High vaccination coverage is associated with low epidemic level of seasonal influenza in elementary schools: an observational study in Matsumoto City, Japan

Influenza vaccination of school teachers: A scoping review and an impact estimation

Introduction

Influenza vaccination, besides protecting traditional risk groups, can protect employees and reduce illness-related absence, which is especially relevant in sectors with staff shortages. This study describes current knowledge of influenza vaccination in teachers and estimates its potential impact.

Methods

We conducted a scoping review of the considerations for and impact of influenza vaccination of schoolteachers (grey and scientific literature up to 2020 March, complemented with interviews). We then estimated the potential impact of teacher vaccination in the Netherlands, with different scenarios of vaccine uptake for 3 influenza seasons (2016–2019). Using published data on multiple input parameters, we calculated potentially averted absenteeism notifications, averted absenteeism duration and averted doctor visits for influenza.

Results

Only one scientific paper reported on impact; it showed lower absenteeism in vaccinated teachers, whereas more knowledge of vaccination impact was deemed crucial by 50% of interviewed experts. The impact for the Netherlands of a hypothetical 50% vaccine uptake was subsequently estimated: 74–293 potentially averted physician visits and 11,178–28,896 potentially averted days of influenza absenteeism (on ≈200,000 total teacher population). An estimated 12–32 vaccinations were required to prevent one teacher sick-leave notification, or 3.5–9.1 vaccinations to prevent one day of teacher absenteeism (2016–2019).

Conclusion

Scientific publications on influenza vaccination in teachers are few, while public interest has increased to reduce teacher shortages. However, school boards and public health experts indicate requiring knowledge of impact when considering this vaccination. Estimations of 3.5–9.1 vaccinated teachers preventing one day of influenza-related sick leave suggest a possible substantial vaccination impact on absenteeism. Financial incentives, more accessible on-site vaccinations at workplaces, or both, are expected to increase uptake, but more research is needed on teachers’ views and vaccine uptake potential and its cost-effectiveness. Piloting free on-site influenza vaccination in several schools could provide further information on teacher participation.

Attitudes and perceptions of mothers towards childhood vaccination in Greece: lessons to improve the childhood COVID-19 vaccination acceptance

BACKGROUND

Maternal attitudes and beliefs have been shown to influence childhood vaccination coverage, resulting in under-vaccination, non-vaccination, and vaccination delay. This study aimed to investigate the mothers' attitudes and perceptions about vaccination for their children in Greece.

METHODS

This was an online cross-sectional study, conducted from 4 April to 8 June 2020. A self-administered questionnaire was used to collect information about mothers' and their children's socio-demographic characteristics, previous vaccination behavior, and mothers' attitudes and perceptions about childhood vaccination. Participants included adult mothers with at least one minor child.

RESULTS

One thousand eight hundred eighty-five mothers participated, with the majority (91.7%) believing in the usefulness of vaccines and that vaccines protect children from serious and life-threatening diseases. A larger percentage of mothers with higher educational attainment agreed/absolutely agreed that all vaccinations provided by the National Vaccination Program must be offered to their children (91.6%) (p = 0.02) and that vaccines protect children from serious and life-threatening diseases (92.9%) (p = 0.01). Significant more married/in cohabitation and not single-parent mothers agreed that vaccines are safe (53.5% and 53.4%, respectively). There were also several significant associations between maternal attitudes toward childhood vaccination and previous maternal vaccination practices [(e.g., adherence to recommended vaccination dosages (all p-values < 0.01), vaccination delays (all p-values < 0.05), and vaccination during pregnancy (all p-values < 0.01)].

CONCLUSION

Maternal attitudes and perceptions toward childhood vaccination are significantly influenced by sociodemographic factors and maternal vaccination practices. Revealing those is essential for public health officials in developing future strategies to improve childhood vaccination coverage and acceptance of new vaccines such as the COVID-19 vaccine.

E-health roadmap for COVID-19 vaccine coverage in Iran

BACKGROUND

Vaccination is the effective and long-term pharmacological solution to deal with COVID-19. Information technology (IT) and electronic immunization can be effective in accelerating and improving vaccine coverage. The aim of this paper is to develop multi-dimensional framework of e-health roadmap to response Covod-19 pandemic and examine the role of IT for improving vaccine distribution in Iran.

METHODS

The study methodology was based on a two-stage Delphi method which included literature studies at the beginning. Key steps in creating a roadmap in this study include definition, development and evaluation. The initial conceptual model was developed after literature review. Proposed roadmap was reviewed and evaluated in two stages based on the Delphi method by experts in the fields of E-health.

RESULTS

In the e-health roadmap model, 14 stages of vaccine distribution were presented in three phases of vaccination and then were determined the type of technology in each phase. The 4 conceptual models were approved based on the two stages Delphi approach in a survey of 14 e-health experts. In the second phase of the Delphi process, the selected items were sent back to the specialists to verification. Then e-health roadmap was confirmed by experts and was finalized the approved model.

CONCLUSIONS

The technology-based roadmap is one plan in the form of a transfer strategy that aligns goals with specific technical solutions and helps to meet them. This roadmap empowers decision makers to decide on alternative paths and achieve goals.

A Web Application About Herd Immunity Using Personalized Avatars: Development Study

BACKGROUND

Herd immunity or community immunity refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving the understanding of community immunity may increase intentions to get vaccinated.

OBJECTIVE

This study aims to design a web application about community immunity and optimize it based on users' cognitive and emotional responses.

METHODS

Our multidisciplinary team developed a web application about community immunity to communicate epidemiological evidence in a personalized way. In our application, people build their own community by creating an avatar representing themselves and 8 other avatars representing people around them, for example, their family or coworkers. The application integrates these avatars in a 2-min visualization showing how different parameters (eg, vaccine coverage, and contact within communities) influence community immunity. We predefined communication goals, created prototype visualizations, and tested four iterative versions of our visualization in a university-based human-computer interaction laboratory and community-based settings (a cafeteria, two shopping malls, and a public library). Data included psychophysiological measures (eye tracking, galvanic skin response, facial emotion recognition, and electroencephalogram) to assess participants' cognitive and affective responses to the visualization and verbal feedback to assess their interpretations of the visualization's content and messaging.

RESULTS

Among 110 participants across all four cycles, 68 (61.8%) were women and 38 (34.5%) were men (4/110, 3.6%; not reported), with a mean age of 38 (SD 17) years. More than half (65/110, 59.0%) of participants reported having a university-level education. Iterative changes across the cycles included adding the ability for users to create their own avatars, specific signals about who was represented by the different avatars, using color and movement to indicate protection or lack of protection from infectious disease, and changes to terminology to ensure clarity for people with varying educational backgrounds. Overall, we observed 3 generalizable findings. First, visualization does indeed appear to be a promising medium for conveying what community immunity is and how it works. Second, by involving multiple users in an iterative design process, it is possible to create a short and simple visualization that clearly conveys a complex topic. Finally, evaluating users' emotional responses during the design process, in addition to their cognitive responses, offers insights that help inform the final design of an intervention.

CONCLUSIONS

Visualization with personalized avatars may help people understand their individual roles in population health. Our app showed promise as a method of communicating the relationship between individual behavior and community health. The next steps will include assessing the effects of the application on risk perception, knowledge, and vaccination intentions in a randomized controlled trial. This study offers a potential road map for designing health communication materials for complex topics such as community immunity.

The role of alternative and complementary medical practices in vaccine hesitancy among nurses: A cross-sectional survey in Brittany

INTRODUCTION

Given today's increasing calling into question of vaccination, we have studied possible connections between alternative and complementary medical practices (CAM) and vaccine hesitancy (VH) among nurses.

METHOD

Ours was a cross-sectional study by self-administered online questionnaire addressed to a panel of nurses in Brittany. After adjustment for other proximal and distal determinants of VH, we examined the impact of CAM use.

RESULTS

Multivariate logistic regressions confirmed the existence of a link between CAM and VH. While trust in medical institutions seems to have an important role, CAM use appears largely independent of VH.

CONCLUSION

Association between CAM and VH in nurses raises the question not only of their training with respect to these alternative practices, but also of the role of medical institutions in the training of practitioners availing themselves of the latter.

Factors associated with parental acceptance of influenza vaccination for their children: the evidence from four cities of China

BACKGROUND

It is necessary and urgent to vaccinate 245 million Chinese children against influenza pandemics. The main purpose of this study was to evaluate different psychological and demographic factors that influence parental willingness to vaccinate their children against influenza.

METHODS

A hybrid theoretical framework was expanded and verified with 462 sample data collected from four cities in China. Structural equation models were used to test nine theoretical hypotheses, and the non-standardized coefficient method was used to discuss the moderating effects among demographic variables.

RESULTS

Knowledge is considered to be the significant factor of performance expectancy (β = 0.228), effort expectancy (β = 0.227) and perceived risk (β = -0.138), and social influence also has the significant impacts on the above three variables, with β values of 0.437, 0.386, and -0.172. Performance expectancy (β = 0.402), effort expectancy (β = 0.343), and perceived risk (β = -0.244) thus significantly affect parental behavioral intention regarding children's influenza vaccination. Gender, education, and kids' gender are demographic variables with significant moderating effects, while age, income, number of kids are not significant.

CONCLUSION

To improve the acceptability of influenza vaccination among Chinese children, the promoting policies should emphasize on public knowledge and social influence, as well as effectiveness, affordability, and safety of vaccination.

Success and Limitation of Equine Influenza Vaccination: The First Incursion in a Decade of a Florida Clade 1 Equine Influenza Virus that Shakes Protection Despite High Vaccine Coverage

Every year, several epizooties of equine influenza (EI) are reported worldwide. However, no EI case has been identified in France between 2015 and late 2018, despite an effective field surveillance of the pathogen and the disease. Vaccination against equine influenza virus (EIV) remains to this day one of the most effective methods to prevent or limit EI outbreaks and the lack of detection of the pathogen could be linked to vaccination coverage. The aim of this study was to evaluate EI immunity and vaccine coverage in France through a large-scale serological study. A total of 3004 archived surplus serums from French horses of all ages, breeds and sexes were selected from four different geographical regions and categories (i.e., sanitary check prior to exportation, sale, breeding protocol or illness diagnosis). EIV-specific antibody response was measured by single radial hemolysis (SRH) and an EIV-nucleoprotein (NP) ELISA (used as a DIVA test). Overall immunity coverage against EIV infection (i.e., titers induced by vaccination and/or natural infection above the clinical protection threshold) reached 87.6%. The EIV NP ELISA results showed that 83% of SRH positive serum samples from young horses (≤3 years old) did not have NP antibodies, which indicates that the SRH antibody response was likely induced by EI vaccination alone (the HA recombinant canarypoxvirus-based EI vaccine is mostly used in France) and supports the absence of EIV circulation in French horse populations between 2015 and late 2018, as reported by the French equine infectious diseases surveillance network (RESPE). Results from this study confirm a strong EI immunity in a large cohort of French horses, which provides an explanation to the lack of clinical EI in France in recent years and highlights the success of vaccination against this disease. However, such EI protection has been challenged since late 2018 by the incursion in the EU of a Florida Clade 1 sub-lineage EIV (undetected in France since 2009), which is also reported here.

Demographic Determinants of Influenza Vaccination and Infection, Brazos County, Texas, 2017

BACKGROUND

Seasonal influenza constitutes an enormous public health burden. The 2017-2018 influenza season was the most severe since the 2009 novel Influenza A (H1N1) pandemic. The State of Texas, like other states, experienced unusually high and persistent influenza activity.

METHODS

Data on confirmed cases of influenza and influenza-like illness (ILI) in Brazos County during December 2017 were collected by the Brazos County Health Department (BCHD) from medical records. Records of vaccine administered between January 1 and December 31, 2017 were collected from vaccination providers. The total number of influenza cases for 2017 was compiled from regular weekly influenza counts reported to BCHD by healthcare providers.

RESULTS

A total of 1651 cases of laboratory-confirmed influenza were reported in Brazos County residents in December 2017, 10 times more than that reported in December 2016. The highest rates of infection were in 2 ZIP codes where vaccination rates were also high. A total of 16 027 influenza vaccinations were given to individuals reporting a residential address in Brazos County in 2017. Vaccination coverage was lowest among adults aged 18 to 49, whereas those aged 65 or older and Hispanics were most likely to be hospitalized.

DISCUSSION

Overall, vaccination coverage in Brazos County, Texas is low, less than half of the Healthy People 2020 target. The development of health education materials and an increased use of social media, local television and radio, and communication methods that can reach parents, younger adults, and Hispanic residents are needed.