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de Pouvourville G, Breau-Brunel M, Loncle-Provot V, Beck E, Gaugain L, Nachbaur G, Pribil C. Public Health Impact and Cost-Effectiveness Analysis of 4-Component Meningococcal Serotype B Vaccination for Infants in France. PHARMACOECONOMICS - OPEN 2024; 8:539-557. [PMID: 38780884 PMCID: PMC11252096 DOI: 10.1007/s41669-024-00488-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND AND OBJECTIVES In France, meningococcal serogroup B (MenB) is the most common serogroup causing invasive meningococcal disease (IMD) in infants and young children. Our objective was to illustrate the impact of model choices on health outcomes and the cost-effectiveness of infant vaccination with the multicomponent meningococcal serogroup B vaccine (4CMenB) versus no vaccine in France. METHODS A previously published dynamic transmission-based cost-effectiveness model was adapted for the French context using updated, French-specific demographic, epidemiological, and cost data. IMD incidence and long-term sequelae were derived through analysis of French healthcare and surveillance databases. A collective perspective over a 100-year time horizon was adopted, with a discount rate of 2.5%, reduced to 1.5% after the first 30 years. Deterministic and probabilistic sensitivity and scenario analyses were performed. RESULTS In the base case analysis, infant vaccination with 4CMenB avoided 3101 MenB IMD cases in infants aged < 1 year (- 54%) and 6845 cases in all age groups (- 21%). The estimated incremental cost-effectiveness ratio was €316,272/quality-adjusted life-year (QALY) but was highly sensitive to the types of sequelae included, MenB incidence, vaccine effectiveness parameters, and consideration of life-expectancy in IMD survivors (range: €65,272/QALY to €493,218/QALY). CONCLUSIONS Using economic models compliant with French methodology guidelines, 4CMenB does not seem cost-effective; however, results are sensitive to model choices and 4CMenB immunization is an effective strategy to prevent MenB IMD cases and to improve quality of life and economic burden associated with MenB IMD treatment, especially with regard to long-term sequelae.
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Affiliation(s)
| | | | | | | | | | | | - Céline Pribil
- GSK, 23, rue François Jacob, 92500, Rueil-Malmaison, France.
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2
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Effraimidou E, Cassimos DC, Medic S, Topalidou M, Theodoridou M, Maltezou HC. Vaccination programs for children aged up to 18 years in Europe, 2020. J Child Health Care 2023; 27:336-350. [PMID: 34844456 DOI: 10.1177/13674935211055294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although all European countries have vaccination policies for children, there are no comprehensive studies of pediatric vaccination programs in Europe. We studied vaccination programs for children in Europe. Vaccinations against diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae type b, hepatitis B, measles, mumps, rubella, and influenza existed in 42 countries, against human papilloma virus in 41 countries, and against pneumococcus in 40 countries. In addition, the following vaccinations existed: against tuberculosis (35 countries), hepatitis A (33), meningococcus A, C, W, Y (30), rotavirus and varicella (28 countries each), meningococcus B (24), tick-born encephalitis (22), and meningococcus C (16). Mandatory vaccinations are implemented in 21 countries, mainly against diphtheria, tetanus, pertussis, poliomyelitis, H. influenzae type b, hepatitis B, measles, mumps, rubella, tuberculosis, and pneumococcus. There are significant differences among pediatric vaccination programs in Europe regarding number, schedules, indications, and regulatory frame (recommended or mandatory vaccinations). A consensus-based vaccination program for all children is needed.
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Affiliation(s)
| | | | - Snezana Medic
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Maria Topalidou
- Pediatric Clinic, Komotini General Hospital, Komotini, Greece
| | - Maria Theodoridou
- First Department of Pediatrics, University of Athens, Athens, Greece
| | - Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece
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3
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Presa J, Serra L, Weil-Olivier C, York L. Preventing invasive meningococcal disease in early infancy. Hum Vaccin Immunother 2022; 18:1979846. [PMID: 35482946 PMCID: PMC9196819 DOI: 10.1080/21645515.2021.1979846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This review considers the pathogenesis, diagnosis, and epidemiology of invasive meningococcal disease in infants, to examine and critique meningococcal disease prevention in this population through vaccination. High rates of meningococcal disease and poor outcomes, particularly for very young infants, highlight the importance of meningococcal vaccination in early infancy. Although effective and safe meningococcal vaccines are available for use from 6 weeks of age, they are not recommended globally. Emerging real-world data from the increased incorporation of these vaccines within immunization programs inform recommendations regarding effectiveness, appropriate vaccination schedule, possible long-term safety effects, and persistence of antibody responses. Importantly, to protect infants from IMD, national vaccination recommendations should be consistent with available data regarding vaccine safety, effectiveness, and disease risk.
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Affiliation(s)
- Jessica Presa
- Vaccine Medical, Development, Scientific, and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Lidia Serra
- Global Vaccines Medical Development and Scientific, and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | | | - Laura York
- York Biologics Consulting LLC, Wayne, PA, USA
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4
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Ethics of Vaccination in Childhood-A Framework Based on the Four Principles of Biomedical Ethics. Vaccines (Basel) 2021; 9:vaccines9020113. [PMID: 33540732 PMCID: PMC7913000 DOI: 10.3390/vaccines9020113] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/19/2021] [Accepted: 01/29/2021] [Indexed: 02/07/2023] Open
Abstract
Although vaccination is recognised as the top public health achievement of the twentieth century, unequivocal consensus about its beneficence does not exist among the general population. In countries with well-established immunisation programmes, vaccines are “victims of their own success”, because low incidences of diseases now prevented with vaccines diminished the experience of their historical burdens. Increasing number of vaccine-hesitant people in recent years threatens, or even effectively disables, herd immunity levels of the population and results in outbreaks of previously already controlled diseases. We aimed to apply a framework for ethical analysis of vaccination in childhood based on the four principles of biomedical ethics (respect for autonomy, nonmaleficence, beneficence and justice) to provide a comprehensive and applicable model on how to address the ethical aspects of vaccination at both individual and societal levels. We suggest finding an “ethical equilibrium”, which means that the degree of respect for parents’ autonomy is not constant, but variable; it shall depend on the level of established herd immunity and it is specific for every society. When the moral obligation of individuals to contribute to herd immunity is not fulfilled, mandatory vaccination policies are ethically justified, because states bear responsibility to protect herd immunity as a common good.
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5
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Baldolli A, Michon J, Verdon R, Fournier A. Vaccination perception and coverage among healthcare students in France in 2019. BMC MEDICAL EDUCATION 2020; 20:508. [PMID: 33317501 PMCID: PMC7734903 DOI: 10.1186/s12909-020-02426-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Vaccine hesitancy in healthcare workers has been increasing especially in France while they are the cornerstone of vaccination programs. Greater understanding of healthcare students (HCS) vaccine knowledge, attitudes and beliefs is necessary to provide an adequate vaccination education to better equip them to promote vaccination in their future careers. The aim of this study was to assess vaccination perception (VP) (perception of benefits and risks of vaccines) and its impact on vaccination coverage (VC) for mandatory and recommended vaccines among HCS. METHODS A standardized, anonymous self-reporting electronic questionnaire was prospectively sent to HCS (medicine, nursing, pharmacy, midwifery, physiotherapy students and 1st year of health sciences students) of Normandy University in France between 18/03/2019 and 8/04/2019. VP was evaluated with questions regarding vaccination hesitancy, safety of vaccine and the benefit/risk balance of vaccination. Global VC (GVC) was defined as being vaccinated according to the mandatory and/or recommended vaccination schedule by national French law in 2018. RESULTS 542 HCS took part in this survey. VC was high for mandatory (diphtheriae, poliomyelitis, tetanus 93.5%, hepatitis B virus 88.6%) and even most of recommended vaccinations (measles 95%, pertussis 88.2%). Global VC (40.4%) was not statistically different between HCS except for 1st year health sciences students who were less vaccinated (25.6%). Regarding VP, 97.8% of HCS thought that vaccine are effective. When vaccine safety and level of vaccine hesitancy were assessed (on a 0-10 scale, 0: not safe or not hesitant and 10: completely safe and strongly hesitant for vaccine), 91% of respondents stated that vaccine safety is ≥7 and in 80% the vaccine hesitancy was < 3. There was no difference among student categories. 80.6% of HCS recommended all vaccines but only 52% agreed that flu vaccination should be mandatory for HCS. In the multivariate analysis, being a 1st year health care sciences student was associated with a lower GVC (OR 95% CI = 2 [1.2-3.3], p = 0.004) than being a medical student. CONCLUSION HCS perceived vaccine as effective and secure. Despite the good perception of vaccines, less than half HCS are well vaccinated.
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Affiliation(s)
- Aurélie Baldolli
- Department of Infectious Diseases, CHU de Caen, Avenue de la Côte de Nacre, F-14000, Caen, France.
| | - Jocelyn Michon
- Department of Infectious Diseases, CHU de Caen, Avenue de la Côte de Nacre, F-14000, Caen, France
| | - Renaud Verdon
- Department of Infectious Diseases, CHU de Caen, Avenue de la Côte de Nacre, F-14000, Caen, France
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Université Caen Normandie, F-14000, Caen, France
| | - Anna Fournier
- Department of Infectious Diseases, CHU de Caen, Avenue de la Côte de Nacre, F-14000, Caen, France
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Université Caen Normandie, F-14000, Caen, France
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6
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Maltezou HC, Theodora M, Lytras T, Fotiou A, Nino E, Theodoridou M, Rodolakis A. Knowledge, attitudes and practices about vaccine-preventable diseases and vaccinations of children among pregnant women in Greece. Vaccine 2020; 38:7654-7658. [PMID: 33077302 DOI: 10.1016/j.vaccine.2020.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/27/2020] [Accepted: 10/02/2020] [Indexed: 01/05/2023]
Abstract
Vaccine hesitancy has been recognized by the World Health Organization as one of ten threats to public health globally in 2019. Pregnant women constitute an extremely important group for the study of knowledge and attitudes towards pediatric vaccinations. This is a cross-sectional survey conducted in two maternity hospitals in Athens. A standardized questionnaire was used. A total of 814 pregnant women with a mean age of 33.1 years and a mean gestational age of 24.4 weeks were studied. Overall, 717 (89%) of 804 pregnant women reported that they intend to vaccinate their baby in accordance with the National Vaccination Program, 7 (1%) that they do not, while 80 (10%) reported that they have not decided yet. The women provided a mean of 11.4 correct replies out of 14 questions about vaccine-preventable diseases and vaccines (mean knowledge score: 81.5%). A pediatrician has been recognized as the source for information about vaccines in most cases (611/809, 75.5%), while in 215 (26.6%) the internet was also used. Overall, pregnant women trusted physicians about information for vaccines ("very much trusted" in 55.9% and "quite trusted" in 40% of cases). Lastly, 642 (81%) women agreed with the statement "vaccinations should be mandatory for school entry" while 70 (9%) women agreed with the statement "parents should have the right to refuse their children vaccinations". A multivariate analysis found that a gestational age of ≤20 weeks (OR = 2.33, CIs: 1.27-4.28, p-value = 0.006), having another child (OR = 4.44, CIs: 2.30-8.58, p-value < 0.001), a history of influenza vaccination (OR = 2.54, CIs = 1.37-4.71, p-value = 0.003), and a higher knowledge score about vaccine-preventable diseases and vaccines (OR = 1.33, CIs: 1.23-1.45, p-value < 0.001) were significantly associated with an increased probability to get their child vaccinated in accordance with the National Vaccination Program.
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Affiliation(s)
- Helena C Maltezou
- Directorate for Epidemiological Surveillance and Interventions of Infectious Diseases, National Public Health Organization, Athens, Greece.
| | - Marianna Theodora
- First Department of Obstetrics and Gynecology, University of Athens, Alexandra General Hospital, Athens, Greece
| | - Theodore Lytras
- Department of Database Design, Statistics and Data Management, National Public Health Organization, Athens, Greece
| | - Aikaterini Fotiou
- Neonatal Department, Elena Venizelou Maternity Hospital, Athens, Greece
| | - Emily Nino
- Neonatal Department, Elena Venizelou Maternity Hospital, Athens, Greece
| | - Maria Theodoridou
- First Department of Pediatrics, University of Athens, Aghia Sophia Children Hospital, Athens, Greece
| | - Alexandros Rodolakis
- First Department of Obstetrics and Gynecology, University of Athens, Alexandra General Hospital, Athens, Greece
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7
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Lahouati M, De Coucy A, Sarlangue J, Cazanave C. Spread of vaccine hesitancy in France: What about YouTube™? Vaccine 2020; 38:5779-5782. [PMID: 32682617 DOI: 10.1016/j.vaccine.2020.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This work characterises the information about vaccination available on YouTube™ in France. METHODS YouTube™ (www.YouTube.com) was searched using "vaccines" as a keyword. Videos in French with at least 10,000 views were identified. For each video, specific descriptive information including the opinion on vaccination was identified. To study the anti-vaccine reaction linked to a change in French policy on vaccination, the main arguments used in videos with negative opinions on vaccination uploaded in 2017 and 2018 were also collected. RESULTS We identified 166 videos: 120 (72.2%) were considered anti-vaccine videos and 46 (27.8%) were pro-vaccine; 92 (55%) were uploaded between 2017 and 2018. The anti-vaccine videos had been viewed 5,129,215 times and the pro-vaccine videos 2,371,048 times. The three most widely used anti-vaccination arguments were in regard to side effects (75.8%), pharmaceutical lobbying (61.3%), and the presence of adjuvants (51.6%). CONCLUSION Health professionals should be aware of the widely disseminated vaccination misinformation available on the Internet. Health professionals and health authorities must invest in these platforms, perhaps in collaboration with popular channels, to inform users accurately and to refute arguments put forward by anti-vaccine videos. Increasing and maintaining vaccination use is vital for vaccines to achieve success, particularly in France where vaccine hesitancy is strong.
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Affiliation(s)
- Marin Lahouati
- Pharmacy and Clinical Pharmacy Department, Bordeaux University Hospital, F-33000 Bordeaux, France.
| | - Antoine De Coucy
- Pharmacy and Clinical Pharmacy Department, Bordeaux University Hospital, F-33000 Bordeaux, France
| | - Jean Sarlangue
- Pediatric Department, Pellegrin Hospital, Bordeaux University Hospital, F-33000 Bordeaux, France
| | - Charles Cazanave
- Infectious and Tropical Diseases Department, Pellegrin Hospital, Bordeaux University Hospital, F-33000 Bordeaux, France; USC EA 3671, Mycoplasma and Chlamydia Human Infections, Bordeaux University Hospital, F-33000 Bordeaux, France
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8
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Hadjipanayis A, Efstathiou E. Editorial Commentary on the paper "Mandatory vaccination in Europe". Transl Pediatr 2020; 9:206-209. [PMID: 32775237 PMCID: PMC7347765 DOI: 10.21037/tp-20-128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Elisavet Efstathiou
- Department of Paediatric, Larnaca General Hospital, Inomenon Polition, Larnaca, Cyprus
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9
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Hadjipanayis A, Dornbusch HJ, Grossman Z, Theophilou L, Brierley J. Mandatory vaccination: a joint statement of the Ethics and Vaccination working groups of the European Academy of Paediatrics. Eur J Pediatr 2020; 179:683-687. [PMID: 31773329 DOI: 10.1007/s00431-019-03523-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/31/2019] [Accepted: 11/03/2019] [Indexed: 11/24/2022]
Abstract
Vaccinating children is amongst the most cost-effective interventions for reducing children's morbidity and mortality. Parents who choose not to vaccinate their children despite having been informed about the evidence on safety and efficacy of vaccines may seriously jeopardise the health of both their own children and others. Contemporary ethical thinking about the limits of parental decision-making over their children's healthcare treatment often considers the zone of parental discretion. However, with vaccination this is slightly less direct as the benefits are not only accumulated by an individual child but also by children as a population. Forcing parents is of course not the only solution to counteracting the fear of vaccines. Health authorities should certainly fund research and deploy resources on combatting vaccine disinformation.Conclusion: It would be preferable to achieve high rates of vaccination coverage by educating both parents and physicians without adopting any legislation for mandatory vaccination. However, in countries where vaccination uptake is low and/or outbreaks of vaccine-preventable diseases occur, the implementation of mandatory vaccination will most probably save children's lives. EAP calls for action to make all scheduled childhood vaccinations a matter of fact for all European children.
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Affiliation(s)
- Adamos Hadjipanayis
- Department of Paediatrics, Larnaca General Hospital, Larnaca, Cyprus. .,Medical School, European University of Cyprus, Nicosia, Cyprus. .,European Academy of Paediatrics, Brussels, Belgium.
| | - Hans Jürgen Dornbusch
- European Academy of Paediatrics, Brussels, Belgium.,Medical University of Graz, Graz, Austria
| | - Zachi Grossman
- European Academy of Paediatrics, Brussels, Belgium.,Pediatric Clinic, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Leda Theophilou
- Paediatrics University of Nicosia, Arch. Makarios III Hospital, Nicosia, Cyprus
| | - Joe Brierley
- European Academy of Paediatrics, Brussels, Belgium.,Paediatric Bioethics Centre & Paediatric Intensive Care, Great Ormond Street Institute of Child Health, NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, WC1N 1EH, UK
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10
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Maltezou HC, Poland GA. Immunization of healthcare personnel in Europe: Time to move forward with a common program. Vaccine 2020; 38:3187-3190. [PMID: 32173093 DOI: 10.1016/j.vaccine.2020.02.090] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/17/2020] [Accepted: 02/29/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Helena C Maltezou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, 3-5 Agrafon Street, Athens, 15123 Greece.
| | - Gregory A Poland
- Mayo Vaccine Research Group, Mayo Clinic and Foundation, 200 First Street, Rochester, MN 55905, United States
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11
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Cohen R, Martinot A, Gaudelus J, Subtil D, Stahl JP, Pujol P, Picquet V, Lepetit H, Longfier L, Leboucher B. Infant mandatory vaccinations: Confirmation of a positive impact. Med Mal Infect 2020; 50:74-77. [DOI: 10.1016/j.medmal.2019.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 10/25/2022]
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12
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Vaccination Programs for Adults in Europe, 2019. Vaccines (Basel) 2020; 8:vaccines8010034. [PMID: 31968652 PMCID: PMC7157239 DOI: 10.3390/vaccines8010034] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background: While all European countries implement vaccination programs for children, there are gaps in terms of vaccination programs for adults. Methods: We studied the 2019 vaccination policies for adults in 42 European countries. Results: Vaccination programs for adults were in place in all countries. However, there were considerable differences between countries in terms of number of vaccinations, target populations and frame of implementation (recommended or mandatory vaccinations). In particular the following vaccination policies were in place: influenza (42 countries), tetanus (31), diphtheria (30), pneumococcus (29), hepatitis B (20), pertussis (18), measles (14), human papilloma virus (14), meningococcus tetravalent A,C,W,Y (14), rubella (13), hepatitis A (11), mumps (11), poliomyelitis (10), herpes zoster (9), varicella (8), tick-born encephalitis (8), meningococcus B (6), rabies (6), Haemophilus influenzae type b (5), tuberculosis (3), typhoid fever (3), meningococcus C (2), and yellow fever (1). Seventeen countries implement mandatory vaccinations, mainly against diphtheria, tetanus and hepatitis B. Conclusions: There are significant differences in vaccination programs for adults in Europe. Routine vaccination programs for adults need to be strengthened. A consensus-based vaccination program is needed.
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13
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Vrdelja M, Učakar V, Kraigher A. From mandatory to voluntary vaccination: intention to vaccinate in the case of policy changes. Public Health 2019; 180:57-63. [PMID: 31855620 DOI: 10.1016/j.puhe.2019.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/06/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The aim of the study was to assess the association between sociodemographic characteristics and attitudes according to health belief model (HBM) attributes with the intention to vaccinate children in cases of non-mandatory vaccination to support informed decisions in planned revision of our vaccination policy. STUDY DESIGN This is a cross-sectional study carried out on a random sample of 3,854 women with young children in Slovenia. METHODS The participants' attitudes were grouped within six HBM attributes (perceived susceptibility, severity, benefits, barriers, clue to action and self-efficacy). Possible associations between the intention to vaccinate children in cases of non-mandatory vaccination and sociodemographic characteristics or attitudinal attributes according to HBM were explored in univariate analyses by calculating odds ratios (ORs) with 95% confidence interval (CI) estimates. RESULTS Just more than half (56.2%; 95% CI: 53.8-58.5%) of the women reported on their intention to vaccinate their children in the case of non-mandatory vaccination, and 23.4% (95% CI: 21.4-25.5%) were undecided. There were no significant sociodemographic predictor variables in relation to this intention. Those who perceived higher susceptibility to vaccine-preventable diseases or the benefits of vaccination were more likely to intend to vaccinate in the case of non-mandatory vaccination (OR = 5.70; 95% CI: 4.64-7.00) and (OR = 7.62; 95% CI: 5.96-9.76). Perceived barriers to vaccinate (fear of side-effects or lack of comprehensive information from physicians) and parents not getting enough useful information in general as a clue to action were significant predictors of an intention not to vaccinate. CONCLUSIONS Our results show that a mandatory vaccination policy is an important factor in ensuring high levels of vaccination coverage in Slovenia. In future, more comprehensive communication activities focused on vaccine-preventable diseases and the benefits and safety of vaccination (for the education of parents and their healthcare providers) are needed to diminish the reliance on a mandatory vaccination policy.
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Affiliation(s)
- M Vrdelja
- National Institute of Public Health, Trubarjeva 2, 1000, Ljubljana, Slovenia.
| | - V Učakar
- National Institute of Public Health, Trubarjeva 2, 1000, Ljubljana, Slovenia
| | - A Kraigher
- Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot 5, 1000 Ljubljana, Slovenia
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14
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Müller-Schulte E, Gärtner BC. Vaccinations during pregnancy: a call to sting into action. Future Microbiol 2019; 14:995-1006. [PMID: 31373211 DOI: 10.2217/fmb-2019-0101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Safety and efficacy of vaccinations during pregnancy have been a matter of debate. In the aftermath of the 2009 H1N1 influenza pandemic, a growing body of research has emerged, which points toward the importance of adhering to influenza vaccination recommendations for pregnant women. The same applies for vaccination against pertussis. Some vaccines (e.g., live attenuated) are still contraindicated during pregnancy. However, data indicate that these vaccines do not result in fetal impairment when administered accidentally during pregnancy. In the following, we provide a review on vaccination-related safety and efficacy aspects in pregnant women, shedding some light on potential barriers that stymie vaccination uptake among pregnant women and introducing strategies to overcome these barriers.
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Affiliation(s)
- Eloise Müller-Schulte
- Centre of Excellence for Microbiology & Hygiene, St. Franziskus-Hospital, Münster, Germany.,Institute of Medical Microbiology & Hygiene, Saarland University Medical Center, Homburg, Germany
| | - Barbara C Gärtner
- Institute of Medical Microbiology & Hygiene, Saarland University Medical Center, Homburg, Germany
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15
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Alessandrini V, Anselem O, Girault A, Mandelbrot L, Luton D, Launay O, Goffinet F. Does the availability of influenza vaccine at prenatal care visits and of immediate vaccination improve vaccination coverage of pregnant women? PLoS One 2019; 14:e0220705. [PMID: 31369626 PMCID: PMC6675112 DOI: 10.1371/journal.pone.0220705] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 07/22/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction Although vaccination against influenza is recommended for pregnant women in France because it exposes them to a risk of death and severe respiratory complications, their vaccination coverage in 2016 was estimated at 7%. This study's principal objective was to assess the association between the availability of influenza vaccination at prenatal care visits and vaccination coverage. Material and methods This multicenter survey took place in 3 Paris-area public hospital (AP-HP) maternity wards (A, B, and C). Only maternity ward A offered the vaccine and vaccination without charge at prenatal visits. Data were collected from parturients during 10 days in January 2017 by a self-administered anonymous questionnaire. Results Data from 248 women showed overall vaccination coverage of 19.4% (48/248): 35.4% (46/130) in maternity unit A, 2.7% (2/75) in B, and 0% (0/43) in C (P<0.01). After adjustment for socio-demographic characteristics, women at maternity ward A were significantly more likely to be vaccinated than those at B and C (aOR 25.52, 95%CI [5.76–113.10]). Other factors significantly associated with higher vaccination coverage were the mother’s French birth (aOR 2.37 CI [1.03–5.46]) and previous influenza vaccination (aOR 3.13, 95%CI [1.25–7.86]). Vaccinated women generally considered they had received adequate information (aOR 4.15 CI [2.10–8.22]), principally from the professional providing their prenatal care. Nonvaccination was attributed to the absence of an offer of vaccination (81.5%), fear of fetal side effects (59.5%), and inadequate information (51.4%). Conclusion Our results show that availability of influenza vaccination, free of charge, at prenatal consultations at the maternity ward increases vaccination coverage significantly.
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Affiliation(s)
- Vivien Alessandrini
- Maternité Port-Royal, Université Paris Descartes, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France
- * E-mail:
| | - Olivia Anselem
- Maternité Port-Royal, Université Paris Descartes, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France
| | - Aude Girault
- Maternité Port-Royal, Université Paris Descartes, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France
| | - Laurent Mandelbrot
- DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France
- Maternité Louis-Mourier, Université Diderot Paris 7, Hôpitaux Universitaires Paris Nord Val-de-Seine, Assistance Publique Hôpitaux de Paris, Colombes, France
| | - Dominique Luton
- DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France
- Maternité Bichat-Claude Bernard, Université Diderot Paris 7, Hôpitaux Universitaires Paris Nord Val-de-Seine, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Odile Launay
- DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC 1417, AP-HP, Groupe Hospitalier Cochin-Broca-Hôtel-Dieu, Centre d’investigation Clinique Cochin-Pasteur,Paris, France
| | - François Goffinet
- Maternité Port-Royal, Université Paris Descartes, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France
- Unité INSERM U953, Recherche épidémiologique en santé périnatale et santé des femmes et des enfants, UPMC, Paris, France
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16
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Bechini A, Boccalini S, Ninci A, Zanobini P, Sartor G, Bonaccorsi G, Grazzini M, Bonanni P. Childhood vaccination coverage in Europe: impact of different public health policies. Expert Rev Vaccines 2019; 18:693-701. [PMID: 31268739 DOI: 10.1080/14760584.2019.1639502] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Vaccination is a crucial tool for the primary prevention of infectious diseases. Thanks to widespread vaccination, in the last century smallpox has been eradicated, and the Americas and Europe have become polio-free. Areas covered: The aim of our study was to assess vaccination coverage in childhood up to booster preschool age in order to update the analysis on European trends of immunization coverage in the last nine years (2009-2017) and to assess the impact of different national policies on vaccine uptake. Expert opinion: Despite the good results, several EU countries are going through unprecedented outbreaks of vaccine-preventable diseases due to insufficient coverage. The increase of vaccine hesitancy has made it difficult to reach and maintain high rates of vaccination coverage. Enforcing mandatory vaccinations is one of the strategies adopted by some countries, like Italy and France, to increase coverage. However, each country should find the most suitable way to keep up with vaccination coverages according to own cultural and organizational background.
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Affiliation(s)
- Angela Bechini
- a Department of Health Sciences, University of Florence , Florence , Italy
| | - Sara Boccalini
- a Department of Health Sciences, University of Florence , Florence , Italy
| | - Alessandra Ninci
- b Medical Specialization School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | - Patrizio Zanobini
- b Medical Specialization School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | - Gino Sartor
- b Medical Specialization School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy
| | | | - Maddalena Grazzini
- a Department of Health Sciences, University of Florence , Florence , Italy
| | - Paolo Bonanni
- a Department of Health Sciences, University of Florence , Florence , Italy
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17
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Maltezou HC, Ledda C, Rapisarda V. Mandatory vaccinations for children in Italy: The need for a stable frame. Vaccine 2019; 37:4419-4420. [PMID: 31280946 DOI: 10.1016/j.vaccine.2019.05.095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/13/2019] [Accepted: 05/22/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Healthcare Facilities, Hellenic Centre for Disease Control and Prevention, Athens, Greece.
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Italy
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18
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Buxeraud J. La prévention vaccinale est l’affaire de tous à l’officine. ACTUALITES PHARMACEUTIQUES 2019. [DOI: 10.1016/j.actpha.2019.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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