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Flannery DD, Zevallos Barboza A, Wade KC, Pfeifer MR, Gerber JS, Morris JS, Puopolo KM. Measles Serostatus Among Parturient Patients at 2 Philadelphia Hospitals in 2021. JAMA 2023; 329:682-684. [PMID: 36735270 PMCID: PMC9975922 DOI: 10.1001/jama.2023.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This observational study explores whether rubella serostatus, which is routinely assessed during pregnancy, can serve as a proxy for measles serostatus in parturient persons.
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Affiliation(s)
- Dustin D. Flannery
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Kelly C. Wade
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Madeline R. Pfeifer
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jeffrey S. Gerber
- Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jeffrey S. Morris
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia
| | - Karen M. Puopolo
- Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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Do LAH, Toh ZQ, Licciardi PV, Mulholland EK. Can early measles vaccination control both measles and respiratory syncytial virus infections? THE LANCET GLOBAL HEALTH 2022; 10:e288-e292. [PMID: 34953518 PMCID: PMC8694706 DOI: 10.1016/s2214-109x(21)00464-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/19/2021] [Accepted: 09/24/2021] [Indexed: 12/11/2022] Open
Abstract
Measles virus and respiratory syncytial virus (RSV) are two important global health pathogens causing substantial morbidity and mortality worldwide. The current measles vaccination schedule has the first dose given at 9–12 months of age and the second dose given at 15–18 months of age. Measles outbreaks have been associated with an increase in severe RSV infections in children younger than 6 months, probably as a result of measles-induced immunosuppression. A resurgence in measles cases was already occurring before the COVID-19 pandemic, which has affected global immunisation programmes, resulting in millions of children, mostly in low-income and middle-income countries (LMICs), missing out on their measles vaccine. This will leave many children living in the most vulnerable of circumstances highly susceptible to measles and RSV infections when current COVID-19 public health control measures are lifted. This Viewpoint discusses these issues and highlights the need for urgent action to address this looming crisis. The use of early measles vaccination at 4 months of age could be an effective strategy to prevent severe morbidity and death from both measles and RSV infections in many LMICs.
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Affiliation(s)
- Lien Anh Ha Do
- New Vaccines Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.
| | - Zheng Quan Toh
- New Vaccines Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Paul Vincent Licciardi
- New Vaccines Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Edward Kim Mulholland
- New Vaccines Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Reñosa MDC, Wachinger J, Bärnighausen K, Aligato MF, Landicho-Guevarra J, Endoma V, Landicho J, Bravo TA, Demonteverde MP, Guevarra JR, de Claro Iii N, Inobaya M, Adam M, Chase RP, McMahon SA. How can human-centered design build a story-based video intervention that addresses vaccine hesitancy and bolsters vaccine confidence in the Philippines? A mixedmethod protocol for project SALUBONG. BMJ Open 2021; 11:e046814. [PMID: 34108166 PMCID: PMC8190986 DOI: 10.1136/bmjopen-2020-046814] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Since the onset of a dengue vaccine controversy in late 2017, vaccine confidence has plummeted in the Philippines, leading to measles and polio outbreaks in early 2019. This protocol outlines a human-centered design (HCD) approach to co-create and test an intervention that addresses vaccine hesitancy (VH) via narrative and empathy with and among families and healthcare workers. METHODS AND ANALYSIS: 'Salubong' is a Filipino term that means to welcome someone back into one's life, reinforcing notions of family ties and friendships. We apply this sentiment to vaccines. Following the phases of HCD, guided by a theoretical framework, and drawing from locally held understandings of faith and acceptance, we will conduct in-depth interviews (IDIs) and focus group discussions (FGDs) in rural and urban Filipino communities that witnessed dramatic increases in measles cases in recent years. During qualitative engagements with caretakers, providers, and policymakers, we will collect narratives about family and community perceptions of childhood vaccinations, public health systems and opportunities to restore faith. IDIs and FGDs will continuously inform the development of (and delivery mechanisms for) story-based interventions. Once developed, we will test our co-created interventions among 800 caretakers and administer a VH questionnaire prior to and immediately following the intervention encounter. We will use the feedback gained through the survey and Kano-style questionnaires to further refine the intervention. Considering the data collection challenges posed by the ongoing COVID-19 pandemic, we have developed workarounds to conduct data collection primarily online. We will use systematic online debriefings to facilitate comprehensive participation of the full research team. ETHICS AND DISSEMINATION Ethical approval has been granted by the Institutional Review Board of the Research Institute for Tropical Medicine (number 2019-44) and Ethical Commission of Heidelberg University, Faculty of Medicine (S-833/2019). Study findings will be disseminated in scientific conferences and published in peer-reviewed journals.
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Affiliation(s)
- Mark Donald C Reñosa
- Heidelberg Institute of Global Health, Ruprecht Karls Universität Heidelberg, Heidelberg, Germany
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Jonas Wachinger
- Heidelberg Institute of Global Health, Ruprecht Karls Universität Heidelberg, Heidelberg, Germany
| | - Kate Bärnighausen
- Heidelberg Institute of Global Health, Ruprecht Karls Universität Heidelberg, Heidelberg, Germany
- School of Public Health, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Mila F Aligato
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Jhoys Landicho-Guevarra
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Vivienne Endoma
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Jeniffer Landicho
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Thea Andrea Bravo
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Maria Paz Demonteverde
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Jerric Rhazel Guevarra
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Nicanor de Claro Iii
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Marianette Inobaya
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Maya Adam
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | | | - Shannon A McMahon
- Heidelberg Institute of Global Health, Ruprecht Karls Universität Heidelberg, Heidelberg, Germany
- International Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Kauffmann F, Heffernan C, Meurice F, Ota MOC, Vetter V, Casabona G. Measles, mumps, rubella prevention: how can we do better? Expert Rev Vaccines 2021; 20:811-826. [PMID: 34096442 DOI: 10.1080/14760584.2021.1927722] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Measles, mumps, and rubella incidence decreased drastically following vaccination programs' implementation. However, measles and mumps' resurgence was recently reported, outbreaks still occur, and challenges remain to control these diseases. AREAS COVERED This qualitative narrative review provides an objective appraisal of the literature regarding current challenges in controlling measles, mumps, rubella infections, and interventions to address them. EXPERT OPINION While vaccines against measles, mumps, and rubella (including trivalent vaccines) are widely used and effective, challenges to control these diseases are mainly related to insufficient immunization coverage and changing vaccination needs owing to new global environment (e.g. traveling, migration, population density). By understanding disease transmission peculiarities by setting, initiatives are needed to optimize vaccination policies and increase vaccination coverage, which was further negatively impacted by COVID-19 pandemic. Also, awareness of the potential severity of infections and the role of vaccines should increase. Reminder systems, vaccination of disadvantaged, high-risk and difficult-to-reach populations, accessibility of vaccination, healthcare infrastructure, and vaccination services management should improve. Outbreak preparedness should be strengthened, including implementation of high-quality surveillance systems to monitor epidemiology. While the main focus should be on these public health initiatives to increase vaccination coverage, slightly more benefits could come from evolution of current vaccines.
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Affiliation(s)
| | - Catherine Heffernan
- NHS England (London Region), 1st Floor, Wellington House, 133-155 Waterloo Road, London, SE16UG, UK
| | - François Meurice
- GSK, Avenue Fleming 20, 1300 Wavre, Belgium.,Biomedical Sciences Department, Faculty of Medicine, University of Namur (UNamur), Rue de Bruxelles 61, 5000 Namur, Belgium
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Qamruddin AA, Qamruddin R, Malik A. Analysis and Factors Associated with Measles in Larut, Matang and Selama Districts, Perak, Malaysia. Malays J Med Sci 2020; 27:130-140. [PMID: 33154709 PMCID: PMC7605828 DOI: 10.21315/mjms2020.27.5.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/12/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To determine the incidence rate of measles and the factors associated with confirmed measles cases in Larut, Matang and Selama districts. METHODS Cross-sectional analysis was carried out looking at all suspected and laboratory-confirmed measles cases in Larut, Matang and Selama districts between 2015 and 2019. Multiple logistic regression analysis was used to determine the associated factors for laboratory-confirmed measles cases. RESULTS The incidence rate for suspected measles showed an increasing trend from 2015-2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. From multiple logistic regression analysis, cases that fulfilled the case definition of measles were more likely to be laboratory-confirmed measles. On the other hand, a prior history of measles immunisation was a protective factor. CONCLUSION Measles incidence is increasing in trend. Any suspected measles cases that fulfilled the clinical case definitions need to be further investigated. Immunisation should be promoted as they are effective in preventing and eliminating measles.
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Affiliation(s)
| | | | - Ayu Malik
- Larut Matang and Selama District Health Office, Perak, Malaysia
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de Figueiredo A, Simas C, Karafillakis E, Paterson P, Larson HJ. Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study. Lancet 2020; 396:898-908. [PMID: 32919524 PMCID: PMC7607345 DOI: 10.1016/s0140-6736(20)31558-0] [Citation(s) in RCA: 554] [Impact Index Per Article: 138.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019. METHODS In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. FINDINGS Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake. INTERPRETATION To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence. FUNDING European Commission, Wellcome, and Engineering and Physical Sciences Research Council.
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Affiliation(s)
- Alexandre de Figueiredo
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Mathematics, Imperial College London, London, UK
| | - Clarissa Simas
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Emilie Karafillakis
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Pauline Paterson
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Heidi J Larson
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
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