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In recent years, serosurveillance has gained momentum as a way of determining disease transmission and immunity in populations, particularly with respect to vaccine-preventable diseases. At the end of 2017, the Oxford University Clinical Research Unit and the National Institute of Hygiene and Epidemiology held a meeting in Vietnam with national policy makers, researchers, and international experts to discuss current seroepidemiologic projects in Vietnam and future needs and plans for nationwide serosurveillance. This report summarizes the meeting and the plans that were discussed to set up nationwide serosurveillance in Vietnam.

Resumen: Tras la revisión de la mejor información científica disponible, el CAV-AEP publica las nuevas recomendaciones para proteger con vacunas a las embarazadas, los niños y los adolescentes residentes en España.Se mantienen las mismas recomendaciones que el año anterior en cuanto a las vacunas hexavalentes y a la vacuna neumocócica conjugada de 13 serotipos, al refuerzo con tétanos, difteria, tosferina y poliomielitis inactivada (Tdpa-VPI) a los seis años y con tétanos, difteria y tosferina (Tdpa) a los 12-14 años y a las embarazadas a partir de la semana 27 (desde la semana 20 si hay alto riesgo de parto pretérmino).Lo mismo sucede con las vacunas del rotavirus, del meningococo B tetraantigénica (2 + 1), de la vacuna meningocócica tetravalente (MenACWY), de la triple vírica, de la varicela y de la vacuna del virus del papiloma humano (VPH), en ambos géneros.Como novedades este año el CAV-AEP recomienda:La vacunación antigripal de seis a 59 meses de edad siempre que sea factible y no perjudique al programa vacunal dirigido a las personas de mayor riesgo.En consonancia con las recomendaciones oficiales nacionales, el CAV-AEP recomienda el uso sistemático a partir de los 5 años de las vacunas para la COVID-19 de ARNm. Abstract: After reviewing the best available scientific information, CAV-AEP publishes their new recommendations to protect pregnant women, children and adolescents living in Spain through vaccination.The same recommendations as the previous year regarding hexavalent vaccines, pneumococcal conjugate vaccine of 13 serotypes, booster with tetanus, diphtheria, pertussis and inactivated poliomyelitis (Tdpa-IPV) at 6 years and with tetanus, diphtheria and pertussis (Tdpa) at 12–14 years and pregnant women from week 27 (from week 20 if there is a high risk of preterm delivery).Also with rotavirus, tetraantigenic meningococcal B (2 + 1), meningococcal quadrivalent (MenACWY), MMR, varicella and human papillomavirus (HPV) vaccines, for both genders.As novelties this year the CAV-AEP recommends:.Influenza vaccination from 6 to 59 months of age whenever feasible and does not harm the vaccination program aimed at people at higher risk.According to official national recommendations, the CAV-AEP recommends the systematic use of COVID mRNA vaccines since 5 years old.

Despite its effectiveness in preventing invasive meningococcal disease (IMD), pediatric uptake of recombinant meningococcal vaccination for serogroup B meningitis (MenB) is low in Italy. This study aimed to investigate knowledge, attitudes, and practice (KAP) about IMD and the vaccine uptake for MenB from July to December 2019, in a sample collected from a series of local Facebook discussion groups from the provinces of Parma and Reggio Emilia (North-Eastern Italy; 337,104 registered users). A self-administered anonymous web-based questionnaire was used to collect demographics, knowledge status, perceived risk for contracting meningitis, attitude towards the utility of meningococcal vaccine, and willingness to receive/perform MenB vaccine in their offspring. In total, 541 parents returned a fully completed questionnaire (response rate of 1.6% of potential recipients), with a mean age of 39.2 years ± 6.3 (78.1% females). Meningococcal infection was identified as severe or highly severe by most participants (88.9%), while it was recognized as being frequent/highly frequent in the general population by 18.6% of respondents. The overall knowledge status was unsatisfactory (57.6% ± 33.6 of correct answers to the knowledge test). Even though 63.4% of participants were somewhat favorable to MenB/MenC vaccines, offspring’s vaccination towards MenB was reported by only 38.7% of participants. In a binary logistic regression model, the male gender of respondents (adjusted odds ratio [aOR] 3.184, 95% confidence interval [95%CI] 1.772 to 5.721), living in a municipality >15,000 inhabitants (aOR 1.675, 95%CI 1.051 to 2.668), reporting a favorable attitude on meningococcus B vaccine (aOR 12.472, 95%CI 3.030 to 51.338), having been vaccinated against serogroup B (aOR 5.624, 95%CI 1.936 to 16.337) and/or serogroup C (aOR 2.652, 95%CI 1.442 to 4.872), and having previously vaccinated their offspring against serogroup C meningococcus (aOR 6.585, 95%CI 3.648 to 11.888) were characterized as positive effectors of offspring’s vaccination. On the contrary, having a higher risk perception on vaccines was identified as the only negative effector (aOR 0.429, 95%CI 0.241 to 0.765). Our results hint towards extensive knowledge gaps on IMD and preventive interventions in the general population, suggesting that a positive attitude towards vaccines and vaccinations could be identified as the main effector also for MenB acceptance. Interventions in the general population aimed at improving confidence, compliance, and acknowledgment of the collective responsibility, as well as preventing actual constraints and the sharing of false beliefs on infectious diseases and their preventive measures, could therefore increase vaccination acceptance in both targeted individuals and their offspring.

Introduction Indonesia has a high incidence of diphtheria, especially in children. Surabaya has become a government regional reference center, as it is the capital of East Java province, which has the highest rate of diphtheria across the 38 regions. The aim of this study is to report our six-year pediatric diphtheria data, focusing on comparisons between before and during the pandemic era. Method This surveillance report was collected from community health centers and hospitals throughout Surabaya from January 1, 2017 to December 31, 2022. Collected data included demographic characteristics, clinical and laboratory aspects, the health centers, immunization history, and management. As per Indonesian guidelines, the diagnosis of diphtheria in this country requires a positive microbiological culture or approval from the National Experts on Diphtheria Committee. Results In total, there were 112 cases, of which 89 were found before the pandemic era. Although the number of cases declined during 2020-2022, the predominant age group, the immunization status, and the most common type of diphtheria remained consistent with pre-pandemic trends. Most cases had incomplete immunization or unimmunized children (67.8%), with the age group of 5-12 years old (44.6%), and with tonsillar diphtheria (83%). The case fatality ratio was 1.8%. Regarding the biovar of Corynebacterium diphtheriae , gravis is the most frequent finding. Conclusion The incidence of diphtheria cases in children in Surabaya was significantly lower during the pandemic. Although immunization coverage was not better, preventive measures during the pandemic may have played a role. Most patients did not have complete immunization histories during the study period, and the predominant type was tonsillar diphtheria. Since the trend in 2021-2022 increased, routine surveillance is essential., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Health Research Ethical Committee of Dr. Soetomo General Academic Hospital issued approval 1646/LOE/301.4.2/IV/2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Husada et al.)

Introduction: High childhood vaccine adherence is critical for disease prevention, and poverty is a key barrier to vaccine uptake. Interventions like microfinance programs that aim to lift individuals out of poverty could thus improve vaccine adherence of the children in the household. BIGPIC Family Program in rural Western Kenya provides group-based microfinance services while working to improve access to healthcare and health screenings for the local community. The aim of the present paper is to evaluate the association between household participation in BIGPIC's microfinance program and vaccine adherence among children in the household. We hypothesize that microfinance group participation will have a positive impact on vaccine adherence among children in the household. Methods: From 2018 to 2019, we surveyed a sample of 300 participants from two rural communities in Western Kenya, some of whom were participants in the BIGPIC Family's microfinance program. The primary outcome of interest was vaccine adherence of children in the household. Log-binomial models were used to estimate the relationship between microfinance group participation and vaccine adherence, adjusted for key covariates. We also assessed whether the relationship differed by gender of the adult respondent. Results: Microfinance group members were more likely to have all children in their households fully vaccinated [aPR (95% CI): 1.68 (1.20,2.35)] compared to non-microfinance group members. Further, the association was stronger when women were the microfinance members [PR (95% CI): 1.87 (1.27,2.76)] compared to men [PR (95% CI): 1.24 (0.81,1.90)]. Conclusions: Microfinance participation was associated with higher childhood vaccine adherence in rural Western Kenya. Microfinance interventions should be further explored as strategies to improve child health and well-being in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Assessing the cost of vaccine preventable diseases (VPD) surveillance is becoming more important in the context of the Global Polio Eradication Initiative (GPEI) funding transition, since GPEI support to polio surveillance helped the incremental building of VPD surveillance systems in many countries, including low income countries such as Nepal. However, there is limited knowledge on the cost of conducting VPD surveillance, especially the national cost for surveillance of multiple vaccine-preventable diseases. The current study sought to calculate the economic and financial costs of Nepal's comprehensive VPD surveillance systems from July 2016 to July 2017. At thecentral level, all surveillance units were included in the sample. At sub-national level, a purposive sampling strategy was used to select a representative sample from locations involved in conducting surveillance. The sub-national sample costs were extrapolated to the nationwide VPD surveillance system. Nepal's total annual economic cost of VPD surveillance was USD 4.81 million or USD 0.18 per capita, while the total financial cost was USD 4.38 million or USD 0.16 per capita. Government expenditures accounted for 56% of the total economic cost, and World Health Organization accounting for 44%. The biggest cost driver was personnel accounting for 51% of the total economic cost. WHO supported trained surveillance personnel through donor funding, mainly from Global Polio Eradication Initiative. As a polio transition priority country, Nepal will need to make strategic choices to fully self-finance or seek full donor support or a mixed-financing model as polio program funding diminishes. [ABSTRACT FROM AUTHOR]

Introduction: with the current situation of measles outbreak in Brazil and the sharp drop in immunization coverage nationwide, it is necessary to think about ways to intervene in the face of so many difficulties, since the expansion of immunization coverage is the most effective and safe for the control of infectious diseases. Objective: to analyze vaccine coverage of two National Campaigns during the COVID-19 pandemic in Vitória/ES. Methods: a descriptive experience report on the implementation of an intervention plan to expand vaccination coverage of two National Vaccination Campaigns in 2020 in a Family Health Unit (FHU) during the Curricular Internship I (EC-I). It was based on the Situational Strategic Planning. Descriptive and bivariate statistical analyzes were performed. Results: there was an increase of 5.79 times in the vaccination coverage of the National Measles Vaccination Campaign 2020 in the territory, from 0.86% (vaccination coverage of the triple viral before the start of EC-I) to 4.98% at the end of EC-I (p = 0.438). When comparing the vaccination coverage of the National Multivaccination Campaign 2020 of immunobiologicals administered before and after the EC-I period at the FHU, we observed that there was a statistically significant difference (p = 0.0049). Conclusion: the proposed and implemented intervention plan had a positive outcome on the FHU, as the vaccination coverage of the two campaigns were expanded, despite all the challenges of the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Notably, less than two-thirds of under-5 children received full immunization in 2016 in India. It is critical to understand the inequalities in access to immunization for determining an effective health policy agenda to ensure universal health coverage. Hence, we performed a study to assess the determinants of income-based inequality in the full immunization of children aged 12–23 using Fairlie decomposition analysis. Methods: This cross-sectional study was a part of a community-based project that aimed to improve maternal and child health in the backward states of India, namely Bihar and Assam. The study was conducted in the rural and urban areas of Munger and Darrang districts of Bihar and Assam, respectively. The degree of income-related inequality in full immunization coverage was obtained through the concentration index. The Fairlie decomposition was employed to quantify the absolute contribution of socio-demographic factors explaining the group differences (higher or lower income) in the probability of having full immunization. Results: There were 73 fully and 82 non-fully immunized children. The concentration curve was lying above the line of equality, which implied that full immunization coverage was concentrated towards the lower-income group. Maternal education (7.5%) and place of residence (5.1%) widened the inequality gap, and caste (−13.5%) and age of the child (−2.5%) narrowed down the inequality gap for full immunization among lower and higher-income groups. Conclusions: The socio-economic inequalities in access to full immunization can be mitigated by multi-sectoral interventions with a focus on children with less-educated mothers and living in urban slums.

Introduction: Immunisation coverage is a vital strategy adopted by most programs on child survival globally. A robust immunisation coverage program goes a long way in controlling the Vaccine Preventable Disease (VPDs). It is very important to analyse the factors which are detrimental in achieving 100% immunisation among children. Aim: To find the extent of immunisation coverage and to identify the factors for failure of immunisation among children in the rural field practice area of Mysore Medical College and Research Institute, Mysuru. Materials and Methods: A cross-sectional was carried out from November 2019 to January 2020 on children between 0-2 years of age using the World Health Organisation (WHO) thirty clusters sampling method. The sample size was estimated to be 210. Identification of clusters was done as per the WHO manual on 30×7 cluster survey. Interview was conducted using a structured interview format in selected households with study subjects. Data was entered in Microsoft Excel sheet and analysed using chi-square test. Statistical Package for Social Sciences (SPSS) software version 23.0 was used for analysis of data. Results: Among the study participants, 131 (86%) were fully immunised and 29 (14%) were partially immunised (those who did not receive all the due vaccines till two years of age). Religion, educational status of parents and the presence or absence of immunisation card had significant (p-values=0.01,

Infectious diseases remain a major health threat, not only in resource-poor countries but also in pockets of poverty within middle-income and sometimes high-income countries. Whilst strong research and development for novel vaccines are urgently needed, equal care needs to be taken that current vaccines are produced at affordable prices so that universal childhood immunization will be accomplished. The Serum Institute of India (SII) has become the largest producer of affordable vaccines. Provision of SII produced vaccines against measles, rubella and meningitis to 73 GAVI supported countries alone will avert more than 5 million deaths between 2001 and 2020. Similarly, the SII produced measles vaccine, supplied to UNICEF and PAHO, can be attributed to nearly 22 million averted deaths between 1990 and 2016. Data presented provide compelling evidence for the crucial impact of partnerships between affordable vaccine producers and governmental, intergovernmental and nongovernmental organizations on universal vaccination to reduce childhood mortality.

Introduction: following the declaration of the COVID-19 pandemic, many countries imposed restrictions on public gatherings, health workers were repurposed for COVID-19 response, and public demand for preventive health services declined due to fear of getting COVID-19 in health care settings. These factors led to the disruption in health service delivery, including childhood immunization, in the first months of the pandemic. Measles surveillance supported with laboratory confirmation, is implemented in the African Region as part of the strategies towards attaining measles elimination. World Health Organisation developed guidelines to assist countries to continue to safely provide essential health services including immunization and the surveillance of vaccine preventable diseases during the pandemic. Methods: we analysed the measles case-based surveillance and laboratory databases for the years 2014 to 2020, to determine the impact of the COVID-19 pandemic on measles surveillance, comparing the performance in 2020 against the preceding years. Results: the weekly reporting of suspected measles cases declined starting in April 2020. Twelve countries had more than 50% decline in both the number of reported cases as well as in the number of specimens collected in 2020, as compared to the mean for the years 2014-2018. In 2020, only 30% of the specimens from suspected measles cases arrived at the national laboratory within 3 days of collection. At Regional level, 86% of the districts reported suspected measles cases in 2020, while the nonmeasles febrile rash illness rate was 2.1 per 100,000 population, which was the lowest rate documented since 2014. Only 11 countries met the targets for the two principal surveillance performance indicators in 2020 as compared to an average of 21 countries in the years 2014-2019. Conclusion: the overall quality of measles surveillance has declined during the COVID pandemic in many countries. Countries should implement immediate and proactive measures to revitalise active surveillance for measles and monitor the quality of surveillance. We recommend that countries consider implementing specimen collection and testing methods that can facilitate timely confirmation of suspected measles cases in remote communities and areas with transportation challenges. [ABSTRACT FROM AUTHOR]

Introduction: Immunisation coverage is a vital strategy adopted by most programs on child survival globally. A robust immunisation coverage program goes a long way in controlling the Vaccine Preventable Disease (VPDs). It is very important to analyse the factors which are detrimental in achieving 100% immunisation among children. Aim: To find the extent of immunisation coverage and to identify the factors for failure of immunisation among children in the rural field practice area of Mysore Medical College & Research Institute, Mysuru. Materials and Methods: A cross-sectional was carried out from November 2019 to January 2020 on children between 0-2 years of age using the World Health Organisation (WHO) thirty clusters sampling method. The sample size was estimated to be 210. Identification of clusters was done as per the WHO manual on 30×7 cluster survey. Interview was conducted using a structured interview format in selected households with study subjects. Data was entered in Microsoft Excel sheet and analysed using chi-square test. Statistical Package for Social Sciences(SPSS) software version 23.0 was used for analysis of data. Results: Among the study participants, 131 (86%) were fully immunised and 29 (14%) were partially immunised (those who did not receive all the due vaccines till two years of age). Religion, educational status of parents and the presence or absence of immunisation card had significant (p-values=0.01, <0.05, <0.05 respectively) association with the immunisation status. The main reasons for partial immunisation were: parents being unaware of the need for returning for subsequent doses 13 (44.8%), fear of side-effects 12 (41.3%), and vaccine not being available 7 (24.1%). Coverage of all individual vaccines among the children (0-2 years) were mostly above 199 (95%). Conclusion: This study observed higher immunisation coverage as compared to that of the national immunisation coverage of 62%. In spite of efforts to increase the immunisation coverage in the country there are regional differences in the extent of this coverage which points to the need for better strategies to tackle this problem. [ABSTRACT FROM AUTHOR]

INTRODUCTION: World Health Organisation (WHO) recommends that countries conduct comprehensive national Immunization program reviews regularly to help them identify systems wide-barriers or gaps and monitor performance against the set targets. METHODS: we reviewed reports from the latest national Immunization program reviews conducted in the 20 countries in the sub-region in the course of 2012 - 2018. We generated descriptive analysis of the findings across the sub-region. RESULTS: the 20 program reviews included field observations to the subnational levels as well as interviews with program staff and stakeholders. At the time of the reviews, only 11 countries had functional National Immunization Technical Advisory Groups. Operational funding was inadequate in half of the countries. The reviews documented the cancellation of outreach services, supportive supervision visits and maintenance of cold chain equipment due to the lack of fuel or operational funding. Immunization programs in 10 countries had major human resource gaps. Vaccine stock management tools were not effectively used in 10 countries, and stock out of vaccines and supplies was documented in 9 countries during the review. The full components of the RED strategy were implemented in only 3 of the 20 countries. Twelve countries reported challenges with the availability and accuracy of target populations. Four countries had documented the presence of vaccine hesitant groups at the time of the reviews. CONCLUSION: the reviews demonstrated challenges in various aspects of the programs in different countries. The implementation of the review recommendations should be built into the annual program plans, as well as into coasted multi-year plans, in order to address the gaps and helps the program to attain the set targets. With the rapid evolution of the scope and complexity of the Immunization programs in recent years, countries should invest their efforts in building the capacity of their human resources as well as updating their logistics and data systems.

Resumen: El CAV-AEP publica anualmente el calendario de vacunaciones que estima idóneo para los niños y adolescentes residentes en España, teniendo en cuenta la evidencia científica disponible.Se mantiene el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente.Se aconseja un refuerzo a los 6 años, preferentemente con DTPa (si está disponible), junto a una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, preferentemente entre las 27 y 32 semanas.La vacuna del rotavirus debería ser sistemática para todos los lactantes.Se insiste en la incorporación en el calendario de la vacuna antimeningocócica B, con esquema 2 + 1 en lactantes.Además de la inclusión de la vacuna antimeningocócica conjugada tetravalente (MenACWY) a los 12 años con rescate hasta 18 años, inclusive, el CAV-AEP recomienda que esta vacuna sea introducida también a los 12 meses de edad, sustituyendo a MenC. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos.Se emplearán esquemas de dos dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica.Se recomienda la vacunación sistemática universal frente al VPH, con independencia del género, preferentemente a los 12 años, insistiendo en un mayor esfuerzo para mejorar las coberturas. La de 9 genotipos amplía la cobertura para ambos sexos. Abstract: The CAV-AEP annually publishes the immunisation schedule considered optimal for all children and adolescent resident in Spain, taking into account the available evidence.The 2 + 1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate.A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2 + 1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks.Rotavirus vaccine should be systematic for all infants.Meningococcal B vaccine, with a 2 + 1 schedule, should be included in routine calendar.In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups.Two-dose schedules for triple viral (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine.Universal systematic vaccination against HPV is recommended, regardless of gender, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders.

INTRODUCTION: World Health Organisation (WHO) recommends that countries conduct comprehensive national immunization programme reviews regularly to help them identify systems wide-barriers or gaps, , and monitor performance against the set targets. METHODS: We reviewed reports from the latest national immunization program reviews conducted in the 20 countries in the subregion in the course of 2012 - 2018. We generated descriptive analysis of the findings across the subregion. RESULTS: The 20 program reviews included field observations to the subnational levels as well as interviews with program staff and stakeholders. At the time of the reviews, only 11 countries had functional National Immunisation Technical Advisory Groups. Operational funding was inadequate in half of the countries. The reviews documented the cancellation of outreach services, supportive supervision visits and maintenance of cold chain equipment due to the lack of fuel or operational funding. Immunization programs in 10 countries had major human resource gaps. Vaccine stock management tools were not effectively used in 10 countries, and stockout of vaccines and supplies was documented in 9 countries during the review. The full components of the RED Strategy were implemented in only 3 of the 20 countries. Twelve countries reported challenges with the availability and accuracy of target populations. Four countries had documented the presence of vaccine hesitant groups at the time of the reviews. CONCLUSION: The reviews demonstrated challenges in various aspects of the programs in different countries. The implementation of the review recommendations should be built into the annual program plans, as well as into costed multi-year plans, in order to address the gaps and helps the program to attain the set targets. With the rapid evolution of the scope and complexity of the immunization programs in recent years, countries should invest their efforts in building the capacity of their human resources as well as updating their logistics and data systems.

New Zealand (NZ) is one of few countries to shift from PCV13 to PCV10. The number of serotype 19A cases in young children and the proportions of isolates that are penicillin-resistant have been steadily increasing since. It is time for NZ to reconsider its choice of pneumococcal vaccine. [ABSTRACT FROM AUTHOR]

The current coronavirus disease 2019 (COVID-19) outbreak has caused a persistent decline in childhood vaccination coverage, including Haemophilus influenzae type b (Hib) vaccine, in some countries. Our objective was to evaluate the impact of decreased Hib vaccination due to COVID-19 on invasive Hib disease burden in Japan. Using a deterministic dynamic transmission model (susceptible-carriage-infection-recovery model), the incidence rates of invasive Hib disease in under 5 year olds in rapid vaccination recovery and persistent vaccination declined scenarios were compared for the next 10 years after 2020. The national Hib vaccination rate after the impact of COVID-19 reduced to 87% and 73% in 2020 from approximately 97% each in 2013–2019 for primary and booster doses. While the persistent decline scenarios revealed an increase in invasive Hib disease incidence to 0.50/100,000 children under 5 years old, the incidence of the rapid recovery scenario slightly increased with a consistent decline of incidence after 2021. The shorter the duration of the decline in vaccination rate was, the smaller the incremental disease burden observed in the model. Compared to the rapid recovery scenario, the permanent decline scenario showed a 296.87 cumulative incremental quality-adjusted life years (QALY) loss for the next 10 years. The persistent decline of Hib vaccination rate due to COVID-19 causes an incremental disease burden irrespective of the possible decline of Hib transmission rate by COVID-19 mitigation measures. A rapid recovery of vaccination coverage rate can prevent this possible incremental disease burden. [ABSTRACT FROM AUTHOR]

Introduction: the World Health Organisation (WHO) recommends that countries conduct comprehensive national immunisation program reviews regularly to help them identify systems wide-barriers or gaps and monitor performance against the set targets. Methods: we reviewed reports from the latest national immunisation program reviews conducted in the 20 countries in the sub-region in the course of 2012-2018. We generated descriptive analysis of the findings across the sub-region. Results: the 20 program reviews included field observations to the subnational levels as well as interviews with program staff and stakeholders. At the time of the reviews, only 11 countries had functional National Immunisation Technical Advisory Groups. Operational funding was inadequate in half of the countries. The reviews documented the cancellation of outreach services, supportive supervision visits and maintenance of cold chain equipment due to the lack of fuel or operational funding. Immunisation programs in 10 countries had major human resource gaps. Vaccine stock management tools were not effectively used in 10 countries, and stock out of vaccines and supplies was documented in 9 countries during the review. The full components of the RED strategy were implemented in only 3 of the 20 countries. Twelve countries reported challenges with the availability and accuracy of target populations. Four countries had documented the presence of vaccine hesitant groups at the time of the reviews. Conclusion: the reviews demonstrated challenges in various aspects of the programs in different countries. The implementation of the review recommendations should be built into the annual program plans, as well as into coasted multi-year plans, in order to address the gaps and helps the program to attain the set targets. With the rapid evolution of the scope and complexity of the immunisation programs in recent years, countries should invest their efforts in building the capacity of their human resources as well as updating their logistics and data systems. [ABSTRACT FROM AUTHOR]

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What Is Already Known About This Topic?: The incidences of vaccine-preventable diseases (VPDs) included in the Expanded Program on Immunization in China have decreased significantly in recent decades., What Is Added by This Report?: This study summarizes the national incidences of nine VPDs and the seroprevalence of hepatitis B surface antigen (HBsAg) under different immunization strategies from 1950 through 2021 in China. The sharpest decreases in VPD incidence and under-5-year HBsAg seroprevalence occurred during the latest stage of the National Immunization Program. The decreases in VPD incidence were most prominent among children under five years of age., What Are the Implications for Public Health Practice?: These findings provide valuable insights for vaccine value assessment and emphasize the importance of implementing immunization strategies in targeted populations., Competing Interests: No conflicts of interest., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2024.)

The World Health Organization (WHO) African Regional training course for Mid-level managers (MLM) of immunization programs launched in 2004, has undergone revisions across the years, to accommodate new developments in the field. In 2016, the WHO African regional office conducted a thorough review of the course materials and delivery methods to document lessons to help improve the course. Some of the gaps included inappropriate selection of trainees, inadequate focus on skills development, heavy reliance on text and presentations, as well as resource limitations to reach a critical mass of learners. The Regional office worked with Bull City Learning to redesign the course materials along carefully crafted course objectives and curricula, and to assist facilitators to better deliver the course. In addition, the materials were converted into online learning tools. Within 10 months, a total of 3011 learners were enrolled in the online MLM training platform and earned a total of 9209 certificates. The MLM course will continue to be highly relevant as the immunization area of work expands significantly, with the addition of new vaccines, introduction of new technologies, and expanding opportunities for online learning.

Resumen: El CAV-AEP publica anualmente el calendario de vacunaciones que estima idóneo para los niños residentes en España, teniendo en cuenta la evidencia científica disponible.Se mantiene el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente.Se aconseja un refuerzo a los 6 años, preferentemente con DTPa (si está disponible), junto a una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, preferentemente entre las 27 y las 32 semanas.La vacuna del rotavirus debería ser sistemática para todos los lactantes.Se sigue proponiendo la incorporación en el calendario de la vacuna antimeningocócica B, con esquema 2 + 1 en lactantes.Además de la inclusión de la vacuna antimeningocócica conjugada tetravalente (MenACWY) a los 12 años con rescate hasta los 18 años, inclusive, el CAV recomienda que esta vacuna sea introducida también a los 12 meses de edad, sustituyendo a MenC. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos.Se emplearán esquemas de 2 dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica.Se recomienda la vacunación sistemática universal frente al VPH, tanto a chicas como a chicos, preferentemente a los 12 años, debiendo realizar un mayor esfuerzo para mejorar las coberturas. La de 9 genotipos amplía la cobertura para ambos sexos. Abstract: The CAV-AEP annually publishes the immunisation schedule considered optimal for all children resident in Spain, taking into account the available evidence.The 2 + 1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate.A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2 + 1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks.Rotavirus vaccine should be systematic for all infants.Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar.In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups.Two-dose schedules for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine.Universal systematic vaccination against HPV is recommended, both for girls and boys, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders.

Abstract Background Despite effective national immunisation programmes in Europe, some groups remain incompletely or un-vaccinated (‘under-vaccinated’), with underserved minorities and certain religious/ideological groups repeatedly being involved in outbreaks of vaccine preventable diseases (VPD). Gaining insight into factors regarding acceptance of vaccination of ‘under-vaccinated groups’ (UVGs) might give opportunities to communicate with them in a trusty and reliable manner that respects their belief system and that, maybe, increase vaccination uptake. We aimed to identify and describe UVGs in Europe and to describe beliefs, attitudes and reasons for non-vaccination in the identified UVGs. Methods We defined a UVG as a group of persons who share the same beliefs and/or live in socially close-knit communities in Europe and who have/had historically low vaccination coverage and/or experienced outbreaks of VPDs since 1950. We searched MEDLINE, EMBASE and PsycINFO databases using specific search term combinations. For the first systematic review, studies that described a group in Europe with an outbreak or low vaccination coverage for a VPD were selected and for the second systematic review, studies that described possible factors that are associated with non-vaccination in these groups were selected. Results We selected 48 articles out of 606 and 13 articles out of 406 from the first and second search, respectively. Five UVGs were identified in the literature: Orthodox Protestant communities, Anthroposophists, Roma, Irish Travellers, and Orthodox Jewish communities. The main reported factors regarding vaccination were perceived non-severity of traditional “childhood” diseases, fear of vaccine side-effects, and need for more information about for example risk of vaccination. Conclusions Within each UVG identified, there are a variety of health beliefs and objections to vaccination. In addition, similar factors are shared by several of these groups. Communication strategies regarding these similar factors such as educating people about the risks associated with being vaccinated versus not being vaccinated, addressing their concerns, and countering vaccination myths present among members of a specific UVG through a trusted source, can establish a reliable relationship with these groups and increase their vaccination uptake. Furthermore, other interventions such as improving access to health care could certainly increase vaccination uptake in Roma and Irish travellers.

Healthcare workers (HCW) are at an increased risk of acquiring vaccine preventable diseases (VPD) due to their higher patient exposure at the workplace. In this context, they form an important target population for vaccination. The authors of this article wanted to explore into the history of vaccination, the risk profile of the health care workers and the current vaccines recommended for the health care workers. Looking forward, vaccine uptake among the healthcare workers can be improved by measures such as conducting periodic annual health check ups and establishing written hospital vaccination policies. [ABSTRACT FROM AUTHOR]

• Vaccination of healthcare workers prevents the spread of infections in hospitals. • A forth of healthcare workers reported to be non-immune to vaccine-preventable diseases. • Nine out of 10 employees supported vaccination of non-immune healthcare workers. • National recommendations for vaccination of healthcare workers in Denmark are needed. Denmark has no general recommendations for vaccination of healthcare workers (HCWs). We explored the self-reported immunity to varicella, measles, mumps, and rubella, reasons for receiving the influenza vaccine or not, and opinions on vaccination of HCWs against varicella, MMR, pertussis, diphtheria, and influenza among staff from departments with a high risk of exposure to infectious agents. From May 2019 to August 2019, a structured questionnaire was distributed to clinical and non-clinical HCWs at a tertiary and a general paediatric department in Denmark. Self-reported immunity was defined as either previous infection or vaccination against the disease. Of 619 employed HCWs, 555 (90%) were included. A large proportion were unsure of or denied previous vaccination or infection with measles (20.1%), mumps (30.2%), rubella (21.4%), varicella (12.1%), pertussis (44.1%), and diphtheria (32.1%). Non-clinical personnel and employees born in 1974–1983 had the lowest level of self-reported immunity. Mandatory vaccination of non-immune HCWs was approved by 54–68.9% of participants, and any kind of vaccination (mandatory or as an offer at hospitals) was approved of up to 95.3% of all participants depending on the disease. During the season 2018/19, 214 (38.6%) HCWs received the influenza vaccine, including 20.3% of non-clinical staff, 34.8% of nurses and 56.5% of doctors (P < 0.001). Reasons for lack of vaccine uptake were mainly employees considering themselves rarely sick, the vaccine was not regarded as necessary, forgetfulness or lack of time. Only 37.8% was in favour of mandatory influenza vaccination. A large proportion of paediatric HCWs were not aware of their immune status against important vaccine-preventable diseases. >90% supported vaccination of HCWs, with two out of three supporting mandatory MMR, pertussis and diphtheria vaccination. Better information and an official immunisation policy of non-immune HCWs in Denmark is warranted. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the seroprevalence of Hepatitis A, Hepatitis B, Hepatitis C, HIV, Mumps, Measles and Chickenpox for all staff and trainee students working under SBU Fatih Sultan Mehmet EAH in 2018. Methods: A total of 1674 medical staff and trainee students' serum samples were screened retrospectively for Hepatitis A, Hepatitis B, Hepatitis C, HIV, Mumps, Measles and Chickenpox. The findings were analyzed by using IBM SPSS Statistics 22 (IBM SPSS, Turkey) program. Descriptive statistical methods, Chi Square and Fisher Freeman Halton tests were used in order to analyze of the data. Results: A total of 1674 people, 636 (38%) males and 1038 (62%) females were included in the study. Of these, 502 (30%) were internships in the health school. When examined in terms of total staff; AntiHBs (86%), Mumps IgG (97%), Measles IgG (94%) and VZV IgG (97%) were found to be highly positive. There were no health workers who were positive for anti HIV and measles IgM. There were 4 anti-HCV positive, 2 mumps IgM positive and 1 VZV IgM positive people. Conclusion: It is important to take preventive measures against vaccination preventable diseases and immunization of the personnel working in hospitals. The results obtained in our study were found to be consistent with similar studies conducted in our country. [ABSTRACT FROM AUTHOR]

Introduction: World Health Organisation (WHO) recommends that countries conduct comprehensive national immunisation programme reviews regularly to help them identify systems wide-barriers or gaps and monitor performance against the set targets. Methods: we reviewed reports from the latest national immunisation program reviews conducted in the 20 countries in the subregion in the course of 2012-2018. We generated descriptive analysis of the findings across the subregion. Results: the 20 program reviews included field observations to the subnational levels as well as interviews with program staff and stakeholders. At the time of the reviews, only 11 countries had functional National Immunisation Technical Advisory Groups. Operational funding was inadequate in half of the countries. The reviews documented the cancellation of outreach services, supportive supervision visits and maintenance of cold chain equipment due to the lack of fuel or operational funding. Immunisation programs in 10 countries had major human resource gaps. Vaccine stock management tools were not effectively used in 10 countries, and stockout of vaccines and supplies was documented in 9 countries during the review. The full components of the Reaching Every District (RED) Strategy were implemented in only 3 of the 20 countries. Twelve countries reported challenges with the availability and accuracy of target populations. Four countries had documented the presence of vaccine hesitant groups at the time of the reviews. Conclusion: the reviews demonstrated challenges in various aspects of the programs in different countries. The implementation of the review recommendations should be built into the annual program plans, as well as into costed multiyear plans, in order to address the gaps and helps the program to attain the set targets. With the rapid evolution of the scope and complexity of the immunisation programs in recent years, countries should invest their efforts in building the capacity of their human resources as well as updating their logistics and data systems. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) African regional training course for mid-level managers (MLM) of immunization programs launched in 2004, has undergone revisions across the years, to accommodate new developments in the field. In 2016, the WHO African regional office conducted a thorough review of the course materials and delivery methods to document lessons to help improve the course. Some of the gaps included inappropriate selection of trainees, inadequate focus on skills development, heavy reliance on text and presentations, as well as resource limitations to reach a critical mass of learners. The regional office worked with Bull City Learning to redesign the course materials along carefully crafted course objectives and curricula, and to assist facilitators to better deliver the course. In addition, the materials were converted into online learning tools. Within 10 months, a total of 3011 learners were enrolled in the online MLM training platform and earned a total of 9209 certificates. The MLM course will continue to be highly relevant as the immunization area of work expands significantly, with the addition of new vaccines, introduction of new technologies, and expanding opportunities for online learning. [ABSTRACT FROM AUTHOR]

• Hepatitis B prevalence was 3.1% among 6–7-year-old school children, one province had 55% of cases. • Coverage with timely hepatitis B birth dose was low (59%) but >90% for 3 doses of hepatitis B vaccine. • Immunoprotection estimates were 99% for measles and rubella, 85% for tetanus, 51% for diphtheria. • Improving timely hepatitis B birth dose coverage would help reach hepatitis B control goals. • Low immunity suggests need for tetanus and diphtheria booster doses for long-term protection. The Western Pacific Region (WPR) established a goal to decrease chronic hepatitis B virus (HBV) infection among children to <1% and to achieve ≥95% hepatitis B vaccine birth dose (HepB-BD) and ≥95% three-dose (HepB3) coverage by 2017. In 2016, we conducted a national serosurvey in the Solomon Islands among 6–7-year-old school children to assess progress towards the control goal and immunity to measles, rubella, tetanus and diphtheria. Eighty schools were selected systematically proportional to their 6–7-year-old population; all 6–7-year-olds were enrolled. We collected basic demographic information and vaccination history. Children were tested for HBV surface antigen (HBsAg) using a rapid test, and for immunity to measles, rubella, tetanus, and diphtheria using a multiplex bead assay. In total, 1,249 out of 1,492 children (84%) were enrolled, among whom 1,169 (94%) underwent HBsAg testing and 1,156 (93%) provided dried blood spots. Almost 80% (n = 982) of enrolled children had vaccination cards, among whom 59% (n = 584) received a timely HepB-BD (within 24 hours of birth), 95% (n = 932) received HepB3, and >90% received vaccines for diphtheria, tetanus, and measles (rubella vaccine was not available at the time). HBsAg prevalence was 3.1% (95% confidence interval (CI): 2.0%–4.9%), with 55% of identified cases from one province. Among 982 children with vaccination cards, HBsAg prevalence was higher among children who had not received a timely HepB-BD and at least two HepB doses compared to those who had (4% vs. 2%). Of 1,156 tested children, immunoprotection estimates were 99% (95% CI: 98%–99%) for measles, 99% (95% CI: 97%–100%) for rubella, 85% (95% CI: 83%–87%) for tetanus, and 51% (95% CI: 47%–55%) for diphtheria. Improving timely HepB-BD coverage and maintaining high HepB3 coverage could help Solomon Islands reach the regional HBV control goal. Low immunity to tetanus and diphtheria suggests the need to introduce booster doses to ensure long-term protection. [ABSTRACT FROM AUTHOR]

The 1st Regional Experts on Infant Vaccination (REIV) meeting generated updated consensus recommendations to improve the control of various major vaccine preventable diseases (VPD) in Latin America. Workshops highlighted recent changes in immunization schedules within the region, experience of countries incorporating combined acellular pertussis vaccines schedules and parenteral inactivated polio vaccine (IPV). The need to definitively replace oral polio vaccine (OPV) by IPV, and potential benefits of introducing new combined vaccines, were extensively discussed. REIV strongly advised immediate adoption of either complete IPV schedules for all Latin America or schedules including at least two initial doses of IPV. Use of fractional doses of intradermally administered IPV (fIPV ID) was not recommended due to lower immunogenicity, lack of evidence on long-term protection, and technical difficulty to implement. Routine pertussis vaccination of pregnant women in addition to health workers of neonatology units and any previously unimmunized parent was encouraged. Administration of HBV vaccine to newborns within the first 24 hours of life, and then at 2, 4, and 6 months, and of a booster dose of conjugate Hib vaccine at age 12 through 15 months, was also recommended. Incorporation of combined vaccines (CV) was considered potentially advantageous. [ABSTRACT FROM AUTHOR]

Socioeconomic status (SES) is a well-known determinant of health, but its relation with vaccine-induced immunity is less documented. We explored the association between SES and immunoglobulin G (IgG) levels against vaccine-preventable diseases in vaccinated children in the Dutch National Immunization Programme. Data from a population-wide cross-sectional serosurvey in the Netherlands (2006–2007) were used. We compared geometric mean IgG concentrations/titers (GMC/T ratios) against measles, mumps, rubella, Haemophilus influenzae type b (Hib), Neisseria meningococcus type C, diphtheria, tetanus, poliovirus types 1,2,3 and pertussis in children of high versus low SES by linear regression analysis. We included 894 children (0–12 years) at one of two timeframes: 1 month to 1 year, or 1–3 years after vaccination. Mother's educational level and net household income served as binary indicators of SES. Of 58 possible associations of vaccine-induced antibody responses with educational level and 58 with income, 10 (9%) were statistically significant: 2 favouring (that is, with higher IgG levels at) high educational level (for Hib 1 m-1y after vaccination (GMC/T ratio: 2.99, 95%CI: 1.42–6.30) and polio 2 1 m-1y after the 9-year booster dose (1.14, 1.01–1.27)) and 8 favouring low income (polio 1, 2 and 3 1 m-1y after the 11-month booster (0.74, 0.58–0.94; 0.79, 0.64–0.97; 0.72, 0.55–0.95), polio 3 and pertussis 1-3y after the 11-month booster (0.70, 0.56–0.88; pertussis-prn: 0.60, 0.37–0.98; pertussis-ptx: 0.66, 0.47–0.95), mumps and rubella 1-3y after first vaccination (0.73, 0.55–0.97; 0.70, 0.55–0.90), and rubella 1 m-1y after second vaccination (0.83, 0.55–0.90)). After adjustment for multiple testing, none of the differences remained significant. There was no association between SES and proportion of children with protective IgG levels. In this explorative study, we found no consistent association between SES and immune response to vaccination in the Netherlands and no association with protective IgG levels. Additional studies in other settings should confirm this finding. [ABSTRACT FROM AUTHOR]

• High susceptibility rates for measles, mumps and HAV is remarkable. This shows that past vaccination activities have failed over the scope of suboptimal vaccination in children especially for measles and mumps. • Vaccination without prescreening for other diseases except VZV is found to be more cost effective. • Recognizing and identifying the vulnerable populations such as HCWs and students also age groups is important for preventing and controlling outbreaks. Health care workers (HCWs) and students are at increased risk for blood borne infections and vaccine preventable diseases (VPDs). The aim of this study was to determine the seroprevalence of antibodies against measles, rubella, mumps, varicella zoster virus (VZV), hepatitis A and B viruses among HCWs and students and to determine whether there are differences according to gender and age group. Information about characteristics of the 1053 participants, history of disease and vaccination status were collected using a structured questionnaire. Serum samples were tested for antibodies by commercial immunoenzymatic assays. Seropositivity rates were 57.1% for measles, 74% for mumps, 96.3% for rubella, 93.7% for VZV, 33.9% for hepatitis A virus and 92.2% for hepatitis B virus. Susceptibility rates among participants 18–26, 27–38 and >38 years of age were statistically significant for measles (46%, 18.6% and 0%; p < 0.001) and mumps (27.1%, 12.9% and 21.4%; p < 0.05), respectively. Low seropositivity rates for measles, mumps and HAV are important findings. For other diseases other than VZV, it is thought that vaccination without pre-screening is more appropriate. Healthcare institutions should have policies for screening and vaccination of their staff and students. [ABSTRACT FROM AUTHOR]

The European Vaccine Action Plan 2015-2020 highlights the importance of reducing inequities and monitoring performance in underserved groups including migrants. However, there are limited data from European countries and policies for catch-up vary by country. Vaccination coverage in accompanied asylum-seeking children aged 5 to 16 years in two dispersal areas of Wales is presented alongside the coverage in the local population. Coverage data for asylum-seeking children were collated locally using asylum seeker nurse records whilst coverage in the local population was calculated using data from the National Community Child Health Database, a repository of data from all local Child Health Systems in Wales. The processes for following up outstanding vaccinations were also collected using a face-to-face questionnaire distributed to lead asylum seeker nurses in each area. As at the date of assessment, 45.6% (67/147) of children dispersed to area one had received all recommended immunisations compared with 62.2% (150/241) dispersed to area two, OR 0.51 (95% CI 0.33-0.79). At both sites the odds of being vaccinated against key vaccine preventable infections were around three times lower if you were an asylum-seeking child, compared with the local population. Similar procedures were in place for new asylum seekers in both dispersal areas. Area one had less resource to follow up missing immunisations, and children did not receive an initial health assessment unlike area two. Verbal history was accepted in area one but not in area two, despite area two having higher vaccine uptake.Conclusion: Asylum-seeking children have low rates of vaccine uptake compared with the general population, although uptake differs depending on dispersal area. Inequalities in vaccination services, such as resource and strategies to improve uptake, need to be considered.What is Known:• The European Vaccine Action Plan 2015-2020 highlights the importance of reducing inequities and monitoring performance in underserved groups including migrants.• Limited data from European countries suggest inequalities in uptake of immunisations in migrants compared with the local population. Policies for catching up immunisations vary by country.What is New:• Despite national policy for vaccination of migrants with missing or incomplete vaccination history in Wales, this work suggests vaccination coverage in asylum-seeking children is not equitable with the local population.• Vaccination coverage in asylum-seeking children dispersed to different areas of Wales also varies, and this may be associated with differences in local catch-up strategies and the ability to follow national policy. Resource and strategies to maintain engagement with health services play an important role in increasing vaccine uptake in underserved groups. [ABSTRACT FROM AUTHOR]

We describe and analyse an outbreak of measles that affected Belgium early 2017. In total, 289 cases were reported, mostly (53%) in people 15 years or older. For 133 (46%) vaccination status was unknown and a further 117 (41%) were not vaccinated. According to national guidelines, 83 of the unvaccinated cases (29% of total cases) should have received minimum one dose of vaccine, but did not. One in five cases (21%) did not present with the classical triad of fever, rash and any of coryza, conjunctivitis or cough. Rash was the most sensitive symptom, being absent in only six cases. A large proportion of cases (125/289, 43%) required hospitalisation. In hospitalised patients, the most commonly observed complications were hepatic disorders (present in 58/125 hospitalised patients, 46%). Thirty-six of the cases (12%) were in healthcare workers and nosocomial spread contributed importantly to the out- break. Older age at presentation, altered clinical presentations and presence of complications like hepatitis can delay the correct diagnosis of measles. Clinicians should maintain a high index of suspicion in any individual presenting with rash. If the elimination target is to be reached, catch-up vaccination campaigns should be intensified and target young adults and health care workers. [ABSTRACT FROM AUTHOR]

Hepatitis B vaccination is recommended for men who have sex with men (MSM) in many countries, but information on vaccine coverage is scarce. We studied hepatitis B vaccination programmes and coverage among MSM in Europe to guide prevention. From a large (N = 174 209) pan-European MSM survey (EMIS-2010), we used data on self-reported hepatitis B vaccination, age, education, settlement size and disclosure of the same-sex sexual orientation (‘outness’). We excluded participants with a history of hepatitis B. In multilevel (participants, countries) logistic regression models, we calculated adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). We analysed data of 163 987 MSM in 38 European countries: 38.3% were ‘out’ to all or almost all, 56.4% reported vaccination against hepatitis B and 65.5% lived in countries with free recommended hepatitis B vaccination for MSM. In the final model the odds for being vaccinated increased with outness (‘out to all or almost all’: aOR 1.76, 95% CI 1.70–1.83 vs. ‘out to no one’) and with living in countries, where hepatitis B vaccination was recommended and free-of-charge for MSM (aOR 2.21, 95% CI 1.47–3.32 vs. ‘no or unclear recommendation’). To increase hepatitis B vaccination coverage among MSM, implementation of MSM-specific recommendations and improvement of the societal climate for MSM is needed. [ABSTRACT FROM AUTHOR]

On 16-17 January 2020, four suspected mumps cases were reported to the local Public Health Authorities with an epidemiological link to a local school and football club. Of 18 suspected cases identified, 14 were included in this study. Laboratory results confirmed mumps virus as the cause and further sequencing identified genotype G. Our findings highlight that even with a high MMR vaccine coverage, mumps outbreaks in children and young adults can occur. Since most of the cases had documented immunity for mumps, we hypothesise that waning immunity or discordant mumps virus strains are likely explanations for this outbreak. [ABSTRACT FROM AUTHOR]

Active immunization is an important concern for health care workers (HCWs) susceptible subjects and potential sources of infection for patients. However, the vaccine coverage for vaccine preventable diseases (VPDs) is below recommended standards. The aims of the study were to estimate the hospitals' HCWs' susceptibility and vaccination coverage rates for VPDs and to analyze the role of HCWs' attitudes and knowledge as determinants of the immunization practices. A cross-sectional study enrolled 334 HCWs (physicians, nurses, others) at local hospital in L'Aquila (Italy). By means of an anonymous questionnaire, self-report data about history of disease and active vaccination for seasonal influenza, chickenpox, measles-mumps-rubella and hepatitis B were collected, as well as attitudes and knowledge about vaccination in HCWs. The employees showed high levels of susceptibility and insufficient vaccination coverage rates, particularly for influenza. Specific trends were detected for different VPDs across age strata and professional categories, not always consistent with literature. Overall, the level of knowledge about recommended vaccination for HCWs was low, in all categories. The active immunization status against influenza was found the most clearly associated with difference levels in 3 psychometric variables: personal responsibility, beliefs on usefulness and beliefs on risk of vaccination. A mediation mechanism was analyzed between these constructs, and an interesting indirect effect was highlighted for beliefs that could enhance the advantage of increased responsibility for HCWs. Further effort in research is needed to evaluate the black-box of longitudinal intervention studies (education, environmental changes, policies), to improve HCWs immunization.

Healthcare workers (HCW) are at an increased risk of acquiring vaccine preventable diseases (VPD) due to their higher patient exposure at the workplace. In this context, they form an important target population for vaccination. The authors of this article wanted to explore into the history of vaccination, the risk profile of the health care workers and the current vaccines recommended for the health care workers. Looking forward, vaccine uptake among the healthcare workers can be improved by measures such as conducting periodic annual health check ups and establishing written hospital vaccination policies. [ABSTRACT FROM AUTHOR]

The number of children who survive to adolescence is increasing in Nigeria, significantly due to the success of child survival programs, with immunization as a major theme. However, the national immunization schedule in Nigeria is presently restricted to early childhood with no attention paid to immunization in adolescence. Presently, the vaccines that are readily available for adolescents include tetanus toxoid which is normally administered to pregnant women, so necessarily includes adolescent mothers; and a few research programs which offers hepatitis B vaccines. Also, there are few Nigerian adolescents who access immunization as a requirement for travelling outside the country or as a result of parental effort. Knowledge and awareness about adolescent immunization is generally poor. Nigerian adolescents have been shown to be poorly protected from tetanus, rubella and hepatitis B which are vaccine preventable. Neonatal, childhood and adult tetanus, congenital rubella syndrome, cervical cancer and hepatocellular carcinoma are just few of the diseases whose incidence can be reduced with an effective adolescent immunization program. This will also ensure that the gains of childhood immunization is concretized and socio-economic losses as a result of vaccine preventable diseases are eliminated to create a healthy and vibrant workforce. There is an urgent need to build a viable adolescent immunization program in Nigeria as adolescents represent a window of opportunity to prevent diseases which affect both the younger and older age group. This can be extended to other developing countries as well.

Resumen: El Comité Asesor de Vacunas de la Asociación Española de Pediatría publica anualmente el calendario de vacunaciones que estima idóneo para los niños residentes en España, teniendo en cuenta la evidencia disponible.En cuanto a las vacunas financiadas, se recomienda emplear el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente.Se aconseja un refuerzo a los 6 años, preferentemente con DTPa, junto con una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, entre la semana 27 y la 32.Se emplearán esquemas de 2 dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica.Se recomienda vacunación sistemática universal frente al VPH, tanto a chicas como a chicos, preferentemente a los 12 años, debiéndose realizar un mayor esfuerzo para mejorar las coberturas. La nueva vacuna de 9 genotipos amplía la cobertura para ambos sexos.Se recomienda que la vacuna antimeningocócica conjugada tetravalente (MenACWY) se introduzca en el calendario financiado a los 12 meses y a los 12-14 años, aconsejándose un rescate hasta los 19 años. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos.Respecto a las vacunas no financiadas, se recomienda la antimeningocócica B, con esquema 2 + 1, solicitando su entrada en el calendario. Es recomendable vacunar a todos los lactantes frente al rotavirus. Abstract: The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines.As regards funded immunisations, the 2 + 1 strategy (2, 4, 11 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended.Administration of the 6-year booster dose with DTPa is recommended, with a poliomyelitis dose for children who had received the 2 + 1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy between 27 and 32 weeks gestation.The 2-dose scheme should be used for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years). MMRV vaccine could be applied as the second dose.Vaccination against HPV is recommended in both genders, preferably at 12 years of age. A stronger effort should be made to improve vaccination coverage. The new 9-valent vaccine is now available, expanding the coverage for both genders.Tetravalent meningococcal vaccine (MenACWY) is recommended at 12 months and 12-14 years, with a catch-up up at 19 years of age. It is also recommended in infants older than 6 weeks of age with risk factors, or travellers to countries with high incidence of ACWY meningococcal serogroups.As regards non-funded immunisations, it is recommended meningococcal B vaccination, with a 2 + 1 schedule, and requests that it be included in the National Immunisation Program. Vaccination against rotavirus is recommended in all infants.

Background: Vaccine preventable diseases (VPDs) such as measles and rubella cause significant morbidity and mortality globally every year. The World Health Organization (WHO), reported vaccine coverage for both measles and rubella to be 71 % in 2019, indicating an immunity gap. Migrants in the EU/EEA may be at high risk of VPDs due to under-immunisation and poor living conditions. However, there are limited data on VPD seroprotection rates amongst migrants living in the United Kingdom (UK)., Methods: We conducted an exploratory cross-sectional serosurvey amongst a sample of adult migrants living in Leicester, UK to: (a) determine seroprotection rates for measles, varicella zoster, and rubella in this group; (b) identify risk factors associated with seronegativity and, (c) understand if self-reported vaccine or diseases history is an effective measure of seroprotection. Participants gave a blood sample and completed a questionnaire asking basic demographic details and vaccine and disease history for the three VPDs. We summarised the data using median and interquartile range (IQR) for non-parametric continuous variables and count and percentage for categorical variables. We used logistic regression to establish predictors of seroprotection against these diseases. We examined the reliability of self-reported vaccination/disease history for prediction of seroprotection through a concordance analysis., Results: 149 migrants were included in the analysis. Seroprotection rates were: varicella zoster 98 %, rubella 92.6 % and measles 89.3 %. Increasing age was associated with seroprotection (OR 1.07 95 % CI 1.01-1.13 for each year increase in age). Migrants from Africa and the Middle East (aOR 15.16 95 % CI 1.31 - 175.06) and South/East Asia and Pacific regions (aOR 15.43 95 %CI 2.38 - 100.00) are significantly more likely to be seroprotected against measles as compared to migrants from Europe and Central Asia. The proportions of migrants unsure about their vaccination and disease history combined were 53.0 % for measles; 57.7 % for rubella; 43.0 % for varicella. There was no agreement between self-reported vaccination/disease history and serostatus., Conclusion: Our findings suggest lower levels of seroprotection against measles in migrants living in Leicester, UK, with younger migrants and those from Europe and Central Asia more likely to lack seroprotection. A high proportion of surveyed migrants were unaware of their vaccination/disease history and self-reported vaccine/disease was a poor predictor of seroprotection against VPDs which is important for clinical decision-making regarding catch-up vaccination in this population. Our results, although derived from a small sample, suggest that there may be gaps in seroimmunity for certain VPDs in particular migrant populations. These findings should inform future qualitative studies investigating barriers to vaccine uptake in migrants and population-level seroprevalence studies aimed at determining individualised risk profiles based on demographic and migration factors., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MP reports grants and personal fees from Gilead Sciences and personal fees from QIAGEN, outside the submitted work. MG, CAM, PWB, MJW, JG, KE, VR, AJL, and SH have no competing interest to declare., (© 2024 Published by Elsevier Ltd.)

Introduction: Vaccination remains underutilised worldwide with low vaccine uptake rates across the board with many adults remaining unprotected. Across the Arab world, attitudes towards vaccines vary but high rates of vaccine hesitancy have been found. This study aims to explore the adult vaccination attitudes and practices by physicians in the UAE, both before and after the introduction of the COVID-19 vaccines., Methodology: This cross-sectional, descriptive study used convenience and snowball sampling to collect comprehensive data from UAE physicians. A self-administered questionnaire was distributed in two stages: the first (pre-COVID-19 vaccines) between the months of June and October 2020 and the second between the months of November 2022 and March 2023., Results: 1000 responses, 500 from each time period, were collected. Nearly a third were family physicians or internists with more than 70% of the physicians working in governmental hospitals. 95% agreed that vaccines are safe in both cohorts but 74.4% reported not having enough time to advise about vaccines. 80.8% of physicians in the 2022 cohort reported safety concerns as the most common reason for patients to refuse vaccines. The most recommended vaccines were influenza (68.6%), Hepatitis B (66.0%) and HPV (61.4%), with pneumococcal coming in close at 57.8%. Family medicine physicians showed the highest utilisation of preventive practices across both cohorts. Nearly half of all family medicine physicians did not regularly evaluate both the influenza and general immunisation status of their patients. 54.6% of physicians reported having patients with VPDs in the last five years (not including COVID-19) in 2022., Conclusion: Physicians have overly positive attitudes, but their practices reflect a more superficial appreciation of vaccines and lack of initiative. Physicians need to adopt a pro-vaccine stance, armed with the proper tools and the right mentality and beliefs., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

BackgroundVaccination adherence among healthcare workers (HCWs) is fundamental for the prevention of vaccine-preventable diseases (VPDs) in healthcare. This safeguards HCWs' well-being, prevents transmission of infections to vulnerable patients and contributes to public health.AimThis systematic review and meta-analysis aimed to describe interventions meant to increase HCWs' adherence to vaccination and estimate the effectiveness of these interventions.MethodsWe searched literature in eight databases and performed manual searches in relevant journals and the reference lists of retrieved articles. The study population included any HCW with potential occupational exposure to VPDs. We included experimental and quasi-experimental studies presenting interventions aimed at increasing HCWs' adherence to vaccination against VPDs. The post-intervention vaccination adherence rate was set as the main outcome. We included the effect of interventions in the random-effects and subgroup meta-analyses.ResultsThe systematic review considered 48 studies on influenza and Tdap vaccination from database and manual searches, and 43 were meta-analysed. A statistically significant, positive effect was seen in multi-component interventions in randomised controlled trials (relative risk (RR) = 1.37; 95% CI: 1.13-1.66) and in observational studies (RR = 1.43; 95% CI: 1.29-1.58). Vaccination adherence rate was higher in community care facilities (RR = 1.58; 95% CI: 1.49-1.68) than in hospitals (RR = 1.24; 95% CI: 0.76-2.05).ConclusionInterventions aimed at increasing HCWs' adherence to vaccination against VPDs are effective, especially multi-component ones. Future research should determine the most effective framework of interventions for each setting, using appropriate study design for their evaluation, and should compare intervention components to understand their contribution to the effectiveness.

Infectious diseases can differ by sex in their incidence, prevalence, or severity of disease. These differences may be induced by sex-dependent immune responses and resulting protection, for example after vaccination. Therefore, this study aims to assess possible sex-differences in immunoglobulin levels (IgG) after infant and childhood vaccination. Data from a national cross-sectional serosurvey conducted in 2006/2007 were used (Pienter 2). We compared IgG levels against measles, mumps, rubella, diphtheria, tetanus, poliomyelitis, pertussis, Haemophilus influenzae type b (Hib), and Neisseria meningitidis serogroup C (MenC) between girls and boys both short term (1 month to 1 year) and long term (1–3 year) after infant and childhood vaccinations, using linear regression analysis. Proportions of boys and girls reaching a protective IgG level were compared using Fishers exact test. Differences in IgG were found at specific time points after vaccination against measles, mumps, rubella, MenC, and polio. The geometric mean concentration or titer (GMC/T) girls:boys ratios ranged between 1.10 for polio type 1 <1 year after the first childhood booster to 1.90 for MenC <1 year after infant vaccination, indicating higher antibody levels in girls. No significant differences were found between boys and girls for diphtheria, tetanus, pertussis, and Hib at either time point. Proportions with protective levels differed only at 1–3 years after infant vaccination for mumps (82.5% boys vs. 91.9% girls, p = 0.046), and at the same time point for MenC (7.0% boys vs. 18.2% girls, p = 0.015), and polio type 1 (87.8% boys vs. 95.9% girls, p = 0.047). Differences in IgG between boys and girls were generally small and not consistent, neither between pathogens nor within pathogens. If differences were observed, girls were favored over boys. On the whole, the results suggest that there are no major sex differences in protection from the studied pathogens in the Netherlands. [ABSTRACT FROM AUTHOR]

The number of children who survive to adolescence is increasing in Nigeria, significantly due to the success of child survival programs, with immunization as a major theme. However, the national immunization schedule in Nigeria is presently restricted to early childhood with no attention paid to immunization in adolescence. Presently, the vaccines that are readily available for adolescents include tetanus toxoid which is normally administered to pregnant women, so necessarily includes adolescent mothers; and a few research programs which offers hepatitis B vaccines. Also, there are few Nigerian adolescents who access immunization as a requirement for travelling outside the country or as a result of parental effort. Knowledge and awareness about adolescent immunization is generally poor. Nigerian adolescents have been shown to be poorly protected from tetanus, rubella and hepatitis B which are vaccine preventable. Neonatal, childhood and adult tetanus, congenital rubella syndrome, cervical cancer and hepatocellular carcinoma are just few of the diseases whose incidence can be reduced with an effective adolescent immunization program. This will also ensure that the gains of childhood immunization is concretized and socio-economic losses as a result of vaccine preventable diseases are eliminated to create a healthy and vibrant workforce. There is an urgent need to build a viable adolescent immunization program in Nigeria as adolescents represent a window of opportunity to prevent diseases which affect both the younger and older age group. This can be extended to other developing countries as well. [ABSTRACT FROM AUTHOR]

Abstract Background Planning and monitoring vaccine introduction and effectiveness relies on strong vaccine-preventable disease (VPD) surveillance. In low and middle-income countries (LMICs) especially, cost is a commonly reported barrier to VPD surveillance system maintenance and performance; however, it is rarely calculated or assessed. This review describes and compares studies on the availability of cost information for VPD surveillance systems in LMICs to facilitate the design of future cost studies of VPD surveillance. Methods PubMed, Web of Science, and EconLit were used to identify peer-reviewed articles and Google was searched for relevant grey literature. Studies selected described characteristics and results of VPD surveillance systems cost studies performed in LMICs. Studies were categorized according to the type of VPD surveillance system, study aim, the annual cost of the system, and per capita costs. Results Eleven studies were identified that assessed the cost of VPD surveillance systems. The studies assessed systems from six low-income countries, two low-middle-income countries, and three middle-income countries. The majority of the studies (n = 7) were conducted in sub-Saharan Africa and fifteen distinct VPD surveillance systems were assessed across the studies. Most studies aimed to estimate incremental costs of additional surveillance components and presented VPD surveillance system costs as mean annual costs per resource category, health structure level, and by VPD surveillance activity. Staff time/personnel cost represents the largest cost driver, ranging from 21% to 61% of total VPD surveillance system costs across nine studies identifying a cost driver. Conclusions This review provides a starting point to guide LMICs to invest and advocate for more robust VPD surveillance systems. Critical gaps were identified including limited information on the cost of laboratory surveillance, challenges with costing shared resources, and missing data on capital costs. Appropriate guidance is needed to guide LMICs conducting studies on VPD surveillance system costs. [ABSTRACT FROM AUTHOR]

Abstract During 2017 an alert was raised in relation to a possible vaccination failure occurred in Friuli Venezia Giulia Region (Italy) between 2009 and 2015, exposing multiple cohorts of children and the entire community to vaccine preventable diseases outbreak risk. The Codroipo case resulted in 20,441 vaccine doses being in doubt, thus prompting the healthcare system to react in order to revaccinate 5444 children through planning and implementing network actions and multiple channels of communication. [ABSTRACT FROM AUTHOR]