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The South-East Asia (SEA) Region of the World Health Organization (WHO), through a Regional Committee resolution in 2013, adopted the goal of "measles elimination and rubella control by 2020". The goal was revised in 2019 to "measles and rubella elimination by 2023". Countries of the Region have made significant efforts to achieve the goal. Progress has been made in the Region, with five of the 11 countries of the Region having been verified for having eliminated measles and rubella. Surveillance and immunization program performance for measles and rubella has shown an improvement since 2013. This progress has been possible due to a high level of political and programmatic commitment in the countries of the Region, as well as due to the alliances and infrastructures established for disease elimination initiatives in the past, notably for polio, being utilized effectively to implement strategies for measles and rubella elimination. The unforeseen COVID-19 pandemic had a detrimental effect on the immunization and surveillance efforts, leading to a delay in the achievement of measles and rubella elimination in the Region. Challenges to achieve the goal remain; however, efforts are ongoing in countries to not only protect the gains made so far but also to make further progress towards the goal of measles and rubella elimination. [ABSTRACT FROM AUTHOR]

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In October 2023, the Tel Aviv District was notified of ten cases of measles. The outbreak initiated in a preschool with high vaccination coverage with one dose of MMR vaccine. Serological testing was available for eight patients (six children and two adults). Among the six children vaccinated with one dose of MMR vaccine, primary vaccine failure was demonstrated. Among the adults, secondary vaccine failure was confirmed. The outbreak was successfully contained due to a combination of factors, notably its occurrence within a population characterized by high vaccination coverage in Tel Aviv, during a period of restricted public interactions due to the prevailing state of war in the country. Despite challenging wartime conditions, effective prophylactic measures were promptly executed, encompassing a 2-dose MMR vaccination schedule for close contacts and the broader community of children in the TA district, successfully curbing the outbreak and preventing widespread infections. [ABSTRACT FROM AUTHOR]

Summary: The WHO categorized vaccine hesitancy as one of the greatest threats to global health worldwide. Vaccination of elderly persons is of increasing relevance, given that they represent a growing segment in the population and considering the burden diseases pose to them. Many factors leading to vaccine hesitancy are related to inadequate communication. In the present report, experts from various academic fields present recommendations to support communication strategies that may help to initiate targeted communication measures to enhance vaccination compliance in adults. [ABSTRACT FROM AUTHOR]

The impact of outbreak response immunization (ORI) can be estimated by comparing observed outcomes to modelled counterfactual scenarios without ORI, but the most appropriate metrics depend on stakeholder needs and data availability. This study developed a framework for using mathematical models to assess the impact of ORI for vaccine-preventable diseases. Framework development involved (1) the assessment of impact metrics based on stakeholder interviews and literature reviews determining data availability and capacity to capture as model outcomes; (2) mapping investment in ORI elements to model parameters to define scenarios; (3) developing a system for engaging stakeholders and formulating model questions, performing analyses, and interpreting results; and (4) example applications for different settings and pathogens. The metrics identified as most useful were health impacts, economic impacts, and the risk of severe outbreaks. Scenario categories included investment in the response scale, response speed, and vaccine targeting. The framework defines four phases: (1) problem framing and data sourcing (identification of stakeholder needs, metrics, and scenarios); (2) model choice; (3) model implementation; and (4) interpretation and communication. The use of the framework is demonstrated by application to two outbreaks, measles in Papua New Guinea and Ebola in the Democratic Republic of the Congo. The framework is a systematic way to engage with stakeholders and ensure that an analysis is fit for purpose, makes the best use of available data, and uses suitable modelling methodology. [ABSTRACT FROM AUTHOR]

This document provides a summary of various research articles on the impact of the COVID-19 pandemic on vaccine implementation strategies and routine immunization services in different countries. The articles highlight the importance of effective communication systems, multidisciplinary leadership structures, and patient-centered engagement strategies in vaccine implementation. They also discuss the Whole Family Approach in Nigeria, which aims to increase COVID-19 vaccine uptake by leveraging the demand for other primary health services. The articles address challenges such as vaccine scarcity, vaccine hesitancy, and disruptions to routine immunization services. They propose interventions such as tailored decision aids, social mobilization campaigns, and the involvement of politicians to improve vaccine acceptance and uptake. The research findings contribute to the evidence needed to inform immunization recovery strategies during and after the pandemic. [Extracted from the article]

The South-East Asia (SEA) Region of the World Health Organization (WHO), through a Regional Committee resolution in 2013, adopted the goal of “measles elimination and rubella control by 2020”. The goal was revised in 2019 to “measles and rubella elimination by 2023”. Countries of the Region have made significant efforts to achieve the goal. Progress has been made in the Region, with five of the 11 countries of the Region having been verified for having eliminated measles and rubella. Surveillance and immunization program performance for measles and rubella has shown an improvement since 2013. This progress has been possible due to a high level of political and programmatic commitment in the countries of the Region, as well as due to the alliances and infrastructures established for disease elimination initiatives in the past, notably for polio, being utilized effectively to implement strategies for measles and rubella elimination. The unforeseen COVID-19 pandemic had a detrimental effect on the immunization and surveillance efforts, leading to a delay in the achievement of measles and rubella elimination in the Region. Challenges to achieve the goal remain; however, efforts are ongoing in countries to not only protect the gains made so far but also to make further progress towards the goal of measles and rubella elimination.

Background Vaccine-preventable infections are generally well controlled in Australia. However, gaps in immunity can lead to outbreaks and are important to identify. Young adults are a highly mobile population and a potential source of imported infections. We aimed to evaluate anti- measles, mumps, rubella and varicella (MMR&V) IgG seroprevalence and explore factors relating to antibody seropositivity. Methods A cross-sectional online survey was conducted among students from a large Australian university to collect demographic, vaccination, infection and travel characteristics. Blood samples were collected to measure MMR&V seroprevalence. Logistic regression was used to identify factors associated with seropositivity. Results Among 804 university students, seroprevalence (positive or equivocal) for measles was 82.3% (95% CI 79.6–84.8%), mumps 79.5% (95% CI 76.7–82.3%), rubella 91.5% (95% CI 89.6–93.5%) and varicella 86.2% (95% CI 84.1–88.8%), with 452 (56.2%, 95% CI 52.8–59.6) seropositive to all four viruses. Varicella seropositivity was highest in the older birth cohort (born 1988–1991). Measles seropositivity was higher for international students compared to domestic students. Among international students, mumps seroprevalence was significantly lower than measles and rubella seroprevalence. International travel in the previous 12 months was reported by 63.1% of students, but only 18.2% of travellers reported seeking pre-travel health advice prior to most recent international travel. Conclusions Overall, this study suggests immunity to MMR&V is sub-optimal. We found the university student population to be highly mobile and unlikely to seek pre-travel advice; thus, they are a potential source of infection importation. The implementation of university immunization policies could address the gaps identified and our findings can inform the development of targeted vaccination campaigns. [ABSTRACT FROM AUTHOR]

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.

Abstract The COVID-19 pandemic and vaccine hesitancy are not the only causes of the increase in measles cases in low- and middle-income countries. Measles epidemics, like the recent one in eastern DRC, are often quickly halted by mass vaccination in ‘easy to reach’ refugee camps. However, governmental and humanitarian actors fail to respond effectively in ‘hard-to-reach’ areas like Masisi, frequently limiting themselves to more accessible areas close to big cities.

Abstract Background Routine immunization contributes greatly to reduction in mortality from vaccine preventable diseases among children. The Somaliland Demographic and Health survey, 2020 revealed that only 13.7% of children in Marodijeh (Hargeisa) region had received all recommended vaccines, which is far below the World Health Organization (WHO) target of 80%. We therefore, assessed factors associated with immunization coverage among children under five years at Mohamed Mooge Health Center in Hargeisa, Somaliland. Methods Institutional based cross-sectional study was conducted on 174 systematically sampled, consented mothers that visited Mohamed Mooge Health Center for antenatal care during December 2022 to May 2023. Data was collected using a structured questionnaire. Data was analysed using SPSS and the relationship between dependent and independent variables was checked chi-square test at p ≤ 0.05. Finally, candidate variables were tested by using multivariate logistic regression in order to control potential confounders and the result was presented using AOR and 95% confidence interval. Model fitness was checked using Hosmer-Lemeshaw goodness of fit test with P > 0.05 for fitness. Multicollinearity between variables was checked using correlation coefficients at 0.80 or higher. Result Among 174 study participants, the prevalence of overall vaccine completion in this study was 55.3%. Women who had being aware about childhood immunization on BCG vaccination (AOR = 3.887; 95% CI: 1.275, 6.844), pentavalent (AOR = 11.385; 95% CI: 5.424–14.464), and measles (AOR = 3.074; 95% CI: 1.822–6.130) had higher odds of having immunized their children. Mothers who had employment had higher odds of having their children immunized against measles (AOR = 4.069; 95% CI: 1.822–6.130) compared to those who had not. Conclusions Full immunization coverage was lower than the target set by the World Health Organization in this study area. The current study revealed that, the mother’s awareness of childhood vaccinations on BCG, pentavalent, measles and employment status of mothers were positively associated with immunization coverage. To promote vaccination coverage, the government should implement a national awareness campaign on childhood immunization and increase the number of outreach services.

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.

Objective: To describe the decision-making processes, enablers, challenges and lessons learned in Costa Rica for implementing a sustained and multi-pronged approach in health workers vaccination (HW). Methods: A retrospective descriptive analysis was conducted by searching published and grey literature, including scientific publications, legislation, decrees, policies, manuals, technical reports, and platforms used for data register and coverage monitoring. Key informants from the Ministry of Health (MoH), the Costa Rican Social Security Fund (CCSS) were interviewed representing national, subnational and local levels; as well as members of the National Technical Advisory Group (NITAG) and the private sector. Collected data were transcribed and categorized by the following specific topics using a thematic content analysis approach: decision making process, pre-service screening, vaccination for current HWs and engagement with the private sector. Major findings were discussed and organized into enablers, challenges and lessons learned. Results: Decision making processes to establish the vaccination strategies and schedules in Costa Rica were based on the epidemiological trends of vaccine-preventable diseases (VPDs) and cost analysis. Risk assessment and feasibility considerations determined that some vaccines such as hepatitis B, varicella and influenza, were first introduced in HWs and then were expanded to other target populations. These decisions were approved by the NITAG as the advisory technical advisory group of the MoH. Main enablers identified were: high level and sustained political will, decisions based on data analysis and feasibility considerations, HWs knowledge and high vaccine acceptance and demand. Challenges were related to effective coverage monitoring, and private sector engagement. Conclusions: The Costa Rican experience provides lessons learned that can be leveraged by other countries to strengthen HWs vaccination strategies at regional and global levels.

Pertussis causes significant morbidity and mortality in infants aged <6 months. Maternal pertussis vaccination during pregnancy has been recommended in Canada since 2018 to reduce these negative outcomes. In the absence of routine immunization coverage data, our objective was to evaluate uptake in Toronto, Canada. We recruited mother-infant pairs at The Hospital for Sick Children, Toronto, between 2018 and 2020. We performed logistic regression to examine associations between demographics and self-reported pertussis vaccination. 76/243 mothers (31.3 %) reported receiving pertussis vaccination during their most recent pregnancy. Odds of receiving vaccination more than doubled with each 1-year increase in year of pregnancy (aOR: 2.2; 95 % CI: 1.3, 3.6; p < 0.01) and among those born in Canada as compared to those not (aOR: 2.0; 95 % CI: 1.1, 3.6; p = 0.02) Uptake of pertussis vaccination during pregnancy in Ontario has increased in recent years, however coverage remains lower than desirable. [ABSTRACT FROM AUTHOR]

Background: Routine immunization contributes greatly to reduction in mortality from vaccine preventable diseases among children. The Somaliland Demographic and Health survey, 2020 revealed that only 13.7% of children in Marodijeh (Hargeisa) region had received all recommended vaccines, which is far below the World Health Organization (WHO) target of 80%. We therefore, assessed factors associated with immunization coverage among children under five years at Mohamed Mooge Health Center in Hargeisa, Somaliland. Methods: Institutional based cross-sectional study was conducted on 174 systematically sampled, consented mothers that visited Mohamed Mooge Health Center for antenatal care during December 2022 to May 2023. Data was collected using a structured questionnaire. Data was analysed using SPSS and the relationship between dependent and independent variables was checked chi-square test at p ≤ 0.05. Finally, candidate variables were tested by using multivariate logistic regression in order to control potential confounders and the result was presented using AOR and 95% confidence interval. Model fitness was checked using Hosmer-Lemeshaw goodness of fit test with P > 0.05 for fitness. Multicollinearity between variables was checked using correlation coefficients at 0.80 or higher. Result: Among 174 study participants, the prevalence of overall vaccine completion in this study was 55.3%. Women who had being aware about childhood immunization on BCG vaccination (AOR = 3.887; 95% CI: 1.275, 6.844), pentavalent (AOR = 11.385; 95% CI: 5.424–14.464), and measles (AOR = 3.074; 95% CI: 1.822–6.130) had higher odds of having immunized their children. Mothers who had employment had higher odds of having their children immunized against measles (AOR = 4.069; 95% CI: 1.822–6.130) compared to those who had not. Conclusions: Full immunization coverage was lower than the target set by the World Health Organization in this study area. The current study revealed that, the mother’s awareness of childhood vaccinations on BCG, pentavalent, measles and employment status of mothers were positively associated with immunization coverage. To promote vaccination coverage, the government should implement a national awareness campaign on childhood immunization and increase the number of outreach services. [ABSTRACT FROM AUTHOR]

Vaccine-preventable diseases (VPDs) remain a significant public health challenge, particularly in sub-Saharan Africa. The high burden of VPDs in this region necessitates the need for continued investigation and intervention. This paper presents a bibliometric analysis of research on VPDs in children in sub-Saharan Africa in the last 10 years to capture the current state of research in the field. This study used a systematic search for articles published between 2013 and 2022 in the Web of Science Core Collection database and, subsequently, scientometric techniques for data analyses and interpretation. Annual scientific production of publications on the research of VPDs in children in sub-Saharan Africa increased from 2013 to 2019 and then gradually declined. South Africa had the most VPD studies (n = 148; 16.2%), followed by Nigeria, Ghana, Kenya, The Gambia, Malawi, Ethiopia, and the Republic of Congo. The Vaccine journal published the most. The Pan African Medical Journal was the most frequent destination journal based in Africa. The commonly studied pathogens were Streptococcus pneumoniae and Haemophilus influenzae. Research productivity increased exponentially in the pre-COVID era and declined in the past two years, so more VPD research in this region is needed. [ABSTRACT FROM AUTHOR]

The impact of outbreak response immunization (ORI) can be estimated by comparing observed outcomes to modelled counterfactual scenarios without ORI, but the most appropriate metrics depend on stakeholder needs and data availability. This study developed a framework for using mathematical models to assess the impact of ORI for vaccine-preventable diseases. Framework development involved (1) the assessment of impact metrics based on stakeholder interviews and literature reviews determining data availability and capacity to capture as model outcomes; (2) mapping investment in ORI elements to model parameters to define scenarios; (3) developing a system for engaging stakeholders and formulating model questions, performing analyses, and interpreting results; and (4) example applications for different settings and pathogens. The metrics identified as most useful were health impacts, economic impacts, and the risk of severe outbreaks. Scenario categories included investment in the response scale, response speed, and vaccine targeting. The framework defines four phases: (1) problem framing and data sourcing (identification of stakeholder needs, metrics, and scenarios); (2) model choice; (3) model implementation; and (4) interpretation and communication. The use of the framework is demonstrated by application to two outbreaks, measles in Papua New Guinea and Ebola in the Democratic Republic of the Congo. The framework is a systematic way to engage with stakeholders and ensure that an analysis is fit for purpose, makes the best use of available data, and uses suitable modelling methodology.

This systemic review aimed to evaluate the effectiveness of interventions for increasing the uptake of immunisation in healthcare workers (HCWs) compared to no or alternative interventions. A systematic review was undertaken (until March 2022) using a search strategy established a priori to capture studies that examined the effect of interventions on vaccination levels in HCWs. We included randomised controlled trials (RCT), cluster RCTs, controlled before-after (CBA) studies and interrupted time-series (ITS) studies. We described studies descriptively and synthesized results with a fixed-effect or random-effects model meta -analysis, where appropriate. The risk of bias was assessed for each study; the quality evidence per comparison was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). We identified three RCTs, six cluster RCTs and four ITS studies. There was a diverse range of interventions; many included an educational component. Based on the evidence examined the following may be effective strategies in increasing the proportion of HCWs vaccinated: policy interventions, targeted and multicomponent strategies, tailored programs directed at management, physician delivered education with a vaccine 'champion' and individual decision analysis. Limited eligible studies restricted synthesis and interpretation of findings. No studies evaluated the effectiveness of legislation. Nor did we find studies evaluating the effectiveness of incentives on their own or studies focusing solely on improving access to vaccination. We judged all the studies as either unclear or high risk of bias. Few robust studies that evaluate interventions to increase vaccination in HCWs are available. A limitation of this systematic review is that interventions are diverse, poorly reported and few were sufficiently alike to combine in an evaluation. More research on the effects of interventions to increase vaccination in HCWs is required, this should address a variety of vaccines and not just influenza vaccination. [ABSTRACT FROM AUTHOR]

In August 2022, Italy launched a vaccination campaign to combat the spread of the monkeypox virus, which the WHO has designated as a public health emergency. Priority targets for the campaign included laboratory personnel and men who have sex with men with specific risk criteria. Primary immunization involved two doses of the Imvanex/Jynneos vaccine, followed by a single booster dose. We conducted a study in two Italian towns, Bologna and Forlì, in October and November 2022 to investigate adverse events following immunization (AEFIs) of the monkeypox vaccine through participant-based active surveillance. Participants who received the vaccine and were aged 18 and over were invited to complete an e-questionnaire by scanning a QR code during their second vaccine appointment or by email one month after the booster dose. A descriptive analysis of AEFI incidences was conducted, with the results stratified by type and severity of symptoms. A total of 135 first-dose, 50 second-dose, and 6 single-dose recipients were included, with a mean age of 36.4 ± 8.7 years. Systemic reactions after the first and second doses were reported by 39.3% and 26.0% of participants, respectively, with asthenia being the most common symptom. Local site reactions were reported by 97.0% and 100.0% of participants, respectively, with redness, swelling, and itching being the most common local AEFIs. Grade 3 or 4 AEFIs were reported for local AEFIs only by 16.8% and 14.0% of participants after the first and second doses, respectively. Our findings suggest that the monkeypox vaccine has a high tolerability profile in terms of short-term common systemic AEFIs. However, the high incidence and severity of local AEFIs highlight the need to monitor their persistence following intradermal administration of the vaccine. [ABSTRACT FROM AUTHOR]

There is an ongoing resurgence of diphtheria infection worldwide despite a vaccine being available to prevent it for more than four decades. To study the clinical characteristics and risk factors for mortality of diphtheria cases among children 1–12 years of age treated in our hospital from 1 April 2014 to 31 March 2021. The data of hospitalised cases of childhood diphtheria from 1 April 2014 to 31 March 2019 were retrospectively analysed from the medical records department of our hospital. All hospitalised children with diphtheria from 1 April 2019 to 31 March 2021, were prospectively studied. All categorical variables were expressed as proportion/percentage and all continuous variables were expressed as median with interquartile range (IQR). Risk factors for morbidity and mortality were analysed and tested for significance. Unadjusted odds ratio (OR) was calculated and significant variables were subjected to multivariate logistic regression. Of the 58 children with diphtheria, 62% were lab-confirmed, most cases (45%) were between 5 and 9 years of age. Majority (57%) were completely immunised as per the national immunisation schedule. Fever (97%) was the most predominant clinical symptom. The classical diphtheria pseudo membrane was identified in all. Respiratory failure was the most predominant complication, followed by myocarditis and acute kidney injury. The case fatality rate was 8.6%. Diphtheria cases were seen among children 5–9 years of age more commonly. Infection requiring hospitalisation was seen in vaccinated children too. No atypical manifestations were observed. Complications of the disease adversely affected the overall survival. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Infectious diseases are a major cause of morbidity and mortality in children. Immunization remains a cost-effective method for child survival against vaccine-preventable diseases. Despite all the interventions put in by the government for 100% immunization coverage, there remain pockets of low coverage, especially in rural areas. Our aim was to estimate the immunization coverage and assess sociodemographic factors associated with immunization among children aged 12-23 months in a rural area of Bareilly. METHODS: The present cross-sectional study was carried out in the field practice area under RHTC from January 2016 to June 2016 using a 30 by 7 cluster sampling technique. A total of seven children aged 12-23 months were interviewed from each cluster on a preformed, pretested, and semi-structured questionnaire, thus giving a sample size of 210. Statistical analysis was done using the Chi-square test. RESULTS: More than two-thirds (69%) of study participants were completely vaccinated, whereas about 31% were partially or not vaccinated. Immunization coverage was found to be highest for BCG (80.4%) and lowest for the third dose of DPT (69.0%). The most common reason for partial or non-immunization was found to be unawareness (45.5%) and fear of side effects (43.9%). CONCLUSION: There is a need to create awareness and increase knowledge among caretakers of children about the importance and benefits of getting immunization for their children as a major step toward achieving Sustainable Development Goals (SDGs) goals.

Background. The vaccine preventable diseases outbreaks have become more frequent in recent decades and the lack of global vaccine awareness has been increasing and deteriorating vaccine compliance. The aim. To assess the attitude towards vaccination of parents from India and Russia. Methods. 1620 parents from Russia (Irkutsk city) and 214 parents from India (Kerala state) took part in the international cross-sectional multicenter study via survey method. Results. Parents from both countries showed good adherence to vaccination, only 1 % of Indians and 2 % of Russians did not vaccinate their children. More than 90 % of Russians took information from pediatricians compared with other sources with a prevalence of pediatricians working in the public health system 91.7 % (95 % CI: 90.2–92.9), whereas only 50 % of Indians were informed about vaccination from pediatricians (p < 0.0001). The main source of vaccine information for Indian parents was Internet (52.8 %; 95 % CI: 46.1–59.3) and mass-media (83.6 %; 95% CI: 78.1–87.9), whereas Russians resorted to this source much less (0.3 %; 95 % CI: 0.1–0.7 for Internet; and 4.3 %; 95 % CI: 3.4–5.4 for mass-media; p < 0.0001). Interestingly, while the vast majority of Russians received information about vaccination from a pediatrician, 71.2 % (95 % CI: 68.9–73.3) wanted to know more. Indians suffered from a lack of information too, but not as much (63.1 %; 95 % CI: 56.4–69.3; p = 0.01). Conclusion. Despite of a good attitude to vaccination of parents from India and Russia the lack of vaccine information was registered.

Serological surveys provide an objective biological measure of population immunity, and tetanus serological surveys can also assess vaccination coverage. We undertook a national assessment of immunity to tetanus and diphtheria among Nigerian children aged <15 years using stored specimens collected during the 2018 Nigeria HIV/AIDS Indicator and Impact Survey, a national cross-sectional household-based survey. We used a validated multiplex bead assay to test for tetanus and diphtheria toxoid-antibodies. In total, 31,456 specimens were tested. Overall, 70.9% and 84.3% of children aged <15 years had at least minimal seroprotection (≥0.01 IU/mL) against tetanus and diphtheria, respectively. Seroprotection was lowest in the north west and north east zones. Factors associated with increased tetanus seroprotection included living in the southern geopolitical zones, urban residence, and higher wealth quintiles (p < 0.001). Full seroprotection (≥0.1 IU/mL) was the same for tetanus (42.2%) and diphtheria (41.7%), while long-term seroprotection (≥1 IU/mL) was 15.1% for tetanus and 6.0% for diphtheria. Full- and long-term seroprotection were higher in boys compared to girls (p < 0.001). Achieving high infant vaccination coverage by targeting specific geographic areas and socio-economic groups and introducing tetanus and diphtheria booster doses in childhood and adolescence are needed to achieve lifelong protection against tetanus and diphtheria and prevent maternal and neonatal tetanus. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

BackgroundA variety of circumstances can influence how widely vaccination during pregnancy is accepted. Healthcare workers (HCWs) are often seen as the main resource for recommending vaccination. The purpose of the current study was to determine whether Italian HCWs advise and recommend pregnant people to receive the influenza vaccinations, as well as what knowledge and attitudes affect their practices. A secondary aim of the study was to evaluate HCWs’ knowledge and attitudes towards COVID-19 vaccination.MethodsThis cross-sectional study, took place between August 2021 and June 2022 in a randomly selected sample of HCWs in three Italian regions. The target population comprised obstetricians-gynecologists, midwives and primary care physicians, who provide medical care to pregnant people. The questionnaire consisted of 19 items divided into 5 parts gathered information about the participants’ sociodemographic and professional characteristics, general knowledge about vaccinations during pregnancy, and vaccine-preventable diseases (VPDs), attitudes and practices towards immunization, and strategies to potentially increase vaccination uptake during pregnancy.ResultsAmong the participants, 78.3% knew that pregnant people are at increased risk of severe complications from influenza, 57.8% that the influenza vaccine is not provided only in the 2nd/3rd trimester of pregnancy and 60% that pregnancy is a risk factor for severe COVID-19 infection. Of the enrolled HCWs, 10.8% believed that the potential risks of vaccines administered during pregnancy are greater than the benefits. An even higher proportion of the participants was unsure (24.3%) or did not deem (15.9%) that vaccinating against influenza during pregnancy reduces the risk of preterm birth and abortion. Moreover, 11.8% of the sample did not believe or was uncertain that COVID-19 vaccine must be offered to all pregnant people. Among HCWs, 71.8% advised women about influenza vaccination during pregnancy, and 68.8% recommended getting vaccinated against influenza during pregnancy. Results showed that good knowledge and positive attitudes were the strongest factors positively associated with advising women about influenza vaccination during pregnancy.ConclusionThe gathered data showed that a sizable portion of the HCWs lacks up-to-date knowledge, underestimates the risks of contracting a VPD, and overestimates the risks of vaccine side effects during pregnancy. The findings shed light on such attributes useful to promote adherence to evidence-based recommendations among HCWs.

Introduction: During the Coronavirus Disease 2019 (COVID19) pandemic, lockdown was imposed to break the rapid spread of infection which hampered many essential services. This included medical services and particularly the scheduled vaccinations among children. Consequently, many children missed or delayed vaccinations. Aim: To find the incidence and reasons for missed/delayed vaccination in children during the COVID-19 pandemic. Materials and Methods: This was a prospective hospital-based cross-sectional study done in the Department of Paediatrics, East Point College of Medical Sciences and Research Centre, Bengaluru, Karnataka, from March 2020 to February 2021.The total number of patients studied were 515. The samples included all children aged 0-10 years attending the paediatric Outpatient Department (OPD) for vaccination. Details about age, gender, address, parental details of education, occupation and income were recorded, using a questionnaire. Immunisation card was checked to ascertain whether any of the vaccines were missed or delayed and advice about catch up vaccination was given. The reasons for delay or missed vaccinations were recorded. Multivariate logistic regression was used to compare different classes of population with delay and as per schedule classes of children for individual vaccines. Results: The mean age of the population was 13.77 months. Delay in vaccinations was seen in 213 (41.35%) children, among among them were 94 (44.13%) girls, and 119 (55.86%) boys. Mean age of the population with delay /missed vaccinations were 21.23 months. Main cause cited in 88.2% cases for delayed /missed vaccination was fear of getting infected with Covid-19 during hospital visits. The vaccinations with most significant delay were pentavalent vaccination at 10 weeks with a mean age of delay being 1.1 month as per National Immunisation Schedule (NIS) and Typhoid vaccination as per in Indian Academy of Pediatrics (IAP) schedule with a mean age of delay of 5.2 months. The vaccinations were delayed in all socio-economic classes of the populations during the study period. Conclusion: The COVID-19 pandemic has hampered all healthcare services including immunisation. Intentional vaccine delay due to any reason by parents should be avoided and catch up immunisation should be given at the earliest.

Background: The morbidity and mortality rate for children under five in Indonesia is high in eastern Indonesia. Incomplete coverage of basic immunization for children under five can increase the risk of Vaccine-Preventable Diseases (VPD). As a province in eastern Indonesia, the coverage of complete basic immunization in Papua is low. Purpose: This study aimed to identify sociodemographic and healthcare factors among children who default to complete basic immunizations in Papua. Methods: This study utilized data from the 2018 Indonesian National Basic Health Research (Riskesdas). The sample was children aged 12-35 months who live in the Census Blocks (BS) of Riskesdas 2018 in Papua Province and selected to be the sample of Riskesdas 2018. Totally 453 children were included. Bivariate analysis of the data was using Chi-Square test and multivariate with logistic regression. Results: The result showed that the prevalence rate for defaulting basic immunization was 71.74%. Sociodemographic factors that increased incomplete basic immunization were poor economic families (OR=1.97; 95% CI=1.10-3.56) and low maternal education (OR=2.00; 95%CI=1.09-3.65). Meanwhile, healthcare factors like no immunization card (OR=6.82; 95%CI=2.65-17.56) and not being born in a healthcare facility (OR=6.05; 95%CI=3.14-11.66) become the strongest factors that increase the risk of incomplete basic immunization. Conclusion: This study indicates that sociodemographic and healthcare factors could increase the risk of incomplete basic immunization in Papua. It is important to actively improve healthcare services and educate people about the importance of immunization to reduce the risk of incomplete basic immunization for children in Papua. [ABSTRACT FROM AUTHOR]

While the incidence of infections with the human immunodeficiency virus largely remained unchanged in Germany, an increase of other sexually transmitted infections (STIs) was observed. The aim was to analyse the effectiveness of our sexual education lecture for students in improving the awareness, knowledge and prevention of STIs. We conducted a cross-sectional survey after students had attended our extra-curricular lecture at the Department of Dermatology of the Ludwig-Maximilians-University of Munich, Germany (LMU). We compared the data with a previously performed study in which the same survey was carried out before the lecture had started. A total of 5866 questionnaires were included in the analysis. After attending the lecture significantly more students were aware of STIs (syphilis: 36.8% (before) vs. 63.5% (after); chlamydia: 30.5% vs. 49.3%; gonorrhoea: 22.4% vs. 38.2%; human papillomaviruses (HPV): 17.7% vs. 30.2%), the transmission pathways of STIs (oral: 36.6% vs. 82.6%; vaginal: 81.8% vs. 97.3%; anal: 42.8% vs. 94.0%; penile: 68.7% vs. 92.1%), knew that the HPV vaccination is directed against a virus (36.8% vs. 56.9%) and were interested in receiving a vaccination (57.7% vs. 78.8%). This study demonstrates the positive educative effects of our lecture for awareness and improved knowledge of STIs. To satisfy the need for a comprehensive sexual education, a combination of school and health facility-based programmes should be implemented as one single lecture cannot convey the entire information about STIs. [ABSTRACT FROM AUTHOR]

Our study population consisted of all children and adolescents, with laboratory-confirmed SARS-Co-V-2 infection, hospitalised from February 2020 through February 2022, among residents of the Tel Aviv (TA) District, Israel. There were 491 children and adolescents hospitalised with Sars-CoV-2 infection. Among them, 281 (57%) admitted with coronavirus disease 2019 (COVID-19) as the primary cause of admission (rate of 39 per 100 000). Among all children and adolescents in the TA District, the highest hospitalisation rates were observed among infants and children below the age of 4 years (rate of 311 per 100 000 population). Severe disease was observed mostly among children with multiple underlying medical conditions. Admission rates were also elevated among residents of the ultra-orthodox community (rate ratio (RR) compared to the rest of the district; 95% confidence interval (CI) 2.38–3.82). Admission rates with COVID-19 as primary cause of admission were higher during Omicron compared to Delta predominance period (RR 1.7; 95% CI 1.22–2.32). Targeted social and public health policies should be put in place when rates of disease start to increase, such as encouraging vaccine uptake for eligible children and social distancing when necessary, taking into account already existing social and learning gaps, in order to reduce the burden of disease. [ABSTRACT FROM AUTHOR]

While the incidence of infections with the human immunodeficiency virus largely remained unchanged in Germany, an increase of other sexually transmitted infections (STIs) was observed. The aim was to analyse the effectiveness of our sexual education lecture for students in improving the awareness, knowledge and prevention of STIs. We conducted a cross-sectional survey after students had attended our extra-curricular lecture at the Department of Dermatology of the Ludwig-Maximilians-University of Munich, Germany (LMU). We compared the data with a previously performed study in which the same survey was carried out before the lecture had started. A total of 5866 questionnaires were included in the analysis. After attending the lecture significantly more students were aware of STIs (syphilis: 36.8% (before) vs. 63.5% (after); chlamydia: 30.5% vs. 49.3%; gonorrhoea: 22.4% vs. 38.2%; human papillomaviruses (HPV): 17.7% vs. 30.2%), the transmission pathways of STIs (oral: 36.6% vs. 82.6%; vaginal: 81.8% vs. 97.3%; anal: 42.8% vs. 94.0%; penile: 68.7% vs. 92.1%), knew that the HPV vaccination is directed against a virus (36.8% vs. 56.9%) and were interested in receiving a vaccination (57.7% vs. 78.8%). This study demonstrates the positive educative effects of our lecture for awareness and improved knowledge of STIs. To satisfy the need for a comprehensive sexual education, a combination of school and health facility-based programmes should be implemented as one single lecture cannot convey the entire information about STIs. [ABSTRACT FROM AUTHOR]

Abstract Background As of October 2021, 47 (80%) of the 59 countries, identified at highest risk for Maternal and Neonatal Tetanus (MNT), had been validated for elimination. We assessed sustainability of MNT elimination (MNTE) in 28 countries that were validated during 2011‒2020. Methods We assessed the attainment of the following MNTE sustainability indicators: 1) ≥ 90% coverage with three doses of Diphtheria-Tetanus-Pertussis vaccine (DTP3) among infants

Vaccine-preventable diseases (VPDs) remain a significant public health challenge, particularly in sub-Saharan Africa. The high burden of VPDs in this region necessitates the need for continued investigation and intervention. This paper presents a bibliometric analysis of research on VPDs in children in sub-Saharan Africa in the last 10 years to capture the current state of research in the field. This study used a systematic search for articles published between 2013 and 2022 in the Web of Science Core Collection database and, subsequently, scientometric techniques for data analyses and interpretation. Annual scientific production of publications on the research of VPDs in children in sub-Saharan Africa increased from 2013 to 2019 and then gradually declined. South Africa had the most VPD studies (n = 148; 16.2%), followed by Nigeria, Ghana, Kenya, The Gambia, Malawi, Ethiopia, and the Republic of Congo. The Vaccine journal published the most. The Pan African Medical Journal was the most frequent destination journal based in Africa. The commonly studied pathogens were Streptococcus pneumoniae and Haemophilus influenzae. Research productivity increased exponentially in the pre-COVID era and declined in the past two years, so more VPD research in this region is needed.

Background: Various strategies have been made to make vaccines universally available including to most hard-to-reach and vulnerable population. However, change in coverage level never reached upto expected level in spite of giving so much effort by the Govt. of India and World bodies. Therefore, there is the need to look beyond. Hence, the process evaluation of Universal Immunization Program (UIP) was conducted to evaluate the process of UIP using selected variables. Methods: A cross-sectional observation was done during the period from May 2017 to April 2020 among the 14 health-care facilities and 36 selected session sites, and interview was done to 48 health-care providers working at different levels, located in Imphal East district of Manipur. Both checklist and pretested semi-structured questioners were used for collection of data. Descriptive statistics such as frequency, proportion, and percentage were used. Results: Ice-lined refrigerator and Deep-freezer were found to be present in working condition in 11 (100%) centers. The use of vaccine carrier was found in all 36 (100%) centers. Way of vaccine administration was found to be correct in 26 (72.2%) centers. Availability of up-to-date microplan was found in 18 (78.3%) centers. Conclusions: Barriers in the UIP were not uniform throughout the villages and districts. Hence, area-specific measures need to be taken up for overcoming the barriers and challenges.

Background: Patients with congestive cardiac failure (CCF) are at increased risk of morbidities and mortality associated with pneumococcal infections and thus should be vaccinated against Streptococcus pneumoniae. However, there is dearth of scientific data on pneumococcal vaccine uptake in this environment. This study set out to assess the vaccination status and its associated factors among CCF patients in Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria. Methodology: A questionnaire based cross-sectional study of one hundred patients with CCF conducted at the adult cardiology out-patient clinic of LASUTH between December 2021 and March 2022. Socio-demographic and clinical characteristics were recorded as well as Pneumococcal vaccination status, source of vaccination, challenges and reasons for non-vaccination. The likelihood of recommending vaccination for others was also obtained. Results: The mean age of the study population was 51.55±16.36 years (range 21-78 years). The male to female ratio was 56:44. Pneumococcal vaccination rate was 9% with only 4% fully vaccinated. Lack of information about vaccine was the commonest reason for non-vaccination. Healthcare providers were the source of vaccine information in only 58% of the vaccinated subjects. Majority of the vaccinated respondents (67%) had their vaccines outside the country and most of them will likely recommend vaccination to others. Conclusion: Pneumococcal vaccination rate among CCF patients was poor. Better patients’ education and prompt vaccine recommendation by the managing physicians will improve vaccination uptake. A National guideline for adult pneumococcal vaccine in Nigeria is desirable.

Outbreaks of vaccine preventable diseases (VPDs) in hospital settings remain a challenge even in countries with established (childhood-) vaccination programs. Healthcare workers (HCWs) with an updated vaccination card play an important role in reducing the risk of nosocomial spread of VPDs. Yet, in many places, HCWs report their immunization status to be unknown or not updated. In times of a global pandemic, the debate on vaccination of HCWs is as hot as ever; do HCWs have an increased responsibility to get vaccinated against VPDs? If so, how do we increase vaccination uptake rates among HCWs? Mandatory vaccination against VPDs for HCWs has been introduced in some countries, but it may cause ethical dilemmas and not be culturally acceptable everywhere. We looked at vaccination policies and HCWs’ attitudes toward immunization against VPDs. We found that missing vaccine policies and lack of knowledge of VPDs, vaccination benefits, as well as inadequate organization around HCWs’ immunizations were important barriers to have a complete vaccination record. A systematic approach to employees providing information of VPDs and vaccinations, going through their vaccination cards and offering antibody testing where appropriate or a shot of a missing vaccine could support staff to adhere to vaccination schemes.

Introduction: Vaccine-preventable diseases (VPD) are considered one of the leading causes of sicknesses and deaths among children worldwide. Parents’ knowledge and attitude towards immunisation are likely to influence uptake. Vaccination is one of the most cost-effective public health tools to prevent infectious diseases. Aim:This study assessed parents’ knowledge, attitudes, and practice towards their children’s vaccination. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatrics, at Karpaga Vinayaga Institute of Medical Sciences and Research, Chengalpattu, Tamil Nadu, India from April 2019 to June 2019. Two hundred and sixty-six parents of 0 to 12-year-old children, attending the paediatric Outpatient Department (OPD), were recruited for the study. A prestructured questionnaire on knowledge, attitude, and practices regarding immunisation was administered, and other socio-demographic details were collected. Descriptive analysis was done by frequency and percentage. Data entry and analysis were performed in Microsoft Excel. Results: Among the 266 parents studied, a majority 129 (48.5%) of the mothers were 26 to 30 years old, and fathers were in the age group of 31-35 years 98 (36.8%). The majority 89 (33.5%) of the fathers were semi-skilled workers, and mothers were unskilled workers 180 (67.7%). Overall, 36.5% of children were 6 to 10 years old, and 53.4% were male children. Among the parents, 98.1% stated vaccines were safe, 95.1% knew that vaccine would prevent their children from diseases. 99.2% agreed that all children should be vaccinated, 96.2% maintained a vaccination card, 81.2% were aware of the following vaccination date for their children. Conclusion: According to the present study findings, there is generally good knowledge, attitude, and practices regarding vaccination of children among their parents. Knowledge regarding optional vaccinations needs to be improved through creating awareness.

In August 2022, Italy launched a vaccination campaign to combat the spread of the monkeypox virus, which the WHO has designated as a public health emergency. Priority targets for the campaign included laboratory personnel and men who have sex with men with specific risk criteria. Primary immunization involved two doses of the Imvanex/Jynneos vaccine, followed by a single booster dose. We conducted a study in two Italian towns, Bologna and Forlì, in October and November 2022 to investigate adverse events following immunization (AEFIs) of the monkeypox vaccine through participant-based active surveillance. Participants who received the vaccine and were aged 18 and over were invited to complete an e-questionnaire by scanning a QR code during their second vaccine appointment or by email one month after the booster dose. A descriptive analysis of AEFI incidences was conducted, with the results stratified by type and severity of symptoms. A total of 135 first-dose, 50 second-dose, and 6 single-dose recipients were included, with a mean age of 36.4 ± 8.7 years. Systemic reactions after the first and second doses were reported by 39.3% and 26.0% of participants, respectively, with asthenia being the most common symptom. Local site reactions were reported by 97.0% and 100.0% of participants, respectively, with redness, swelling, and itching being the most common local AEFIs. Grade 3 or 4 AEFIs were reported for local AEFIs only by 16.8% and 14.0% of participants after the first and second doses, respectively. Our findings suggest that the monkeypox vaccine has a high tolerability profile in terms of short-term common systemic AEFIs. However, the high incidence and severity of local AEFIs highlight the need to monitor their persistence following intradermal administration of the vaccine.

In Nigeria, nursing mothers in rural communities lack public amenities such as safe water, adequate primary health care, good electricity supply, GSM network coverage and good road network. These often predispose them to be noncompliant to infants' immunization uptakes and have high rates of morbidity in Vaccine Preventable Diseases (VPD) among infants. Mobile phones can be leveraged upon to provide a viable medium to support immunization uptakes and adherence using few mobile phone-based interventions which are available for low-income nursing mothers. Hence the study assessed development of a low cost mobile phone-based intervention to support infants' vaccination among nursing mothers The study developed a low cost mobile phone-based intervention to support infants' vaccination among nursing mothers in an effort to alleviate the challenges of infant's vaccination among nursing mothers, a low cost mobile phone-based application was designed and tested among nursing mothers. In the development of the app, incremental software development was adhered to using Java programming language in an Android Studio Integrated Development Environment (IDE). The software was pretested using pre and post experimental data collection. The app is a reminder system, preloaded with immunization awareness messages. It is simple to install and use and does not cost nursing mothers airtime or data. It only requires scheduling at-birth immunization's date. The app can schedule and display all other immunization dates automatically; relate specific health benefits of each vaccine as a reminder messages both in English and Yoruba languages automatically as scheduled. The experiences of the nursing mothers with this software were gathered for six months through pre-test and post-test pre-experimental design. The app was found effective in reminding the nursing mothers about immunizations appointments, enlightening them about the immunization health benefits to their infants. The intervention has possibility of improving immunization compliances and attendants at clinic appointments. Since it is low cost software, it is therefore recommended for the nursing mothers. [ABSTRACT FROM AUTHOR]

Serological surveys provide an objective biological measure of population immunity, and tetanus serological surveys can also assess vaccination coverage. We undertook a national assessment of immunity to tetanus and diphtheria among Nigerian children aged p < 0.001). Full seroprotection (≥0.1 IU/mL) was the same for tetanus (42.2%) and diphtheria (41.7%), while long-term seroprotection (≥1 IU/mL) was 15.1% for tetanus and 6.0% for diphtheria. Full- and long-term seroprotection were higher in boys compared to girls (p < 0.001). Achieving high infant vaccination coverage by targeting specific geographic areas and socio-economic groups and introducing tetanus and diphtheria booster doses in childhood and adolescence are needed to achieve lifelong protection against tetanus and diphtheria and prevent maternal and neonatal tetanus.

Sierra Leone is highly endemic for hepatitis B virus (HBV) infection and thus recommends three doses of hepatitis B vaccine (HepB3) from 6 weeks of age but does not recommend a birth dose (HepB-BD) to prevent mother-to-child transmission (MTCT). We evaluated impact of the existing HepB3 schedule and risk for MTCT of HBV. We conducted a community-based serosurvey among 4–30-month-olds, their mothers, and 5–9-year-olds in three districts in Sierra Leone. Participants had an HBV surface antigen (HBsAg) rapid test; all HBsAg-positive and one HBsAg-negative mother per cluster were tested for HBV markers. We collected children's HepB3 vaccination history. Among 1889 children aged 4–30 months, HepB3 coverage was 85% and 20 (1·3% [95% CI 0·8–2·0]) were HBsAg-positive, of whom 70% had received HepB3. Among 2025 children aged 5–9 years, HepB3 coverage was 77% and 32 (1·6% [1·1–2·3]) were HBsAg-positive, of whom 56% had received HepB3. Of 1776 mothers, 169 (9·8% [8·1–11·7]) were HBsAg-positive. HBsAg prevalence was 5·9% among children of HBsAg-positive mothers compared to 0·7% among children of HBsAg-negative mothers (adjusted OR = 10·6 [2·8–40·8]). HBsAg positivity in children was associated with maternal HBsAg (p = 0·026), HBV e antigen (p < 0·001), and HBV DNA levels ≥ 200 000 IU/mL (p < 0·001). HBsAg prevalence was lower among children than mothers, for whom HepB was not available, suggesting routine infant HepB vaccination has lowered HBV burden. Since HBsAg positivity in children was strongly associated with maternal HBV infection and most of the HBsAg-positive children in the survey received HepB3, HepB-BD may prevent MTCT and chronic HBV infection. [ABSTRACT FROM AUTHOR]

Background: As of October 2021, 47 (80%) of the 59 countries, identified at highest risk for Maternal and Neonatal Tetanus (MNT), had been validated for elimination. We assessed sustainability of MNT elimination (MNTE) in 28 countries that were validated during 2011‒2020.Methods: We assessed the attainment of the following MNTE sustainability indicators: 1) ≥ 90% coverage with three doses of Diphtheria-Tetanus-Pertussis vaccine (DTP3) among infants < 1 year, 2) ≥ 80% coverage with at least two doses of tetanus toxoid-containing vaccine (TTCV2 +) among pregnant women, 3) ≥ 80% protection at birth (PAB), 4) ≥ 70% skilled birth attendance (SBA), and 4) ≥ 80% first (ANC1) and fourth antenatal care (ANC4) visits. We assessed the introduction of TTCV booster doses. Data sources included the 2020 WHO /UNICEF Joint Reporting Forms, and the latest Demographic and Health Survey (DHS) or Multi-Indicator Cluster Surveys (MICS) for each country, if available. We reviewed literature and used DHS/MICS data to identify barriers to sustaining MNTE.Results: Of 28 assessed countries, 7 (25%) reported ≥ 90% DTP3 coverage, 4 of 26 (16%) reported ≥ 80% TTCV2 + coverage, and 23 of 27 (85%) reported ≥ 80% PAB coverage. Based on DHS/MICS in 15 of the 28 countries, 10 (67%) achieved ≥ 70% SBA delivery, 13 (87%) achieved ≥ 80% ANC1 visit coverage, and 3 (20%) ≥ 80% ANC4 visit coverage. We observed sub-optimal coverage in many countries at the subnational level. The first, second and third booster doses of TTCV respectively have been introduced in 6 (21%), 5 (18%), and 1 (4%) of 28 countries. Only three countries conducted post-MNTE validation assessments. Barriers to MNTE sustainability included: competing program priorities, limited resources to introduce TTCV booster doses and implement corrective immunization in high-risk districts and socio-economic factors.Conclusions: Despite good performance of MNTE indicators in several countries, MNTE sustainability appears threatened in some countries. Integration and coordination of MNTE activities with other immunization activities in the context of the Immunization Agenda 2030 lifecourse vaccination strategy such as providing tetanus booster doses in school-based vaccination platforms, during measles second dose and HPV vaccination, and integrating MNTE post-validation assessments with immunization program reviews will ensure MNTE is sustained. [ABSTRACT FROM AUTHOR]

• Checking vaccination status at school was reported by 77% of the countries in 2018 • Individual home-based records were the most frequently checked document • Children were most often referred to health centers to receive missed vaccines • Checking vaccination status at school was infrequently monitored or evaluated Checking vaccination status at school is widely recommended as a strategy to strengthen routine childhood vaccination coverage. Documentation of approaches, challenges, strengths, and impact of this strategy in a variety of contexts is key to enhancing adoption and implementation. However, there is limited information about the prevalence of policies and the implementation of checking vaccination status at school globally. A one-time supplementary survey was circulated with the annual World Health Organization (WHO) and United Nations International Children's Emergency Fund (UNICEF) Joint Reporting Form in 2019 to all WHO member states and non-member state reporting entities. Additional publicly available country-level data, including primary school enrollment, home-based record (HBR) ownership, and World Bank income classification were linked to the supplementary survey responses, which were descriptively analyzed. We received survey responses from 130 of the 194 (67%) WHO member states and 15 non-member state reporting entities. Almost half (46%) of the respondents reported having a law requiring proof of vaccination to enter at least one level of education, and 60% of the respondents reported having a law that requires checking vaccination status at school in 2018. Three-quarters of the respondents (77%) reported the practice of routinely checking vaccination status at school. Both laws and the practice of checking were more common in the WHO Region of the Americas and the WHO European Region, and in high- and upper-middle-income countries. Individual HBR was the document most frequently checked. Catch-up vaccination occurred most frequently at health centers. Evaluation of checking vaccination status at school to determine what has worked and its effect was infrequently reported. Despite widespread implementation of checking vaccination status at school in 2018, documentation of the experiences in planning and implementing this strategy, and its effects remains sparse, particularly in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background In Italy vaccine hesitancy worsened after a failure to vaccinate episode that took place in Friuli Venezia-Giulia Region until early 2017 which undermined herd immunity by leaving unprotected more than 5,444 children. Methods Between May and June 2017, 2,557 parents were surveyed at the local vaccination clinic where they were invited within the subsequent extraordinary vaccination campaign. The aim of the survey was to evaluate whether the multi-channel extraordinary vaccination campaign had reached the target population and to know parental beliefs and trusted sources of information after the failure to vaccinate event. Results While 279 parents were non-hesitant (10.9%) and 1,491 hesitant acceptors (58.3%), just 38 (1.5%) refused to have their children revaccinated. Overall, the most consulted sources of information were print media (18.8%), physicians (16.0%), relatives and friends (12.1%). The majority of parents considered vaccination as a fundamental practice (73.9%), but many were worried about potential side effects (38.8%) or doubtful about the effectiveness of some vaccines (11.0%). According to parents, 19.7% of them (57) changed their opinion about vaccines after the Codroipo case. Conclusions After the Codroipo case, most parents chose to have their children re-vaccinated and just a little proportion refused the re-administration of vaccines. More studies are needed to confirm the importance of a coherent multi-channel communication strategy using both traditional and new media in order to counteract vaccine hesitancy.

Back ground: The COVID-19 pandemic has created a lot of disruptions for delivery of health care services like routine immunization. Delayed immunization can lead to outbreak of many vaccine preventable diseases. The current pandemic created confusions and fear among mothers to vaccinate their children. This study was an initiative to understand the struggles faced by them during the pandemic. Objective: To estimate the prevalence of hesitancy for routine immunization among urban mothers during COVID-19 pandemic and to determine the factors responsible for their hesitancy. Methodology: It was a community based cross-sectional study which was done for three months, data were collected from 246 mothers (sample size calculated by assuming 20% as prevalence based on pilot study) having children whose age was less than 6 years by administering a pre-tested semi structured questionnaire. Result: It was found that 38% of mothers were having vaccine hesitancy during the pandemic mainly due to the factors like fear of exposure to COVID-19 and due to lockdown.Out of 6 variables 5 variables(except religion) was found to be statistically significant.On the multivariate analysis only prior to pandemic hesitancy retained statistical significance. Conclusion: From our study we infer that the pandemic has increased hesitancy among mothers, hampering routine immunization. Thus, this domain deserves more consideration by health care officials and policy makers, to prevent disruption of the immunization programme.

Adherence to recommended age-specific immunisation schedules is critical in ensuring vaccine effectiveness against vaccine preventable diseases (VPDs). There is limited data on immunisation timeliness in sub-Saharan Africa. Therefore, this study assessed the timeliness of age-specific routine childhood immunisation within the Western Cape Province of South Africa. Participant records (N = 709) from a prospective health-facility based study conducted in Cape Town, SA in 2012–2016 were analysed. The outcome measure was receiving age-specific immunisations ≥4 weeks of that recommended for age as per the South African Expanded Programme on Immunisation (EPI-SA) schedule. Proportions, medians, inter-quartile ranges (IQR) and regression were used to obtain the prevalence, time-at-risk, and risk factors for delayed immunisation. A total of 652 /709 (91.9%) participants were eligible. Immunisation coverage declined with age from 94.9% (95% CI 92.9–96.4) at birth to 72.0% (95% CI 65.7–77.6) at 18 months. The highest delay in the uptake of vaccine doses was observed among the 3 rd dose of the DTP vaccine [163 (34.6% (95% CI 30.3–39.1)], while the lowest was seen among BCG [40 (6.5% (95% CI 4.7–8.8)]. The longest median time-at-risk of VPDs was among the 2 nd dose of the measles vaccine [12.9 (IQR 6.7–38.6) weeks] and the lowest was OPV birth dose [IQR 6.3 (5.3–9.1) weeks]. Low and upper-middle socio-economic quartiles were associated with delayed uptake of vaccine doses. Delayed vaccination increases the time of susceptibility to VPDs during infancy and childhood. There is a need to develop strategies aimed at mitigating factors associated with delay in uptake of routine childhood vaccines in the Western Cape. Mitigation strategies should provide vaccine education and mobile reminder systems. Education about timely vaccine uptake will aid in the provision of informed council from healthcare providers to caregivers. Multiple reminder systems could cater for low network coverage areas and caregivers with busy schedules.

Costa Rica is an upper middle-income country in Central America with a vigorous public health system. We have studied the number of cases, hospitalizations, and deaths due to pertussis from 1961 to 2018, in relation to vaccine coverage. Following the introduction of the fourth and fifth doses of DTP (booster doses) in 1973 there was a marked reduction of reported pertussis. In 2002 pertussis surveillance and laboratory diagnosis were improved. In 2007, Tdap post-partum immunization was introduced and then switched to intrapartum Tdap immunization in 2011. Of these two strategies post-partum vaccination seemed to have a greater effect in decreasing hospitalizations and deaths, nevertheless, since 2011 there has been only 4 infant deaths due to pertussis. [ABSTRACT FROM AUTHOR]