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Murciano-Gamborino C, Diez-Domingo J, Fons-Martinez J. Healthcare Professionals' Perspectives on HPV Recommendations: Themes of Interest to Different Population Groups and Strategies for Approaching Them. Vaccines (Basel) 2024; 12:748. [PMID: 39066386 PMCID: PMC11281591 DOI: 10.3390/vaccines12070748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
As a flagship of the Europe's Beating Cancer Plan, the European Commission supports EU member states' efforts to strengthen and expand the routine vaccination of girls and boys against human papillomavirus (HPV). Populations across Europe have grown in diversity, and health systems must adapt to meet the specific needs of increasing diversity. Healthcare professionals (HCPs) must strive to communicate HPV vaccine information in a culturally sensitive manner and address specific concerns related to cultural beliefs, trust in health systems and perceived risks. The objectives of this exploratory study are to identify which themes are most frequently raised during the recommendation of vaccination to minors based on the characteristics of the population (religion, region of origin, gender, level of education and language proficiency) and to collect strategies to improve communication with a diverse population. A survey was distributed through various European public health institutions to HCPs in the region and their networks. The survey included multi-response questions (themes addressed during vaccination recommendation based on population characteristics) and open-ended questions (own qualitative comments and strategies). The most common issues that arise during vaccine recommendation are a lack of knowledge, followed by misinformation. Differences were detected according to the population characteristics. Suggested strategies to improve HPV vaccine recommendation focused on the following aspects: affordability; sexuality and gender; communication platforms; multilingualism; quality of care; school collaboration. HCPs report differences according to the characteristics of the population receiving the recommendation. Personalisation of the recommendations would help to optimise the decision-making process for some groups.
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Affiliation(s)
- Carlos Murciano-Gamborino
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain;
| | - Javier Diez-Domingo
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain;
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jaime Fons-Martinez
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 46020 Valencia, Spain;
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain
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Malchrzak W, Babicki M, Pokorna-Kałwak D, Mastalerz-Migas A. The Influence of Introducing Free Vaccination against Streptococcus pneumoniae on the Uptake of Recommended Vaccination in Poland. Vaccines (Basel) 2023; 11:1838. [PMID: 38140242 PMCID: PMC10747999 DOI: 10.3390/vaccines11121838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Since 2017, pneumococcal vaccination has evolved from a recommended chargeable vaccination to a mandatory, and therefore free, vaccination for all children. While a 10-valent vaccine is commonly used, parents have the option to use a 13-valent vaccine for a fee. This study aimed to investigate whether and how the introduction of free pneumococcal vaccination affected the uptake of recommended vaccination and to assess the association of chargeable pneumococcal vaccination with recommended vaccination. Data from 1595 vaccination record cards kept by six primary care clinics in urban and rural areas of Poland were collected and analyzed for children born between 2015 and 2018. Belonging to the clinic and the year of birth were the only inclusion criteria. Following the introduction of free universal pneumococcal vaccination, more children were vaccinated with the recommended vaccination (61.2% vs. 66.6%, p = 0.026). The most significant change was in vaccination against rotavirus (48.5% vs. 54.4%, p = 0.018) and against meningococcal B bacteria (4.8% vs. 17.0%, p < 0.001). Children who received chargeable pneumococcal vaccination were also significantly more likely to be vaccinated with recommended vaccines (54.6% vs. 75.9%, p < 0.001). In particular, this was the case for multivalent vaccinations-against rotavirus, chickenpox, and meningococcal C bacteria. Reducing the impact of the economic factor, for example, by introducing free vaccinations, should have a positive impact on the uptake of other recommended vaccinations.
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Affiliation(s)
- Wojciech Malchrzak
- Department of Family Medicine, Faculty of Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.B.); (D.P.-K.); (A.M.-M.)
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3
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Martinón-Torres F, de Miguel ÁG, Ruiz-Contreras J, Vallejo-Aparicio LA, García A, Gonzalez-Inchausti MC, de Gomensoro E, Kocaata Z, Gabás-Rivera C, Comellas M, Prades M, Lizán L. Societal Preferences for Meningococcal B Vaccination in Children: A Discrete Choice Experiment in Spain. Infect Dis Ther 2023; 12:157-175. [PMID: 36367677 PMCID: PMC9868201 DOI: 10.1007/s40121-022-00708-7] [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: 08/03/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Immunization is the most effective strategy for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroup B (MenB); however, parents need to weigh the risk-benefit and financial impact of immunizing their children against MenB in the absence of a national immunization program (NIP). This study aimed to explore societal preferences (of parents and pediatricians) regarding the attributes of a MenB vaccine in Spain. METHODS A discrete choice experiment (DCE) based on cross-sectional surveys was carried out to determine preferences. A literature review and scientific committee determined the six attributes related to the MenB vaccine included in the DCE: vaccination age, cost, duration, percentage of protection, adverse events probability, and expert/authority recommendation. Data were analyzed using a mixed logit model. Relative importance (RI) of attributes was calculated and compared between parents and pediatricians. RESULTS A total of 278 parents [55.8% female, mean age 40.4 (standard deviation, SD 7.3) years] and 200 pediatricians [73.0% female, mean age 45.8 (SD 12.9) years] answered the DCE. For parents, the highest RI was attributed to vaccine cost, expert/authority recommendation, and percentage of protection (26.4%, 26.1%, and 22.9%, respectively), while for pediatricians the highest RI was assigned to percentage of protection, expert/authority recommendation, and vaccination age (27.2%, 23.7%, and 22.6%, respectively). Significant differences between parents and pediatricians were found in the RI assigned to all attributes (p < 0.001), except for vaccine recommendation. CONCLUSION In the decision regarding MenB vaccination, cost was a driver in parental decision-making but had a low RI for pediatricians and, conversely, vaccination age was highly valued by pediatricians but was the attribute with least importance for parents. Despite these differences, expert/authority recommendation and percentage of protection were essential criteria for both groups. These results provide relevant information about MenB vaccination, highlighting the importance of considering societal preferences for NIP inclusion.
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Affiliation(s)
- Federico Martinón-Torres
- grid.411048.80000 0000 8816 6945Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain ,grid.11794.3a0000000109410645Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Ángel Gil de Miguel
- grid.28479.300000 0001 2206 5938Department of Preventive Medicine and Public Health, Universidad Rey Juan Carlos, Madrid, Spain
| | - Jesús Ruiz-Contreras
- grid.144756.50000 0001 1945 5329Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Department of Pediatrics, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | | | | | - Zeki Kocaata
- grid.425090.a0000 0004 0468 9597GSK, Wavre, Belgium
| | | | | | | | - Luis Lizán
- Outcomes’10, Castellón, Spain ,Department of Medicine, Universidad Jaime I, Castellón, Spain
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Zhu S, Chang J, Hayat K, Li P, Ji W, Fang Y. Parental preferences for HPV vaccination in junior middle school girls in China: A discrete choice experiment. Vaccine 2020; 38:8310-8317. [DOI: 10.1016/j.vaccine.2020.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 08/27/2020] [Accepted: 11/06/2020] [Indexed: 12/11/2022]
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Hills SL, Fischer M, Biggerstaff BJ. Perceptions among the U.S. population of value of Japanese encephalitis (JE) vaccination for travel to JE-endemic countries. Vaccine 2020; 38:2117-2121. [DOI: 10.1016/j.vaccine.2020.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/08/2020] [Accepted: 01/16/2020] [Indexed: 11/25/2022]
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Marshall HS, Clarke M, Heath C, Quinn H, Richmond PC, Crawford N, Elliott E, Toi C, Kynaston A, Booy R, Macartney K. Severe and Complicated Varicella and Associated Genotypes 10 Years After Introduction of a One-Dose Varicella Vaccine Program. J Infect Dis 2019; 219:391-399. [PMID: 30184182 DOI: 10.1093/infdis/jiy518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/26/2018] [Indexed: 11/14/2022] Open
Abstract
Background This national, sentinel prospective study aimed to identify children with severe hospitalized varicella, despite availability of universal 1-dose vaccination since 2005, and determine associations between virus genotypes and disease severity. Methods Children with varicella or zoster from 5 Paediatric Active Enhanced Disease Surveillance hospitals were enrolled. Lesions were swabbed for genotyping. Associations with disease severity were analyzed using multiple regression. Results From 2007 to 2015, 327 children with confirmed varicella (n = 238) or zoster (n = 89) were enrolled. Two hundred three (62%) were immunocompetent children; including 5 of 8 children who required intensive care unit management. Eighteen percent (36 of 203) of immunocompetent children had been previously vaccinated. Vaccinated children aged >18 months were less likely to have severe disease (9%; 5 of 56) than unvaccinated children (21%; 21 of 100; P = .05). Three of 126 children who had virus genotyping (2 immunocompromised) had varicella (n = 2) or zoster (n = 2) due to the Oka/vaccine strain. European origin clades predominated and were independently associated with more severe disease (odds ratio = 3.2; 95% confidence interval, 1.1- 9.5; P = .04). Conclusions Severe hospitalized varicella still occurs with a 1-dose varicella program, although predominantly in unvaccinated children. Most 1-dose vaccine recipients were protected against severe disease. Viral genotyping in complex hospitalized cases is important to assist in monitoring disease due to Oka-vaccine strain.
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Affiliation(s)
- Helen S Marshall
- Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Australia
| | - Michelle Clarke
- Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Australia
| | | | - Helen Quinn
- National Centre for Immunization Research and Surveillance, Westmead, Sydney, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Peter C Richmond
- Wesfarmer's Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia.,Division of Paediatrics, University of Western Australia, Perth, Australia.,Princess Margaret Hospital, Perth, Australia
| | - Nigel Crawford
- Murdoch Children's Research Institute, Parkville, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Elizabeth Elliott
- Discipline of Paediatrics and Child Health, University of Sydney, Australia.,Children's Hospital Westmead, Sydney, Australia.,Australian Paediatric Surveillance Unit, Westmead, Australia
| | - Cheryl Toi
- Department of Medical Entomology, Centre for Infectious Disease Microbiological Laboratory Services, Pathology West-ICPMR, Westmead Hospital, Sydney, Australia
| | - Anne Kynaston
- Lady Cilento Children's Hospital, Brisbane, Australia
| | - Robert Booy
- National Centre for Immunization Research and Surveillance, Westmead, Sydney, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia.,Children's Hospital at Westmead, Sydney, Australia
| | - Kristine Macartney
- National Centre for Immunization Research and Surveillance, Westmead, Sydney, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia.,Children's Hospital at Westmead, Sydney, Australia
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Morikawa Y, Morino S, Ito K, Furuichi M, Miyokawa S, Shoji T, Horikoshi Y. Trends in varicella and mumps vaccination rates in children under 3 years of age in a tertiary children's hospital in Japan. Pediatr Int 2019; 61:882-888. [PMID: 31211889 DOI: 10.1111/ped.13916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 05/31/2019] [Accepted: 06/14/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Japan, the voluntary vaccination rate is not known accurately. Although two doses of the measles and rubella vaccines have been part of the universal vaccine program since 2006, the varicella vaccine was added in October 2014 while the mumps vaccine still remains voluntary. The aim of this study was to evaluate trends in the live measles, rubella, varicella and mumps vaccination rates in Japan. METHODS This retrospective cohort study was conducted at Tokyo Metropolitan Children's Medical Center between October 2012 and December 2016. Patients aged 1-2 years who were admitted to the Department of General Pediatrics were enrolled. The trend in the vaccination rate against measles, rubella, varicella, and mumps was examined. RESULTS The measles and rubella vaccination rate was 80-90%. The varicella vaccination rate in the second quarter of 2012, the third quarter of 2014, and the fourth quarter of 2016 was 34.6%, 67.1%, and 80.7%, respectively. The mumps vaccination rate in the second quarter of 2012, the third quarter of 2014, and the fourth quarter of 2016 was 27.6%, 59.5%, and 61.8%, respectively. CONCLUSIONS The varicella and mumps vaccination rate improved until 2014 despite the fact that they were voluntary vaccinations. After varicella vaccination was added to the universal vaccination program, the varicella vaccination rate continued to improve. The mumps vaccination, which was not included, failed to improve, suggesting that the universal vaccination program contributed to increasing the uptake of the vaccines it includes.
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Affiliation(s)
- Yoshihiko Morikawa
- Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Saeko Morino
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.,Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenta Ito
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.,Department of General Pediatrics, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Mihoko Furuichi
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.,Division of Infectious Diseases and Immunology, Saitama Children's Medical Center, Saitama, Japan
| | - Shigeko Miyokawa
- Nursing Division, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Takayo Shoji
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.,Department of Pediatric Infectious Diseases, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Yuho Horikoshi
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
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Wang B, Chen G, Ratcliffe J, Afzali HHA, Giles L, Marshall H. Adolescent values for immunisation programs in Australia: A discrete choice experiment. PLoS One 2017; 12:e0181073. [PMID: 28746348 PMCID: PMC5528895 DOI: 10.1371/journal.pone.0181073] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 06/26/2017] [Indexed: 01/19/2023] Open
Abstract
Objectives The importance of adolescent engagement in health decisions and public health programs such as immunisation is becoming increasingly recognised. Understanding adolescent preferences and further identifying barriers and facilitators for immunisation acceptance is critical to the success of adolescent immunisation programs. This study applied a discrete choice experiment (DCE) to assess vaccination preferences in adolescents. Methods This study was conducted as a cross-sectional, national online survey in Australian adolescents. The DCE survey evaluated adolescent vaccination preferences. Six attributes were assessed including disease severity, target for protection, price, location of vaccination provision, potential side effects and vaccine delivery method. A mixed logit model was used to analyse DCE data. Results This survey was conducted between December 2014 and January 2015. Of 800 adolescents aged 15 to 19 years, stronger preferences were observed overall for: vaccination in the case of a life threatening illness (p<0.001), lower price vaccinations (p<0.001), mild but common side effects (p = 0.004), delivery via a skin patch (p<0.001) and being administered by a family practitioner (p<0.001). Participants suggested that they and their families would be willing to pay AU$394.28 (95%CI: AU$348.40 to AU$446.92) more for a vaccine targeting a life threatening illness than a mild-moderate illness, AU$37.94 (95%CI: AU$19.22 to AU$57.39) more for being vaccinated at a family practitioner clinic than a council immunisation clinic, AU$23.01 (95%CI: AU$7.12 to AU$39.24) more for common but mild and resolving side effects compared to rare but serious side effects, and AU$51.80 (95%CI: AU$30.42 to AU$73.70) more for delivery via a skin patch than injection. Conclusions Consideration of adolescent preferences may result in improved acceptance of, engagement in and uptake of immunisation programs targeted for this age group.
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Affiliation(s)
- Bing Wang
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
- Vaccinology and Immunology Research Trials Unit (VIRTU), Women's and Children's Hospital, North Adelaide, South Australia, Australia
- * E-mail:
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Clayton, Victoria, Australia
| | - Julie Ratcliffe
- Institute for Choice, UniSA Business School, University of South Australia, Adelaide, South Australia, Australia
| | | | - Lynne Giles
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Helen Marshall
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
- Vaccinology and Immunology Research Trials Unit (VIRTU), Women's and Children's Hospital, North Adelaide, South Australia, Australia
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van Lier A, Tostmann A, Harmsen IA, de Melker HE, Hautvast JLA, Ruijs WLM. Negative attitude and low intention to vaccinate universally against varicella among public health professionals and parents in the Netherlands: two internet surveys. BMC Infect Dis 2016; 16:127. [PMID: 26979822 PMCID: PMC4793755 DOI: 10.1186/s12879-016-1442-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 02/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prior to introduction of universal varicella vaccination, it is crucial to gain insight into the willingness to vaccinate among the population. This is because suboptimal national vaccination coverage might increase the age of infection in children, which will lead to higher complication rates. We studied the attitude and intention to vaccinate against varicella among Dutch public health professionals who execute the National Immunisation Programme (NIP), and parents. METHODS Medical doctors and nurses of regional public health services (RPHS) and child health clinics (CHC), and a random sample of parents received an internet survey on varicella vaccination. Separate logistic regression models were used to identify determinants for a positive attitude (professionals) or a positive intention (parents) to vaccinate against varicella within the NIP (free of charge). RESULTS The questionnaire was completed by 181 RPHS professionals (67%), 260 CHC professionals (46%), and 491 parents (33%). Of professionals, 21% had a positive attitude towards universal varicella vaccination, while 72% preferred to limit vaccination to high-risk groups only. Of parents, 28% had a positive intention to vaccinate their child against varicella within the NIP. The strongest determinant for a positive attitude or intention to vaccinate against varicella among professionals and parents was the belief that varicella is a disease serious enough to vaccinate against. CONCLUSIONS We showed that a majority of the Dutch public health professionals and parents in this study have a negative attitude or low intention to vaccinate universally against varicella, as a result of the perceived low severity of the disease. Most participating professionals support selective vaccination to prevent varicella among high-risk groups.
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Affiliation(s)
- Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.
| | - Alma Tostmann
- Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Irene A Harmsen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.,Department of Work & Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands
| | - Jeannine L A Hautvast
- Regional Public Health Service 'GGD Gelderland-Zuid', P.O. Box 1120, 6501 BC, Nijmegen, The Netherlands.,Academic Collaborative Centre AMPHI, Department of Primary and Community Care, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Wilhelmina L M Ruijs
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1 (internal P.O. Box 75), 3720 BA, Bilthoven, The Netherlands.,Regional Public Health Service 'GGD Gelderland-Zuid', P.O. Box 1120, 6501 BC, Nijmegen, The Netherlands
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Marshall H, Chen G, Clarke M, Ratcliffe J. Adolescent, parent and societal preferences and willingness to pay for meningococcal B vaccine: A Discrete Choice Experiment. Vaccine 2016; 34:671-677. [DOI: 10.1016/j.vaccine.2015.11.075] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/26/2015] [Accepted: 11/30/2015] [Indexed: 12/15/2022]
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Hoffmann K, van Bijnen EM, George A, Kutalek R, Jirovsky E, Wojczewski S, Maier M. Associations between the prevalence of influenza vaccination and patient's knowledge about antibiotics: a cross-sectional study in the framework of the APRES-project in Austria. BMC Public Health 2015; 15:981. [PMID: 26416304 PMCID: PMC4587920 DOI: 10.1186/s12889-015-2297-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/16/2015] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to identify associations between GP patient’s knowledge about the spectrum of effectiveness of antibiotics and the probability of vaccination against influenza. The underlying hypothesis was that individuals with an understanding that antibiotics are ineffective against viruses, common colds, and flu were more likely to be vaccinated than persons lacking this knowledge. Methods This cross-sectional study was conducted within the context of the European APRES project in Austria. Between November 2010 and July 2011, patients were recruited from GP practices to complete questionnaires about their knowledge about antibiotics and their influenza vaccination status. Statistical analyses included subgroup analyses and logistic regression models. Results Data of 3224 patients was analyzed, demonstrating that patients with better knowledge concerning antibiotics had a significantly higher likelihood of being vaccinated (OR 1.35, CI 95 % 1.18–1.54). While the overall vaccination rate was low (18.6 % in 2009/2010 and 14.0 % in 2010/2011), elderly compared to younger adults (OR 0.06 CI 95 % 0.03–0.13) and healthcare workers (OR 2.24, CI 95 % 1.42–3.54) demonstrated higher likelihood of vaccination. Additionally, female GPs had significantly more vaccinated patients than male GPs (OR 2.90, CI 95 % 1.32–6.40). Discussion There has been little prior study on the association between a patient’s knowledge of the effectiveness spectrum of antibiotics and influenza vaccination status. Given the public health imperative to increase annual prevalence of influenza vaccination, understanding this educational gap can improve specificity in counseling as well as vaccination rates. Ultimately, we found that those with a better knowledge on about antibiotics had a significantly higher likelihood of being vaccinated. Conclusions The results of this study demonstrate that vaccination prevalence is associated with patient’s knowledge about antibiotics. It can be concluded that one strategy to improve the overall low vaccination rates for seasonal influenza in Austria would be, particularly for male GPs, to have a specific discussion with patients about these circumstances by focusing on younger patients. Further, public health efforts could supplement in-office strategies to improve this area of health literacy. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2297-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kathryn Hoffmann
- Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, 1090, Vienna, Austria.
| | - Evelien Me van Bijnen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
| | - Aaron George
- Department of Community and Family Medicine, Duke Medical Center, Durham, NC, USA.
| | - Ruth Kutalek
- Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, 1090, Vienna, Austria.
| | - Elena Jirovsky
- Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, 1090, Vienna, Austria.
| | - Silvia Wojczewski
- Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, 1090, Vienna, Austria.
| | - Manfred Maier
- Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, 1090, Vienna, Austria.
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Macartney K, Heywood A, McIntyre P. Vaccines for post-exposure prophylaxis against varicella (chickenpox) in children and adults. Cochrane Database Syst Rev 2014; 2014:CD001833. [PMID: 24954057 PMCID: PMC7061782 DOI: 10.1002/14651858.cd001833.pub3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The prevention of varicella (chickenpox) using live attenuated varicella vaccines has been demonstrated both in randomised controlled trials (RCTs) and in population-based immunisation programmes in countries such as the United States and Australia. Many countries do not routinely immunise children against varicella and exposures continue to occur. Although the disease is often mild, complications such as secondary bacterial infection, pneumonitis and encephalitis occur in about 1% of cases, usually leading to hospitalisation. The use of varicella vaccine in persons who have recently been exposed to the varicella zoster virus has been studied as a form of post-exposure prophylaxis (PEP). OBJECTIVES To assess the efficacy and safety of vaccines for use as PEP for the prevention of varicella in children and adults. SEARCH METHODS We searched CENTRAL (2014, Issue 1), MEDLINE (1966 to March week 1, 2014), EMBASE (January 1990 to March 2014) and LILACS (1982 to March 2014). We searched for unpublished trials registered on the clinicaltrials.gov and WHO ICTRP websites. SELECTION CRITERIA RCTs and quasi-RCTs of varicella vaccine for PEP compared with placebo or no intervention. The outcome measures were efficacy in prevention of clinical cases and/or laboratory-confirmed clinical cases and adverse events following vaccination. DATA COLLECTION AND ANALYSIS Two review authors independently extracted and analysed data using Review Manager software. MAIN RESULTS We identified three trials involving 110 healthy children who were siblings of household contacts. The included trials varied in study quality, vaccine used, length of follow-up and outcomes measured and, as such, were not suitable for meta-analysis. We identified high or unclear risk of bias in two of the three included studies. Overall, 13 out of 56 vaccine recipients (23%) developed varicella compared with 42 out of 54 placebo (or no vaccine) recipients (78%). Of the vaccine recipients who developed varicella, the majority only had mild disease (with fewer than 50 skin lesions). In the three trials, most participants received PEP within three days following exposure; too few participants were vaccinated four to five days post-exposure to ascertain the efficacy of vaccine given more than three days after exposure. No included trial reported on adverse events following immunisation. AUTHORS' CONCLUSIONS These small trials suggest varicella vaccine administered within three days to children following household contact with a varicella case reduces infection rates and severity of cases. We identified no RCTs for adolescents or adults. Safety was not adequately addressed.
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Affiliation(s)
- Kristine Macartney
- Children's Hospital at Westmead and University of SydneyNational Centre for Immunisation Research and Surveillance of Vaccine Preventable DiseasesLocked Bag 4001WestmeadSydneyNSWAustralia2145
| | - Anita Heywood
- University of New South WalesSchool of Public Health and Community MedicineLevel 2, Samuels BuildingGate 11, Botany StreetKensingtonNSWAustralia2052
| | - Peter McIntyre
- Children's Hospital at Westmead and University of SydneyNational Centre for Immunisation Research and Surveillance of Vaccine Preventable DiseasesLocked Bag 4001WestmeadSydneyNSWAustralia2145
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The missing link: family physician perspectives on barriers and enablers to prescribing a new Meningococcal B vaccine and other recommended, non-government funded vaccines. Vaccine 2014; 32:4214-9. [PMID: 24923639 DOI: 10.1016/j.vaccine.2014.04.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/10/2014] [Accepted: 04/17/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To determine factors influencing Family Physician (FP) uptake of non government-funded vaccines, and to explore FP attitudes towards the introduction and use of a new vaccine to protect against serogroup B meningococcal disease to inform its future introduction into the Australian Immunisation Schedule. DESIGN SETTING AND PARTICIPANTS Quantitative, self-administered state-wide questionnaire mailed to all FPs in South Australia (n=1786). Results from 523 FP respondents in South Australia, collected between June and October 2013. MAIN OUTCOME MEASURES Self-reported immunisation counselling practices; and knowledge, attitudes and barriers to prescribing of Meningococcal B (Men B) vaccine and other recommended, non-funded immunisations. RESULTS The response rate was 30% (n=523). While most (59%) respondents had worked in general practice for over 20 years, only 39% of all respondents had ever had personal or professional experience with a case of invasive meningococcal disease (IMD). Most FPs (63%) were aware that a meningococcal B vaccine was being developed, and 93% of respondents agreed that this vaccine should be government-funded. FPs ranked Men B vaccine as the highest priority to receive funding of eight currently non-funded immunisation strategies. High vaccine cost and low patient socioeconomic status were identified as definite barriers to prescribing non-funded vaccines by 59% of respondents. Past IMD experience significantly affected attitudes and prescribing practices. CONCLUSIONS IMD, while encountered rarely in clinical practice, is considered an important disease to vaccinate against by FPs. Cost and perceived low socioeconomic status of patients are substantial barriers to FPs prescribing Men B and other non-funded vaccines, and inclusion of such vaccines on the National Immunisation Program is likely to improve equity of access.
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Scheifele DW, Ward BJ, Halperin SA, McNeil SA, Crowcroft NS, Bjornson G. Approved but non-funded vaccines: accessing individual protection. Vaccine 2013; 32:766-70. [PMID: 24374500 DOI: 10.1016/j.vaccine.2013.12.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 12/04/2013] [Accepted: 12/10/2013] [Indexed: 10/25/2022]
Abstract
Funded immunization programs are best able to achieve high participation rates, optimal protection of the target population, and indirect protection of others. However, in many countries public funding of approved vaccines can be substantially delayed, limited to a portion of the at-risk population or denied altogether. In these situations, unfunded vaccines are often inaccessible to individuals at risk, allowing potentially avoidable morbidity and mortality to continue to occur. We contend that private access to approved but unfunded vaccines should be reconsidered and encouraged, with recognition that individuals have a prerogative to take advantage of a vaccine of potential benefit to them whether it is publicly funded or not. Moreover, numbers of "approved but unfunded" vaccines are likely to grow because governments will not be able to fund all future vaccines of potential benefit to some citizens. New strategies are needed to better use unfunded vaccines even though the net benefits will fall short of those of funded programs. Canada, after recent delays funding several new vaccine programs, has developed means to encourage private vaccine use. Physicians are required to inform relevant patients about risks and benefits of all recommended vaccines, publicly funded or not. Likewise, some provincial public health departments now recommend and promote both funded and unfunded vaccines. Pharmacists are key players in making unfunded vaccines locally available. Professional organizations are contributing to public and provider education about unfunded vaccines (e.g. herpes zoster, not funded in any province). Vaccine companies are gaining expertise with direct-to-consumer advertising. However, major challenges remain, such as making unfunded vaccines more available to low-income families and overcoming public expectations that all vaccines will be provided cost-free, when many other recommended personal preventive measures are user-pay. The greatest need is to change the widespread perception that approved vaccines should be publicly funded or ignored.
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Affiliation(s)
- David W Scheifele
- Vaccine Evaluation Center, University of British Columbia, Vancouver, BC, Canada.
| | - Brian J Ward
- The Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shelly A McNeil
- Canadian Center for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Natasha S Crowcroft
- Dalla Lana School of Public Health, University of Toronto, Public Health Ontario, Toronto, Ontario, Canada
| | - Gordean Bjornson
- Vaccine Evaluation Center, University of British Columbia, Vancouver, BC, Canada
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Changes in patterns of hospitalized children with varicella and of associated varicella genotypes after introduction of varicella vaccine in Australia. Pediatr Infect Dis J 2013; 32:530-7. [PMID: 23249914 DOI: 10.1097/inf.0b013e31827e92b7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Varicella in children, although usually mild, can cause hospitalization and rarely death. This study examined patterns of hospitalized children with varicella, and associated varicella genotypes, in 4 tertiary children's hospitals throughout Australia before and after varicella vaccine was introduced. METHODS We obtained coded data on discharge diagnoses from each hospital before (1999 to 2001) and after (2007 to 2010) varicella vaccine introduction in 2005, adding active surveillance to capture clinical features, complications and immunization history in the latter period. Varicella vesicles were swabbed, and genotyping of varicella strains was performed by real-time polymerase chain reaction amplification. RESULTS Overall, a 68% reduction in coded hospitalizations (varicella, 73.2% [P < 0.001]; zoster, 40% [P = 0.002]) occurred post-vaccine introduction. Of children with detailed clinical data (97 varicella and 18 zoster cases), 46 (40%) were immunocompromised. Only 6 of 32 (19%) age-eligible immunocompetent children were immunized. Complications, most commonly secondary skin infections (n = 25) and neurologic conditions (n = 14), occurred in 44% of children. There were no deaths; but 3 immunocompetent unimmunized children had severe multiple complications requiring intensive care. All strains genotyped were "wild-type" varicella, with Clade 1 (European origin) predominating. CONCLUSIONS After the introduction of varicella vaccine, coverage of greater than 80% at 2 years of age was achieved, with varicella hospitalizations reduced by almost 70%. Of hospitalized children age-eligible for varicella vaccine, 80% were unimmunized, including all cases requiring intensive care.
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Herpes zoster in Australia: evidence of increase in incidence in adults attributable to varicella immunization? Epidemiol Infect 2010; 139:658-65. [PMID: 20727248 DOI: 10.1017/s0950268810001949] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Rates of herpes zoster (HZ) hospitalizations, antiviral prescriptions, and New South Wales emergency-department presentations for age groups <20, 20-39, 40-59 and ⩾60 years were investigated. Trends were analysed using Poisson regression to determine if rates increased following funding of varicella immunization in Australia in November 2005. The regression analysis revealed significantly increasing trends of between 2% and 6% per year in both antiviral prescriptions and emergency-department presentations in all except the <20 years age group. When considered together, the differential changes in rates observed by age group provides preliminary evidence to indicate that HZ incidence is increasing in adults aged >20 years. However, it is not possible to attribute the increasing trends in HZ observed directly to the varicella immunization programme, and continued monitoring and analyses of data for a longer duration, both pre- and post-vaccine introduction, is required.
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Varicella vaccination coverage in Bavaria (Germany) after general vaccine recommendation in 2004. Vaccine 2010; 28:5738-45. [PMID: 20600490 DOI: 10.1016/j.vaccine.2010.06.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 05/27/2010] [Accepted: 06/01/2010] [Indexed: 02/02/2023]
Abstract
Since 2004, general varicella vaccination has been recommended for all children 11-14 months of age in Germany. The objective of this study was to examine vaccination coverage in children and factors associated with parental acceptance during the first years after recommendation. In a regional surveillance area, cross-sectional parent surveys were conducted in 2006, 2007 and 2008 in random samples (n=600) of children aged 18-36 months; data were obtained for 372, 364 and 352 children, respectively. Parents were questioned on their child's varicella disease history, and on varicella vaccination status as recorded in the child's vaccination booklet. Overall coverage increased from 38% in 2006 to 51% in 2007 and stagnated at 53% in 2008; in susceptible children (without previous varicella disease until vaccination or time of survey) coverage was 42%, 61% and 59%, respectively. Recommendation by the paediatrician as reported by the parents increased from 48% (2006) to 57% (2007) and 60% (2008), and was the main independent factor associated with parental acceptance. In 32-35% of unvaccinated children parents had not yet decided whether to vaccinate against varicella. Additional programmes targeting paediatricians' and parents' acceptance of varicella vaccination are needed to achieve the WHO-defined goal of at least 85% coverage.
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Carville KS, Riddell MA, Kelly HA. A decline in varicella but an uncertain impact on zoster following varicella vaccination in Victoria, Australia. Vaccine 2010; 28:2532-8. [PMID: 20117265 DOI: 10.1016/j.vaccine.2010.01.036] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 01/07/2010] [Accepted: 01/16/2010] [Indexed: 10/19/2022]
Abstract
Varicella vaccine was licensed in Australia in 1999 and publicly funded in 2005. We examined trends in varicella and zoster hospitalisations and community consultations in Victoria during periods of no vaccine, private availability of vaccine and funded vaccination. Varicella hospitalisation rates declined 7% per year (95% CI 5-9%) from 2000 to 2007, predominately in children under five (12% per year, 95% CI 9-16%). A similar decline was seen in community data. The zoster hospitalisation rate increased from 1998 to 2007 (5% per year, 95% CI 3-6%), before introduction of varicella vaccine. Among those aged 80 and over the hospitalisation rate increased 5% per year (95% CI 3-7%) from 1998 to 2007. Zoster increased in community data from 2001.
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Affiliation(s)
- Kylie S Carville
- Epidemiology Unit, Victorian Infectious Diseases Reference Laboratory, Australia.
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