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Ye P, Zhao L, Pang R, Zheng X. A retrospective study of variations in the kinds of diseases discharged from the Department of Infectious Diseases of a large general hospital in Central China during 2013-2019. Front Public Health 2024; 12:1289972. [PMID: 38420029 PMCID: PMC10899503 DOI: 10.3389/fpubh.2024.1289972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
Objective To analyze the changing trend of the absolute number and constituent ratio of various in-patient diseases in the Department of Infectious Diseases of a large general hospital in Central China during 2013-2019. Methods A retrospective study was conducted to analyze the diagnostic data of discharged patients for seven consecutive years, from 2013 to 2019. The first discharge diagnosis is used as the basis for the disease classification. The absolute number, constituent ratio, and changing trend of major diseases in hepatobiliary diseases and infectious diseases were analyzed. Results The changing trend of the diseases during 2013-2019 showed that the absolute number of cases of hepatobiliary disease did not change significantly (p = 0.615), while the constituent ratio decreased significantly, from 68.01% in 2013 to 55.29% in 2019 (p<0.001). The absolute number (constituent ratio) of cases of infectious diseases increased significantly from 585 (21.91%) in 2013 to 1,244 (36.86%) in 2019 (p = 0.015, p<0.001). The major part of the increase was non-communicable infectious diseases (NCIDs). Conclusion During 2013-2019, the proportion of cases of hepatobiliary disease gradually decreased. The absolute number and proportion of cases of infectious diseases, especially NCIDs, have increased rapidly.
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Affiliation(s)
| | | | | | - Xin Zheng
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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2
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Kim J, Han K, Chung SJ, Kim C. Psychometric validation of the Korean versions of the Vaccine Hesitancy Scale and Vaccination Attitudes Examination Scale. Vaccine 2023:S0264-410X(23)00721-1. [PMID: 37353453 DOI: 10.1016/j.vaccine.2023.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
PURPOSE Strategies for reducing vaccine hesitancy and negative attitudes toward vaccination and measures to accurately assess them have been developed worldwide. The Vaccine Hesitancy Scale (VHS) and Vaccination Attitudes Examination Scale (VAX) are reliable and valid tools. This study evaluates the validity and reliability of the Korean versions of the Vaccine Hesitancy Scale (K-VHS) and Vaccination Attitudes Examination Scale (K-VAX). METHODS We translated the VHS and VAX into Korean using forward and backward translations and tested their psychometric attributes. We collected data from a sample of 2,292 Koreans, recruited in June 2021 from a large online panel using quotas for age and gender. We used content validity, construct validity with confirmatory factor analysis, concurrent validity, and convergent validity to assess the validity of the scales, and tested their reliability with evaluations of internal consistency and stability. RESULTS The K-VHS and K-VAX showed good model fits in the validity tests, with seven items for one factor and 12 items for four factors, respectively. The internal consistency (Cronbach's alpha = 0.94 for the K-VHS, and 0.86 for the K-VAX) and stability (ICC = 0.86 for the K-VHS, and 0.88 for the K-VAX) of the measures indicated that they are reliable. CONCLUSIONS Both tools are effective psychometric instruments for assessing vaccine hesitancy and vaccination attitudes in Korean adults. K-VHS and K-VAX would be useful for predicting vaccination behaviors in novel infectious disease contexts and communicating the evidence needed to develop related policies or programs.
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Affiliation(s)
- Jieun Kim
- Chung-Ang University College of Nursing, Seoul, South Korea
| | - Kihye Han
- Chung-Ang University College of Nursing, Seoul, South Korea.
| | - Sophia J Chung
- Chung-Ang University College of Nursing, Seoul, South Korea
| | - Chaehee Kim
- Chung-Ang University Graduate School Department of Nursing, Seoul, South Korea
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3
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Lai SW, Liao KF, Lin CL, Liu CS, Hwang BF. Association between cirrhosis and herpes zoster in a cohort study in Taiwan. Int J Clin Pract 2021; 75:e14677. [PMID: 34324755 DOI: 10.1111/ijcp.14677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 07/25/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of the study was to assess if an association exists between cirrhosis and herpes zoster in Taiwan. METHODS A retrospective cohort study was designed to analyse the 2000-2013 claim dataset of 1 million insured residents who were randomly sampled from the Taiwan National Health Insurance Program. In total, 16 190 subjects aged 20-84 years old with newly diagnosed cirrhosis since 2000 to 2012 were identified as the cirrhosis group and 16 190 sex- and age-matched subjects without cirrhosis were selected as the non-cirrhosis group. Both cirrhosis and non-cirrhosis groups were followed until a new diagnosis of herpes zoster was made or until the end of 2013. The multivariable Cox proportional hazard regression model was applied to calculate the hazard ratio (HR) and 95% confidence interval (CI) for herpes zoster associated with cirrhosis. RESULTS The incidence rate of herpes zoster was 1.08-fold greater in the cirrhosis group than the non-cirrhosis group (8.33 vs 7.69 per 1000 person-years, 95%CI 1.02-1.15). After adjusting for confounders, the adjusted HR of herpes zoster was 1.11 (95% CI 1.004-1.24) for the cirrhosis group compared with the non-cirrhosis group. The adjusted HR increased to 1.33 (95% CI 1.02-1.74) for the decompensated cirrhosis group compared with the non-cirrhosis group. CONCLUSIONS Cirrhosis is associated with a small but significant increase in the risk of herpes zoster. Given that the risk of herpes zoster is small and the expense of herpes zoster vaccination is high, whether cirrhotic persons need to be vaccinated should assess the balance of cost and benefit.
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Affiliation(s)
- Shih-Wei Lai
- Department of Public Health, College of Public Health, and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
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4
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Valdez RB, Romero KS. Improving Adult Vaccination Status in the United States. Healthcare (Basel) 2021; 9:healthcare9111411. [PMID: 34828459 PMCID: PMC8620051 DOI: 10.3390/healthcare9111411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/09/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
Adult immunization practices leave much to be desired. Misinformation has increased mistrust. As a result, Latino and African American populations have low rates of annual flu vaccinations and, during the COVID-19 pandemic, lag behind for COVID-19 vaccination. Historically, healthcare staff have failed to adhere to adult immunization guidelines contributing to patient infections. Healthcare staff, both clinical and non-clinical, must lead by example by making “prevention primary”. Most adults may not realize they need immunizations. We recommend the following steps to increase immunization uptake: Make adult immunization a standard of patient care as we do for children. Assess immunization status at every clinical opportunity. Strongly recommend vaccinations needed. Administer needed vaccinations, multiple if warranted. Document vaccines received by your patient. Participate in your state’s immunization registry and work with community organizations that can help make adult immunization the norm.
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Affiliation(s)
- R. Burciaga Valdez
- Department of Family & Community Medicine and Economics, University of New Mexico, Albuquerque, NM 87131-0001, USA
- Correspondence: or
| | - Korazon S. Romero
- School of Medicine, University of New Mexico, Albuquerque, NM 87131-0001, USA;
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5
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A Review of Research on Tourism Industry, Economic Crisis and Mitigation Process of the Loss: Analysis on Pre, During and Post Pandemic Situation. SUSTAINABILITY 2021. [DOI: 10.3390/su131810314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Throughout time, the global tourism industry and economy have been significantly affected by disasters and crises. At present, COVID-19 represents one of these disasters as it has been causing a serious economic downturn with huge implications in tourism. In this review paper, we have analysed more than 100 papers regarding the effect and consequences of a pandemic on tourism and related industries, the economic situation in countries and areas, and mitigation of the loss incurred due to pandemic situations. The article (1) is based on past research on tourism and economy, (2) examines the effects of a pandemic on listed sectors and mitigation processes, and (3) suggests future research and approaches to help progress the field. We have gathered and categorised the literature reviews into several parts. In addition, we have listed the name of authors, journal names, books, websites, and relevant data.
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Alshammari SZ, AlFayyad I, Altannir Y, Al-Tannir M. Parental Awareness and Attitude about Childhood Immunization in Riyadh, Saudi Arabia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168455. [PMID: 34444205 PMCID: PMC8393381 DOI: 10.3390/ijerph18168455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/06/2020] [Accepted: 08/09/2020] [Indexed: 11/25/2022]
Abstract
Parental beliefs about vaccination are one of the main factors in reaching high vaccination rates. This cross-sectional study aims to assess the awareness and attitudes regarding routine childhood immunization among Saudi parents in Riyadh, Saudi Arabia. This survey, with a pretested 18-item questionnaire, was conducted on parents having at least one child from Riyadh, Saudi Arabia, between 1 May 2019 and 1 November 2019. The validated questionnaire consisted of three sections; participants’ demographics, awareness, and attitude regarding the immunization of their children. In total, 1200 parents participated in the study, 883 (73.3%) of the parents scored a good knowledge of childhood immunization, and 93% knew that routine vaccination protects children from infectious diseases and their complications. Around 10% stated that immunization can cause autism. Only parents in age groups 30–39 and 40–49 were 1.76 (p < 0.05) times and 1.92 (p < 0.05) times, respectively, more likely to exhibit good knowledge. About 522 (43.6) of the parents attained a positive attitude toward immunization. Adherence to the immunization schedule was confirmed important by 93%, while 91% presumed that immunization keeps their children healthy. Additionally, immunization was perceived as important by 94% of parents and only 8% agreed that immunization is prohibited by religion. Females were 1.45 (p < 0.05) times more likely to exhibit positive attitudes than males. Parents have good knowledge and a positive attitude towards child immunization. However, parental education should be focused on the fact that religion supports immunization, and more awareness should be focused on the lack of correlation between autism and vaccination.
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Affiliation(s)
- Shuaa Z. Alshammari
- Research Center, King Fahad Medical City, Riyadh 11525, Saudi Arabia; (S.Z.A.); (I.A.)
| | - Isamme AlFayyad
- Research Center, King Fahad Medical City, Riyadh 11525, Saudi Arabia; (S.Z.A.); (I.A.)
| | - Youssef Altannir
- College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia;
| | - Mohamad Al-Tannir
- Research Center, King Fahad Medical City, Riyadh 11525, Saudi Arabia; (S.Z.A.); (I.A.)
- Correspondence:
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Belice T, Ubay M, Gozubuyuk FO, Yilmaz RS, Yuksel A. An example of clinical inertia in geriatrics. J Family Med Prim Care 2020; 9:5695-5698. [PMID: 33532416 PMCID: PMC7842489 DOI: 10.4103/jfmpc.jfmpc_1427_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/17/2020] [Accepted: 09/28/2020] [Indexed: 11/04/2022] Open
Abstract
Background As we know that close contact is the main reason of the contagious diseases, caregivers are at higher risk for diseases that we can prevent by vaccines. In present study, we aim at revealing an example of clinical inertia in geriatrics, which shows us the status of vaccination both in a group of older patients and their caregivers. Materials and Methods Both the caregivers and their dependent geriatric patients were included, and the selection of the participants was designed on a random and volunteer basis. We performed the study with a phenomenological design and asked the participants their vaccination status. For the participants that were not vaccinated, the reasons were questioned with a demographic form. Correlations between parameters were analyzed with an independent t-test and analysis of variance. SPSS (IBM SPSS for Windows, ver.24) was used to analyze the data, which were saved in excel files. Results A total of 144 caregivers with 21 men (14.6%) and 123 female (85.4%) were included in the study. A total of 111(77.1%) caregivers had never been vaccinated before, while 21 (14.6%) caregivers were vaccinated occasionally, and finally, 12 (8.3%) caregivers were vaccinated on a regular base. The vaccination status of the older adults was as follows: 42 patients (29.2%) had never been vaccinated before, 60 (41.7%) had been vaccinated occasionally, and 42 (29.2%) patients had been vaccinated regularly. Conclusion The vaccination rates of caregivers and older patients were lower than we expected, so primary-care providers need to plan more vaccination awareness studies in social media and communities. Clinical inertia might be an essential reason in the lower vaccination rates of the caregivers and older adults' population.
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Affiliation(s)
- Tahir Belice
- Department of Internal Diseases, İzmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir-Turkey
| | - Mustafa Ubay
- Department of Internal Diseases, İzmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir-Turkey
| | - Fatma O Gozubuyuk
- Department of Internal Diseases, İzmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir-Turkey
| | - Rasim S Yilmaz
- Department of Internal Diseases, İzmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir-Turkey
| | - Arif Yuksel
- Department of Internal Diseases, İzmir Bozyaka Training and Research Hospital, University of Health Sciences, İzmir-Turkey
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8
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RICCò M, Vezzosi L, Gualerzi G, Bragazzi NL, Balzarini F. Pertussis immunization in healthcare workers working in pediatric settings: Knowledge, Attitudes and Practices (KAP) of Occupational Physicians. Preliminary results from a web-based survey (2017). JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E66-E75. [PMID: 32490271 PMCID: PMC7225653 DOI: 10.15167/2421-4248/jpmh2020.61.1.1155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 01/09/2020] [Indexed: 01/05/2023]
Abstract
Introduction The present study aims to characterize knowledge, attitudes and practices in a sample of occupational physicians (OPh) towards pertussis immunization in healthcare workers (HCWs) from pediatric settings. Material and methods A total of 148 OPh (45.9% males, mean age of 40.3 ± 13.2 years) compiled a web questionnaire including a knowledge test on Italian recommendations for HCWs, epidemiology and pathology of pertussis infection, being then investigated about risk perceptions and vaccination practices. A General Knowledge Score (GKS) and a Risk Perception Score (RPS) were calculated. Multivariate odds ratios (OR) for predictors of vaccine propensity were calculated through regression analysis. Results 78 participants regularly recalled pertussis vaccination status and/or performed pertussis vaccination in HCWs (52.7%). Proactive status was correlated with the aim to avoid pertussis infection in HCWs and its diffusion to other adults (p < 0.001, both statements). GKS was satisfying (72.4% ± 14.9), but participants underestimated the clinical issues of pertussis infection (RPS 60.8% ± 9.5) when confronted with influenza (73.9% ± 10.9) and HBV infection (68.1% ± 10.1). GKS and RPS were well correlated (r = 0.244, p = 0.003). Eventually, a better GKS and the aim to avoid pertussis infection in HCWs were predictive of a proactive status for pertussis vaccination (OR 4.186 95%CI 1.809-9.685 and OR 11.459, 95%CI 3.312-39.651, respectively). Conclusions Adherence of OPh to HCWs pertussis vaccination was unsatisfying. As knowledge status was predictive for vaccine propensity, information programs for OPh should be more appropriately designed, stressing that HCWs may represent a significant reservoir for pertussis infection in high risk groups (e.g. children/newborns, frail elderly).
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Affiliation(s)
- M RICCò
- IRCCS-AUSL di Reggio Emilia; Department of Public Health, Service for Health and Safety in the Workplace; Reggio Emilia (RE), Italy
- Provincial Agency for Health Services of the Autonomous Province of Trento; Department of Prevention, Occupational Health and Safety Unit, Trento (TN), Italy
| | - L Vezzosi
- University of Campania "Luigi Vanvitelli", Department of Experimental Medicine, Naples (NA), Italy
| | - G Gualerzi
- University of Parma, Department of Medicine and Surgery; School of Medicine, Parma (PR), Italy
| | - N L Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, Canada
| | - F Balzarini
- University "Vita e Salute", San Raffaele Hospital, Milan (MI), Italy
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Bach AT, Kang AY, Lewis J, Xavioer S, Portillo I, Goad JA. Addressing common barriers in adult immunizations: a review of interventions. Expert Rev Vaccines 2019; 18:1167-1185. [PMID: 31791159 DOI: 10.1080/14760584.2019.1698955] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction: Low levels of adult vaccination have been documented in the United States and globally. Research has been conducted to identify reasons for low immunization rates; however, the most useful studies are those that implemented interventions for identified barriers to evaluate their impact on rates of immunization. Identifying successful interventions provides immunization providers with evidence-based methods that can be utilized to increase the uptake of recommended vaccines.Areas covered: This review focuses on known barriers to adult immunizations and the interventions available in the literature to overcome these barriers. It outlines interventions that may increase vaccine uptake in the adult population through addressing barriers related to lack of vaccine knowledge, cost, access, provider and practice-based challenges, and racial and ethnic disparities.Expert opinion: Improving adult immunization rates is critical to protecting a population against vaccine-preventable diseases. Those interventions that appeared to increase immunization rates in the adult population included education and reminders about vaccination using text and telephone calls, low-cost or subsidized vaccines, easy access to immunization services, and understanding the cultural and social needs of different racial and ethnic populations. It is likely that an evidence-based multimodal approach using different categories of interventions is necessary to significantly improve adult immunization rates.
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Affiliation(s)
- Albert T Bach
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Amy Y Kang
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Jelena Lewis
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Sharon Xavioer
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Ivan Portillo
- AHIP Health Sciences Librarian, Leathery Libraries, Chapman University, Irvine, CA, USA
| | - Jeffery A Goad
- Chair of the Department of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
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10
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Doherty TM, Del Giudice G, Maggi S. Adult vaccination as part of a healthy lifestyle: moving from medical intervention to health promotion. Ann Med 2019; 51:128-140. [PMID: 31025882 PMCID: PMC7857442 DOI: 10.1080/07853890.2019.1588470] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
As the global population ages, there is concern about the effect of an increased proportion of older individuals on the economic sustainability of healthcare systems and the social effects of an older society. Health authorities and advocacy groups in countries at the forefront of this trend are now developing strategies to ameliorate the social and financial effects of an ageing population. There is broad agreement that for both society and for the individuals, it is important to ensure that increasing lifespans are matched with increased "healthspans" - the number of years spent in good health. There is also growing consensus that vaccination is one of the tools that can play an important role in improving adult health - though currently vaccination coverage is often poor. This review focuses on two issues that consistently appear to be associated with under-vaccination: the low awareness of risk (and potential consequences) for vaccine-preventable diseases and a poor understanding of the value of improved vaccination coverage for adults. We suggest that understanding of vaccination as a health-promoting activity, rather than a medical intervention designed to prevent the spread of a specific pathogen - is a crucial step to improve vaccination uptake among adults (see Supplementary video abstract ). Key messages As populations age globally, we are seeing an increasing burden of vaccine-preventable disease in adults. Adult vaccination against some common diseases has been shown to dramatically improve health and quality of life for older people. Despite the attested benefits, vaccination coverage is almost always poor in adults, even in countries where access is free at point of care. In this article, we discuss what appears to a neglected issue in adult vaccination, that of personal autonomy. We argue that adult vaccination will only be successful if it respects individual autonomy and that this requires treating the choice to vaccinate as a public health issue akin to smoking cessation, exercise and healthy diet.
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Affiliation(s)
| | | | - Stefania Maggi
- c CNR, Institute of Neuroscience - Aging Branch , Padua , Italy
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11
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Bacci JL, Hansen R, Ree C, Reynolds MJ, Stergachis A, Odegard PS. The effects of vaccination forecasts and value-based payment on adult immunizations by community pharmacists. Vaccine 2018; 37:152-159. [PMID: 30446177 DOI: 10.1016/j.vaccine.2018.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND The prevalence of vaccine-preventable diseases in adults remains a significant public health issue in the United States. The objectives of this demonstration project were to increase the number of influenza, pneumococcal, pertussis, and herpes zoster immunizations administered to adults by community pharmacists, evaluate the percentage of immunizations documented in the state immunization information system (IIS), and design and pilot a value-based payment model. METHODS A one-year prospective, observational demonstration project was conducted in 70 community pharmacies in western Washington State from September 1, 2016 to August 31, 2017. An immunization interface was integrated into workflow at each pharmacy to enable "forecasting" of and proactive recommendation to patients about their vaccine needs and documentation of vaccines administered in the state IIS. Categorical value-based payment models were developed and implemented in a subgroup of 12 community pharmacies from March 1 to November 30, 2017. The change in the number of immunizations administered in comparison to the baseline period and the percentage of immunizations documented in the state IIS during the demonstration period were analyzed using descriptive statistics. RESULTS There was a 15% total increase in the collective number of influenza, pneumococcal, pertussis, and herpes zoster vaccines administered in the demonstration year in the 70 pharmacies, due to increases in influenza and pertussis vaccinations. Eighty-three percent of the vaccines administered were documented in the state IIS. Pneumococcal, pertussis, and herpes zoster performance appeared to be unaffected by the value-based payment models while influenza performance improved across the 12 pilot pharmacies. CONCLUSIONS This work demonstrated that community pharmacists contribute to improving adult immunizations through vaccine "forecasting" and proactive recommendation. Meaningful quality measures with both positive and negative incentives could further drive adoption of best immunization practices. Further implementation and outcomes research is needed to fully examine the impact and scalability of these strategies.
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Affiliation(s)
- Jennifer L Bacci
- University of Washington School of Pharmacy, 1959 NE Pacific Street Box 357630, Seattle, WA 98195-7630, United States.
| | - Ryan Hansen
- University of Washington School of Pharmacy, 1959 NE Pacific Street Box 357630, Seattle, WA 98195-7630, United States
| | - Christina Ree
- Bartell Drugs, 4025 Delridge Way SW Suite 400, Seattle, WA 98106, United States
| | - Marci J Reynolds
- Quality Food Centers, 10116 NE 8th St, Bellevue, WA 98004, United States
| | - Andy Stergachis
- University of Washington School of Pharmacy, 1959 NE Pacific Street Box 357630, Seattle, WA 98195-7630, United States
| | - Peggy S Odegard
- University of Washington School of Pharmacy, 1959 NE Pacific Street Box 357630, Seattle, WA 98195-7630, United States
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Gümüştakım RŞ, Bilgili P, Çevik M, Başer DA, Doğaner A, Saper SHK, Kanevetci Z, Özçelebi E. A Double-Sided View to Adult Vaccination: The Opinions and Attitudes of Patients and Health Workers. Health (London) 2018. [DOI: 10.4236/health.2018.1012128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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13
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Kunze U, Groman E. [Immunizing is not only a children's matter! : Why vaccinations are also important for adults]. Wien Med Wochenschr 2017; 169:203-214. [PMID: 28905246 DOI: 10.1007/s10354-017-0598-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/18/2017] [Indexed: 12/30/2022]
Abstract
Vaccinations belong to the ten most effective public health achievements worldwide. While immunization programms for children are installed in Europe, vaccinations for adults are not established. However, adult vaccination is extremely meaningful: increasing age means a higher susceptibility to infectious diseases, health problems and multimorbidity will increase. The burden of vaccine-preventable diseases is still high in Europe. Due to immunosenescence (older) adults are less protected against pathogens, antibody titers after vaccinations are lower and immunity lasts shorter. There is striking lack of data of adult vaccination rates and an international consensus regarding adult vaccination recommendations or guidelines are not available in Europe. In only six countries a comprehensive document describing recommended vaccinations for adults is available, among them Austria. The awareness of the importance of adult vaccination over the whole lifetime is not present to the necessary extent in Europe and has to be promoted.
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Affiliation(s)
- Ursula Kunze
- Institute of Social Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Österreich.
| | - Ernest Groman
- Institute of Social Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Österreich
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14
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Focusing on the implementation of 21st century vaccines for adults. Vaccine 2017; 36:5358-5365. [PMID: 28807604 DOI: 10.1016/j.vaccine.2017.07.100] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/21/2017] [Accepted: 07/26/2017] [Indexed: 12/17/2022]
Abstract
Adult immunization is a priority for public health, particularly in countries where an aging population has become increasingly more numerous. Protection against diseases which typically affect adults (like flu, pneumococcal diseases and Herpes zoster), the shift of age of infections which originally affected children (like measles), the decreasing protection with time for infections which need periodical booster doses of vaccines (Tdap), the availability of vaccines which can also impact on adult health (HPV) are only some examples of the importance of implementing targeted vaccination strategies. The possibility to reach high coverage with immunizations that can guarantee a fundamental improvement of health for adults and the elderly can only be achieved through a coordinated effort where all stakeholders, under the coordination of public health, contribute to issue recommendations; create a functioning database for vaccine coverage registration; promote formative courses for healthcare workers and continuous information for the public; increase vaccines uptake among healthcare workers, who need to give the first testimony on the relevance of immunization.
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Dirmesropian S, Wood JG, MacIntyre CR, Beutels P, Newall AT. Economic Evaluation of Vaccination Programmes in Older Adults and the Elderly: Important Issues and Challenges. PHARMACOECONOMICS 2016; 34:723-731. [PMID: 26914091 DOI: 10.1007/s40273-016-0393-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
High-income countries are undergoing demographic transitions towards populations with substantial larger proportions of older adults. Due to the increased susceptibility of older adults to infectious diseases and their consequences, vaccination programmes are an important health intervention to help maintain healthy ageing. While much of the existing literature suggests that current vaccination programmes targeted at older adults and the elderly are likely to be cost effective in high-income countries, we argue that it is important to more fully consider some important issues and challenges. Since the majority of vaccines have been developed for children, economic evaluations of vaccination programmes have consequentially tended to focus on this age group and on how to incorporate herd-immunity effects. While programmes targeted at older adults and the elderly may also induce some herd effects, there are other important challenges to consider in these economic evaluations. For example, age and time effects in relation to vaccine efficacy and duration of immunity, as well as heterogeneity between targeted individuals in terms of risk of infection, severity of disease and response to vaccination. For some pathogens, there is also the potential for interactions with childhood programmes in the form of herd-immunity effects.
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Affiliation(s)
- Sevan Dirmesropian
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia
| | - James G Wood
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia
| | - C Raina MacIntyre
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia
| | - Philippe Beutels
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID) and Centre for the Evaluation of Vaccination (CEV), Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Anthony T Newall
- Samuels Building, School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, 2052, Australia.
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Esposito S, Bonanni P, Maggi S, Tan L, Ansaldi F, Lopalco PL, Dagan R, Michel JP, van Damme P, Gaillat J, Prymula R, Vesikari T, Mussini C, Frank U, Osterhaus A, Celentano LP, Rossi M, Guercio V, Gavazzi G. Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid). Hum Vaccin Immunother 2016; 12:1777-94. [PMID: 27135390 PMCID: PMC4964839 DOI: 10.1080/21645515.2016.1150396] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 12/27/2022] Open
Abstract
Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of ≥ 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research.
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Affiliation(s)
- Susanna Esposito
- Pediatric Highly Intensive Care Unit, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stefania Maggi
- CNR - Institute of Neuroscience, Aging Branch Center for Research, Padua, Italy
| | - Litjan Tan
- Immunization Action Coalition, St Paul, MN, USA
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, IRCCS San Martino-IST University Teaching Hospital, Genoa, Italy
| | | | - Ron Dagan
- Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | | | - Pierre van Damme
- Vaccine & Infectious Disease Institute, Antwerp University, Wilrijk, Belgium
| | | | - Roman Prymula
- Department of Social Medicine, Faculty of Medicine, Charles University, Sokolska, Hradec Kralove, Czech Republic
| | - Timo Vesikari
- Vaccine Research Center, Tampere University Hospital, Tampere, Finland
| | - Cristina Mussini
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - Uwe Frank
- Division of Infection Control and Hospital Epidemiology, Department of Infectious Diseases, Heidelberg University, Heidelberg, Germany
| | | | | | - Marta Rossi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Valentina Guercio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Gaetan Gavazzi
- University Clinic of Geriatric Medicine, University Hospital of Grenoble, and GREPI University of Grenoble-Alpes, Grenoble, France
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17
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Bitsori M, Galanakis E. Vaccine-preventable infection morbidity of patients with chronic kidney disease and cocoon vaccination strategies. Expert Rev Vaccines 2015; 14:1385-95. [PMID: 26289972 DOI: 10.1586/14760584.2015.1075397] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Individuals with chronic kidney disease (CKD) are vulnerable to vaccine-preventable infections due to impaired immunity, immunosuppressive treatments and dialysis. Protection of CKD patients by vaccination is hampered by reduced efficacy of vaccines and safety concerns for transplant candidates or recipients. 'Cocooning' vaccination policies, targeting the protection of a vulnerable individual through immunization of close contacts, have recently been introduced for infants and, to a lesser degree, for high-risk groups of immunocompromised individuals. In this article, we discuss the potentiality of implementing cocoon strategies for the high-risk group of CKD patients and conclude that this not yet officially recommended policy can substantially contribute to protection against infection and motivate vaccination among families and healthcare workers.
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Affiliation(s)
- Maria Bitsori
- a Department of Paediatrics, University Hospital, Heraklion 71003, Greece
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18
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Vaccination recommendations for patients with neuromuscular disease. Vaccine 2014; 32:5893-900. [PMID: 25223270 DOI: 10.1016/j.vaccine.2014.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/28/2014] [Accepted: 09/02/2014] [Indexed: 12/17/2022]
Abstract
Neuromuscular diseases (NMDs) encompass a broad spectrum of conditions. Because infections may be relevant to the final prognosis of most NMDs, vaccination appears to be the simplest and most effective solution for protecting NMD patients from vaccine-preventable infections. However, very few studies have evaluated the immunogenicity, safety, tolerability, and efficacy of different vaccines in NMD patients; therefore, detailed vaccination recommendations for NMD patients are not available. Here, we present vaccination recommendations from a group of Italian Scientific Societies for optimal disease prevention in NMD patients that maintain high safety levels. We found that NMD patients can be classified into two groups according to immune function: patients with normal immunity and patients who are immunocompromised, including those who intermittently or continuously take immunosuppressive therapy. Patients with normal immunity and do not take immunosuppressive therapy can be vaccinated as healthy subjects. In contrast, immunocompromised patients, including those who take immunosuppressive therapy, should receive all inactivated vaccines as well as influenza and pneumococcal vaccines; these patients should not be administered live attenuated vaccines. In all cases, the efficacy and long-term persistence of immunity from vaccination in NMD patients can be lower than in normal subjects. Household contacts of immunocompromised NMD patients should also be vaccinated appropriately.
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