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Vaccinators fulfill an important role in a nation's public health by reducing the burden of disease on the population. Understanding patterns of attack employed against vaccinators is important to determine how to protect them. We conducted a search of the Global Terrorism Database for terrorist attacks against vaccinators that occurred between the years 1970 and 2018. Using the search terms "hospital," "healthcare," "clinic," "doctor," "nurses," "vaccinators," and "vaccinations," 2,322 healthcare-related entries were identified. We then manually searched the dataset for incidents related to attacks on vaccinators, which resulted in the identification of 133 attacks against vaccinators. The majority (128 out of 133) of attacks occurred during or after 2010. Every attack except one has occurred in the Middle East, South Asia, or sub-Saharan Africa. Pakistan has seen the most attacks against vaccinators, with 112 incidents recorded. Vaccinators continue to be vulnerable to terrorist attacks. Protection of healthcare personnel during mass vaccination efforts is critical so that they can continue their lifesaving mission.

Background: We examined clinical outcomes among combat casualties with genitourinary injuries after blast trauma. Methods: Characteristics, clinical care, urologic complications, and infections for subjects enrolled in the Trauma Infectious Disease Outcomes Study (TIDOS) were collected from Department of Defense (DOD) and Department of Veterans Affairs (VA) sources. Logistic regression identified predictors for urinary tract infections (UTIs) after genitourinary trauma. Results: Among 530 TIDOS enrollees who entered VA care, 89 (17%) sustained genitourinary trauma. The majority of subjects (93%) were injured via a blast and 27% had a dismounted complex blast injury (DCBI). Sexual dysfunction was reported with 36% of subjects, whereas 14% had urinary retention/incontinence and 8% had urethral stricture. Urologic complications were comparable between patients with and without DCBIs. Nineteen (21%) subjects had one or more UTI with a total of 40 unique UTI events (25% during initial hospitalization and 75% during subsequent DOD or VA care). The UTI incidence rate was 0.89 per patient-year during initial hospitalization, 0.05 per patient-year during DOD follow-up, and 0.07 per patient-year during VA healthcare. Subjects with UTIs had a higher proportion of bladder injury (53% vs. 13%; p