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Jiang H, Wei C. How to address vaccine hesitancy? Lessons from National Hepatitis B Immunization Program in China. Front Public Health 2024; 12:1286801. [PMID: 38317799 PMCID: PMC10838994 DOI: 10.3389/fpubh.2024.1286801] [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: 08/31/2023] [Accepted: 01/10/2024] [Indexed: 02/07/2024] Open
Abstract
China, with the severe burden of hepatitis B, plays a significant role in the global efforts towards eliminating hepatitis B disease by 2030. Vaccination is recognized as the most effective measure to prevent infectious diseases. However, vaccine hesitancy remains a significant barrier to achieving herd immunity across diverse populations. To address this issue, the health ministries and public health authorities in China have implemented various measures to encourage hepatitis B vaccination. China's National Hepatitis B Immunization Program, initiated in 1985, has been successful in controlling this vaccine-preventable disease. Given the challenges in eliminating hepatitis B, strengthening the National Hepatitis Immunization Program in China is of utmost importance. Through an analysis of policy documents, reports, and scientific papers, the history of the program was summarized, and effective approaches to address vaccine hesitancy were identified. This will help achieve universal health coverage of vaccines and effectively work towards meeting the goals set for 2030.
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Affiliation(s)
- Haiting Jiang
- Department of Medical History and Medical Philosophy, School of Health Humanities, Peking University, Beijing, China
| | - Chengyu Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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Mooneyhan E, Qureshi H, Mahmood H, Tariq M, Maqbool NA, Anwar M, Aslam M, Azam F, Blach S, Khan AG, Hamid S, Hussain T, Akhter MK, Khan A, Khan U, Khowaja S, Mahmood K, Mazhar S, Nawaz A, Rose A, Ghorezai GSA, Shah S, Sarwar SZ, Razavi H. Hepatitis C prevalence and elimination planning in Pakistan, a bottom-up approach accounting for provincial variation. J Viral Hepat 2023; 30:345-354. [PMID: 36650932 DOI: 10.1111/jvh.13802] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023]
Abstract
In Pakistan, substantial changes to hepatitis C virus (HCV) programming and treatment have occurred since the 2008 nationwide serosurvey estimated a 4.8% anti-HCV prevalence. In the absence of an updated national study, this analysis uses provincial data to estimate a national prevalence and the interventions needed to achieve elimination. Using a Delphi process, epidemiologic HCV data for the four provinces of Pakistan (accounting for 97% of the population) were reviewed with 21 subject-matter experts in Pakistan. Province-level estimates were inputted into a mathematical model to estimate the national HCV disease burden in the absence of intervention (Base), and if the World Health Organization (WHO) elimination targets are achieved by 2030 (80% reduction in new infections, 90% diagnosis coverage, 80% treatment coverage, and 65% reduction in mortality: WHO Elimination). An estimated 9,746,000 (7,573,000-10,006,000) Pakistanis were living with viraemic HCV as of January 1, 2021; a viraemic prevalence of 4.3% (3.3-4.4). WHO Elimination would require an annual average of 18.8 million screens, 1.1 million treatments, and 46,700 new infections prevented anually between 2022 and 2030. Elimination would reduce total infections by 7,045,000, save 152,000 lives and prevent 104,000 incident cases of hepatocellular carcinoma from 2015 to 2030. Blood surveys, programmatic data, and expert panel input uncovered more HCV infections and lower treatment numbers in the provinces than estimated using national extrapolations, demonstrating the benefits of a bottom-up approach. Screening and treatment must increase 20 times and 5 times, respectively, to curb the HCV epidemic in Pakistan and achieve elimination by 2030.
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Affiliation(s)
- Ellen Mooneyhan
- Center for Disease Analysis Foundation (CDAF), Lafayette, Colorado, USA
| | - Huma Qureshi
- Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan
| | - Hassan Mahmood
- Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan
| | | | | | | | | | - Farooq Azam
- Chemonics International, Lahore, Pakistan.,United States Agency for International Development (USAID), Karachi, Pakistan
| | - Sarah Blach
- Center for Disease Analysis Foundation (CDAF), Lafayette, Colorado, USA
| | | | - Saeed Hamid
- Aga Khan University and Hospitals, Karachi, Pakistan
| | | | | | | | - Uzma Khan
- Interactive Research and Development (IRD) Pakistan, Karachi, Pakistan.,IRD Global, Singapore City, Singapore
| | - Saira Khowaja
- Indus Hospital and Health Network, Karachi, Pakistan
| | | | - Samra Mazhar
- Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan
| | | | - Ayub Rose
- Chemonics International, Lahore, Pakistan.,United States Agency for International Development (USAID), Karachi, Pakistan
| | | | - Sabeen Shah
- Indus Hospital and Health Network, Karachi, Pakistan
| | | | - Homie Razavi
- Center for Disease Analysis Foundation (CDAF), Lafayette, Colorado, USA
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Shimizu T, Matsuzaki T, Fukuda S, Yoshioka C, Shimazaki Y, Takese S, Yamanaka K, Nakae T, Ishibashi M, Hamamoto H, Ando H, Ishima Y, Ishida T. Ionic Liquid-Based Transcutaneous Peptide Antitumor Vaccine: Therapeutic Effect in a Mouse Tumor Model. AAPS J 2023; 25:27. [PMID: 36805860 DOI: 10.1208/s12248-023-00790-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
Traditional vaccinations need to be injected with needles, and since some people have a strong aversion to needles, a needle-free alternative delivery system is important. In this study, we employed ionic liquids (ILs) for transcutaneous delivery of cancer antigen-derived peptides to obtain anticancer therapeutic effects in a needle-free manner. ILs successfully increased the in vitro skin permeability of a peptide from Wilms tumor 1 (WT1), one of the more promising cancer antigens, plus or minus an adjuvant, resiquimod (R848), a toll-like receptor 7 agonist. In vivo studies demonstrated that concomitant transcutaneous delivery of WT1 peptide and R848 by ILs induced WT1-specific cytotoxic T lymphocyte (CTL) in mice, resulting in tumor growth inhibition in Lewis lung carcinoma-bearing mice. Interestingly, administrating R848 in ILs before WT1 peptides in ILs increased tumor growth inhibition effects compared to co-administration of both. We found that the prior application of R848 increased the infiltration of leukocytes in the skin and that subsequent delivery of WT1 peptides was more likely to induce WT1-specific CTL. Furthermore, sequential immunization with IL-based formulations was applicable to different types of peptides and cancer models without induction of skin irritation. IL-based transcutaneous delivery of cancer antigen-derived peptides and adjuvants, either alone or together, could be a novel approach to needle-free cancer therapeutic vaccines.
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Affiliation(s)
- Taro Shimizu
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan.
| | - Takaaki Matsuzaki
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan
| | - Shoichiro Fukuda
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan
| | - Chihiro Yoshioka
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan
| | - Yuna Shimazaki
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan
| | - Shunsuke Takese
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan
| | - Katsuhiro Yamanaka
- MEDRx Co., Ltd, 431-7 Nishiyama, Higashikagawa City, Kagawa, 769-2712, Japan
| | - Takashi Nakae
- MEDRx Co., Ltd, 431-7 Nishiyama, Higashikagawa City, Kagawa, 769-2712, Japan
| | - Masaki Ishibashi
- MEDRx Co., Ltd, 431-7 Nishiyama, Higashikagawa City, Kagawa, 769-2712, Japan
| | - Hidetoshi Hamamoto
- MEDRx Co., Ltd, 431-7 Nishiyama, Higashikagawa City, Kagawa, 769-2712, Japan
| | - Hidenori Ando
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan
| | - Yu Ishima
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan
| | - Tatsuhiro Ishida
- Department of Pharmacokinetics and Biopharmaceutics, Institute of Biomedical Sciences, Tokushima University, 1-78-1, Sho-Machi, Tokushima, 770-8505, Japan.
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