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Introduction: Hepatitis B Virus (HBV) infection is an important occupational hazard for Healthcare Workers (HCWs), with an approximately four-fold increased risk of acquiring this infection compared to the normal population. The horizontal mode of transmission is the predominant mode among HCWs. Additionally, vaccination trends among HCWs have been disappointing, with paramedics reported to have a higher risk of HBV transmission and receiving HBV vaccination less often than doctors. Aim: To determine the burden of hepatitis B infection and vaccination trends among HCWs. Materials and Methods: This cross-sectional study was conducted at Pandit Bhagwat Dayal Sharma PGIMS, Rohtak Haryana, India, from March 2019 to January 2020, enrolling 250 HCWs. The study included 80 junior residents, 17 house surgeons, 123 nursing staff, 18 Laboratory Technicians (LTs), and 12 Operation Theatre Assistants (OTAs). The subjects were divided into two groups: medical workers (Group-1; House Surgeons and Junior Residents) and paramedical workers (Group-2; Nursing staff, LTs, OTAs). The sample size was calculated using Probability Proportion to Size (PPS) of HCWs. Descriptive statistics were performed. Results: None of the subjects tested positive for Hepatitis B surface Antigen (HBsAg) during the study period. A total of 196 (78.4%) subjects were vaccinated, while 54 (21.6%) subjects remained Non-Vaccinated (NV). Out of the 196 vaccinated subjects, 140 (71.4%) were Completely Vaccinated (CV), and 56 (28.6%) were Incompletely Vaccinated (IV). The vaccination rate was highest among junior residents (95%) and lowest among LTs and OTAs (50%). Among the 80 junior residents, 76 (95%) were vaccinated, and 4 (5%) were NV. Among the 123 nursing staff, 89 (72.3%) were vaccinated, and 34 (27.7%) were CV. Among the 18 LTs, 6 (33.3%) were CV, 9 (50%) were NV and 3 were in category of IV. None of the 12 OTAs were CV, with 6 (50%) being NV. Conclusion: HCWs are at a potential risk of contracting HBV infection as an occupational hazard. There is need to strengthen efforts towards vaccination and prevention of HBV infection. [ABSTRACT FROM AUTHOR]

Introduction: Since the emergence of Coronavirus Disease 2019 (COVID-19) pandemic, there has been an intense burden on the health system and economy worldwide with millions of people being affected leading to several deaths. In this scenario vaccination seems to be a hope to control the pandemic. However, fear of adverse events following immunisation sometimes makes people hesitant about vaccination. Aim: To assess the spectrum of post vaccination symptoms and also to identify the motivational factors along with their determinants at a tertiary care hospital, West Bengal, India. Materials and Methods: A cross-sectional study was conducted in the COVID-19 Vaccination Centre at Nil Ratan Sircar Medical College and Hospital, Kolkata West Bengal, India (tertiary care hospital), from August 2021 to November 2021. A total of 448 vaccinated beneficiaries were enrolled in the study. Data collection was done by an online questionnaire, sent to the participants in their registered mobile numbers. Descriptive statistics and Chisquare tests were used for data analysis. Results: Among 448 study participants, 262 (58.5%) were in 18-44 years of age group, 248(55.4%) female, 384 (85.7%) Hindu, 132 (29.5%) medical or paramedical students, 290 (64.7%) passed graduation and above and 306 (68.3%) belonged to nuclear family. About 228 (50.9%) beneficiaries reported post vaccination symptoms. Most common being local pain at injection site, found among 150 (65.8%) out of them. Most common motivational factors of COVID-19 vaccination were found to be fear of COVID-19 infection, reported by 274 (61.2%) participants, which showed significant difference with various age groups (p-value=0.001), religions (p-value=0.030), occupations (p-value<0.001) and educations (p-value=0.002). Statistical significant (p<0.05) differences were also found according to age, gender, co-morbidities, interval between vaccination and past COVID-19 infection and type of COVID-19 vaccine in relation to onset of post vaccination symptoms. Conclusion: Following COVID-19 immunisation minor adverse events were reported. Monitoring of those adverse events will help in further responding and prompt action. Also, the knowledge about motivational factors is expected to reduce vaccine hesitancy among unvaccinated people. [ABSTRACT FROM AUTHOR]

Aim: To assess knowledge, attitudes, and beliefs among dental students and faculty members regarding COVID-19 vaccines in dental colleges in Haryana, India. Objectives: To assess knowledge level, attitudes, and beliefs differences among BDS, MDS students and faculty members and find association between knowledge and COVID-19 vaccine inoculation among study participants. Materials and Methods: A cross-sectional study was carried out among students and faculty members of dental colleges in Haryana, India. Data collection was done via an online questionnaire based on questions to assess the knowledge, attitude and beliefs regarding COVID-19 vaccines. Results: The present study comprised of 270 study participants, where majority, i.e., 81.5% have reported COVID-19 vaccine inoculation. The mean knowledge score of the participants was reported to be 5.54 ± 2.19. A significant difference was found in the mean knowledge score of faculty members (7.81 ± 1.69), MDS (6.72 ± 1.49), and BDS (4.39 ± 1.68) students. COVID-19 vaccine inoculation was found to be significantly associated with average knowledge score of participants (OR = 6.1, P < 0.01). Conclusion: Dental professionals have an adequate degree of knowledge and attitude level regarding COVID-19 vaccines and are generally optimistic about resolving the pandemic situation with the immunization. [ABSTRACT FROM AUTHOR]

Introduction: The novel Coronavirus disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is seen to primarily affect the human respiratory system. Chest CT Severity Score (CTSS) provides a semi quantitative assessment of pulmonary involvement in COVID- 19 patients. COVID-19 pandemic mitigation measures such as SARS-CoV-2 vaccination are being deployed worldwide. However, with the emerging variants of concern of SARS-CoV-2, a high prevalence of post vaccination breakthrough infections is seen. Aim: To assess the association of CTSS with the vaccination status in a cohort of COVID-19 patients referred to a tertiary diagnostic centre and to evaluate the association of CTSS with other clinical parameters including co-morbidities in these patients. Materials and Methods: This cross-sectional observational study was conducted at a tertiary care diagnostic imaging centre in the city of Pune, Maharashtra, India. Data of 1002 symptomatic, adult patients who underwent chest CT and SARSCoV- 2 Reverse Transcription Polymerase Chain Reaction (RTPCR)/ Rapid Antigen Test (RAT) laboratory test between March 13, 2021 and June 22, 2021, were collected. COVID-19 reporting and Data System (CO-RADS) categories and the corresponding semi quantitative CTSS were calculated for each patient. Based on their vaccination status, patients were categorised into three groups: unvaccinated, partially vaccinated and fully vaccinated. The association of CTSS with various categories of vaccination status, demographics, co-morbidities and stages of the disease of the patients, was evaluated. Results: Of the 1002 COVID-19 patients, 768 (76.6%) were unvaccinated, 190 (19.0%) were partially vaccinated and 44 (4.4%) were fully vaccinated. Mean CTSS in the fully vaccinated cohort was significantly lower (3.75±4.7) than that in the partially vaccinated (6.05±5.7) and unvaccinated (8.29±4.9) patients (mean 3.75 vs. 6.05 vs. 8.29, respectively; (p<0.05). Mean CTSS in patients with no co-morbidities was significantly lower than that in patients with hypertension and diabetes (7.12 vs. 8.75 vs. 10.39, respectively; (p<0.05). Conclusion: Significant association was noted between the Chest CTSS and the vaccination status, age, gender, co-morbidities and stage of disease in this large cohort of COVID-19 patients. The study reiterates that full vaccination aids in reducing the severity of lung involvement in COVID-19 infection. [ABSTRACT FROM AUTHOR]

Vaccines have contributed substantially to decreasing the morbidity and mortality rates of many infectious diseases worldwide. Despite this achievement, an increasing number of parents have adopted hesitant behaviours towards vaccines, delaying or even refusing their administration to children. This has implications not only on individuals but also society in the form of outbreaks for e.g. measles, chicken pox, hepatitis A, etc. A review of the literature was conducted to identify the determinants of vaccine hesitancy (VH) as well as vaccine confidence and link them to challenges and opportunities associated with vaccination in India, safety concerns, doubts about the need for vaccines against uncommon diseases and suspicions towards new vaccines were identified as major vaccine-specific factors of VH. Lack of awareness and limited access to vaccination sites were often reported by hesitant parents. Lastly, socio-economic level, educational level and cultural specificities were contextual factors of VH in India. Controversies and rumours around some vaccines (e.g., human papillomavirus) have profoundly impacted the perception of the risks and benefits of vaccination. Challenges posed by traditions and cultural behaviours, geographical specificities, socio-demographic disparities, the healthcare system and vaccine-specific features are highlighted, and opportunities to improve confidence are identified. To overcome VH and promote vaccination, emphasis should be on improving communication, educating the new generation and creating awareness among the society. Tailoring immunisation programmes as per the needs of specific geographical areas or communities is also important to improve vaccine confidence. [ABSTRACT FROM AUTHOR]

Background: Childhood vaccinations are a vital preventive measure to reduce disease incidence and deaths among children. As a result, immunisation coverage against measles was a key indicator for monitoring the fourth Millennium Development Goal (MDG), aimed at reducing child mortality. India was among the list of countries that missed the target of this MDG. Immunisation targets continue to be included in the post-2015 Sustainable Development Goals (SDG), and are a monitoring tool for the Indian health care system. The SDGs also strongly emphasise reducing inequalities; even where immunisation coverage improves, there is a further imperative to safeguard against inequalities in immunisation outcomes. This study aims to document whether socioeconomic inequalities in immunisation coverage exist among children aged 12-59 months in India.Methods: Data for this observational study came from the fourth round of the National Family Health Survey (2015-16). We used the concentration index to assess inequalities in whether children were fully, partially or never immunised. Where children were partially immunised, we also examined immunisation intensity. Decomposition analysis was applied to examine the underlying factors associated with inequality across these categories of childhood immunisation.Results: We found that in India, only 37% of children are fully immunised, 56% are partially immunised, and 7% have never been immunised. There is a disproportionate concentration of immunised children in higher wealth quintiles, demonstrating a socioeconomic gradient in immunisation. The data also confirm this pattern of socioeconomic inequality across regions. Factors such as mother's literacy, institutional delivery, place of residence, geographical location, and socioeconomic status explain the disparities in immunisation coverage.Conclusions: In India, there are considerable inequalities in immunisation coverage among children. It is essential to ensure an improvement in immunisation coverage and to understand underlying factors that affect poor uptake and disparities in immunisation coverage in India in order to improve child health and survival and meet the SDGs. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis A Virus (HAV) is a major cause of acute viral hepatitis caused by a Ribonucleic Acid (RNA) virus. The mode of transmission is fecal-oral route and the risk factors include unsafe water, poor personal hygiene and sanitation. Even though seroprevalence rate is high in low socio-economic regions, it is low in urban areas and the need of vaccination is looked for. Aim: To estimate the seroprevalence of hepatitis A in medical students of Southern India. Materials and Methods: The present study was a cross-sectional study conducted in the medical students of Government Medical College, Manjeri, Kerala, India. Blood samples of 377 students during the year 2015-2018 were taken. These students were in their 1st, 2nd, 3rd and 4th year MBBS course who admitted in the years 2018, 2017, 2016 and 2015, respectively. Commercially available Enzyme-Linked Immunoassay (ELISA) kits for anti HAV IgG antibodies were used. Chi-square test was used for statistical analysis. Results: Out of 377 participants 238 (63.2%) were females and 139 (36.8%) were males. A total of 51 (13.5%) were positive for IgG antibodies. A total of 43 were in 21-22 age group with a p-value >0.05. An association of seropositivity and seronegativity with frequency of dining out pattern was there with a p-value <0.05. Conclusion: The seroprevalence of hepatitis A was found in a declining stage hence, vaccination against hepatitis A should be included in the National Immunisation Schedule. [ABSTRACT FROM AUTHOR]

Introduction: Rubella is a mild exanthematous illness caused by Rubella virus which belongs to the family Togaviridae. Rubella is considered of public health importance for the teratogenic potential of the virus, this lead to disastrous consequences in pregnant women if contracted during first trimester. An effective and safe vaccine against rubella is available, yet according to estimation, over 100,000 infants are born with Congenital Rubella Syndrome (CRS) annually worldwide. Rubella is endemic in India and CRS contributes in morbidity and mortality among the live birth. As rubella vaccine has been incorporated in their immunisation schedule, the incidence of rubella has been reduced drastically. But still seronegative population has been noted in various studies in India. Aim: To evaluate the immune status (Rubella specific IgG antibody) of Rubella among Health Care Workers (HCW) of our hospital. Materials and Methods: A prospective, cross-sectional study was conducted among female health care students and workers (n=145) in a tertiary care teaching hospital in South Chennai from January to February 2017. Blood samples were collected after getting informed consent and serum was separated. A rubella specific IgG antibody was detected by ELISA using the commercially available kit as per the manufacturer's instruction. Samples showing IgG antibody titre >10 IU/mL were taken as positive and =10 IU/mL as negative. The results were analysed statistically using Epi Info version 7.2. Results: A total n=145 samples were analysed and among which 124 (85.5%) workers had adequate titre and 21 (14.48%) were negative for rubella IgG antibody. The mean age of the participants was 19.65. The participants were MBBS students (n=75), BDS students (n=48), Laboratory technicians (n=12), Staff nurses (n=9) and Doctor (n=1). None of them was remembering their vaccination status. Conclusion: The study concludes that immunisation of HCWs against rubella is an important target regardless of their vaccination status. There is a more chance of exposure to infection and also in transmission of infection in the hospital environment. Hence, maintenance of immunity is an essential part of prevention and infection control scheme. [ABSTRACT FROM AUTHOR]

The study analyses the effects of some selected demographic and socioeconomic predictor variables on the likelihood of immunisation of a child for six vaccinepreventable diseases covered under the Universal Immunisation Programme. It focuses on immunisation coverage (a) in all India, (b) in rural and urban areas of India, (c) for demographic factors and socioeconomic factors, (d) for three groups of states, namely, Empowered Action Group, North-Eastern and Other states. The study applies logistic regression model to NFHS-4 (2015-16) data. Results are robust across different models. The likelihood of immunisation increases with mother's education level, mother's age, mother's exposure to mass media, mother's awareness about immunisation, antenatal care during pregnancy, wealth index, household electrification, mother's empowerment index, and caste/ tribe hierarchy. Likelihood of immunisation decreases with birth-order and urban area. However, sex of children and sex of household head has no effect on likelihood of immunisation. [ABSTRACT FROM AUTHOR]

Introduction: Many children in low-income and middle-income countries fail to receive any routine vaccinations. There is little evidence on how to effectively and efficiently identify and target such 'zero-dose' (ZD) children., Methods: We examined how well predictive algorithms can characterise a child's risk of being ZD based on predictor variables that are available in routine administrative data. We applied supervised learning algorithms with three increasingly rich sets of predictors and multiple years of data from India, Mali and Nigeria. We assessed performance based on specificity, sensitivity and the F1 Score and investigated feature importance. We also examined how performance decays when the model is trained on older data. For data from India in 2015, we further compared the inclusion and exclusion errors of the algorithmic approach with a simple geographical targeting approach based on district full-immunisation coverage., Results: Cost-sensitive Ridge classification correctly classifies most ZD children as being at high risk in most country-years (high specificity). Performance did not meaningfully increase when predictors were added beyond an initial sparse set of seven variables. Region and measures of contact with the health system (antenatal care and birth in a facility) had the highest feature importance. Model performance decreased in the time between the data on which the model was trained and the data to which it was applied (test data). The exclusion error of the algorithmic approach was about 9.1% lower than the exclusion error of the geographical approach. Furthermore, the algorithmic approach was able to detect ZD children across 176 more areas as compared with the geographical rule, for the same number of children targeted., Interpretation: Predictive algorithms applied to existing data can effectively identify ZD children and could be deployed at low cost to target interventions to reduce ZD prevalence and inequities in vaccination coverage., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives Childhood immunisation is one of the important public health interventions, and poor migrants are vulnerable to forego these services. The objective of the study is to understand the access of childhood immunisation services to the socio-economically disadvantaged migrants and the determinants of full immunisation uptake up to the age of 1 year. Methods In a cross-sectional survey, 458 migrant households with a child aged up to 2 years were identified. Data on sociodemographics, migration history, receipt of various vaccines and maternal healthcare services were collected through interviewer-administered pretested questionnaires. Multiple logistic regression analysis was performed to identify the determinants of full immunisation status. Results Childhood immunisation coverage rates were low as only 31% of recent-migrant children and 53% of settled-migrant children were fully immunised against seven vaccine-preventable diseases (VPDs) by 12 months of age. Lack of awareness of the immunisation schedule and location of health facilities, mobility, illness of the child, fear of vaccines and side-effects were the main reasons for incomplete or no immunisation. Mother's educational attainment, TV viewership, hospital birth and receipt of information on childhood immunisation from the health workers during postnatal visits increased chances of getting the child fully immunised against seven VPDs by 1 year of age. Conclusion The migrants, particularly the recent migrants, are at the risk of foregoing immunisation services because of livelihood insecurity, mobility and non-familiarity of services in the new urban environment. There is a need to deliver services with a focus on recent migrants. Investing in education and socio-economic development and providing secured livelihoods and equitable services are important to improve and sustain access to healthcare services in the long run. [ABSTRACT FROM AUTHOR]

Child malnutrition is a major health problem in India. Mumbai Metropolitan Region is an economically most developed region of Maharashtra. High economics growth of region should not have high incidence of malnutrition among below five age group children. But we found that there is high incidence of underweight among below five age group children in Govandi, Thane, Bhandup. The incidence of stunting is found more in Ghatkopar, Thane, Turbhe, Mulund and Bhandup. The wasting incidence among below five age group children is found more in Koparkhirne, Turbhe, Mulund and Bhandup. At below one age group, more children are underweight, stunted and wasted. Lower household size, parents lower education, lower income and lower asset holding leads to malnutrition among children. We estimated around one lakh deaths per annum of under-five age group children in Mumbai Metropolitan Region. We have used logit regression model to examine the co-relation of child malnutrition with socioeconomic and demographic factors. The incidence of underweight is negatively co-related to age, per capita income, time required to carry water, television, pulses, other methods of contraceptives, injections. It is positively co-related to telephone and curd. The stunting among children is negatively co-related to age, time required, television, bike, pulses, other methods of contraceptives, injections, age at marriage and sterilisation. It is positively co-related to sex, bed, curd, and home delivery. The incidence of wasting is negatively co-related to age, television, pulses and injections. It is positively co-related to per capita income and curd. There is need of different policies in different slums of region. Health care staff must visit slums regularly. They must treat all patients, counsel on immunisation, breastfeeding and institutional deliveries. Government must start training and self-employment for poor people of slums. The NGO'S, researchers, social workers, politicians must work together for the higher standard of living of population. Government must invest money infrastructure in facilities for poor of slums. Slums should not be demolished in region. They are integrated part of region. Every child must be seen as window of opportunity for future human resource of region. Such policies will certainly reduce malnutrition among children at some extent in Mumbai Metropolitan Region. [ABSTRACT FROM AUTHOR]

Introduction: Even after 20 years of UIP diphtheria is still prevalent showing up and down trends in India. India contributes about 19 to 84% of total burden worldwide and many of time it is unidentified and notified. Present study is aimed to study Diphtheria cases in a tertiary care hospital Ahmedabad from January 2012 to December 2015. Methodology: Total 74 confirm throat swab smear or culture for C Diphtheria positive patients were included in study. Their age, immunisation status, response to treatment in form of throat swab clearance of bacilli, complications and mortality was noted and analysed. Results: 38(51.35%) were from 5-10 years age groups. Inappropriate booster doses and waning immunity in older age is responsible for shifting of age pattern. 9% of cases were fully immunised and had very milder form of disease. 56.65% were unimmunised had more severe form, complications, delayed clearance of throat bacilli and mortality. 90% patients throat swab cleared within 72 hours of starting treatment showing sensitivity of bacilli to slandered treatment. 12(18.9%) patients were expired mostly due to cardiac complications. Conclusion: Thus strengthening of routine immunisation, early identification and timely intervention can definitely overcome the resurgence of disease. [ABSTRACT FROM AUTHOR]

Background: Direct-to-beneficiary communication mobile programmes are among the few examples of digital health programmes to have scaled widely in low-resource settings. Yet, evidence on their impact at scale is limited. This study aims to assess whether exposure to mobile health information calls during pregnancy and postpartum improved infant feeding and family planning practices., Methods: We conducted an individually randomised controlled trial in four districts of Madhya Pradesh, India. Study participants included Hindi speaking women 4-7 months pregnant (n=5095) with access to a mobile phone and their husbands (n=3842). Women were randomised to either an intervention group where they received up to 72 Kilkari messages or a control group where they received none. Intention-to-treat (ITT) and instrumental variable (IV) analyses are presented., Results: An average of 65% of the 2695 women randomised to receive Kilkari listened to ≥50% of the cumulative content of calls answered. Kilkari was not observed to have a significant impact on the primary outcome of exclusive breast feeding (ITT, relative risk (RR): 1.04, 95% CI 0.88 to 1.23, p=0.64; IV, RR: 1.10, 95% CI 0.67 to 1.81, p=0.71). Across study arms, Kilkari was associated with a 3.7% higher use of modern reversible contraceptives (RR: 1.12, 95% CI 1.03 to 1.21, p=0.007), and a 2.0% lower proportion of men or women sterilised since the birth of the child (RR: 0.85, 95% CI 0.74 to 0.97, p=0.016). Higher reversible method use was driven by increases in condom use and greatest among those women exposed to Kilkari with any male child (9.9% increase), in the poorest socioeconomic strata (15.8% increase), and in disadvantaged castes (12.0% increase). Immunisation at 10 weeks was higher among the children of Kilkari listeners (2.8% higher; RR: 1.03, 95% CI 1.00 to 1.06, p=0.048). Significant differences were not observed for other maternal, newborn and child health outcomes assessed., Conclusion: Study findings provide evidence to date on the effectiveness of the largest mobile health messaging programme in the world., Trial Registration Number: Trial registration clinicaltrials.gov; ID 90075552, NCT03576157., Competing Interests: Competing interests: All authors have completed the Unified Competing Interest form (available on request from the corresponding author) and declare that the research reported was funded by the Bill and Melinda Gates Foundation. AG, SC, PD are employed by BBC Media Action; one of the entities supporting program implementation. The authors do not have other relationships and are not engaged in activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

World Health Organization and United Nations International Children's Emergency Fund have strongly recommended a sustained coverage of universal immunisation among all children against tuberculosis, polio, diphtheria, pertussis, tetanus and measles. In India, these vaccines under the universal immunisation programme are made available absolutely free of cost to all children through the public health system. Information regarding immunisation coverage among HIV exposed children in India is still very limited. The objective of this study was to estimate the proportion of children of people living with HIV who had been completely immunised by the age of 12 months and to find predictors of complete immunisation. A community-based cross-sectional survey was conducted in the Kolkata Metropolitan Area between 15 June and 14 September 2009 using a pre-structured interview schedule. Data were analysed from 256 care-givers of children (85.5% response rate) whose parents were randomly selected from the Bengal Network of HIV-positive people. Multiple logistic regression was used to estimate and test associations of predictors with complete immunisation. The percentage of children of people living with HIV completely immunised at the age of 12 months was 73.0% (67.3% to 78.1%), which was not significantly different from that for all children at 12 months. Mothers having received antenatal care [OR (odds ratio): 7.29; 95% confidence intervals (CI): 2.39-22.25], mothers having postprimary education (OR: 3.37; 95% CI: 1.45-7.81), children of Hindu and Christian religion (OR: 3.74; 95% CI: 1.63-8.62), children not belonging to scheduled castes, tribes and 'other backward classes' (OR: 2.08; 95% CI: 1.02-4.25) were significant independent predictors of complete immunisation status of these children. This emphasises the imperative need for up-scaling of antenatal care among the pregnant mothers to ensure complete immunisation among their children. A special focus on girl child education should also be implemented to empower future mothers for a sustained improvement of child immunisation in the long-run. The current national immunisation programme should focus on the children from the Muslim community and those belonging to scheduled castes, tribes and other backward classes to improve coverage. [ABSTRACT FROM AUTHOR]

Lack of proper communication has been identified as a major factor in relapse of polio. This is indeed majorly related to under developed and developing countries. Designing a planned communication strategy can be instrumental in sustainable steps to eradicate polio. The paper focuses on a case study of Maheshtala, a city of South 24 Parganas under state of West Bengal in India. The experience further points out to the need of proper community relations. The challenge of designing effective message for the target group also throws light on knowing the community well. The importance of opinion leader is also immense in this respect. Altogether it has to be an overall inclusive approach. [ABSTRACT FROM AUTHOR]

In cooperation with Indian health authorities, the GAVI Alliance (GAVI) is introducing Hepatitis B (HepB) vaccination into the immunisation programmes of 11 'better-performing' Indian states. This article describes the concerns and interests of major stakeholders in the programme, including GAVI partners and the Indian government, and summarises Indian debates that have emerged in response to the project, especially on the issue of selective vs. universal immunisation. The article suggests that programme planning should be based on a good knowledge of disease prevalence and the relative importance of perinatal HepB transmission, which would require a comprehensive cross-country study of the epidemiology of HepB among different populations, the relative importance of different transmission routes and the degree of geographical variation in India. Based on this research, further studies could address the feasibility and cost-effectiveness of routine birth-dose administration and selective birth-dose immunisation of infants born to mothers who are chronic HepB virus carriers. The GAVI 'formula' could be strengthened by supporting the basic epidemiological research that is essential to effective programme planning in recipient countries, which are by definition among the world's poorest countries. [ABSTRACT FROM AUTHOR]

Mass polio immunisation campaign was launched in the national capital territory of Delhi with 2 doses of polio vaccine to be administered to children upto 3 years of age on October and December 4, 1994 respectively. Massive information, education & communication (IEC) efforts through mass media and interpersonal communication preceded the dates of the campaign. A study to assess the awareness of general population was carried out by interviewing 225 adult residents of Delhi using a structured questionnaire. These were drawn by two stage stratified random sampling. Zonewise assembly segments in the first stage and census enumeration blocks in the second stage formed the sampling frame. The study, carried out 3 days prior to date of administration of first dose of oral polio, revealed that 60.4% of population was aware of the programme being launched and 31.6% about aim of the programme. None of the respondents were aware of all the specific parameters put together correctly viz., objective, immunisation days, age group & immunisation status of children. The higher level of awareness was directly proportional to the level of education. The overwhelming success of the programme was indicated by immunisation of > 90% children upto 3 years of age all over Delhi in the first phase of the programme. The key to success of the programme despite low awareness is explained on the basis of unflinching efforts put in by vaccine centre level committees, integrated child development scheme (ICDS) and urban basic service (UBS) functionaries in mobilising people to reach various vaccination centres. Other states planning to launch such mass campaigns should pay attention to social mobilisation in addition to IEC efforts for successful completion of the programme. [ABSTRACT FROM AUTHOR]

Introduction: Immunisation plays a vital role in reducing child mortality and morbidity against preventable diseases. As part of a randomised controlled trial in rural Madhya Pradesh, India to assess the impact of Kilkari, a maternal messaging programme, we explored determinants of parental immunisation knowledge and immunisation practice (completeness and timeliness) for children 0-12 months of age from four districts in Madhya Pradesh., Methods: Data were drawn from a cross-sectional survey of women (n=4423) with access to a mobile phone and their spouses (n=3781). Parental knowledge about immunisation and their child's receipt of vaccines, including timeliness and completeness, was assessed using self-reports and vaccination cards. Ordered logistic regressions were used to analyse the factors associated with parental immunisation knowledge. A Heckman two-stage probit model was used to analyse completeness and timeliness of immunisation after correcting for selection bias from being able to produce the immunisation card., Results: One-third (33%) of women and men knew the timing for the start of vaccinations, diseases linked to immunisations and the benefits of Vitamin-A. Less than half of children had received the basic package of 8 vaccines (47%) and the comprehensive package of 19 vaccines (44%). Wealth was the most significant determinant of men's knowledge and of the child receiving complete and timely immunisation for both basic and comprehensive packages. Exposure to Kilkari content on immunisation was significantly associated with an increase in men's knowledge (but not women's) about child immunisation (OR: 1.23, 95% CI 1.02 to1.48) and an increase in the timeliness of the child receiving vaccination at birth (Probit coefficient: 0.08, 95% CI 0.08 to 0.24)., Conclusion: Gaps in complete and timely immunisation for infants persist in rural India. Mobile messaging programmes, supported by mass media messages, may provide one important source for bolstering awareness, uptake and timeliness of immunisation services., Trial Registration Number: NCT03576157., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Aims: The success of the COVID-19 vaccination program is dependent on people's knowledge and attitude regarding the vaccination program. Higher vaccine acceptance can be ensured by strengthening the facilitators and limiting the barriers being observed among the general population., Material and Methods: Indexed study is a cross-sectional web-based survey using a pre-validated questionnaire to assess knowledge, barriers and facilitators of COVID-19 vaccine and vaccination programme administered on adults across India using a Google online survey platform., Results: A total of 1294 responses (age: 38.02 ± 13.34 years) were collected. Most of the participants had limited knowledge regarding the eligibility of vaccines in vulnerable population groups such as people with allergies (57.89%) and immune-compromised patients (62.98%), pregnant and lactating women (41.89%) and patients with chronic illness (34.78%). Older participants (>45 years) were more willing to take the COVID-19 vaccine (p < 0.001) as they believed the vaccine is not harmful and considered it as societal responsibility. Younger participants (<45 years) and those residing in urban settings raised concerns on the availability of the vaccine and authenticity of the vaccine (p < 0.001)., Conclusion: There is a scope for improvement in people's knowledge regarding COVID-19 vaccine and the vaccination programme by addressing the barriers and facilitators which can improve the participants' turnover at vaccination centres., Competing Interests: Declaration of competing interest The Author(s) declare(s) that there is no conflict of interest., (Copyright © 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Neonatal pertussis is a resurging disease, possibly due to waning immunity in pregnant women. We report seven cases of neonatal pertussis ( Bordetella pertussis DNA PCR positive) in this retrospective study conducted at a tertiary care teaching hospital in north India over eight months (March to October 2018). All except one were male infants and presented at the age of 14-30 days with paroxysmal cough in all, four had fever, four had respiratory distress, three had similar illness in the family, and two had leucocytosis. All recovered well with azithromycin. The duration of hospital stay was 5-7 days. A strong suspicion of neonatal pertussis in neonates with paroxysmal cough and similar family history should be maintained as the prognosis is excellent, if treated appropriately.

Abstract: The National Technical Advisory Group on Immunisation in India (NTAGI) fulfils a need for informing decision-making concerning the introduction of new vaccines and strengthening the Universal Immunisation Programme (UIP). The role and membership of NTAGI have expanded over the years in tune with the emerging needs and priorities of the Government of India. Current challenges include institutionalizing mechanisms to follow-up and monitor recommendations, to support research needs to fill information gaps, and to provide technical assistance for monitoring and periodically reviewing the UIP. [Copyright &y& Elsevier]