Comparison of early childhood vaccination coverage and timeliness between children born to Italian women and those born to foreign women residing in Italy: A multi-centre retrospective cohort study

Covid-19 vaccination among migrants in Rome, Italy

Migrants may be susceptible to vaccine barriers and hesitancy. We evaluated the association between migrant status, as measured by the citizenship from a High Migratory Pressure Country (HMPC), and COVID-19 vaccination uptake in the resident population in Rome, Italy. We also investigated sex differences. We followed participants for vaccination against COVID-19 in 2021. We calculated crude- and adjusted-vaccination rates and Cox hazard ratios of vaccination for migrants compared to Italians. Among migrants from HMPCs, we estimated HRs for females compared to males, stratifying by geographical area of origin. Models were adjusted for age and deprivation index and stratified by infection history. In 2021, among 1,731,832 18-64-year-olds, migrants were 55% less likely to uptake at least one COVID-19 vaccine dose than their Italian counterpart. Past SARS-CoV-2 infection reduced the difference between migrants and Italians to 27%. Among migrants from HMPCs, we observed a slight excess of vaccination uptake among females compared to males. Focusing on geographical areas, we observed that only females from central-western Asia were 9% less likely to uptake vaccination than males. Health communication strategies oriented to migrants and considering their different languages, cultures, and health literacy should be adopted for prevention before emergencies.

Scoping Review on Barriers and Challenges to Pediatric Immunization Uptake among Migrants: Health Inequalities in Italy, 2003 to Mid-2023

In the aftermath of the COVID-19 pandemic, asylum seekers, refugees, and foreign-born migrants are more likely to suffer from physical, mental, and socioeconomic consequences owing to their existing vulnerabilities and worsening conditions in refugee camps around the world. In this scenario, the education of migrants and newcomers about immunization is critical to achieving health equity worldwide. Globally, it is unclear whether government vaccination policies are prioritizing the health information needs of migrants. We searched for studies investigating the vaccination uptake of migrant children settled in Italy that were published between January 2003 and 25 June 2023. Following Arksey and O'Malley's five-stage method for scoping reviews, all potentially relevant literature published in English was retrieved from SciSearch, Medline, and Embase. This search resulted in 88 research articles, 25 of which met our inclusion criteria. Our findings indicate unequal access to vaccination due to a lack of available information in the native language of the immigrants' country of origin, vaccine safety concerns or lack of awareness, logistical difficulties, and fear of legal consequences. The findings strongly encourage further government and political discourse to ensure migrants have fair, equitable, ethical, and timely access to essential medicines.

Sex and age as determinants of the seroprevalence of anti-measles IgG among European healthcare workers: A systematic review and meta-analysis

INTRODUCTION

The international literature shows good evidence of a significant rate of measles susceptibility among healthcare workers (HCWs). As such, they are an important public health issue.

METHODS

We conducted a systematic review and meta-analysis to estimate the prevalence of susceptible HCWs in EU/EEA countries and in the UK and to explore the characteristics (sex and age differences) and management of those found to be susceptible.

RESULTS

Nineteen studies were included in the meta-analysis. The prevalence of measles-susceptible HCWs was 13.3% (95 %CI: 10.0-17.0%). In a comparison of serosusceptible female vs. male HCWs, the RR was 0.92 (95 %CI = 0.83-1.03), and in a comparison of age classes (born after vs. before 1980) the RR was 2.78 (95 %CI = 2.20-3.50). The most recent studies proposed the mandatory vaccination of HCWs.

DISCUSSION

According to our meta-analysis, the prevalence of serosusceptible European HCWs is 13%; HCWs born in the post-vaccination era seem to be at higher risk. Healthcare professionals susceptible to measles are a serious epidemiological concern. Greater efforts should therefore be made to identify those who have yet to be vaccinated and actively encourage their vaccination.

COVID-19 vaccines coverage and effectiveness against SARS-CoV-2 infection among residents in the largest Health Authority of Lazio region (Italy): a population-based cohort study

BACKGROUND

The waning of the protective effect of COVID-19 vaccines and timing of booster doses are debated.

METHODS

Population-based cohort study in the largest Health Authority of Lazio region, Italy, on 946,156 residents aged 12+ (study period: January 1, 2021-January 10, 2022). Vaccine Effectiveness (VE) against any SARS-CoV-2 infection (symptomatic or asymptomatic) was estimated through multivariable negative binomial models using unvaccinated person-time as reference.

RESULTS

The primary vaccination cycle was completed by 81% of residents; of these, 45% received a booster dose. Vaccine coverages were lower for foreigners, deprived areas, families with children aged 0-11, and households of size 1 or 6+. Overall, VE waned from 71% (95% Confidence Interval (CI) 70-73%) 1 month after the second dose to 43% (CI 41-45%) after 4 months and 24% (CI 21-27%) after 6 months, especially in the elderly aged 70+. We observed a prompt restore of VE 15-19 days after the booster dose (69%, CI 67-70%).

CONCLUSIONS

Our results showed effectiveness of a booster dose four months after completion of the primary cycle, and support the recommendation of prioritizing elderly and fragile individuals. The lower vaccine coverage among social disadvantaged subgroups suggests the need of targeted communication and interventions.

Early childhood vaccination coverage and timeliness by macro-area of origin in children born to foreign women residing in Italy

OBJECTIVES

Country of origin might affect vaccine uptake in children born to immigrants. We aimed to evaluate differences in childhood vaccination coverage (VC) and timeliness by macro-area of origin of foreign mothers residing in Italy.

STUDY DESIGN

Multicentre retrospective birth cohorts.

METHODS

We analysed data of 23,287 children born in 2009-2014 to foreign women in the cities of Rome, Turin and Treviso. We retrieved data through record-linkage of the population, vaccination and birth registries. We estimated VCs at different ages for vaccines against tetanus, measles and meningococcal group-C, using the Kaplan-Meier method. Factors associated with vaccine uptake were evaluated using multilevel Poisson models.

RESULTS

Estimates of VC at any age and for all antigens were significantly lower in children born to women from Asia and higher in children born to women from Africa, as compared to other macro-areas. Similar differences by area of origin were observed for timeliness; independently of mother's sociodemographic characteristics and neonatal outcomes, the probability of delay vaccination after 2 years of age for each antigen was highest in children born to women from Asia. The risk of missed vaccination for all antigens was significantly higher in children born to younger and unemployed women.

CONCLUSIONS

Factors related to area of origin (e.g., cultural habits, language skills) are likely to affect parents' decision to vaccinate their children. These factors, as well as sociodemographic characteristics, should be adequately investigated and addressed to increase vaccine uptake in foreign children, especially those born to Asian women.

Evaluation of measles vaccination coverage in Lincang City, Yunnan Province, China

Background: Lincang City in Yunnan Province on the China-Myanmar border, has reached the World Health Organization recommended coverage (95%) for measles-containing vaccine (MCV), but measles outbreaks still occur. We conducted a survey in Lincang City to determine the measles vaccination status of children on the China-Myanmar border.Methods: We used multistage sampling among children aged 8-83 months. Information on measles vaccination status was obtained from the child's vaccination certificate, and serum samples were tested using commercially available ELISA kits.Results: A total of 938 children were surveyed. The vaccination coverage rate was 98.9% (95% CI: 98.2-99.6%) for measles-containing vaccine dose 1 (MCV1), and 95.8% (95% CI:94.9-96.7%) for measles-containing vaccine dose 2 (MCV2). The timely vaccination coverage rate was 52.0% (95% CI:48.8-55.2%) for MCV1, and 74.1% (95% CI: 82.9-89.0%) for MCV2. The timely-and-complete vaccination coverage rate was 41.0% (95% CI: 36.7-45.3%). The median delay period was 33 (95% CI: 27-39) days for MCV1, and 196 (95% CI: 146-246) days for MCV2. The seropositivity rate in children aged less than 7 years was 94.0% (95% CI: 92.5-95.5%) with a geometric mean titer of 1210.1 mIU/mL.Conclusions: The MCV coverage was high, but timely and timely-and-complete vaccination coverage were low and insufficient to prevent measles outbreaks. It is necessary to add the timely and timely-and-complete vaccination coverage as indicators of vaccination to provide a more complete picture of measles immunization status.