health Rep 2024; 139:218-229. [PMID: 37386826 PMCID: PMC10851903 DOI: 10.1177/00333549231179252] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVES Estimates of vaccination coverage during pregnancy and identification of disparities in vaccination coverage can inform vaccination campaigns and programs. We reported the prevalence of being offered or told to get the influenza vaccine by a health care provider (hereinafter, provider); influenza vaccination coverage during the 12 months before delivery; and tetanus, diphtheria, and acellular pertussis (Tdap) vaccination coverage during pregnancy among women with a recent live birth in the United States. METHODS We analyzed 2020 data from the Pregnancy Risk Assessment Monitoring System from 42 US jurisdictions (n = 41 673). We estimated the overall prevalence of being offered or told to get the influenza vaccine by a provider and influenza vaccination coverage during the 12 months before delivery. We estimated Tdap vaccination coverage during pregnancy from 21 jurisdictions with available data (n = 22 020) by jurisdiction and select characteristics. RESULTS In 2020, 84.9% of women reported being offered or told to get the influenza vaccine, and 60.9% received it, ranging from 35.0% in Puerto Rico to 79.7% in Massachusetts. Influenza vaccination coverage was lower among women who were not offered or told to get the influenza vaccine (21.4%) than among women who were offered or told to get the vaccine (68.1%). Overall, 72.7% of women received the Tdap vaccine, ranging from 52.8% in Mississippi to 86.7% in New Hampshire. Influenza and Tdap vaccination coverage varied by all characteristics examined. CONCLUSIONS These results can inform vaccination programs and strategies to address disparities in vaccination coverage during pregnancy and may inform vaccination efforts for other infectious diseases among pregnant women.
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Affiliation(s)
- Katherine Kortsmit
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Titilope Oduyebo
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Regina M. Simeone
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katherine E. Kahn
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Leidos, Atlanta, GA, USA
| | - Hilda Razzaghi
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Romeo R. Galang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sascha Ellington
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nan Ruffo
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Full Circle Computing, Inc, Exton, PA, USA
| | - Wanda D. Barfield
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lee Warner
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Sonder GJB, Grey C, Ryan D, Cumming J, Sporle A, Hill PC. Selective under-representation of Pacific peoples in population estimates for health indicator measurements in Aotearoa New Zealand misinforms policy making. BMC Public Health 2024; 24:564. [PMID: 38388865 PMCID: PMC10882897 DOI: 10.1186/s12889-024-17984-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The Census of Populations and Dwellings' is the five yearly population count of Aotearoa New Zealand. Best available populations (BAP) are subnational projections based on census data and demographic assumptions developed for healthcare planning and funding allocation but are also used as the denominator for health indicator monitoring. Pacific people are systematically undercounted, but the impact on health statistics is not well studied. For COVID-19 vaccination coverage, health service user (HSU) data were considered a more reliable denominator than BAP but introduced new biases. We aimed to understand how the choice of denominator population impacts estimates of population size and health system performance for Pacific people at a local level. METHODS We described how declining census response rates affected population data quality. We compared BAP and HSU data at district level. For the indicators 'access to primary care' and 'cervical cancer screening uptake' we replaced currently used BAP denominators with HSU and examined the impact for different ethnic groups in different geographic districts. RESULTS Overall Census 2018 response declined by 10%, but for Māori and Pacific people by 21% and 23%, respectively. This inequitably affected BAP accuracy. Census undercount was highest in the district with the largest Pacific populations, where HSU exceeded BAP most. Notably, 'access to primary care' for Pacific people in this district consistently exceeds 100%. Using BAP, both health indicators are currently estimated as highest for Pacific people compared to other ethnic groups, but when based on HSU, they dropped to lowest. Similar, but less pronounced trends occurred in other districts. Changes in trends over time for both indicators coincided mostly with adjustments in BAP, rather than changes in the numerators. CONCLUSIONS The current use of BAP denominators for health statistics does not enable reliable monitoring of key health indicators for Pacific people. HSU denominators are also unsuitable for monitoring health. Exploring the feasibility of a real-time population register is strongly recommended as a new, transparent, way of obtaining more reliable, timely population data to guide policymaking and underpin a more equitable health system under the health reforms. Meanwhile, reporting of ethnic specific outcomes need to include a clear assessment of the potential for bias due to inaccurate population estimates.
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Affiliation(s)
- Gerard J B Sonder
- Pacific Perspectives Ltd, PO Box 8010, Wellington, New Zealand.
- Department of Internal Medicine, Amsterdam Infection & Immunity Institute (AIII), Amsterdam UMC, location Academic Medical Center, Amsterdam, the Netherlands.
| | - Corina Grey
- Pacific Perspectives Ltd, PO Box 8010, Wellington, New Zealand
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Debbie Ryan
- Pacific Perspectives Ltd, PO Box 8010, Wellington, New Zealand
| | | | - Andrew Sporle
- iNZight Analytics Ltd, Auckland, New Zealand
- Department of Statistics, The University of Auckland, Auckland, New Zealand
| | - Philip C Hill
- Centre for International Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Wu G, Zhang W, Wu W, Wang P, Huang Z, Wu Y, Li J, Zhang W, Du Z, Hao Y. Revisiting the complex time-varying effect of non-pharmaceutical interventions on COVID-19 transmission in the United States. Front Public Health 2024; 12:1343950. [PMID: 38450145 PMCID: PMC10915018 DOI: 10.3389/fpubh.2024.1343950] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/08/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Although the global COVID-19 emergency ended, the real-world effects of multiple non-pharmaceutical interventions (NPIs) and the relative contribution of individual NPIs over time were poorly understood, limiting the mitigation of future potential epidemics. Methods Based on four large-scale datasets including epidemic parameters, virus variants, vaccines, and meteorological factors across 51 states in the United States from August 2020 to July 2022, we established a Bayesian hierarchical model with a spike-and-slab prior to assessing the time-varying effect of NPIs and vaccination on mitigating COVID-19 transmission and identifying important NPIs in the context of different variants pandemic. Results We found that (i) the empirical reduction in reproduction number attributable to integrated NPIs was 52.0% (95%CI: 44.4, 58.5%) by August and September 2020, whereas the reduction continuously decreased due to the relaxation of NPIs in following months; (ii) international travel restrictions, stay-at-home requirements, and restrictions on gathering size were important NPIs with the relative contribution higher than 12.5%; (iii) vaccination alone could not mitigate transmission when the fully vaccination coverage was less than 60%, but it could effectively synergize with NPIs; (iv) even with fully vaccination coverage >60%, combined use of NPIs and vaccination failed to reduce the reproduction number below 1 in many states by February 2022 because of elimination of above NPIs, following with a resurgence of COVID-19 after March 2022. Conclusion Our results suggest that NPIs and vaccination had a high synergy effect and eliminating NPIs should consider their relative effectiveness, vaccination coverage, and emerging variants.
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Affiliation(s)
- Gonghua Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wanfang Zhang
- Guangzhou Liwan District Center for Disease Prevention and Control, Guangzhou, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Pengyu Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zitong Huang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yueqian Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Junxi Li
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
- Guangzhou Joint Research Center for Disease Surveillance and Risk Assessment, Sun Yat-sen University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
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Cataldi JR, Suresh K, Brewer SE, Perreira C, Nederveld A, Skenadore A, Furniss A, Williams C, Severson R, Dempsey AF, O'Leary ST. Boot Camp Translation using Community-Engaged messaging for adolescent Vaccination: A Cluster-Randomized trial. Vaccine 2024; 42:1078-1086. [PMID: 38253469 DOI: 10.1016/j.vaccine.2024.01.042] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Routine vaccination coverage for adolescents living in the rural US is lower than adolescents living in urban areas. We sought to measure the effect of Boot Camp Translation (BCT), a community-based participatory intervention, on rural adolescent vaccination coverage. METHODS A cluster randomized controlled trial was performed September 2018-November 2021 involving 16 rural Colorado counties. Intervention county community members engaged in BCT to develop interventions to improve adolescent vaccination locally. Adolescent vaccination coverage was measured using the Colorado Immunization Information System. RESULTS For 11-12-year-olds, HPV initiation, HPV up-to-date, MenACWY, and Tdap vaccination coverage was lower post- versus pre-intervention in the control and intervention groups. For 11-12-year-olds in the intervention group, there was no significant difference post- versus pre-intervention in the odds of HPV vaccine initiation (adjusted ratio of odds ratios [aROR] = 0.93, 95 %: 0.85-1.02, p = 0.10) or up-to-date HPV vaccination (aROR: 1.10, 95 % CI: 0.98-1.23, p = 0.11) compared with the control group. Among 11-12-year-olds, the decrease in the proportion vaccinated with MenACWY and Tdap in the intervention group was significantly greater than the control group. Among 13-17-year-olds, there were significant increases in HPV initiation, HPV up-to-date, MenACWY, and Tdap vaccination coverage from pre- to post-intervention for both groups, with no significant differences between groups. CONCLUSION 11-12-year-old vaccination coverage decreased slightly from pre- to post-intervention while 13-17-year-old vaccination coverage increased. We saw no effect from the BCT intervention. Our findings about the effectiveness of BCT for improving vaccine uptake may not be generalizable because the study coincided with the COVID-19 pandemic. CLINICAL TRIAL REGISTRY This study was registered with ClinicalTrials.gov, NCT03955757.
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Affiliation(s)
- Jessica R Cataldi
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States.
| | - Krithika Suresh
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Sarah E Brewer
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Cathryn Perreira
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Andrea Nederveld
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Amanda Skenadore
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Anna Furniss
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Charnetta Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Rachel Severson
- Colorado Department of Public Health and Environment, Denver, CO, United States
| | - Amanda F Dempsey
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Sean T O'Leary
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
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Wang CP, Lin YT, Du YZ, Zhang T, Wang YY, Wang YJ, Wang JC, Xu RY, Wang ZS, Wang Y, Feng LZ. Impact of innovative immunization strategy on PCV13 vaccination coverage among children under 5 years in Weifang city, China: A retrospective study. Vaccine 2024; 42:1136-1144. [PMID: 38267332 PMCID: PMC10911081 DOI: 10.1016/j.vaccine.2024.01.030] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/22/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Pneumococcal Diseases (PDs) remains a serious public health problem around the world and in China. Pneumococcal vaccination is the most cost-effective measure to prevent PDs. In 2021, the government of Weifang City, Shandong Province, China introduced a free dose of domestic 13-valent Pneumococcal Conjugate Vaccine (PCV 13) to vaccinate registered children aged 6 months-2 years. This study aimed to evaluate the vaccination rate of PCV13 in children aged under 5 years before and after the vaccination program to provide evidences for further improving the prevention and control strategy for PDs. METHODS We collected data from the children's vaccination information management system in Weifang City and analyzed the PCV13 vaccination coverage and characteristics in all vaccination clinics of Weifang City for children aged under 5 years. We compared the differences in vaccination rates by gender, birth year, manufacturer, and county before and after innovative immunization strategy. RESULTS Among the included 593,784 children aged under 5 years, the PCV13 vaccination rate in Weifang was generally low before the innovative immunization strategy. Urban children had a higher PCV13 coverage than rural children (P < 0.001), and parents tended to vaccinate their children with imported PCV13.The full vaccination rate for domestic and imported PCV13 was 0.67 % and 1.70 %, respectively. After the vaccination program, the PCV13 coverage of children increased significantly in all counties within Weifang City (P < 0.001), especially for children above 12 months of age. Most parents preferred to vaccinate their children with domestic PCV13, and the full vaccination rate of domestic and imported PCV13 was 6.59 % and 0.16 %, respectively. CONCLUSIONS The vaccination rate of PCV13 in children is still much lower than the global average, posting a severe health challenge that needs to be addressed thoroughly. To improve the prevention and control strategy for PDs, it is recommended to continue to explore other relevant incentives based on the innovative immunization strategy. Furthermore, it is also recommended that China should incorporate PCV13 into the National Immunization Programs (NIP) as soon as possible.
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Affiliation(s)
- Chun-Ping Wang
- School of Public Health, Shandong Second Medical University, Weifang, Shandong Province 261053, China.
| | - Yue-Tong Lin
- School of Public Health, Shandong Second Medical University, Weifang, Shandong Province 261053, China.
| | - Yuan-Ze Du
- Nursing Department, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu, Sichuan Province 610041, China.
| | - Ting Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
| | - Yuan-Yuan Wang
- Division of Immunization, Center for Disease Control and Prevention, Weifang, Shandong Province 261072, China.
| | - Yu-Jue Wang
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, United States.
| | - Jia-Chen Wang
- School of Public Health, Shandong Second Medical University, Weifang, Shandong Province 261053, China.
| | - Ruo-Yu Xu
- School of Public Health, Shandong Second Medical University, Weifang, Shandong Province 261053, China.
| | - Zong-Shuai Wang
- Department of Pediatrics II, Children's Medical Center, The Second Hospital of Shandong University, Jinan, Shandong Province 250033, China.
| | - Yi Wang
- Department of Public Health, Weifang People's Hospital, Weifang, Shandong Province, 261041, China.
| | - Lu-Zhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
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Balsells E, Vicente M, Reyes S, Figueroa M, Sum K, López Lacán MA, Escalante A, Campos D, Montenegro M, Alvarado G, Quezada LF, Jarquin C, Montufar E, Rondy M. Impact of the 'Health on Wheels' (HoW) strategy on COVID-19 vaccination coverage in hard-to-reach communities in Alta Verapaz, Guatemala, 2022. Vaccine 2024; 42:1179-1183. [PMID: 38281901 PMCID: PMC10911077 DOI: 10.1016/j.vaccine.2024.01.033] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND In April 2022, after a year of COVID-19 vaccination, there were large differences in coverage between urban and rural areas in Guatemala. To address barriers in rural communities, the "Health on Wheels" (HoW) strategy was implemented. The strategy deployed mobile brigades with a dedicated team of health workers and a culturally sensitive health promotion plan in selected communities in 15 districts in Alta Verapaz, a health area with low COVID-19 vaccination uptake and a high-level of COVID-19 vaccine hesitancy. This study evaluates the impact of the HoW strategy. METHODS We measured the relative increase in COVID-19 doses administered prior and during the HoW implementation period in the 190 intervened communities and compared to 188 communities without the intervention. Communities were grouped by health district and the impact analyses were stratified by number of COVID-19 vaccine dose (1st, 2nd, and 3rd doses) and history of vaccine hesitancy. RESULTS The increase in 1st, 2nd, and 3rd dose-COVID-19 vaccination coverage between before and during HoW implementation was 2.4, 2.2 and 2.6 times higher in intervened communities (20 %, 21 % and 37 % increase in 1st, 2nd and 3rd dose, respectively) than in non-intervened communities (8 %, 10 % and 14 % increase in 1st, 2nd and 3rd dose respectively). For the 1st dose, increase in dose administration was 2.9 times higher in intervened communities (n = 24) with hesitancy (24 % increase) compared to non-intervened communities (n = 188) without hesitancy (8 % increase). CONCLUSION The deployment of mobile brigades with a dedicated team of vaccinators and culturally sensitive health promotion through the HoW strategy successfully accelerated the increase in COVID-19 vaccination coverage in rural communities in Guatemala.
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Affiliation(s)
| | | | | | | | - Keyla Sum
- Pan American Health Organization, Guatemala
| | | | | | | | | | | | | | | | | | - Marc Rondy
- Pan American Health Organization, Guatemala
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Walter A, Gandon S, Lion S. Effect of unequal vaccination coverage and migration on long-term pathogen evolution in a metapopulation. J Evol Biol 2024; 37:189-200. [PMID: 38300809 DOI: 10.1093/jeb/voad016] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 02/03/2024]
Abstract
Worldwide inequalities in vaccine availability are expected to affect the spread and spatial distribution of infectious diseases. It is unclear, however, how spatial variation in vaccination coverage can affect the long-term evolution of pathogens. Here we use an analytical model and numerical simulations to analyse the influence of different imperfect vaccines on the potential evolution of pathogen virulence in a two-population model where vaccination coverage varies between populations. We focus on four vaccines, with different modes of action on the life cycle of a pathogen infecting two host populations coupled by migration. We show that, for vaccines that reduce infection risk or transmissibility, spatial heterogeneity has little effect on pathogen prevalence and host mortality, and no effect on the evolution of pathogen virulence. In contrast, vaccines that reduce pathogen virulence can select for more virulent pathogens and may lead to the coexistence of different pathogen strains, depending on the degree of spatial heterogeneity in the metapopulation. This heterogeneity is driven by two parameters: pathogen migration and the difference in the vaccination rate between the two populations. We show that vaccines that only reduce pathogen virulence select mainly for a single pathogen strategy in the long term, while vaccines that reduce both transmission and virulence can favor the coexistence of two pathogen genotypes. We discuss the implications and potential extensions of our analysis.
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Affiliation(s)
- Alicia Walter
- CEFE, CNRS, Univ Montpellier, EPHE, IRD, Montpellier, France
| | - Sylvain Gandon
- CEFE, CNRS, Univ Montpellier, EPHE, IRD, Montpellier, France
| | - Sébastien Lion
- CEFE, CNRS, Univ Montpellier, EPHE, IRD, Montpellier, France
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Sarmiento-Medina MI, de Amaya MP, Villamizar-Gómez L, González-Coba AC, Guzmán-Barajas L. High-risk HPV prevalence and vaccination coverage among Indigenous women in the Colombian Amazon: Implications for cervical cancer prevention. Cross-sectional study. PLoS One 2024; 19:e0297579. [PMID: 38315664 PMCID: PMC10843138 DOI: 10.1371/journal.pone.0297579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
Cervical cancer, primarily caused by Human Papillomavirus (HPV) transmission through sexual contact, necessitates comprehensive strategies to combat its impact on women's health. Yet, certain underserved populations, such as low socioeconomic and ethnic minority groups, encounter barriers in accessing timely interventions and early diagnosis. This cross-sectional study was conducted with the aim of assessing HPV prevalence, genotype distribution, and co-infections among 280 adult women residing in a Colombian Indigenous Reserve within the Amazon region. The research adhered to a community-centric approach that respected cultural norms, native languages, and Indigenous authorities' permission. The study revealed an overall HPV infection prevalence of 31.1% (n = 87, 95% CI 25.7-36.8), with 22.5% (n = 63, 95% CI 17.7-27.8) of women infected by at least one high-risk HPV genotype and 15.0% (n = 42, 95% CI 11-19.7) infected by at least one LR genotype. These results align with the findings of other Colombian studies. Notable high-frequency genotypes included 16, 52, 66, 56, and 68, with the most common combinations being [66-52] and [66-58]. The study also assessed the prevalence of HPV vaccination, revealing a rate of 22.9%, lower than the national average. In vaccinated women, the prevalence of genotypes 16 and 18 was significantly reduced, as anticipated. Importantly, it was observed that 57.1% of all high-risk HPV infections could have been prevented with the use of the nonavalent vaccine. These findings underscore the critical need to enhance adherence to early cervical cancer detection and monitor positive cases to evaluate high-risk HPV persistence. Efforts should be directed toward continuing vaccination coverage against high-risk HPV 16 and 18 with the quadrivalent vaccine, while also striving to make the nonavalent vaccine accessible for inclusion in large-scale public health programs. Additionally, the study did not identify a specific pattern of co-infection. The study emphasizes the significance of adopting a locally tailored epidemiological approach to guide and promote cervical cancer prevention efforts in Indigenous communities.
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Affiliation(s)
| | - Miryam Puerto de Amaya
- Facultad de Tecnologías en Salud, Fundación Universitaria de Ciencias de la Salud, Bogotá D.C, Colombia
| | - Licet Villamizar-Gómez
- Vicerrectoría de Investigaciones, Fundación Universitaria de Ciencias de la Salud, Bogotá D.C, Colombia
| | | | - Laura Guzmán-Barajas
- Facultad de Tecnologías en Salud, Fundación Universitaria de Ciencias de la Salud, Bogotá D.C, Colombia
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Villarroel MA, Galinsky AM, Lu PJ, Pingali C. Human Papillomavirus Vaccination Coverage in Children Ages 9-17 Years: United States, 2022. NCHS Data Brief 2024:1-8. [PMID: 38358336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in men and women in the United States (1). Vaccination prevents and controls HPV infection and associated outcomes, including genital warts, precancerous lesions, and certain cancers, such as cervical, vaginal, vulvar, anal, penile, and oropharyngeal (2,3). HPV vaccination in the United States has been recommended for girls since 2006 and for boys since 2011 and requires multiple doses (2,3). This vaccine, targeted for children ages 11-12 years, may be started at age 9. This report uses parent-reported data from the 2022 National Health Interview Survey to describe the percentage of children ages 9-17 years who received at least one dose of the HPV vaccine by selected sociodemographic and health characteristics.
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Reitsma MB, Rose S, Reinhart A, Goldhaber-Fiebert JD, Salomon JA. Bias-Adjusted Predictions of County-Level Vaccination Coverage from the COVID-19 Trends and Impact Survey. Med Decis Making 2024; 44:175-188. [PMID: 38159263 PMCID: PMC10865746 DOI: 10.1177/0272989x231218024] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 10/11/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The potential for selection bias in nonrepresentative, large-scale, low-cost survey data can limit their utility for population health measurement and public health decision making. We developed an approach to bias adjust county-level COVID-19 vaccination coverage predictions from the large-scale US COVID-19 Trends and Impact Survey. DESIGN We developed a multistep regression framework to adjust for selection bias in predicted county-level vaccination coverage plateaus. Our approach included poststratification to the American Community Survey, adjusting for differences in observed covariates, and secondary normalization to an unbiased reference indicator. As a case study, we prospectively applied this framework to predict county-level long-run vaccination coverage among children ages 5 to 11 y. We evaluated our approach against an interim observed measure of 3-mo coverage for children ages 5 to 11 y and used long-term coverage estimates to monitor equity in the pace of vaccination scale up. RESULTS Our predictions suggested a low ceiling on long-term national vaccination coverage (46%), detected substantial geographic heterogeneity (ranging from 11% to 91% across counties in the United States), and highlighted widespread disparities in the pace of scale up in the 3 mo following Emergency Use Authorization of COVID-19 vaccination for 5- to 11-y-olds. LIMITATIONS We relied on historical relationships between vaccination hesitancy and observed coverage, which may not capture rapid changes in the COVID-19 policy and epidemiologic landscape. CONCLUSIONS Our analysis demonstrates an approach to leverage differing strengths of multiple sources of information to produce estimates on the time scale and geographic scale necessary for proactive decision making. IMPLICATIONS Designing integrated health measurement systems that combine sources with different advantages across the spectrum of timeliness, spatial resolution, and representativeness can maximize the benefits of data collection relative to costs. HIGHLIGHTS The COVID-19 pandemic catalyzed massive survey data collection efforts that prioritized timeliness and sample size over population representativeness.The potential for selection bias in these large-scale, low-cost, nonrepresentative data has led to questions about their utility for population health measurement.We developed a multistep regression framework to bias adjust county-level vaccination coverage predictions from the largest public health survey conducted in the United States to date: the US COVID-19 Trends and Impact Survey.Our study demonstrates the value of leveraging differing strengths of multiple data sources to generate estimates on the time scale and geographic scale necessary for proactive public health decision making.
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Affiliation(s)
| | - Sherri Rose
- Department of Health Policy, Stanford University, Stanford, CA, USA
| | - Alex Reinhart
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA, USA
- Delphi Group, Carnegie Mellon University, Pittsburgh, PA, USA
| | | | - Joshua A. Salomon
- Department of Health Policy, Stanford University, Stanford, CA, USA
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
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Ando T, Ibuka Y, Goto R, Haruta J, Le DD, Fujishima S. Re: Letter to the Editor of Public Health in response to 'Effect of influenza vaccine subsidies for older adults on vaccination coverage and mortality before and during the COVID-19 pandemic: An ecological study in Japan'. Public Health 2024; 227:e3-e4. [PMID: 38225182 DOI: 10.1016/j.puhe.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/17/2024]
Affiliation(s)
- T Ando
- Center for General Medicine Education, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Y Ibuka
- Department of Economics, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan
| | - R Goto
- Graduate School of Business Administration, Keio University, 4-1-1 Hiyoshi, Yokohama, Kanagawa, 223-8521, Japan
| | - J Haruta
- Medical Education Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Center for General Medicine Education, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - D D Le
- Department of Economics, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan
| | - S Fujishima
- Center for General Medicine Education, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Preventive Medicine Center, Keio University, 1-3-1 Azabudai, Minato-ku, Tokyo 106-0041, Japan
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31
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Burns R, Wyke S, Eyre MT, Boukari Y, Sørensen TB, Tsang C, Campbell CNJ, Beale S, Zenner D, Hargreaves S, Campos-Matos I, Harron K, Aldridge RW. COVID-19 vaccination coverage for half a million non-EU migrants and refugees in England. Nat Hum Behav 2024; 8:288-299. [PMID: 38049560 PMCID: PMC10896718 DOI: 10.1038/s41562-023-01768-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 10/23/2023] [Indexed: 12/06/2023]
Abstract
Despite evidence suggesting that some migrants are at risk of under-immunization and have experienced severe health inequities during the pandemic, data are limited on migrants' COVID-19 vaccine coverage globally. Here we linked data from non-European Union migrants and resettled refugees to the national COVID-19 vaccination dataset in England. We estimated patterns in second and third dose delays and overdue doses between 12 December 2020 and 20 April 2022 by age, visa type and ethnicity. Of the 465,470 linked records, 91.8% (427,073/465,470) of migrants received a second dose and 51.3% (238,721/465,470) received a third. Refugees had the highest risk of delayed second (adjusted odds ratio 1.66; 95% confidence interval 1.55-1.79) and third dose (1.55; 1.43-1.69). Black migrants were twice as likely to have a second dose delayed (2.37; 2.23-2.54) than white migrants, but this trend reversed for the third dose. Older migrants (>65 years) were four times less likely to have received their second or third dose compared with the general population in England aged >65 or older. Policymakers, researchers and practitioners should work to understand and address personal and structural barriers to vaccination for diverse migrant populations.
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Affiliation(s)
- Rachel Burns
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK.
| | - Sacha Wyke
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, UK
| | - Max T Eyre
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Yamina Boukari
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK
| | - Tina B Sørensen
- Immunisation and Vaccine Preventable Diseases, UK Health Security Agency, London, UK
| | - Camille Tsang
- Immunisation and Vaccine Preventable Diseases, UK Health Security Agency, London, UK
| | - Colin N J Campbell
- Immunisation and Vaccine Preventable Diseases, UK Health Security Agency, London, UK
| | - Sarah Beale
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Dominik Zenner
- Global Public Health Unit, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Infection and Population Health Department, Institute of Global Health, University College London, London, UK
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George's University of London, Cranmer Terrace London, London, UK
| | - Ines Campos-Matos
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, UK
- UK Health Security Agency, London, UK
| | - Katie Harron
- UCL Great Ormond Street, Institute of Child Health, University College London, London, UK
| | - Robert W Aldridge
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK
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32
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Krings A, Schmidt D, Kollan C, Meixenberger K, Bannert N, Münstermann D, Tiemann C, Bremer V, Gunsenheimer-Bartmeyer B. Increasing hepatitis B vaccination coverage and decreasing hepatitis B co-infection prevalence among people with HIV-1 in Germany, 1996-2019. Results from a cohort study primarily in men who have sex with men. HIV Med 2024; 25:201-211. [PMID: 37786263 DOI: 10.1111/hiv.13554] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVES Viral hepatitis co-infection among people living with HIV is known to accelerate the progression of liver disease and AIDS. An increased prevalence and incidence of hepatitis B virus (HBV) infection among people living with HIV demands continuous monitoring to adapt targeted prevention strategies to reach the global goals of eliminating viral hepatitis as a public health threat. METHODS We determined the prevalence and incidence of HBV for the years 1996-2019 from yearly blood sample testing and questionnaire reports among people living with HIV belonging to a nationwide, multicentre observational, prospective cohort study. RESULTS Among this study population of 3479 participants, the majority (87%) indicated that being men who have sex with men (MSM) was their likely HIV transmission route; 51% were recruited from Berlin. HBV prevalence for acute/chronic and resolved infections decreased from 4.1% and 45% in 1996-1999 to 1.3% and 16% in 2019, respectively. Simultaneously, participants with a serological status indicating HBV vaccination increased from 25% in 1996-1999 to 69% in 2019. Among vaccinated participants with relevant information (n = 1135), 38% received their first HBV vaccination after HIV infection. The HBV incidence rate in 565 eligible participants decreased from 6.9/100 person-years in 2004-2007 to 0.45/100 person-years in 2015. CONCLUSION Increasing vaccination coverage because of a general HBV vaccination recommendation and catch-up vaccination efforts among risk groups decreased HBV infection prevalence over time among this study population of people living with HIV, primarily MSM and from Berlin. Despite this success, the prevalence and incidence of HBV remains higher than in the general population in Germany. This emphasizes the need for continued HBV prevention by promoting HBV vaccination and HBV screening at regular intervals based on the individual risk behaviour.
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Affiliation(s)
- A Krings
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - D Schmidt
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - C Kollan
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - K Meixenberger
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - N Bannert
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | | | - C Tiemann
- MVZ Labor Krone GbR, Bad Salzuflen, Germany
| | - V Bremer
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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Meng L, Bell J, Soe M, Edwards J, Lymon H, Barbre K, Reses H, Patel A, Wong E, Dudeck M, Huynh CV, Rowe T, Dubendris H, Benin A. Comparison of factors associated with seasonal influenza and COVID-19 booster vaccination coverage among healthcare personnel working at acute care hospitals during 2021-2022 influenza season, National Healthcare Safety Network, United States. Prev Med 2024; 179:107852. [PMID: 38211802 DOI: 10.1016/j.ypmed.2024.107852] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
The simultaneous circulation of seasonal influenza virus and SARS-CoV-2 variants will likely pose unique challenges to public health during the future influenza seasons. Persons who are undergoing treatment in healthcare facilities may be particularly at risk. It is important for healthcare personnel to protect themselves and patients by receiving vaccines. The purpose of this study is to assess coverage of the seasonal influenza vaccine and COVID-19 monovalent booster among healthcare personnel working at acute care hospitals in the United States during the 2021-22 influenza season and to examine the demographic and facility characteristics associated with coverage. A total of 3260 acute care hospitals with over 7 million healthcare personnel reported vaccination data to National Healthcare Safety Network (NHSN) during the 2021-22 influenza season. Two separate negative binomial mixed models were developed to explore the factors associated with seasonal influenza coverage and COVID-19 monovalent booster coverage. At the end of the 2021-2022 influenza season, the overall pooled mean seasonal influenza coverage was 80.3%, and the pooled mean COVID-19 booster coverage was 39.5%. Several demographic and facility-level factors, such as employee type, facility ownership, and geographic region, were significantly associated with vaccination against influenza and COVID-19 among healthcare personnel working in acute care hospitals. Our findings highlight the need to increase the uptake of vaccination among healthcare personnel, particularly non-employees, those working in for-profit and non-medical school-affiliated facilities, and those residing in the South.
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Affiliation(s)
- Lu Meng
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America.
| | - Jeneita Bell
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Minn Soe
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Jonathan Edwards
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Hoody Lymon
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Kira Barbre
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America; Goldbelt C6, Chesapeake, VA, United States of America
| | - Hannah Reses
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Avni Patel
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Emily Wong
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Margaret Dudeck
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Cam-Van Huynh
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Theresa Rowe
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Heather Dubendris
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America; Lantana Consulting Group, East Thetford, Vermont, United States of America
| | - Andrea Benin
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
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34
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van Zoest V, Lindberg K, Varotsis G, Osei FB, Fall T. Predicting COVID-19 hospitalizations: The importance of healthcare hotlines, test positivity rates and vaccination coverage. Spat Spatiotemporal Epidemiol 2024; 48:100636. [PMID: 38355257 DOI: 10.1016/j.sste.2024.100636] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/06/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024]
Abstract
In this study, we developed a negative binomial regression model for one-week ahead spatio-temporal predictions of the number of COVID-19 hospitalizations in Uppsala County, Sweden. Our model utilized weekly aggregated data on testing, vaccination, and calls to the national healthcare hotline. Variable importance analysis revealed that calls to the national healthcare hotline were the most important contributor to prediction performance when predicting COVID-19 hospitalizations. Our results support the importance of early testing, systematic registration of test results, and the value of healthcare hotline data in predicting hospitalizations. The proposed models may be applied to studies modeling hospitalizations of other viral respiratory infections in space and time assuming count data are overdispersed. Our suggested variable importance analysis enables the calculation of the effects on the predictive performance of each covariate. This can inform decisions about which types of data should be prioritized, thereby facilitating the allocation of healthcare resources.
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Affiliation(s)
- Vera van Zoest
- Department of Information Technology, Uppsala University, P.O. Box 337, Uppsala 751 05, Sweden; Department of Systems Science for Defence and Security, Swedish Defence University, P.O. Box 27805, Stockholm 115 93, Sweden.
| | - Karl Lindberg
- Department of Information Technology, Uppsala University, P.O. Box 337, Uppsala 751 05, Sweden; Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala 751 85, Sweden
| | - Georgios Varotsis
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala 751 85, Sweden
| | - Frank Badu Osei
- Faculty of Geo-Information Science and Earth Observation, University of Twente, P.O. Box 217, Enschede 7500 AE, the Netherlands
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala 751 85, Sweden
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Seeskin ZH, Ganesh N, Maitra P, Herman P, Wolter KM, Copeland KR, English N, Chen MP, Singleton JA, Santibanez TA, Yankey D, Elam-Evans LD, Sterrett N, Smith CS, Gipson K, Meador S. Estimating county-level vaccination coverage using small area estimation with the National Immunization Survey-Child. Vaccine 2024; 42:418-425. [PMID: 38143201 DOI: 10.1016/j.vaccine.2023.12.046] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 12/26/2023]
Abstract
The National Immunization Survey-Child (NIS-Child) provides annual vaccination coverage estimates in the United States for children aged 19 through 35 months, nationally, for each state, and for select local areas and territories. There is a need for vaccination coverage estimates for smaller geographic areas to support local authority planning and identify counties with potentially low vaccination coverage for possible further intervention. We describe small area estimation methods using 2008-2018 NIS-Child data to generate county-level estimates for children up to two years of age born 2007-2011 and 2012-2016. We applied an empirical best linear unbiased prediction method to combine direct estimates of vaccination coverage with model-based prediction using county-level predictors regarding health and demographic characteristics. We review the predictors commonly selected for the small area models and note multiple predictors related to barriers to vaccination.
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Affiliation(s)
- Zachary H Seeskin
- NORC at the University of Chicago, 55 E. Monroe Street, 31(st) Floor, Chicago, IL 60603, USA.
| | - Nadarajasundaram Ganesh
- NORC at the University of Chicago, 55 E. Monroe Street, 31(st) Floor, Chicago, IL 60603, USA
| | | | - Peter Herman
- NORC at the University of Chicago, 55 E. Monroe Street, 31(st) Floor, Chicago, IL 60603, USA
| | - Kirk M Wolter
- NORC at the University of Chicago, 55 E. Monroe Street, 31(st) Floor, Chicago, IL 60603, USA
| | - Kennon R Copeland
- NORC at the University of Chicago, 55 E. Monroe Street, 31(st) Floor, Chicago, IL 60603, USA
| | - Ned English
- NORC at the University of Chicago, 55 E. Monroe Street, 31(st) Floor, Chicago, IL 60603, USA
| | - Michael P Chen
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - James A Singleton
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Tammy A Santibanez
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - David Yankey
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Laurie D Elam-Evans
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Natalie Sterrett
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Chalanda S Smith
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Kevin Gipson
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Seth Meador
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA
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Delalic L, Hussaini L, Gjefsen HM, Gleditsch R, Winje BA, Godøy AA. Vaksinasjonsdekning mot covid-19 etter fødeland og underliggende risiko for alvorlig sykdomsforløp. Tidsskr Nor Laegeforen 2024; 144:23-0334. [PMID: 38258714 DOI: 10.4045/tidsskr.23.0334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
Background Support for the COVID-19 vaccination programme has been high in Norway throughout the pandemic, but previous studies have observed variation based on country of birth. If the unvaccinated are young and healthy, the risk and consequences for the individual and for the health service will be less than if the unvaccinated have underlying risk of severe COVID-19. The purpose of the study was to examine the degree to which vaccination coverage varied by country of birth in persons with and without underlying risk. Material and method We used the Norwegian emergency preparedness register Beredt C19 to link vaccination coverage to demographic and health variables. Using Poisson regression, we estimated the relative likelihood of being vaccinated for foreign-born individuals compared to Norwegian-born individuals, for those with and without underlying risk of severe COVID-19, adjusted for sex, age, level of education, household income and county. Results The study population was 4 304 249, which included 768 312 people who were born outside Norway. The vaccination coverage varied in total from 47 to 94 % between countries of birth. The variation between countries of birth was less in the group with underlying risk, ranging from 63 to 96 %. The difference between persons with and without an underlying risk was most pronounced among those born in Poland (RR 0.71 and 0.55) and Lithuania (RR 0.69 and 0.61). In absolute numbers, this corresponded to a difference in relative risk of 0.16 and 0.08, respectively. Interpretation Higher vaccination coverage against COVID-19 among persons with an underlying risk means that the variation between countries of birth may have had less serious implications in terms of severe clinical course and healthcare needs than previously assumed.
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Affiliation(s)
- Lamija Delalic
- Klynge for forskning og analyse av helsetjenesten, Folkehelseinstituttet
| | - Lema Hussaini
- Klynge for forskning og analyse av helsetjenesten, Folkehelseinstituttet
| | - Hege Marie Gjefsen
- Klynge for forskning og analyse av helsetjenesten, Folkehelseinstituttet
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Ssebagereka A, de Broucker G, Ekirapa-Kiracho E, Kananura RM, Driwale A, Mak J, Mutebi A, Patenaude BN. Equity in vaccine coverage in Uganda from 2000 to 2016: revealing the multifaceted nature of inequity. BMC Public Health 2024; 24:185. [PMID: 38225582 PMCID: PMC10790460 DOI: 10.1186/s12889-023-17592-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 12/26/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND This study analyses vaccine coverage and equity among children under five years of age in Uganda based on the 2016 Uganda Demographic and Health Survey (UDHS) dataset. Understanding equity in vaccine access and the determinants is crucial for the redress of emerging as well as persistent inequities. METHODS Applied to the UDHS for 2000, 2006, 2011, and 2016, the Vaccine Economics Research for Sustainability and Equity (VERSE) Equity Toolkit provides a multivariate assessment of immunization coverage and equity by (1) ranking the sample population with a composite direct unfairness index, (2) generating quantitative measure of efficiency (coverage) and equity, and (3) decomposing inequity into its contributing factors. The direct unfairness ranking variable is the predicted vaccination coverage from a logistic model based upon fair and unfair sources of variation in vaccination coverage. Our fair source of variation is defined as the child's age - children too young to receive routine immunization are not expected to be vaccinated. Unfair sources of variation are the child's region of residence, and whether they live in an urban or rural area, the mother's education level, the household's socioeconomic status, the child's sex, and their insurance coverage status. For each unfair source of variation, we identify a "more privileged" situation. RESULTS The coverage and equity of the Diphtheria-Pertussis-Tetanus vaccine, 3rd dose (DPT3) and the Measles-Containing Vaccine, 1st dose (MCV1) - two vaccines indicative of the health system's performance - improved significantly since 2000, from 49.7% to 76.8% and 67.8% to 82.7%, respectively, and there are fewer zero-dose children: from 8.4% to 2.2%. Improvements in retaining children in the program so that they complete the immunization schedule are more modest (from 38.1% to 40.8%). Progress in coverage was pro-poor, with concentration indices (wealth only) moving from 0.127 (DPT3) and 0.123 (MCV1) in 2000 to -0.042 and -0.029 in 2016. Gains in overall equity (composite) were more modest, albeit significant for most vaccines except for MCV1: concentration indices of 0.150 (DPT3) and 0.087 (MCV1) in 2000 and 0.054 and 0.055 in 2016. The influence of the region and settings (urban/rural) of residence significantly decreased since 2000. CONCLUSION The past two decades have seen significant improvements in vaccine coverage and equity, thanks to the efforts to strengthen routine immunization and ongoing supplemental immunization activities such as the Family Health Days. While maintaining the regular provision of vaccines to all regions, efforts should be made to alleviate the impact of low maternal education and literacy on vaccination uptake.
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Affiliation(s)
| | - Gatien de Broucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
- International Vaccine Access Center, Johns Hopkins University, Baltimore, USA.
| | | | | | - Alfred Driwale
- Uganda National Expanded Program On Immunization (UNEPI), Ministry of Health, Kampala, Uganda
| | - Joshua Mak
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- International Vaccine Access Center, Johns Hopkins University, Baltimore, USA
| | - Aloysius Mutebi
- Makerere University School of Public Health, Kampala, Uganda
| | - Bryan Nicholas Patenaude
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- International Vaccine Access Center, Johns Hopkins University, Baltimore, USA
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Cao Z, Yu R, Yuan Q, Ji W, Li X, Gao P, Miao L, Wen X, Suo L. Impact of the COVID-19 pandemic on routine vaccination coverage under varying prevalence Conditions: A cohort study in Beijing, China. Vaccine 2024; 42:213-219. [PMID: 38097454 DOI: 10.1016/j.vaccine.2023.12.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/28/2023] [Accepted: 12/02/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND The COVID-19 pandemic has experienced various phases including outbreaks, a global health crisis, and eventual de-escalation from a public health emergency of international concern, significantly affecting the delivery and utilization of healthcare services. This study aimed to evaluate the impact of the COVID-19 pandemic on the coverage rate of routine immunization in children under varying prevalence conditions. METHODS We conducted a retrospective, population-based cohort study in Beijing, China, utilizing stratified random sampling by birthdate to obtain a sample of 29,811 participants. Subjects were categorized into four cohorts based on when they became eligible for vaccination: the Pre-COVID Period cohort, the COVID-19 Low Epidemic Period cohort, the COVID-19 Surging Period cohort, and the COVID-19 Slowing Down Period cohort. A one-month follow-up was conducted. Cox proportional hazards model was employed to examine associations between the COVID-19 epidemic status and timely vaccination. RESULTS Participants age-eligible for vaccination during the COVID-19 Low Epidemic Period demonstrated higher rates of timely vaccination (HR 1.18, 95% CI 1.15-1.22) compared to those eligible during the Pre-COVID Period. Conversely, those eligible during the COVID-19 Surging Period displayed lower rates (HR 0.73, 95% CI 0.66-0.82). No significant difference in vaccination timeliness was observed for those eligible during the COVID-19 Slowing Down Period in comparison to the Pre-COVID Period (HR 0.99, 95% CI 0.91-1.09). By the end of May 2023, DTP3 rate among eligible children during the COVID-19 Surging Period had surpassed 90%. CONCLUSIONS Significantly declining rates of timely vaccination were observed during the COVID-19 Surging Period, which lasted two months, but not during the nearly three-year-long COVID-19 Low Epidemic Period. An upward trend in vaccination timeliness followed, culminating in a return to baseline levels over the subsequent 3-4 months. Our findings suggested that the pandemic exerted a decreasing and recoverable impact on the coverage rate of routine immunizations in China.
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Affiliation(s)
- Zhiqiang Cao
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China
| | - Rui Yu
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China
| | - Qianli Yuan
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China
| | - Wenyan Ji
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China
| | - Xiaomei Li
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China
| | - Pei Gao
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China
| | - Liang Miao
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China
| | - Xiaojing Wen
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China
| | - Luodan Suo
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 10013, China.
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Yamada N, Nakatsuka K, Tezuka M, Murata F, Maeda M, Akisue T, Fukuda H, Ono R. Pneumococcal vaccination coverage and vaccination-related factors among older adults in Japan: LIFE Study. Vaccine 2024; 42:239-245. [PMID: 38087713 DOI: 10.1016/j.vaccine.2023.12.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 10/31/2023] [Accepted: 12/01/2023] [Indexed: 01/01/2024]
Abstract
PURPOSE To investigate individual and environmental vaccination-related factors among the older adults in Japan, using administrative data. METHODS We conducted a cohort study and included people who reached the relevant age (≥65 years) for routine pneumococcal vaccination of older adults between April 2015 and March 2020. Monthly data of residents in the two municipalities from April 2014 to March 2020 and vaccination records from April 2015 to March 2020 were used. We defined five cohorts according to the year in which routine vaccinations were available. Each cohort was followed for a total of two years, with the first year being the "baseline period" and second year being the "vaccine follow-up period." Pneumococcal vaccination data was extracted from vaccination records at "first dose." Age, sex, socioeconomic status, comorbidities, hospital visit history, hospitalization history, Specific Health Check-ups participation, and information on contracted hospitals for pneumococcal vaccination were used as covariates. A multivariate logistic regression model was used to investigate the relationship between pneumococcal vaccination and vaccination-related factors. Odds ratios (OR) and 95 % confidence intervals (95 % CI) were calculated. RESULTS Analysis included 17,991 patients. Vaccination coverage was 33.6 % for all subjects. Multivariate analysis found the following as significant vaccination-related factors: female (OR: 1.18, 95 % CI: 1.11-1.26), not low income (1.76, 1.17-2.76), hospital visits: ≥once/month (1.27, 1.19-1.35), and Specific Health Check-ups participation (2.10, 1.95-2.27). No significant results were found for hospitals that contracted pneumococcal vaccination. CONCLUSIONS Individual factors, such as sex and Specific Health Check-ups participation, were found to be important factors affecting pneumococcal vaccination among older adults in Japan. Environmental factors, such as the characteristics of residential areas, should be evaluated in further investigations.
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Affiliation(s)
- Naoki Yamada
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Kiyomasa Nakatsuka
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Masato Tezuka
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Fumiko Murata
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan
| | - Megumi Maeda
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Haruhisa Fukuda
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe 654-0142, Japan; Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, KENTO Innovation Park NK Bldg, 3-17, Senriokashinmachi, Settu, Osaka 566-0002, Japan.
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Lo Vecchio A, Scarano SM, Palladino R, Del Bene M, Trama U, Affinito G, Buono P, Guarino A. Co-administration with Men-B vaccine increases Rotavirus vaccination coverage: A 5-year regionwide retrospective cohort study (STORM study). Vaccine 2024; 42:287-294. [PMID: 38072758 DOI: 10.1016/j.vaccine.2023.12.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 01/01/2024]
Abstract
INTRODUCTION In Italy Rotavirus vaccination (RVV) is provided free of charge from 2018, however, the coverage is scattered and suboptimal. The narrow time frame to complete the schedule is a barrier to uptake, and co-administration with other vaccines may potentially increase the coverage. Although the co-administration of RV vaccine and Meningococcal Group B vaccine (MenB) is not included in the product labels, we aimed at studying its impact on RVV coverage. METHODS This Surveillance study on Timing and cOverage of Rotavirus and MenB vaccine co-administration (STORM study) used the Regional Vaccination Registry to collect data about children born in Campania Region between January 2016 and December 2020, and receiving vaccines scheduled in the first year of life. RESULTS Among the 224,110 children enrolled, 60,614 (27.0%) completed the RVV schedule, with a vaccination rate that increased over time from 1.15% in 2016 to 56.92% in 2020. The first and last dose of RVV schedule were administered beyond the recommended time in 6% of the study population, respectively. Co-administration of RV vaccine with MenB vaccine increased from 0.7 % in 2016 to 46.85 % in 2020. Children receiving RV/MenB vaccines concomitantly had a significantly higher chance of completing the RV schedule compared to those receiving RVV alone during a specific appointment (94.78 % vs 72.26 %, Prevalence Ratio -PR- 1.275, 95 %CI 1.245-1.295p < 0.00001). The positive driving effect of RV/MenB co-administration was more evident for children receiving pentavalent (PR 1.288) than monovalent RVV (PR 1.115) which was confirmed when adjusted for confounding variables (i.e., year of vaccination, local district, gender). CONCLUSIONS Although still far from the target, RVV coverage has increased in recent years in Campania Region. Co-administration with MenB vaccine may aid in increasing RVV coverage, especially for pentavalent RVV. Further safety data are needed to support co-administration as a key tool to increase coverage.
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Affiliation(s)
- Andrea Lo Vecchio
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy.
| | - Sara Maria Scarano
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Margherita Del Bene
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Ugo Trama
- Drug Policy and Devices Unit, Regione Campania Health Department, Naples, Italy
| | - Giuseppina Affinito
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Pietro Buono
- Department of Maternal and Child Health, General Directorate for Health, Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Naples, Italy
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Idris IO, Ouma L, Tapkigen J, Ayomoh FI, Ayeni GO. Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013-2017. BMJ Open 2024; 14:e073789. [PMID: 38216207 PMCID: PMC10806701 DOI: 10.1136/bmjopen-2023-073789] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 12/22/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVES The designing of contextually tailored sustainable plans to finance the procurement of vaccines and the running of appropriate immunisation programmes are necessary to address the high burden of vaccine-preventable diseases and low immunisation coverage in sub-Saharan Africa (SSA). We sought to estimate the minimum fraction of a country's health budget that should be invested in national immunisation programmes to achieve national immunisation coverage of 80% or greater depending on the context, with and without donors' support. DESIGN Multicountry analysis of secondary data using retrieved publicly available data from the WHO, Global Alliance for Vaccines and Immunization (GAVI) and World Bank databases. SETTING Data on 24 SSA countries, between 2013 and 2017. METHODS We model the variations in immunisation coverage across the different SSA countries using a fractional logit model. Three different generalised linear models were fitted to explore how various explanatory variables accounted for the variability in each of the three different vaccines-measles-containing vaccine (MCV)1, diphtheria, pertussis, tetanus (DPT3) and BCG. RESULTS We observed an association between current health expenditure (as a percentage of gross domestic product) and immunisation coverage for BCG (OR=1.01, 95% CI: 1.01 to 1.04, p=0.008) and DPT3 (OR=1.01, 95% CI: 1.0 to 1.02, p=0.020) vaccines. However, there was no evidence to indicate that health expenditure on immunisation (as a proportion of current health expenditure) could be a strong predictor of immunisation coverage (DPT, OR 0.96 (95% CI 0.78 to 1.19; p=0.702); BCG, OR 0.91 (0.69 to 1.19; p=0.492); MCV, OR 0.91 (0.69 to 1.19; p=0.482)). We demonstrate in selected countries that to achieve the GAVI target of 80% in the countries with low DPT3 coverage, health expenditure would need to be increased by more than 45%. CONCLUSIONS There is a need to facilitate the development of strategies that support African countries to increase domestic financing for national immunisation programmes towards achieving 2030 targets for immunisation coverage.
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Affiliation(s)
- Israel Oluwaseyidayo Idris
- Immunization Analysis & Insights Unit, NAIJAHEALTH Initiative, Lagos, Nigeria
- Health Emergencies Programme (WHE), WHO, Geneva, Switzerland
| | - Luke Ouma
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Janet Tapkigen
- Department of Health Sciences, University of Tampere, Tampere, Finland
| | - Francis Ifeanyi Ayomoh
- Health Policy, Federal Ministry of Health, Abuja, Federal Capital Territory, Nigeria
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Gabriel Omoniyi Ayeni
- Immunization Analysis & Insights Unit, NAIJAHEALTH Initiative, Lagos, Nigeria
- Health Emergencies Programme (WHE), WHO Regional Office for Africa, Daresalam, Tanzania
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Wassenaar M, Fombah AE, Chen H, Owusu-Kyei K, Williams J, Sunders JHC, Llach M, Quinto L, Sesay T, Samai M, Menéndez C, González R. Immunisation coverage and factors associated with incomplete immunisation in children under two during the COVID-19 pandemic in Sierra Leone. BMC Public Health 2024; 24:143. [PMID: 38200476 PMCID: PMC10777622 DOI: 10.1186/s12889-023-17534-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Routine childhood immunisation is one of the most important life-saving public health interventions. However, many children still have inadequate access to these vaccines and millions remain (partially) unvaccinated globally. As the COVID-19 pandemic disrupted health systems worldwide, its effects on immunisation have become apparent. This study aimed to estimate routine immunisation coverage among children under two in Sierra Leone and to identify factors associated with incomplete immunisation during the COVID-19 pandemic. METHODS A cross-sectional household survey was conducted in three districts in Sierra Leone: Bombali, Tonkolili and Port Loko. A three-stage cluster sampling method was followed to enrol children aged 10-23 months. Information regarding immunisation status was based on vaccination cards or caretaker's recall. Using WHO's definition, a fully immunised child received one BCG dose, three oral polio vaccine doses, three pentavalent vaccine doses and one measles-containing vaccine dose. Following the national schedule, full immunisation status can be achieved at 9 months of age. Data were weighted to reflect the survey's sampling design. Associations between incomplete immunisation and sociodemographic characteristics were assessed through multivariable logistic regression. RESULTS A total of 720 children were enrolled between November and December 2021. Full vaccination coverage was estimated at 65.8% (95% CI 60.3%-71.0%). Coverage estimates were highest for vaccines administered at birth and decreased with doses administered subsequently. Adjusting for age, the lowest estimated coverage was 40.7% (95% CI 34.5%-47.2%) for the second dose of the measles-containing vaccine. Factors found to be associated with incomplete immunisation status were: living in Port Loko district (aOR = 3.47, 95% CI = 2.00-6.06; p-value < 0.001), the interviewed caretaker being Muslim (aOR = 1.94, 95% CI = 1.25-3.02; p-value = 0.015) and the interviewed caretaker being male (aOR = 1.93, 95% CI = 1.03-3.59, p-value = 0.039). CONCLUSION Though full immunisation coverage at district level improved compared with pre-pandemic district estimates from 2019, around one in three surveyed children had missed at least one basic routine vaccination and over half of eligible children had not received the recommended two doses of a measles-containing vaccine. These findings highlight the need to strengthen health systems to improve vaccination uptake in Sierra Leone, and to further explore barriers that may jeopardise equitable access to these life-saving interventions.
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Affiliation(s)
- Myrte Wassenaar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- University Medical Center Utrecht - Utrecht University, Utrecht, the Netherlands
| | - Augustin E Fombah
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
- Ministry of Health, Freetown, Sierra Leone.
| | - Haily Chen
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Julian Williams
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Joe-Henry C Sunders
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mireia Llach
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Llorenç Quinto
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Manhiça Health Research Center, Manhiça, Mozambique
| | - Tom Sesay
- Directorate of Reproductive Child Health, Ministry of Health, Freetown, Sierra Leone
| | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Directorate of Research and Training, Ministry of Health, Freetown, Sierra Leone
| | - Clara Menéndez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Manhiça Health Research Center, Manhiça, Mozambique
| | - Raquel González
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Manhiça Health Research Center, Manhiça, Mozambique
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Ravi SJ, Vecino-Ortiz AI, Potter CM, Merritt MW, Patenaude BN. Group-based trajectory models of integrated vaccine delivery and equity in low- and middle-income countries. Int J Equity Health 2024; 23:5. [PMID: 38195588 PMCID: PMC10775446 DOI: 10.1186/s12939-023-02088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Integrated vaccine delivery - the linkage of routine vaccination with provision of other essential health services - is a hallmark of robust primary care systems that has been linked to equitable improvements in population health outcomes. METHODS We gathered longitudinal data relating to routine immunization coverage and vaccination equity in 78 low- and middle-income countries that have ever received support from Gavi, the Vaccine Alliance, using multiple imputation to handle missing values. We then estimated several group-based trajectory models to describe the relationship between integrated vaccine delivery and vaccination equity in these countries. Finally, we used multinomial logistic regression to identify predictors of group membership. RESULTS We identified five distinct trajectories of geographic vaccination equity across both the imputed and non-imputed datasets, along with two and four trajectories of socioeconomic vaccination equity in the imputed and non-imputed datasets, respectively. Integration was associated with reductions in the slope index of inequality of measles vaccination in the countries analyzed. Integration was also associated with an increase in the percentage of districts reporting high measles vaccination coverage. CONCLUSIONS Integrated vaccine delivery is most strongly associated with improvements in vaccination equity in settings with high baseline levels of inequity. Continued scholarship is needed to further characterize the relationship between integration and health equity, as well as to improve measurement of vaccination coverage and integration.
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Affiliation(s)
- Sanjana J Ravi
- Center for Health Security, Johns Hopkins Bloomberg School of Public Health, 700 East Pratt Street, Suite 900, Baltimore, MD, 21202, USA.
| | - Andrés I Vecino-Ortiz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8527, Baltimore, MD, 21205, USA
| | - Christina M Potter
- Center for Health Security, Johns Hopkins Bloomberg School of Public Health, 700 East Pratt Street, Suite 900, Baltimore, MD, 21202, USA
| | - Maria W Merritt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8527, Baltimore, MD, 21205, USA
- Berman Institute of Bioethics, Johns Hopkins Bloomberg School of Public Health, 1809 Ashland Avenue, Baltimore, MD, 21205, USA
| | - Bryan N Patenaude
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8527, Baltimore, MD, 21205, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, 5th Floor, Baltimore, MD, 21231, USA
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Macedo LFR, Ribeiro EC, Wanzala EJ, Neto OCS, de Brito SA, de Oliveira CRT, Cavalcante AF, Freitas GLS. Pentavalent and poliomyelitis vaccines: a review of the vaccination coverage in Brazilian children in the last 10 years. Arch Virol 2024; 169:17. [PMID: 38177876 DOI: 10.1007/s00705-023-05939-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/07/2023] [Indexed: 01/06/2024]
Abstract
The pentavalent and poliomyelitis vaccines are provided to children through the National Immunization Program in Brazil. For the last few years, this program has been responsible for eradication of various diseases in the country. To describe the vaccination coverage of the pentavalent vaccine and the polio vaccine in Brazil from 2013 to 2022. This is a retrospective and descriptive study with a time series component in which we analyzed vaccination coverage rates of pentavalent and poliomyelitis in the national vaccination program of Brazil from 2013 to 2022. The collected data were arranged in spreadsheets, analyzed, and presented graphically. In general, the coverage of the poliomyelitis and pentavalent vaccines has declined in all regions of Brazil, with significant differences each year. Although there has been a decrease in vaccination coverage in all regions and states, the most affected regions are the North and Northeast. There has been a significant decrease in polio and pentavalent vaccine coverage in recent years, and the rate of decrease differs in different parts of the country.
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Affiliation(s)
- Luis Fernando Reis Macedo
- Department of Nursing, Center for Biological and Health Sciences, Regional University of Cariri, Crato, Ceará, Brazil.
| | - Erica Cardoso Ribeiro
- Department of Nursing, Center for Biological and Health Sciences, Regional University of Cariri, Crato, Ceará, Brazil
| | - Emmanuel John Wanzala
- Cariri Medical School, Federal University of Cariri, Juazeiro do Norte, Ceará, Brazil
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Matthew Ayodele A, Fasasi MI, Rejoice Uche O, Gideon Ikemdinachi N, Henry Ugochukwu U. Factors associated with full childhood vaccination coverage among young mothers in Northern Nigeria. Pan Afr Med J 2024; 47:4. [PMID: 38371647 PMCID: PMC10870161 DOI: 10.11604/pamj.2024.47.4.37517] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/12/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction wide regional variation in immunization coverage still persists in Nigeria. Full Immunization Coverage (FIC) for more than 80% of all states in the northern region is lower than 40% relative to their southern counterpart. Studies focusing on young women in the north remain sparse, despite the high prevalence of early marriage and poor health-seeking behavior. This study examines FIC among young women in northern Nigeria. Methods we performed a secondary analysis of the 2013 and 2018 Nigeria Demographic and Health Survey on 1,198 women of children aged 12-23 months in 2013 and 405 in the 2018 dataset. Analysis was limited to young women 15-24 years, residing in Northern Nigeria. We used logistics regression to predict factors associated with FIC. Results the proportion of fully immunized children was low, at 11% in 2013 and 18% in 2018. The coverage for most vaccines was low, except for the oral polio vaccine. The children of mothers who had health card [(aOR=18.1,95% C.I (8.1-40.7)], in 2013 and 2018 [(aOR=12.7, 95% C.I (5.9-27.1)], attended ANC [(aOR=8.6, 95% C.I (2.4-30.9)] in 2013 and had facility delivery [(aOR=2.0, 95% C.I (1.0-4.1)] in 2018 were more likely to be fully immunized. Conclusion the study found FIC among children of young women in Northern Nigeria was abysmally low. Ownership of health care, antenatal attendance, and facility delivery significantly predicted the odds of FIC. These findings suggest the need for approaches that remove barriers to good health-seeking behavior, especially among young mothers in Northern Nigeria.
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Affiliation(s)
| | | | - Obiora Rejoice Uche
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
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Peng HK, Dombkowski KJ, Plegue MA, Latta K, Malosh R, Creary MS, Reeves SL. COVID-19 Immunization Coverage Among People With Sickle Cell Disease. JAMA Netw Open 2024; 7:e2351618. [PMID: 38190186 PMCID: PMC10774988 DOI: 10.1001/jamanetworkopen.2023.51618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024] Open
Abstract
This cross-sectional study compares the completion of the primary COVID-19 vaccine series in Michigan residents with vs without sickle cell disease and by age group.
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Affiliation(s)
- Hannah K. Peng
- Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor
| | - Kevin J. Dombkowski
- Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor
| | - Melissa A. Plegue
- Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor
| | - Krista Latta
- Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor
| | - Ryan Malosh
- Michigan Department of Health and Human Services, Lansing
| | | | - Sarah L. Reeves
- Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor
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Brumbaugh KQ, Ornelas IJ, Casas FR, Mokdad AH. Achieving Equity in Childhood Vaccination: A Mixed-Methods Study of Immunization Programs, Policies, and Coverage in 3 US States. J Public Health Manag Pract 2024; 30:E31-E40. [PMID: 37966959 DOI: 10.1097/phh.0000000000001844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVE In this study, we sought to understand patterns of childhood vaccinations in the United States across socioeconomic and racial/ethnic groups over a 12-year period to identify interventions that improve immunization equity and inform public health practice. DESIGN We conducted an explanatory, sequential, mixed-methods study. US state- and county-level immunization data were analyzed to understand trends in immunization coverage among racial/ethnic groups. Qualitative interviews with public health and community leaders were used to explain trends, gain insight into routine childhood immunization interventions, and understand local contexts and data limitations. PARTICIPANTS AND SETTING Secondary data were used from the National Immunization Survey-Child (NIS) public use data sets (2007 and 2019). Eligible participants for qualitative interviews were routine childhood immunization stakeholders from selected counties in North Carolina, Washington, and Arizona. MAIN OUTCOME MEASURE Our integrated findings report trends and probability of children aged 19 months to 3 years being fully vaccinated (measles-mumps-rubella [MMR], diphtheria and tetanus toxoids and acellular pertussis [DTaP], hepatitis B [Hep B]), interventions, and recommendations to improve routine childhood immunization coverage and equity. RESULTS Vaccination coverage remained high and relatively stable between 2007 and 2019; however, there were differences across racial/ethnic groups. Public health leaders identified key interventions that effectively improved vaccine equity and coverage, including data quality improvement, tailored interventions for specific populations, multisector partnerships, addressing common barriers, and data limitations. Participants also identified the critical role of state policies, public health funding, and community vaccine norms. CONCLUSIONS Variability persists in vaccination coverage and equity across states, race/ethnicity, and socioeconomic status despite decades of interventions. Vaccine stakeholders should use our findings to improve coverage and reduce disparities. Equitable improvements can be realized through policy change, data tracking/infrastructure improvements, and tailored interventions. Furthermore, local partners are critical in improving vaccine coverage and equitable interventions to disrupt disparities that long hold true for vaccine-preventable diseases.
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Affiliation(s)
- Kaitlin Quirk Brumbaugh
- Population Health Initiative (Ms Brumbaugh, Mr Rios Casas, and Dr Mokdad), Health Systems and Population Health (Dr Ornelas), and Department of Health Metrics Sciences, Institute for Health Metrics Sciences (Dr Mokdad), University of Washington, Seattle, Washington
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48
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Shuaib F, Odusolu Y, Okposen BB, Osibogun O, Akanmu S, Mohammed A, Yahya S, Akande T, Aliyu A, Ifeadike C, Akande A, Aigbokhaode A, Adebiyi A, Tobin-West C, Olatunya OS, Aguwa E, Danjuma G, Dika J, Nwosu A, Olubodun T, Oladunjoye A, Giwa O, Osibogun A. Coronavirus Disease 2019 Vaccination Coverage and Seropositivity amongst Nigerians 18 Years Old and Above. Niger Postgrad Med J 2024; 31:8-13. [PMID: 38321792 DOI: 10.4103/npmj.npmj_299_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/30/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND This was a cross-sectional community-based survey to study the prevalence of serum antibodies against the severe acute respiratory syndrome coronavirus 1 (SARS-COV-1) and determine possible source of antibodies as to whether from vaccination or from natural infection as well as attempt to compare antibody levels in response to the different four types of vaccines administered in Nigeria. METHODS A cross-sectional community-based study of the prevalence of serum antibodies against all four vaccine types used in Nigeria amongst a representative sample of people aged 18 years and above in the six geopolitical zones of the country using a multistage sampling technique covering 12 states of the country with two states being randomly selected from each geopolitical zone. High-throughput Roche electrochemiluminescence immunoassay system (Elecsys Anti-SARS-COV-1 Cobas) was used for qualitative and quantitative detection of antibodies to SARS-COV-1 in human plasma. RESULTS There was no statistically significant difference between the proportions with seropositivity for both the vaccinated and the unvaccinated (P = 0.95). The nucleocapsid antibody (anti-Nc) titres were similar in both the vaccinated and the unvaccinated, whereas the Spike protein antibody (anti-S) titres were significantly higher amongst the vaccinated than amongst the unvaccinated. Antibody levels in subjects who received different vaccines were compared to provide information for policy. CONCLUSION While only 45.9% of the subjects were reported to have been vaccinated, 98.7% of the subjects had had contact with the SARS-COV-1 as evidenced by the presence of nucleocapsid (NC) antibodies in their plasma. The 1.3% who had not been exposed to the virus, had spike protein antibodies which most likely resulted from vaccination in the absence of NC antibodies. Successive vaccination and booster doses either through heterogeneous or homologous vaccines increased antibody titres, and this stimulation of immune memory may offer greater protection against coronavirus disease 2019.
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Affiliation(s)
- Faisal Shuaib
- National Primary Health Care Development Agency, Lagos, Nigeria
| | - Yetunde Odusolu
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos, Nigeria
| | | | | | - Sulaimon Akanmu
- Department of Haematology and Blood Transfusion, College of Medicine University of Lagos, Zaria, Nigeria
| | | | - Shuaib Yahya
- Department of Community Health, University of Maiduguri, Maiduguri, Nigeria
| | - Tanimola Akande
- Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria
| | - Alhaji Aliyu
- Department of Community Health, Ahmadu Bello University, Zaria, Nigeria
| | - Chigozie Ifeadike
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Aderonke Akande
- Primary Health Care Board, Federal Capital Territory Administration, Abuja, Nigeria
| | | | - Akin Adebiyi
- Department of Epidemiology, College of Medicine University of Ibadan, Ibadan, Nigeria
| | - Charles Tobin-West
- Department of Community Health, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | | | - Emmanuel Aguwa
- Department of Community Health University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Joseph Dika
- Modibbo Adama University Teaching Hospital, Yola, Nigeria
| | - Augustina Nwosu
- Department of Haematology and Blood Transfusion, College of Medicine University of Lagos, Zaria, Nigeria
| | - Tope Olubodun
- Department of Community Medicine and Primary Care, Federal Medical Center, Abeokuta, Nigeria
| | - Adebimpe Oladunjoye
- Primary Health Care Department, Badagry West Local Government Area, Lagos State, Nigeria
| | - Opeyemi Giwa
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Akin Osibogun
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos, Nigeria
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
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49
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Richards J, Brunacini K, Stoll N, Tepper R. Implementing Effective Care in a University Population Based on National Vaccination Recommendations. Am J Med Qual 2024; 39:42-49. [PMID: 38127676 DOI: 10.1097/jmq.0000000000000162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Vaccines are among the most cost-effective and successful medical interventions, saving approximately 2.3 million lives annually. Unfortunately, vaccination coverage for adults remains low, leading to unnecessary and costly health consequences. An initial chart review revealed that 95% (N = 20) of students were not up to date with vaccines. In a patient survey, 100% of students (N = 21) did not recall receiving useful vaccine information, but 66.7% reported it would be helpful (≥4 of 5 on the Likert scale). Strategies supporting effective care, an Institute of Medicine quality domain, were used to address these gaps. The aim was to increase effective care in university adult students for vaccines by 30% over 90 days. The quality improvement method of Plan-Do-Study-Act cycles was used to evaluate iterative tests of change. Examining contextual elements, team and patient feedback, aggregate data, and run charts informed tests of change over 4 cycles. Core interventions included enhanced screening, vaccine shared decision-making, provider checklists, and a team engagement plan. Greater than 83% (N = 152) of students were not up to date with vaccines as per national guidelines. Over 8 weeks, the team effectively referred students for 265 of the 274 vaccines they were eligible for-an accuracy rate of 95.3%. The aim score, a mean composite score reflecting all 3 interventions, increased from 49% to 95%. Effective care for vaccine uptake increased by 83.8%-far exceeding the goal. Campus health centers and other primary care settings could benefit from adopting a similar strategy that provides clear benefits to patients and the broader community while decreasing health care costs.
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Affiliation(s)
- Julie Richards
- Department of Medical Services, Vaden Health Center, Stanford University, Stanford, CA
| | - Kevin Brunacini
- Department of Medical Services, Frontier Nursing University, Versailles, KY
| | - Nancy Stoll
- Department of Medical Services, Vaden Health Center, Stanford University, Stanford, CA
| | - Robyn Tepper
- Department of Medical Services, Vaden Health Center, Stanford University, Stanford, CA
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50
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Albinsson B, Hoffman T, Kolstad L, Bergström T, Bogdanovic G, Heydecke A, Hägg M, Kjerstadius T, Lindroth Y, Petersson A, Stenberg M, Vene S, Ellström P, Rönnberg B, Lundkvist Å. Seroprevalence of tick-borne encephalitis virus and vaccination coverage of tick-borne encephalitis, Sweden, 2018 to 2019. Euro Surveill 2024; 29:2300221. [PMID: 38214080 PMCID: PMC10785208 DOI: 10.2807/1560-7917.es.2024.29.2.2300221] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/07/2023] [Indexed: 01/13/2024] Open
Abstract
BackgroundIn Sweden, information on seroprevalence of tick-borne encephalitis virus (TBEV) in the population, including vaccination coverage and infection, is scattered. This is largely due to the absence of a national tick-borne encephalitis (TBE) vaccination registry, scarcity of previous serological studies and use of serological methods not distinguishing between antibodies induced by vaccination and infection. Furthermore, the number of notified TBE cases in Sweden has continued to increase in recent years despite increased vaccination.AimThe aim was to estimate the TBEV seroprevalence in Sweden.MethodsIn 2018 and 2019, 2,700 serum samples from blood donors in nine Swedish regions were analysed using a serological method that can distinguish antibodies induced by vaccination from antibodies elicited by infection. The regions were chosen to reflect differences in notified TBE incidence.ResultsThe overall seroprevalence varied from 9.7% (95% confidence interval (CI): 6.6-13.6%) to 64.0% (95% CI: 58.3-69.4%) between regions. The proportion of vaccinated individuals ranged from 8.7% (95% CI: 5.8-12.6) to 57.0% (95% CI: 51.2-62.6) and of infected from 1.0% (95% CI: 0.2-3.0) to 7.0% (95% CI: 4.5-10.7). Thus, more than 160,000 and 1,600,000 individuals could have been infected by TBEV and vaccinated against TBE, respectively. The mean manifestation index was 3.1%.ConclusionA difference was observed between low- and high-incidence TBE regions, on the overall TBEV seroprevalence and when separated into vaccinated and infected individuals. The estimated incidence and manifestation index argue that a large proportion of TBEV infections are not diagnosed.
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Affiliation(s)
- Bo Albinsson
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- These authors contributed equally to the work and share the first authorship
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
| | - Tove Hoffman
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- These authors contributed equally to the work and share the first authorship
| | - Linda Kolstad
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tomas Bergström
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Gordana Bogdanovic
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Heydecke
- Centre for Research and Development, Uppsala University, Region Gävleborg, Gävle, Sweden
| | - Mirja Hägg
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Ylva Lindroth
- Department of Laboratory Medicine, Medical Microbiology, Lund University, Skåne Laboratory Medicine, Lund, Sweden
| | - Annika Petersson
- Department of Clinical Chemistry and Transfusion Medicine, Växjö Central Hospital, Växjö, Sweden
| | - Marie Stenberg
- Laboratory Medical Center Gotland, Visby hospital, Visby, Sweden
| | - Sirkka Vene
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Patrik Ellström
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
- Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Bengt Rönnberg
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Laboratory of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
| | - Åke Lundkvist
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
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