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Zens KD, Altpeter E, Wymann MN, Mack A, Baer NB, Haile SR, Steffen R, Fehr JS, Lang P. A combined cross-sectional analysis and case-control study evaluating tick-borne encephalitis vaccination coverage, disease and vaccine effectiveness in children and adolescents, Switzerland, 2005 to 2022. Euro Surveill 2024; 29:2300558. [PMID: 38699900 PMCID: PMC11067431 DOI: 10.2807/1560-7917.es.2024.29.18.2300558] [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: 10/14/2023] [Accepted: 02/08/2024] [Indexed: 05/05/2024] Open
Abstract
BackgroundTick-borne encephalitis (TBE) is a severe, vaccine-preventable viral infection of the central nervous system. Symptoms are generally milder in children and adolescents than in adults, though severe disease does occur. A better understanding of the disease burden and duration of vaccine-mediated protection is important for vaccination recommendations.AimTo estimate TBE vaccination coverage, disease severity and vaccine effectiveness (VE) among individuals aged 0-17 years in Switzerland.MethodsVaccination coverage between 2005 and 2022 was estimated using the Swiss National Vaccination Coverage Survey (SNVCS), a nationwide, repeated cross-sectional study assessing vaccine uptake. Incidence and severity of TBE between 2005 and 2022 were determined using data from the Swiss disease surveillance system and VE was calculated using a case-control analysis, matching TBE cases with SNVCS controls.ResultsOver the study period, vaccination coverage increased substantially, from 4.8% (95% confidence interval (CI): 4.1-5.5%) to 50.1% (95% CI: 48.3-52.0%). Reported clinical symptoms in TBE cases were similar irrespective of age. Neurological involvement was less likely in incompletely (1-2 doses) and completely (≥ 3 doses) vaccinated cases compared with unvaccinated ones. For incomplete vaccination, VE was 66.2% (95% CI: 42.3-80.2), whereas VE for complete vaccination was 90.8% (95% CI: 87.7-96.4). Vaccine effectiveness remained high, 83.9% (95% CI: 69.0-91.7) up to 10 years since last vaccination.ConclusionsEven children younger than 5 years can experience severe TBE. Incomplete and complete vaccination protect against neurological manifestations of the disease. Complete vaccination offers durable protection up to 10 years against TBE.
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Affiliation(s)
- Kyra D Zens
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, University of Zurich, Zurich, Switzerland
- Institute for Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Ekkehardt Altpeter
- Communicable Diseases Division, Swiss Federal Office of Public Health (FOPH), Bern, Switzerland
| | - Monica N Wymann
- Communicable Diseases Division, Swiss Federal Office of Public Health (FOPH), Bern, Switzerland
| | - Annora Mack
- Communicable Diseases Division, Swiss Federal Office of Public Health (FOPH), Bern, Switzerland
| | - Nora B Baer
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, University of Zurich, Zurich, Switzerland
| | - Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute, Department of Epidemiology, University of Zurich, Zurich, Switzerland
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, University of Zurich, Zurich, Switzerland
| | - Jan S Fehr
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, University of Zurich, Zurich, Switzerland
| | - Phung Lang
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, University of Zurich, Zurich, Switzerland
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Zürcher SJ, Signorell A, Léchot-Huser A, Aebi C, Huber CA. Childhood vaccination coverage and regional differences in Swiss birth cohorts 2012-2021: Are we on track? Vaccine 2023; 41:7226-7233. [PMID: 38593195 DOI: 10.1016/j.vaccine.2023.10.043] [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: 07/25/2023] [Revised: 10/13/2023] [Accepted: 10/15/2023] [Indexed: 04/11/2024]
Abstract
AIMS Many western countries are challenged by delayed and insufficient vaccination coverage rates in children, and thus missing WHO coverage targets. This study aimed to estimate vaccination coverage and timeliness in Swiss children over a decade. Furthermore, we evaluated the impact of COVID-19, regional variations, and the adherence to the amended vaccination schedule in 2019. METHODS Retrospective observational study with Swiss health insurance claims data including birth cohorts 2012-2021 of children continuously observed until ages 13, 25, and 48 months respectively. We used population-weighted proportions and time-to-event analyses to describe coverage and timeliness of diphtheria/tetanus/pertussis/poliomyelitis/haemophilus influenzae type b (DTaP-IPV-Hib), measles/mumps/rubella (MMR), hepatitis B (HBV), pneumococcal (PCV), and meningococcal (MCV) vaccinations according to the national schedule. The potential impact of COVID-19 and vaccination schedule adherence were evaluated descriptively. Logistic regression was used to investigate regional factors potentially associated with non-vaccination. RESULTS 120,073 children, representing between 12 and 17 % of all Swiss children born in corresponding years, were included. Coverage remained stable or improved over the years. The 2019 amendment of the national immunization schedule was associated with an increase of ~10 % points in full coverage in Swiss children for DTaP-IPV-Hib, MMR and HBV despite the concurrent COVID-19 pandemic. Nonetheless, full vaccination coverage remained below 90 % with many vaccination series being delayed or not completed. The comparison across the different vaccines revealed large differences in coverage. Moreover, we observed large regional differences in non-vaccination with children living in rural and German-speaking areas more likely to be entirely unvaccinated. CONCLUSION Full vaccination coverage in Swiss children is still below 90 % with many vaccinations administered delayed. Given regional differences, missed or delayed booster vaccinations, and differences in vaccine-specific acceptability, more effort may be needed to achieve national vaccination targets.
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Affiliation(s)
- Simeon J Zürcher
- Department of Health Sciences, Helsana Group, Zürich, Switzerland.
| | - Andri Signorell
- Department of Health Sciences, Helsana Group, Zürich, Switzerland
| | | | - Christoph Aebi
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Carola A Huber
- Department of Health Sciences, Helsana Group, Zürich, Switzerland; Institute of Primary Care, University of Zurich, University Hospital Zurich, Switzerland
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Ji WY, Liu DL, Yu R, Miao L, Yuan QL, Suo LD, Yu JP. Vaccination coverage survey of children aged 1-3 years in Beijing, China, 2005-2021. Vaccine 2023; 41:6444-6452. [PMID: 37709591 DOI: 10.1016/j.vaccine.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The routine immunization program for children is a primary strategy and a core part of vaccination. Achieving and maintaining high level of vaccination coverage are important to reduce morbidity and mortality caused by vaccine-preventable diseases. In Beijing, annual coverage surveys have been conducted since 2005. It is necessary and possible to assess the level and trend of routine vaccination coverage of children in Beijing as well as the disruption of coronavirus disease 2019 (COVID-19) pandemic and provide the reference for the further improve the vaccination coverage. METHODS The data of 61,521 children aged 1-3 years in the vaccination coverage surveys during 2005-2021 were analyzed by Beijing Center for Disease Control and Prevention. Descriptive epidemiological method was used to analyze the data and the difference of vaccination coverage within the time period. RESULTS More than 99 % of participants had immunization cards and electronic immunization records. The concordance rate of both records were also over 99 %. During 2011-2019, the rates of on-time and in-time vaccination of each routine vaccine reached 96 % or more and increased significantly (all P values <0.05), compared with that of 2005-2010. All rates of the investigated vaccine, except for Bacillus Calmette-Guérin vaccine (BCG) and the first dose of hepatitis B vaccine (HepB), decreased in 2020-2021 significantly (all P values <0.05). For the causes of failing to vaccinate on time, delayed vaccination accounted for 47.82 %. The top two vaccines to be missed were the first dose of hepatitis A vaccine and the 4th dose of diphtheria-tetanus-acellular pertussis vaccine, accounting for 21.41 % and 20.79 %, respectively. The main reason for zero-dose/drop-out vaccination was "Guardians regarded the immunization service time as inappropriate", accounting for 72.27 %. CONCLUSION The coverage level and service quality of routine immunization in Beijing were relatively high. However, as influenced by COVID-19 epidemics, both on-time and in-time vaccination rates decreased significantly, except for BCG and HepB. Under the background of COVID-19 pandemic, the keys to maintain high level of vaccination coverage include flexible immunization service time to ensure the guardians bringing their children for vaccination timely, and more attention from providers to the doses after children's first birthday.
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Affiliation(s)
- Wen-Yan Ji
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Dong-Lei Liu
- Department of Vaccines Management and Supply, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China
| | - Rui Yu
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Liang Miao
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Qian-Li Yuan
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Luo-Dan Suo
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Jian-Ping Yu
- Office of Beijing Center for Disease Control and Prevention, Beijing 10013, PR China.
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Veys-Takeuchi C, Gonseth Nusslé S, Estoppey S, Zuppinger C, Dupraz J, Pasquier J, Faivre V, Scuderi R, Vassaux S, Bochud M, D’Acremont V. Determinants of COVID-19 Vaccine Hesitancy During the Pandemic: A Cross-Sectional Survey in the Canton of Vaud, Switzerland. Int J Public Health 2022; 67:1604987. [PMID: 36250155 PMCID: PMC9556695 DOI: 10.3389/ijph.2022.1604987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: COVID-19 vaccine hesitancy is a major obstacle in the fight against the pandemic. This study aimed to identify the local determinants of vaccine hesitancy in the context of COVID-19 to better inform future immunization campaigns. Methods: The study, conducted in February 2021, included 1,189 randomly selected inhabitants of the canton of Vaud, Switzerland. Online questionnaires investigated determinants of the intention to vaccinate. Previously validated scores (Cronbach's alphas >0.70) were applied to our data for inclusion in the ordinal logistic regression model. Results: Individuals were more likely to vaccinate if they were 40 years or older, wealthy, reported a high educational attainment, or reported comorbidities. Doubts regarding vaccine safety and efficacy, mistrust in authorities and a propensity for natural immunity were identified as the main local hindrances to the COVID-19 vaccination. Conclusion: Outreach to people at risk of severe COVID-19 is particularly relevant in the pandemic context to help mitigate vaccine hesitancy in the canton of Vaud, and should take into consideration the level of education. Further investigation is needed to better understand reasons for mistrust in authorities.
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Affiliation(s)
- Caroline Veys-Takeuchi
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Semira Gonseth Nusslé
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Sandrine Estoppey
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Claire Zuppinger
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Julien Dupraz
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Jérôme Pasquier
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Vincent Faivre
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Renzo Scuderi
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Sophie Vassaux
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Murielle Bochud
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Valérie D’Acremont
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
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Parental and provider vaccine hesitancy and non-timely childhood vaccination in Switzerland. Vaccine 2022; 40:3193-3202. [PMID: 35487812 DOI: 10.1016/j.vaccine.2022.04.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/22/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Although medical providers are a trusted vaccination information source for parents, they do not universally support vaccination. Complementary medicine (CM) providers are particularly likely to hold vaccine hesitant (VH) views, and VH parents often consult with them. Little research compares VH of parents and providers, and if and how each is associated with uptake of recommended childhood vaccines. METHODS We defined non-timely receipt as recommended vaccines given > 1 month later than officially recommended, based on vaccination records. We administered versions of the Parent Attitudes about Childhood Vaccines (PACV) 5-item survey instrument to 1256 parents and their children's pediatricians (N = 112, 40 CM-oriented, 72 biomedical [not CM-oriented]) to identify moderately (PACV-score 5-6) and highly (PACV-score 7+) hesitant providers/parents. We obtained multivariable adjusted odds ratios to test relationships between parental VH and provider type/VH, and between non-timely receipt of selected childhood vaccines and parental VH and provider type/VH. RESULTS No biomedical providers were VH, 9 CM providers were moderately VH, and 17 were highly VH. Parents seeing moderately and highly hesitant providers had adjusted odds ratio (AOR) for being VH = 6.6 (95% confidence interval (CI), 3.1-14.0) and AOR = 31.3 (95% CI 16.8-58.3), respectively. Across all vaccine uptake endpoints, children of moderately and highly hesitant parents had 1.9-3.8 and 7.1-12.3 higher odds of non-timely vaccination, and children seeing highly hesitant CM providers had 4.9-9.4 higher odds. Children seeing moderately hesitant CM providers had 3.3 higher odds of non-timely vaccination for the 1st dose of measles and 3.5 higher odds for 1st dose of polio/pertussis/tetanus. CONCLUSION VH by both parents and providers each is associated with non-timely childhood vaccination. As VH parents are more likely to consult with VH providers, interventions aimed at increasing timely vaccination need to primarily target VH providers and their clients.
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Baroutsou V, Wymann M, Zens K, Sinniger P, Fehr J, Lang P. National and regional variations in timely adherence to recommended measles vaccination scheme in 2-years old in Switzerland, 2005–2019. Vaccine 2022; 40:3055-3063. [DOI: 10.1016/j.vaccine.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/29/2022] [Accepted: 04/03/2022] [Indexed: 11/25/2022]
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Schmidt AJ, Altpeter E, Graf S, Steffen R. Tick-borne encephalitis (TBE) in Switzerland: does the prolongation of vaccine booster intervals result in an increased risk of breakthroughs? J Travel Med 2022; 29:6377255. [PMID: 34581402 DOI: 10.1093/jtm/taab158] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND In 2006, the Swiss Federal Office of Public Health (FOPH) decided recommending a prolongation of vaccine booster intervals after the third dose for the prevention of tick-borne encephalitis (TBE) from 3 to 10 years. METHODS To ascertain whether this amendment resulted in an increased rate of vaccine breakthroughs, we conducted a retrospective analysis of surveillance data collected 2000-19 by mandatory reporting to the Swiss FOPH. Fractions of breakthroughs [with 95% confidence intervals (CIs)]-0-3 years vs >3-10 years after the third vaccination dose-were compared across time periods and age groups. RESULTS Among 3205 notified TBE cases, known vaccination status was reported in 2562 (79.9%), including 103 patients with ≥3 vaccine doses (4.0%). Among those, there were 39 patients who had received the last dose within 3 years and 48 patients in the >3-10 years group. During the 2010-19 period in which the new booster strategy was implemented there were 23 and 38 breakthroughs, respectively, and the annual breakthrough rate was 7.7 (95% CI 5.0-11.7) cases during the first 3 years after the last dose, and 5.4 (95% CI 3.9-7.5) cases in following 7 years. We observed no significant trend of TBE breakthroughs with increasing age. Increasing numbers of TBE and of vaccine breakthroughs over time have been associated with spreading endemicity and higher vaccination coverage in Switzerland. CONCLUSIONS There is no indication that extended booster intervals resulted in an increased rate of breakthroughs, but there was a marked public health benefit with respect to increased acceptability of TBE immunization in the general population.
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Affiliation(s)
- Axel J Schmidt
- Communicable Diseases Division, Swiss Federal Office of Public Health, 3003 Bern, Switzerland.,Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Ekkehardt Altpeter
- Communicable Diseases Division, Swiss Federal Office of Public Health, 3003 Bern, Switzerland
| | - Simone Graf
- Communicable Diseases Division, Swiss Federal Office of Public Health, 3003 Bern, Switzerland
| | - Robert Steffen
- Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Traveller's Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX, USA
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Stuckelberger S, Favre G, Ceulemans M, Nordeng H, Gerbier E, Lambelet V, Stojanov M, Winterfeld U, Baud D, Panchaud A, Pomar L. SARS-CoV-2 Vaccine Willingness among Pregnant and Breastfeeding Women during the First Pandemic Wave: A Cross-Sectional Study in Switzerland. Viruses 2021; 13:1199. [PMID: 34206645 PMCID: PMC8310322 DOI: 10.3390/v13071199] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 12/18/2022] Open
Abstract
As pregnant women are at high risk of severe SARS-CoV-2 infection and COVID-19 vaccines are available in Switzerland, this study aimed to assess the willingness of Swiss pregnant and breastfeeding women to become vaccinated. Through a cross-sectional online study conducted after the first pandemic wave, vaccination practices and willingness to become vaccinated against SARS-CoV-2 if a vaccine was available were evaluated through binary, multi-choice, and open-ended questions. Factors associated with vaccine willingness were evaluated through univariable and multivariable analysis. A total of 1551 women responded to questions related to the primary outcome. Only 29.7% (153/515) of pregnant and 38.6% (400/1036) of breastfeeding women were willing to get vaccinated against SARS-CoV-2 if a vaccine had been available during the first wave. Positive predictors associated with SARS-CoV-2 vaccine acceptance were an age older than 40 years, a higher educational level, history of influenza vaccination within the previous year, having an obstetrician as the primary healthcare practitioner, and being in their third trimester of pregnancy. After the first pandemic wave, Switzerland had a low SARS-CoV-2 vaccination acceptance rate, emphasizing the need to identify and reduce barriers for immunization in pregnant and breastfeeding women, particularly among the youngest and those with a lower educational level.
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Affiliation(s)
- Sarah Stuckelberger
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (S.S.); (G.F.); (E.G.); (V.L.); (M.S.); (D.B.)
| | - Guillaume Favre
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (S.S.); (G.F.); (E.G.); (V.L.); (M.S.); (D.B.)
| | - Michael Ceulemans
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium;
- Teratology Information Service, Pharmacovigilance Centre Lareb, 5237 MH ‘s-Hertogenbosch, The Netherlands
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, 0315 Oslo, Norway;
- Department of Child Health and Development, Norwegian Institute of Public Health, 0403 Oslo, Norway
| | - Eva Gerbier
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (S.S.); (G.F.); (E.G.); (V.L.); (M.S.); (D.B.)
| | - Valentine Lambelet
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (S.S.); (G.F.); (E.G.); (V.L.); (M.S.); (D.B.)
| | - Milos Stojanov
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (S.S.); (G.F.); (E.G.); (V.L.); (M.S.); (D.B.)
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service de Pharmacologie Clinique, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
| | - David Baud
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (S.S.); (G.F.); (E.G.); (V.L.); (M.S.); (D.B.)
| | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Léo Pomar
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; (S.S.); (G.F.); (E.G.); (V.L.); (M.S.); (D.B.)
- School of Health Sciences (HESAV) Midwifery Department, University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland
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Oyewole ORA, Lang P, Albrich WC, Wissel K, Leib SL, Casanova C, Hilty M. The Impact of Pneumococcal Conjugate Vaccine (PCV) Coverage Heterogeneities on the Changing Epidemiology of Invasive Pneumococcal Disease in Switzerland, 2005-2019. Microorganisms 2021; 9:microorganisms9051078. [PMID: 34069761 PMCID: PMC8157260 DOI: 10.3390/microorganisms9051078] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 12/24/2022] Open
Abstract
Pneumococcal conjugate vaccines (PCVs) have lowered the incidence of invasive pneumococcal disease (IPD) worldwide. However, the influence of regional vaccine uptake differences on the changing epidemiology of IPD remains unclear. We aimed to examine the overall impact of both seven- and 13-valent PCVs (PCV7 and PCV13) on IPD in Switzerland. Three-year periods from 2005–2010 and 2011–2019 were considered, respectively, as (early and late) PCV7 eras and (early, mid and late) PCV13 eras. Vaccine coverage was estimated from a nationwide survey according to east (German-speaking) and west (French/Italian-speaking) regions for each period. Reported incidence rate ratios (IRRs) were compared between successive periods and regions using nationwide IPD surveillance data. Overall IPD incidence across all ages was only 16% lower in the late PCV13 era compared to the early PCV7 era (IRR 0.83, 95% CI 0.79–0.88), due to increasing incidence of non-PCV-type IPD (2.59, 2.37–2.83) in all age groups, except children <5 years. PCV uptake rates in swiss children were slightly higher in the west than the east (p < 0.001), and were accompanied by lower IPD incidences across all age groups in the former region. Post-PCV13, non-PCV serotypes 8, 22F and 9N were the major cause of IPD in adults ≥65 years. Increased PCV coverage in both areas of Switzerland resulted in a decrease in vaccine-type and overall IPD incidence across all age groups, in a regionally dependent manner. However, the rising incidence of non-vaccine-type IPD, exclusive to older adults, may undermine indirect beneficial effects.
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Affiliation(s)
- Oluwaseun Rume-Abiola Oyewole
- Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland; (O.R.-A.O.); (S.L.L.); (C.C.)
- Graduate School for Cellular and Biomedical Sciences, University of Bern, 3001 Bern, Switzerland
| | - Phung Lang
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, 8001 Zürich, Switzerland;
| | - Werner C. Albrich
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland; (W.C.A.); (K.W.)
| | - Kerstin Wissel
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland; (W.C.A.); (K.W.)
| | - Stephen L. Leib
- Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland; (O.R.-A.O.); (S.L.L.); (C.C.)
- Swiss National Reference Center for Invasive Pneumococci (NZPn), Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland
| | - Carlo Casanova
- Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland; (O.R.-A.O.); (S.L.L.); (C.C.)
- Swiss National Reference Center for Invasive Pneumococci (NZPn), Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland; (O.R.-A.O.); (S.L.L.); (C.C.)
- Swiss National Reference Center for Invasive Pneumococci (NZPn), Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland
- Correspondence: ; Tel.: +41-31-632-49-83
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Leos-Toro C, Ribeaud D, Bechtiger L, Steinhoff A, Nivette A, Murray AL, Hepp U, Quednow BB, Eisner MP, Shanahan L. Attitudes Toward COVID-19 Vaccination Among Young Adults in Zurich, Switzerland, September 2020. Int J Public Health 2021; 66:643486. [PMID: 34744592 PMCID: PMC8565253 DOI: 10.3389/ijph.2021.643486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/01/2021] [Indexed: 12/23/2022] Open
Abstract
Objectives: Young adults are essential to the effective mitigation of the novel coronavirus (SARS-CoV-2/COVID-19) given their tendency toward greater frequency of social interactions. Little is known about vaccine willingness during pandemics in European populations. This study examined young people's attitudes toward COVID-19 vaccines in Fall 2020. Methods: Data came from an ongoing longitudinal study's online COVID-19-focused supplement among young adults aged 22 in Zurich, Switzerland (N = 499) in September 2020. Logistic regressions examined young adults' likelihood of participating in COVID-19 immunization programs. Results: Approximately half of respondents reported being unlikely to get vaccinated against COVID-19. Compared to males, females were more likely to oppose COVID-19 vaccination (p < 0.05). In multivariate models, Sri Lankan maternal background and higher socioeconomic status were associated with a greater likelihood of getting vaccinated against COVID-19 (p < 0.05). Respondents were more likely to report a willingness to get vaccinated against COVID-19 when they perceived 1) an effective government response (p < 0.05) and 2) their information sources to be objective (p < 0.05). Conclusion: This study communicates aspects important to the development of targeted information campaigns to promote engagement in COVID-19 immunization efforts.
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Affiliation(s)
- Cesar Leos-Toro
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Amy Nivette
- Department of Sociology, Utrecht University, Utrecht, Netherlands
| | - Aja L. Murray
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Urs Hepp
- Integrated Psychiatric Services Winterthur-Zurcher Unterland, Winterthur, Switzerland
| | - Boris B. Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Manuel P. Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
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11
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Schneider R, Reinau D, Schur N, Blozik E, Früh M, Signorell A, Heininger U, Schwenkglenks M, Meier CR. Coverage rates and timeliness of nationally recommended vaccinations in Swiss preschool children: A descriptive analysis using claims data. Vaccine 2019; 38:1551-1558. [PMID: 31791812 DOI: 10.1016/j.vaccine.2019.11.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/07/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Low vaccination coverage as well as incomplete and delayed vaccinations pose a risk for the individual and population protection from vaccine-preventable diseases. AIM To describe vaccination patterns for nationally recommended basic and supplementary vaccinations in Swiss preschool children. METHODS We performed a descriptive study based on administrative claims data from a large Swiss health insurer (Helsana), in cohorts of children born between January 2010 and December 2016. We assessed coverage rates of nationally recommended basic vaccinations (i.e., diphtheria, tetanus, acellular pertussis [DTaP], Haemophilus influenzae type b [Hib], poliomyelitis [IPV], measles, mumps, and rubella [MMR]) and supplementary vaccinations (i.e., pneumococcal conjugate vaccine [PCV] and meningococcal group C conjugate vaccine [MCV]) for each birth cohort at the age of 13, 25, and 37 months. Additionally, we analysed timeliness of vaccinations using inverse Kaplan-Meier curves. Results were extrapolated to the Swiss population. RESULTS The study population comprised 563,216 children. We observed continuously increasing coverage rates for all vaccinations until the 2015 birth cohort. Overall, up-to-date status for the first dose of studied vaccinations at 37 months was as follows: DTaP: 95.4%; Hib: 94.9%; IPV: 95.5%; MMR: 86.8%; PCV: 83.2%; and MCV: 66.7%. On average, however, only seven out of ten children had an up-to-date status for completed basic vaccinations; even less (six out of ten) were up-to-date for recommended supplementary vaccinations at 37 months of age. Moreover, 4% of all analysed children received none of the recommended vaccinations and there were substantial regional differences. Delays in vaccine administration were common. The most frequently postponed basic vaccination was MMR; 22.6% of children vaccinated with the first dose experienced delays relative to age-appropriate standards. CONCLUSION To avoid future outbreaks and transmission of vaccine-preventable diseases, vaccination coverage in Switzerland must be further improved. In addition, more emphasis should be placed on timely vaccination.
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Affiliation(s)
- Rahel Schneider
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Spitalstrasse 26, CH-4031 Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, CH-4031 Basel, Switzerland
| | - Daphne Reinau
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Spitalstrasse 26, CH-4031 Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, CH-4031 Basel, Switzerland
| | - Nadine Schur
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Klingelbergstrasse 61, CH-4056 Basel, Switzerland
| | - Eva Blozik
- Department of Health Sciences, Helsana Group, Zürichstrasse 130, CH-8600 Dübendorf, Switzerland
| | - Mathias Früh
- Department of Health Sciences, Helsana Group, Zürichstrasse 130, CH-8600 Dübendorf, Switzerland
| | - Andri Signorell
- Department of Health Sciences, Helsana Group, Zürichstrasse 130, CH-8600 Dübendorf, Switzerland
| | - Ulrich Heininger
- University of Basel Children's Hospital, Paediatric Infectious Diseases and Vaccinology, and University of Basel Medical Faculty, Spitalstrasse 33, CH-4056 Basel, Switzerland
| | - Matthias Schwenkglenks
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Klingelbergstrasse 61, CH-4056 Basel, Switzerland
| | - Christoph R Meier
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Spitalstrasse 26, CH-4031 Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, CH-4031 Basel, Switzerland; Boston Collaborative Drug Surveillance Program, MA 11 Muzzey St, Lexington, MA 02421, USA.
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12
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Deml MJ, Jafflin K, Merten S, Huber B, Buhl A, Frau E, Mettraux V, Sonderegger J, Kliem P, Cattalani R, Krüerke D, Pfeiffer C, Burton-Jeangros C, Tarr PE. Determinants of vaccine hesitancy in Switzerland: study protocol of a mixed-methods national research programme. BMJ Open 2019; 9:e032218. [PMID: 31678955 PMCID: PMC6830664 DOI: 10.1136/bmjopen-2019-032218] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Vaccine hesitancy is a complex public health issue referring to concerns about the safety, efficacy or need for vaccination. Relatively little is known about vaccine hesitancy in Switzerland. This ongoing study (2017-2021) focuses on biomedical and complementary and alternative medicine (CAM) providers and their patients since healthcare professionals play important roles in vaccination decision-making. This national research programme seeks to assess the sociocultural determinants of vaccine hesitancy regarding childhood and human papillomavirus vaccines in Switzerland. We aim to provide a detailed characterisation of vaccine hesitancy, including CAM and biomedical perspectives, patient-provider interactions, and sociocultural factors, to establish the mediating effects of vaccine hesitancy on underimmunisation, and to design an intervention to improve vaccination communication and counselling among physicians, parents and adolescents. METHODS AND ANALYSIS Our transdisciplinary team employs a sequential exploratory mixed-methods study design. We have established a network of more than 150 medical providers across Switzerland, including more than 40 CAM practitioners. For the qualitative component, we conduct interviews with parents, youth, and biomedical and CAM providers and observations of vaccination consultations and school vaccination information sessions. For the quantitative component, a sample of 1350 parents of young children and 722 young adults (15-26 years) and their medical providers respond to questionnaires. We measure vaccine hesitancy with the Parent Attitudes about Childhood Vaccines 15-item survey and review vaccination certificates to assess vaccination status. We administer additional questions based on findings from qualitative research, addressing communication with medical providers, vaccine information sources and perceptions of risk control vis-à-vis vaccine-preventable diseases. The questionnaires capture sociodemographics, political views, religion and spirituality, and moral foundations. ETHICS AND DISSEMINATION The study was approved by the local ethics committee. The results will be published in peer-reviewed journals and disseminated to healthcare professionals, researchers and the public via conferences and public presentations.
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Affiliation(s)
- Michael J Deml
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kristen Jafflin
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Benedikt Huber
- Department of Pediatrics, HFR Fribourg Cantonal Hospital, Fribourg, Switzerland
| | - Andrea Buhl
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Eleonora Frau
- University of Basel, Basel, Switzerland
- University Department of Medicine, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
| | - Valérie Mettraux
- University of Basel, Basel, Switzerland
- University Department of Medicine, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
| | - Joanna Sonderegger
- University of Basel, Basel, Switzerland
- University Department of Medicine, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
| | - Paulina Kliem
- University of Basel, Basel, Switzerland
- University Department of Medicine, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
| | - Rachele Cattalani
- University of Basel, Basel, Switzerland
- University Department of Medicine, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
| | | | - Constanze Pfeiffer
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Philip E Tarr
- University of Basel, Basel, Switzerland
- University Department of Medicine, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland
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13
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Deml MJ, Notter J, Kliem P, Buhl A, Huber BM, Pfeiffer C, Burton-Jeangros C, Tarr PE. “We treat humans, not herds!”: A qualitative study of complementary and alternative medicine (CAM) providers’ individualized approaches to vaccination in Switzerland. Soc Sci Med 2019; 240:112556. [DOI: 10.1016/j.socscimed.2019.112556] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 08/30/2019] [Accepted: 09/12/2019] [Indexed: 11/27/2022]
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Masserey Spicher V, Weiss MG. Policy and socio-cultural differences between cantons in Switzerland with high and low adolescent vaccination coverage for hepatitis B and HPV. Vaccine 2019; 37:7539-7546. [PMID: 31630937 DOI: 10.1016/j.vaccine.2019.09.085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 10/25/2022]
Abstract
Vaccination recommendations in Switzerland are national, but vaccine coverage varies greatly from one canton to another, particularly for vaccinations recommended in adolescence. To explain these differences, we studied vaccination practices and socio-cultural views from the vantage points of policy makers, healthcare providers and community adolescents and parents in 4 cantons with low (LVC) and 4 cantons with high (HVC) vaccination coverage for hepatitis B (HBV) and human papillomavirus (HPV) vaccines. In-depth semi-structured interviews were administered to a policy maker, a private practitioner and 4 to 7 community members (adolescents and parents of adolescents) from each of the 8 cantons. LVCs were notable for less government involvement in vaccination issues, more autonomy of municipalities for school health, lower density of pediatricians, less information about these vaccines, greater emphasis on individual rather than government responsibility for vaccinations and for anticipated community hesitancy. Doctors in HVCs more actively advocated for vaccines. Community views in HVCs were more collectivistic and reliant on schools as a source of information than in LVCs. In both groups, hesitancy and concerns about efficacy were greater for HPV than for HBV vaccine. Findings suggest more systematic involvement of health and school authorities will be appreciated by adolescents and their parents, and will improve vaccination coverage. Interventions focused only on community awareness and hesitancy are likely to be inadequate without efforts to reach policy makers and doctors.
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Affiliation(s)
- Virginie Masserey Spicher
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, 4002 Basel, Switzerland; University of Basel, P.O. Box, 4001 Basel, Switzerland.
| | - Mitchell G Weiss
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, 4002 Basel, Switzerland; University of Basel, P.O. Box, 4001 Basel, Switzerland.
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15
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Riccò M, Vezzosi L, Cella C, Pecoraro M, Novembre G, Moreo A, Ognibeni EM, Schallenberg G, Maranelli G. Tetanus vaccination status in construction workers: results from an institutional surveillance campaign. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:269-278. [PMID: 31125007 PMCID: PMC6776203 DOI: 10.23750/abm.v90i2.6759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 11/14/2017] [Indexed: 11/23/2022]
Abstract
Background: Since 1963 Italian law (Law 292/1963, Legislative Decree n.81/2008), defines Tetanus Vaccination (TeV) as mandatory for defined occupational categories, including Construction Workers (CWs). Materials and Methods: An institutional survey on of CWs was performed in the Autonomous Province of Trento (Oct. 2016 - Apr. 2017). Vaccination booklets/certificate were retrieved recalling: TeV status (1), and TeV settings (2), i.e. basal schedule; year of last shot, healthcare providers who performed TeV, and TeV formulate(s). Results: Data about 205 CWs were collected (mean age 40.6±10.3 years; 78.0% <50 year-old, 71.7% born in Italy). Overall, 38.5% of CW had received last vaccination shot >10 years before the survey (mean: 8.8 ± 8.2 years). The majority of boosters had been administered by Vaccination Services of the Local Health Unit (47.3%), followed by Occupational Physicians (20.0%) and General Practitioners (11.2%). In 85.9% of CWs, a monovalent formulation was used. Combined TeV were mainly reported in CW who had received last vaccination shot in Vaccination Services (96.2%; p<0.001). Conclusions: TeV coverage rates in CWs are insufficient, and vaccination shots are frequently performed with inappropriate, monovalent formulates. As only professionals from Vaccination Services systematically employ combined vaccines and particularly Tdap, our results not only stress the opportunity for promoting TeV among CWs, but also the importance of improving reception of up to date official recommendations in Occupational Physicians, General Practitioner and professionals of Emergency Departments. (www.actabiomedica.it)
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio Emilia V.le Amendola n.2 - 42122 RE Servizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL) Dip. di Prevenzione.
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16
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Sheikh S, Biundo E, Courcier S, Damm O, Launay O, Maes E, Marcos C, Matthews S, Meijer C, Poscia A, Postma M, Saka O, Szucs T, Begg N. A report on the status of vaccination in Europe. Vaccine 2018; 36:4979-4992. [DOI: 10.1016/j.vaccine.2018.06.044] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 06/14/2018] [Accepted: 06/15/2018] [Indexed: 01/13/2023]
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17
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Riesen M, Konstantinoudis G, Lang P, Low N, Hatz C, Maeusezahl M, Spaar A, Bühlmann M, Spycher BD, Althaus CL. Exploring variation in human papillomavirus vaccination uptake in Switzerland: a multilevel spatial analysis of a national vaccination coverage survey. BMJ Open 2018; 8:e021006. [PMID: 29773702 PMCID: PMC5961588 DOI: 10.1136/bmjopen-2017-021006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Understanding the factors that influence human papillomavirus (HPV) vaccination uptake is critically important to the design of effective vaccination programmes. In Switzerland, HPV vaccination uptake (≥1 dose) by age 16 years among women ranges from 31% to 80% across 26 cantons (states). Our objective was to identify factors that are associated with the spatial variation in HPV vaccination uptake. METHODS We used cross-sectional data from the Swiss National Vaccination Coverage Survey 2009-2016 on HPV vaccination status (≥1 dose) of 14-17-year-old girls, their municipality of residence and their nationality for 21 of 26 cantons (n=8965). We examined covariates at municipality level: language, degree of urbanisation, socioeconomic position, religious denomination, results of a vote about vaccination laws as a proxy for vaccine scepticism and, at cantonal level, availability of school-based vaccination and survey period. We used a series of conditional autoregressive models to assess the effects of covariates while accounting for variability between cantons and municipal-level spatial autocorrelation. RESULTS In the best-fit model, living in cantons that have school-based vaccination (adjusted OR 2.51; 95% credible interval 1.77 to 3.56) was associated with increased uptake, while living in municipalities with lower acceptance of vaccination laws was associated with lower HPV vaccination uptake (OR 0.61; 95% credible interval 0.50 to 0.73). Overall, the covariates explained 88% of the municipal-level variation in uptake. CONCLUSIONS In Switzerland, both cantons and community opinion about vaccination play a prominent role in the variation in HPV vaccination uptake. To increase uptake, efforts should be made to mitigate vaccination scepticism and to encourage school-based vaccination.
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Affiliation(s)
- Maurane Riesen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Garyfallos Konstantinoudis
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Phung Lang
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Christoph Hatz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Mirjam Maeusezahl
- Communicable Diseases, Swiss Federal Office of Public Health, Bern, Switzerland
| | - Anne Spaar
- Communicable Diseases, Swiss Federal Office of Public Health, Bern, Switzerland
| | - Marc Bühlmann
- Institute of Political Science, University of Bern, Bern, Switzerland
| | - Ben D Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Pediatrics, Pediatric Respiratory Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian L Althaus
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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RICCÒ M, CATTANI S, VERONESI L, COLUCCI ME. Knowledge, attitudes, beliefs and practices of construction workers towards tetanus vaccine in Northern Italy. INDUSTRIAL HEALTH 2016; 54:554-563. [PMID: 27251030 PMCID: PMC5136613 DOI: 10.2486/indhealth.2015-0249] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 05/09/2016] [Indexed: 05/26/2023]
Abstract
Construction workers (CWs) are both more exposed to tetanus and at higher risk to be inadequately immunized. Our aim was to evaluate tetanus immunization status and knowledge/attitudes towards tetanus vaccination in CWs in Italy. In this field report, the immunization status of 554 unskilled CWs (i.e. labourers). Immunization status was assessed recalling immunization booklets/certificates. Attitudes and knowledge were collected through a standardized questionnaire. In 240/554 CWs, immunization status was inadequate/not documented: in 184 subjects (33.2%), the last vaccination shot was older than 10 years, whereas basal immunization was incomplete in 20 cases, more frequently in foreign-born people (FBP) than in Italian born (IBP) (OR=7.116). In 198 cases (35.7%), an Occupational Physician (OPh) performed last booster, usually with monovalent (T, n=173) vaccine. The main reason for inadequate immunization was having forgotten the periodic booster (148/554; 26.7%), whereas 42 subjects (7.6%) deliberately avoided tetanus vaccine because of personal/religious beliefs, more frequently in FBP than in IBP (OR=3.182). In summary, the prevalence of inadequate immunization status was relatively high (43.4%): the high prevalence of "forgotten boosters" enlightens the key role of OPh in recalling and promoting vaccination policies. Moreover, the inappropriate use of Td vaccine points out the opportunity for educational campaigns in OPh.
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Affiliation(s)
- Matteo RICCÒ
- Azienda Provinciale per i Servizi Sanitari della Provincia Autonoma di Trento Unità Operativa di Prevenzione e Sicurezza degli Ambienti di Lavoro, Italy
| | - Silvia CATTANI
- Department of Clinical Surgery, General Surgery and Surgical Therapy, School of Nursing Sciences, Parma University Hospital, Italy
| | - Licia VERONESI
- Department of Biomedical, Biotechnological, and Translational Sciences (SBiBiT), University of Parma, Italy
| | - Maria Eugenia COLUCCI
- Department of Biomedical, Biotechnological, and Translational Sciences (SBiBiT), University of Parma, Italy
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Meynard A, Rutishauser C, Thomi M, Stronski Huwiler SM. The health of Swiss adolescents and its implications for training of health professionals in Switzerland. Int J Adolesc Med Health 2016; 28:333-7. [PMID: 26124048 DOI: 10.1515/ijamh-2016-5019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 03/04/2015] [Indexed: 11/15/2022]
Abstract
Swiss adolescents generally enjoy satisfying life conditions. Nonetheless, violence, suicide and mental health are the main concerns together with injuries, chronic conditions and eating disorders. Adolescents still face barriers to access the care they need. Adequate training can improve practitioners' skills when dealing with adolescents. The last two decades have seen the development of innovative adolescent health units and networks in various regions of Switzerland as well as research and public health programmes. Training programmes in adolescent health (continuous medical education, post-graduate or pre-graduate) for physicians and nurses are developing but still patchy in Switzerland. Adolescent health is not a sub-specialty as such. Efforts have to be made in order to link with professional associations and institutions to implement adolescent health curricula more efficiently.
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20
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Immunization Status of Young People Attending a Youth Clinic in Geneva, Switzerland. J Immigr Minor Health 2015; 18:353-9. [DOI: 10.1007/s10903-015-0185-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bodilis H, Goffinet F, Krivine A, Andrieu T, Anselem O, Tsatsaris V, Rozenberg F, Launay O. Determinants of measles seroprevalence among pregnant women in Paris, France. Clin Microbiol Infect 2014; 20:O501-4. [DOI: 10.1111/1469-0691.12469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 12/05/2013] [Accepted: 11/20/2013] [Indexed: 11/28/2022]
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Bielicki JA, Achermann R, Berger C. Timing of measles immunization and effective population vaccine coverage. Pediatrics 2012; 130:e600-6. [PMID: 22908102 DOI: 10.1542/peds.2012-0132] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe measles vaccination patterns in a cohort of Swiss children aged up to 3 years insured with a single health insurer. METHODS A dynamic cohort study evaluating measles immunizations patterns in children born between 2006 and 2008 was conducted. Time-to-event analysis was used to describe timing of measles immunization. Effective vaccine coverage was calculated by using an area under the curve approach. RESULTS In the study cohort, 62.6% of 13-month-old children were up-to-date for the first measles immunization (recommended at 12 months of age). Approximately 59% of 25-month-old children were up-to-date for the second measles immunization (recommended at 15-24 months of age). Most doses were delivered during months in a child's life when well-child visits are recommended (eg, 12 months of age). For second measles vaccine dose, accelerations in vaccine delivery occurred at time points for well-child visits during the months 19 and 25 of age but with lower final uptake than for the first measles vaccine dose. Until their second birthday, children in our cohort spent on average 177 days and 89 days susceptible to measles due to policy recommendations and additional delays, respectively. In a group of children aged 6 months to 2 years reflecting the age distribution in our cohort, effective vaccine coverage was only 48.6%. CONCLUSIONS Timing and timeliness of measles immunizations influence effective population vaccine coverage and should be routinely reported in addition to coverage whenever possible. Proposed timing and relation of recommended vaccinations to well-child visits could be relevant aspects in optimizing measles vaccine coverage to reach measles elimination.
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Affiliation(s)
- Julia A Bielicki
- Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital, Zurich, Switzerland
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