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Bonanni P, Castagna S, Gabutti G, Giuffrida S, Marchetti F, Russo R, Prato R, Vitale F. Available evidence on the co-administration of the four-component meningococcal B vaccine (4CMenB) with three vaccines at the same visit among pediatric individuals. Hum Vaccin Immunother 2024; 20:2333106. [PMID: 38566502 PMCID: PMC10993916 DOI: 10.1080/21645515.2024.2333106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
Vaccine co-administration is a useful strategy for improving vaccine coverage and adherence. In Italy, an update to the national immunization program (NIP) in 2023 included recommendations for co-administration of pediatric vaccines, including the four-component vaccine for meningococcus B (4CMenB), pneumococcal conjugate vaccine (PCV), hexavalent vaccines, and oral rotavirus vaccines. Safety is a major concern when considering vaccine co-administration; therefore, a literature review of the available evidence on 4CMenB co-administration with PCV, hexavalent/pentavalent, and rotavirus vaccines was performed. Of 763 publications screened, two studies were reviewed that reported safety data on 4CMenB co-administration with PCV, hexavalent/pentavalent, and rotavirus vaccines in infants aged 0-24 months. Overall, these studies supported that there were no significant safety signals when co-administering 4CMenB with PCV, hexavalent/pentavalent, and rotavirus vaccines, compared with individual vaccination. This review provides key insights for healthcare professionals on the tolerability of co-administering 4CMenB with routine vaccines.
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Affiliation(s)
- Paolo Bonanni
- Dipartimento di Scienze della Salute, University of Florence, Florence, Italy
| | | | - Giovanni Gabutti
- Coordinatore Nazionale GdL Vaccini e Politiche Vaccinali della SItI (Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica), Cogorno, Italy
| | - Sandro Giuffrida
- Dipartimento della Prevenzione, Azienda Sanitaria Provinciale, Reggio Calabria, Italy
| | | | - Rocco Russo
- Unità Operativa Materno Infantile ASL Benevento, Benevento, Italy
| | - Rosa Prato
- Dipartimento di Scienze Mediche e Chirurgiche, University of Foggia, Foggia, Italy
| | - Francesco Vitale
- Dipartimento di Scienze per la Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistiche di Eccellenza “G. D’Alessandro”, University of Palermo, Palermo, Italy
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Ballalai I, Dawson R, Horn M, Smith V, Bekkat-Berkani R, Soumahoro L, Vicic N. Understanding barriers to vaccination against invasive meningococcal disease: a survey of the knowledge gap and potential solutions. Expert Rev Vaccines 2023; 22:457-467. [PMID: 37144283 DOI: 10.1080/14760584.2023.2211163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
INTRODUCTION Invasive meningococcal disease (IMD) is a leading cause of life-threatening bacterial meningitis and septicemia. Evidence points to a knowledge gap among parents, teenagers, and healthcare providers (HCPs) regarding IMD and available vaccines, including those against the highly prevalent serogroup B. AREAS COVERED An online survey was conducted between March 27 and April 12, 2019, to gather insights into the knowledge that parents/guardians have about IMD vaccines. The children were aged 2 months-10 years in Australia, Brazil, Germany, Greece, Italy, and Spain, 5-20 years in the UK, and 16-23 years in the US. The findings were discussed in the context of the available literature and solutions were proposed to minimize the knowledge gap and the barriers to vaccination against IMD. EXPERT OPINION The survey demonstrated that parents have a good understanding of IMD but a limited understanding of the different serogroups and vaccines. The available literature highlighted multiple barriers to IMD vaccine uptake; these may be reduced through education of HCPs, clear recommendations to parents by HCPs, the use of technology, and disease-awareness initiatives that engage parents through physical and digital channels. Further studies are warranted to assess the impact of the COVID-19 pandemic on IMD vaccination.
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Affiliation(s)
| | - Rob Dawson
- Meningitis Research Foundation, Bristol, UK
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Bauwens J, de Lusignan S, Sherlock J, Ferreira F, Künzli N, Bonhoeffer J. Co-administration of routine paediatric vaccines in England often deviates from the immunisation schedule. Vaccine X 2021; 9:100115. [PMID: 34622200 PMCID: PMC8481960 DOI: 10.1016/j.jvacx.2021.100115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 08/13/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
Vaccine co-administration can facilitate the introduction of new vaccines in immunisation schedules and improve coverage. We analysed real life data to quantify the extent of routine paediatric vaccine co-administrations as recommended and as never recommended in the immunisation schedule in England, and assessed factors for recommended and never recommended vaccine co-administrations. Immunisation data for all scheduled routine paediatric vaccines between 2008 and 2018 was obtained from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC). We included 6'257'828 doses administered to 1'005'827 children. Twenty-one percent of vaccines were given separately, 79% were co-administered. Sixty-four percent of vaccines scheduled for co-administration were co-administered as recommended while 15% were administered separately. Among all vaccine co-administrations, 75% happened as recommended in the schedule, 4% were never recommended, while 21% deviated from the schedule. Vaccine co-administration according to the schedule varied greatly between vaccines. Forty-eight percent of English children received at least one of their vaccine co-administrations not as recommended in the immunisation schedule, with 19% of children receiving none of their co-administered vaccines as recommended. Late administration of one or more vaccines increased the odds for deviated co-administrations (OR 1.60) and strongly increased the odds for never recommended co-administrations (OR 5.34). Differences between genders, NHS regions, and IMD quintiles were statistically significant but small. Suboptimal co-administration rates for routine paediatric vaccines are a missed opportunity and should be optimised by concerted public health action.
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Key Words
- COVER, Cover of Vaccination Evaluated Rapidly
- Children
- Co-administration. Immunisation Schedule
- DTaP/HepB/IPV/Hib, Diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B, inactivated poliovirus, and Haemophilus influenzae type b conjugate vaccine
- DTaP/IPV or dTaP/IPV, Diphtheria and tetanus toxoids and acellular pertussis adsorbed, and inactivated poliovirus vaccine
- DTaP/IPV/Hib, Diphtheria and tetanus toxoids and acellular pertussis adsorbed, inactivated poliovirus, and Haemophilus influenzae type b conjugate vaccine
- GP, General Practitioner
- HPV, Human papillomavirus vaccine
- Hib/MenC, Haemophilus influenzae type b conjugate, and bivalent meningococcal conjugate vaccine
- IMD, Index of Multiple Deprivation
- IQR, Interquartile Range
- MMR, Measles, mumps, and rubella vaccine
- MenACWY, Quadrivalent meningococcal conjugate vaccine
- MenB, Serogroup B meningococcal vaccine
- MenC, Serogroup C meningococcal vaccine
- Minors
- OR, Odds Ratio
- PCV, Pneumococcal conjugate vaccine
- PHE, Public Health England
- RCGP, Royal College of General Practitioners
- RSC, Research and Surveillance Centre
- RV, Rotavirus vaccine
- Td/IPV, Tetanus and diphtheria toxoids and inactivated poliovirus vaccine
- Vaccination
- Vaccines
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Affiliation(s)
- Jorgen Bauwens
- University of Basel, Switzerland
- University of Basel Children's Hospital, Switzerland
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
- Royal College of General Practitioners, United Kingdom
| | - Julian Sherlock
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Filipa Ferreira
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Nino Künzli
- University of Basel, Switzerland
- Swiss Tropical and Public Health Institute, Switzerland
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Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare Providers' Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9070713. [PMID: 34358132 PMCID: PMC8310254 DOI: 10.3390/vaccines9070713] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Despite vaccines' effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers' (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs' role as "trusted messengers" to promote vaccine acceptance.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Jewel Mullen
- Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Michaela Kotarba
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Samantha J. Kaplan
- Medical Center Library and Archives, Duke University, Durham, NC 27710, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
- Correspondence:
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Safety of Co-Administration Versus Separate Administration of the Same Vaccines in Children: A Systematic Literature Review. Vaccines (Basel) 2019; 8:vaccines8010012. [PMID: 31906218 PMCID: PMC7157665 DOI: 10.3390/vaccines8010012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 12/21/2019] [Accepted: 12/27/2019] [Indexed: 12/27/2022] Open
Abstract
The growing number of available vaccines that can be potentially co-administered makes the assessment of the safety of vaccine co-administration increasingly relevant but complex. We aimed to synthesize the available scientific evidence on the safety of vaccine co-administrations in children by performing a systematic literature review of studies assessing the safety of vaccine co-administrations in children between 1999 and 2019, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifty studies compared co-administered vaccines versus the same vaccines administered separately. The most frequently studied vaccines included quadrivalent meningococcal conjugate (MenACWY) vaccine, diphtheria and tetanus toxoids and acellular pertussis (DTaP) or tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccines, diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B, inactivated poliovirus and Haemophilus influenzae type b conjugate (DTaP-HepB-IPV/Hib) vaccine, measles, mumps, and rubella (MMR) vaccine, and pneumococcal conjugate 7-valent (PCV7) or 13-valent (PCV13) vaccines. Of this, 16% (n = 8) of the studies reported significantly more adverse events following immunization (AEFI) while in 10% (n = 5) significantly fewer adverse events were found in the co-administration groups. Statistically significant differences between co-administration and separate administration were found for 16 adverse events, for 11 different vaccine co-administrations. In general, studies briefly described safety and one-third of studies lacked any statistical assessment of AEFI. Overall, the evidence on the safety of vaccine co-administrations compared to separate vaccine administrations is inconclusive and there is a paucity of large post-licensure studies addressing this issue.
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