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Singh P, Fesshaye B, Lee C, Njogu RN, Karron RA, Limaye RJ. Maternal Immunization Decision-Making Among Pregnant and Lactating People in Kenya: A Qualitative Exploration of Peer Influences on Vaccine Decision-Making for a Future RSV Vaccine. Matern Child Health J 2024; 28:1822-1832. [PMID: 39141202 PMCID: PMC11420282 DOI: 10.1007/s10995-024-03982-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is a leading cause of respiratory illness in infants globally, with new maternal RSV vaccines on the horizon. Vaccine decision-making during pregnancy is shaped by individual, interpersonal, community, and societal factors. This study explored key interpersonal influences on maternal vaccine decision-making among pregnant and lactating people (PLP) and community members in Kenya. METHODS This qualitative study conducted in-depth interviews with six pregnant people, 18 lactating people, and 10 community members in one rural and one urban county in Kenya. Data were analyzed using a grounded theory approach. RESULTS Participants identified the pregnant person themself, male partners, other family members, peers, and healthcare providers (HCPs) as key influences on the maternal immunization decision-making process. The majority of interviewed PLP believed that decision-making during pregnancy should be left to themselves due to autonomy and their role as the primary caregiver. Community members, including male partners, also identified pregnant people as the key decision-maker. While some PLP said they deferred to male partners to make vaccine decisions, more felt that men were not as informed on maternal and child issues as themselves or other female peers and relatives. HCPs emerged as important influences and information sources for PLP during decision-making. DISCUSSION Understanding who influences vaccine-decision making during pregnancy will help inform demand generation strategies, and in turn, uptake of future maternal vaccines, including RSV vaccines. Given the strong role HCPs and peers have in the decision-making process, targeting key potential influences is essential to improve vaccine acceptance.
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Affiliation(s)
- Prachi Singh
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Baltimore, MD, 21205, USA
| | - Berhaun Fesshaye
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Baltimore, MD, 21205, USA
| | - Clarice Lee
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Baltimore, MD, 21205, USA
| | - Rosemary N Njogu
- Jhpiego Kenya, 2nd Floor, Arlington Block, 12 Riverside, Off Riverside Drive, P.O. Box 66119-00800, Nairobi, Kenya
| | - Ruth A Karron
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Rupali J Limaye
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
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Pecenka C, Sparrow E, Feikin DR, Srikantiah P, Darko DM, Karikari-Boateng E, Baral R, Vizzotti C, Rearte A, Jalang'o R, Fleming JA, Martinón-Torres F, Karron RA. Respiratory syncytial virus vaccination and immunoprophylaxis: realising the potential for protection of young children. Lancet 2024; 404:1157-1170. [PMID: 39265588 DOI: 10.1016/s0140-6736(24)01699-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/23/2024] [Accepted: 08/14/2024] [Indexed: 09/14/2024]
Abstract
The search for safe and efficacious products to prevent severe respiratory syncytial virus (RSV) disease in young infants has lasted more than 60 years. In high-income and middle-income countries, two new products have been authorised: an RSV monoclonal antibody for administration to infants (nirsevimab) and an RSV prefusion F maternal vaccine (RSVpreF [Pfizer, Puurs, Belgium]) for administration to pregnant people. These products are not yet available in low-income and lower-middle-income countries, where most RSV deaths occur. Other papers in this Series describe the acute burden of RSV disease in young children, the effects of RSV infection in early childhood on long-term lung health, and the burden of RSV disease and disease prevention products in older adults. In this Series paper, we briefly review the efficacy, effectiveness, and safety of nirsevimab and RSVpreF maternal vaccine for protection of infants. We then explore potential regulatory, policy, and implementation pathways and provide case studies of intervention uptake in Spain and Argentina, and considerations for use in Kenya. We also explore the health economic evidence to inform product introduction decisions. With sufficient political will and affordable pricing, RSV disease prevention in infants can become a global reality.
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Affiliation(s)
- Clint Pecenka
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA.
| | - Erin Sparrow
- Department of Immunization, Vaccines and Biologicals, WHO, Geneva, Switzerland
| | - Daniel R Feikin
- Department of Immunization, Vaccines and Biologicals, WHO, Geneva, Switzerland
| | - Padmini Srikantiah
- Global Health Division, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | | | | | - Ranju Baral
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
| | - Carla Vizzotti
- Innovation Hub for Health Policies and Equity, National University of San Martin, Buenos Aires, Argentina
| | - Analia Rearte
- School of Medicine of Mar del Plata National University, Mar del Plata, Argentina
| | - Rose Jalang'o
- Ministry of Health, Directorate of Family Health, Nairobi, Kenya
| | | | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia, Spain; Genetics, Vaccines and Infectious Diseases, Healthcare Research Institute of Santiago de Compostela and University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Ruth A Karron
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Mazur NI, Caballero MT, Nunes MC. Severe respiratory syncytial virus infection in children: burden, management, and emerging therapies. Lancet 2024; 404:1143-1156. [PMID: 39265587 DOI: 10.1016/s0140-6736(24)01716-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/25/2024] [Accepted: 08/16/2024] [Indexed: 09/14/2024]
Abstract
The global burden of respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) in young children is high. The RSV prevention strategies approved in 2023 will be essential to lowering the global disease burden. In this Series paper, we describe clinical presentation, burden of disease, hospital management, emerging therapies, and targeted prevention focusing on developments and groundbreaking publications for RSV. We conducted a systematic search for literature published in the past 15 years and used a non-systematic approach to analyse the results, prioritising important papers and the most recent reviews per subtopic. Annually, 33 million episodes of RSV LRTI occur in children younger than 5 years, resulting in 3·6 million hospitalisations and 118 200 deaths. RSV LRTI is a clinical diagnosis but a clinical case definition and universal clinical tool to predict severe disease are non-existent. The advent of molecular point-of-care testing allows rapid and accurate confirmation of RSV infection and could reduce antibiotic use. There is no evidence-based treatment of RSV, only supportive care. Despite widespread use, evidence for high-flow nasal cannula (HFNC) therapy is insufficient and increased paediatric intensive care admissions and intubation indicate the need to remove HFNC therapy from standard care. RSV is now a vaccine-preventable disease in young children with a market-approved long-acting monoclonal antibody and a maternal vaccine targeting the RSV prefusion protein. To have a high impact on life-threatening RSV infection, infants at high risk, especially in low-income and middle-income countries, should be prioritised as an interim strategy towards universal immunisation. The implementation of RSV preventive strategies will clarify the full burden of RSV infection. Vaccine probe studies can address existing knowledge gaps including the effect of RSV prevention on transmission dynamics, antibiotic misuse, the respiratory microbiome composition, and long-term sequalae.
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Affiliation(s)
- Natalie I Mazur
- Department of Pediatrics, Wilhelmina Children's Hospital, Utrecht, Netherlands.
| | - Mauricio T Caballero
- Centro INFANT de Medicina Traslacional (CIMeT), Escuela de Bio y Nanotecnología, Universidad Nacional de San Martín (UNSAM), Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Marta C Nunes
- Center of Excellence in Respiratory Pathogens, Hospices Civils de Lyon and Centre International de Recherche en Infectiologie, Équipe Santé Publique, Épidémiologie et Écologie Évolutive des Maladies Infectieuses, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France; South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Nyiro JU, Nyawanda BO, Mutunga M, Murunga N, Nokes DJ, Bigogo G, Otieno NA, Lidechi S, Mazoya B, Jit M, Cohen C, Moyes J, Pecenka C, Baral R, Onyango C, Munywoki PK, Vodicka E. The cost of care for children hospitalized with respiratory syncytial virus (RSV) associated lower respiratory infection in Kenya. BMC Public Health 2024; 24:2410. [PMID: 39232690 PMCID: PMC11375914 DOI: 10.1186/s12889-024-19875-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 08/26/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is one of the main causes of hospitalization for lower respiratory tract infection in children under five years of age globally. Maternal vaccines and monoclonal antibodies for RSV prevention among infants are approved for use in high income countries. However, data are limited on the economic burden of RSV disease from low- and middle-income countries (LMIC) to inform decision making on prioritization and introduction of such interventions. This study aimed to estimate household and health system costs associated with childhood RSV in Kenya. METHODS A structured questionnaire was administered to caregivers of children aged < 5 years admitted to referral hospitals in Kilifi (coastal Kenya) and Siaya (western Kenya) with symptoms of acute lower respiratory tract infection (LRTI) during the 2019-2021 RSV seasons. These children had been enrolled in ongoing in-patient surveillance for respiratory viruses. Household expenditures on direct and indirect medical costs were collected 10 days prior to, during, and two weeks post hospitalization. Aggregated health system costs were acquired from the hospital administration and were included to calculate the cost per episode of hospitalized RSV illness. RESULTS We enrolled a total of 241 and 184 participants from Kilifi and Siaya hospitals, respectively. Out of these, 79 (32.9%) in Kilifi and 21(11.4%) in Siaya, tested positive for RSV infection. The total (health system and household) mean costs per episode of severe RSV illness was USD 329 (95% confidence interval (95% CI): 251-408 ) in Kilifi and USD 527 (95% CI: 405- 649) in Siaya. Household costs were USD 67 (95% CI: 54-80) and USD 172 (95% CI: 131- 214) in Kilifi and Siaya, respectively. Mean direct medical costs to the household during hospitalization were USD 11 (95% CI: 10-12) and USD 67 (95% CI: 51-83) among Kilifi and Siaya participants, respectively. Observed costs were lower in Kilifi due to differences in healthcare administration. CONCLUSIONS RSV-associated disease among young children leads to a substantial economic burden to both families and the health system in Kenya. This burden may differ between Counties in Kenya and similar multi-site studies are advised to support cost-effectiveness analyses.
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Affiliation(s)
- Joyce U Nyiro
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
| | - Bryan O Nyawanda
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Martin Mutunga
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Nickson Murunga
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - D James Nokes
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Life Sciences and Zeeman Institute (SBIDER), University of Warwick, Coventry, UK
| | - Godfrey Bigogo
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Nancy A Otieno
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | - Shirley Lidechi
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya
| | | | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Cheryl Cohen
- The Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), Johannesburg, South Africa
| | - Jocelyn Moyes
- The Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), Johannesburg, South Africa
| | - Clint Pecenka
- Center for Vaccine Innovation and Access, PATH, Seattle, USA
| | - Ranju Baral
- Center for Vaccine Innovation and Access, PATH, Seattle, USA
| | - Clayton Onyango
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Nairobi, USA
| | - Patrick K Munywoki
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Nairobi, USA
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Limaye RJ, Sauer M, Njogu R, Singh P, Fesshaye B, Karron RA. Characterizing Attitudes Toward Maternal RSV Vaccines Among Pregnant and Lactating Persons in Kenya: Key Considerations for Demand Generation Efforts for Vaccine Acceptance. J Pediatric Infect Dis Soc 2023; 12:638-641. [PMID: 37944043 DOI: 10.1093/jpids/piad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023]
Abstract
This study examined attitudes toward maternal RSV vaccines among pregnant and lactating persons in Kenya. First pregnancy was associated with higher vaccine hesitancy among pregnant and lactating people, and social norms were associated with higher vaccine hesitancy among lactating people. Understanding maternal RSV attitudes is critical for vaccine acceptance.
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Affiliation(s)
- Rupali J Limaye
- Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of International Health, International Vaccine Access Center, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health, Behavior & Society, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Molly Sauer
- Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of International Health, International Vaccine Access Center, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rosemary Njogu
- Department of International Health, Jhpiego, Nairobi, Kenya
| | - Prachi Singh
- Department of International Health, International Vaccine Access Center, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Berhaun Fesshaye
- Department of International Health, International Vaccine Access Center, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ruth A Karron
- Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
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Du Y, Yan R, Wu X, Zhang X, Chen C, Jiang D, Yang M, Cao K, Chen M, You Y, Zhou W, Chen D, Xu G, Yang S. Global burden and trends of respiratory syncytial virus infection across different age groups from 1990 to 2019: A systematic analysis of the Global Burden of Disease 2019 Study. Int J Infect Dis 2023; 135:70-76. [PMID: 37567553 DOI: 10.1016/j.ijid.2023.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE Understanding the global patterns of respiratory syncytial virus (RSV) is crucial for developing effective prevention and control strategies. METHODS Data on RSV-related burden were extracted from the Global Burden of Disease 2019. Joinpoint regression models were used to assess the global temporal trends of RSV and further stratified analyses were conducted according to the Socio-demographic Index (SDI), which is a composite measure of income, education, and total fertility. Age-period-cohort model was used to evaluate age, period, and cohort effects. RESULTS In 2019, the global age-standardized rate of mortality (ASMR) and disability-adjusted life years (ASR-DALYs) of RSV were 4.79/100,000 (95% uncertainty interval [95% UI]: 1.82/100,000-9.32/100,000) and 218.34/100,000 (95% UI: 92.06/100,000-376.80/100,000), respectively. The burden of RSV was higher in men than women. The highest ASMR (10.26/100,000, 3.80/100,000-20.16/100,000) and ASR-DALYs (478.71/100,000, 202.40/100,000-840.85/100,000) were reported in low-SDI region. Although mortality and DALYs rates in all age groups declined globally, the pace of decline was not uniform across age groups. Mortality rate in the elderly over 70 years surpassed that in children under 5 years in 2019. CONCLUSION This study highlights the need for targeted interventions to reduce the burden of RSV, particularly in low-SDI region, and among the elderly over 70 years.
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Affiliation(s)
- Yuxia Du
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Rui Yan
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Xiaoyue Wu
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaobao Zhang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Can Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Daixi Jiang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengya Yang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Kexin Cao
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengsha Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yue You
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenkai Zhou
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Dingmo Chen
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Gang Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shigui Yang
- Department of Emergency Medicine, Second Affiliated Hospital, Department of Public Health, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China.
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Limaye RJ, Fesshaye B, Singh P, Karron RA. RSV awareness, risk perception, causes, and terms: Perspectives of pregnant and lactating women in Kenya to inform demand generation efforts for maternal RSV vaccines. Hum Vaccin Immunother 2023; 19:2258580. [PMID: 37807864 PMCID: PMC10563615 DOI: 10.1080/21645515.2023.2258580] [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: 07/03/2023] [Accepted: 09/10/2023] [Indexed: 10/10/2023] Open
Abstract
Respiratory syncytial virus (RSV) causes a substantial proportion of acute lower respiratory tract infections (LRTI) among infants. In low- and middle-income countries, RSV may be responsible for approximately 40% of all hospital admissions of infants less than one year. A safe and immunogenic RSV vaccine, given to pregnant persons, is imminent. In this qualitative study, we sought to understand factors that could inform maternal vaccine decision-making to inform future demand generation strategies in Kenya. We conducted in-depth interviews with 24 pregnant and lactating persons from two counties, with two communities in each county. Four key themes emerged, including terms used for RSV, awareness of and risk perception related to RSV, causes of RSV, and questions about future maternal RSV vaccines. Regarding terms, no participant used the term RSV to describe the disease. Most participants associated RSV with cold things such as cold weather and cold food/drink. Most participants believed that RSV was caused by the cold or an unclean environment. Finally, key questions related to a maternal RSV vaccine were related to vaccine safety, and more specifically side effects. Questions arose related to vaccine effectiveness as well as timing of administration and dosing. A maternal RSV vaccine is on the horizon. However, vaccines do not save lives; vaccination does. As such, it is critical to develop and implement demand generation approaches to ensure that once a maternal RSV vaccine is available, communities are sensitized and willing to accept it.
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Affiliation(s)
- Rupali J. Limaye
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Berhaun Fesshaye
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Prachi Singh
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ruth A. Karron
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Nyawanda BO, Opere VA, Nyiro JU, Vodicka E, Fleming JA, Baral R, Khan S, Pecenka C, Ayugi JO, Atito R, Ougo J, Bigogo G, Emukule GO, Otieno NA, Munywoki PK. Respiratory Syncytial Virus (RSV) Disease and Prevention Products: Knowledge, Attitudes, and Preferences of Kenyan Healthcare Workers in Two Counties in 2021. Vaccines (Basel) 2023; 11:1055. [PMID: 37376444 PMCID: PMC10302044 DOI: 10.3390/vaccines11061055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection (LRTI) among infants under 6 months of age. Yet, in Kenya, little is known about healthcare workers' (HCWs) knowledge, attitudes, and perceptions around RSV disease and the prevention products under development. Between September and October 2021, we conducted a mixed methods cross-sectional survey to assess HCWs' knowledge, attitudes, and perceptions of RSV disease and RSV vaccinations in two counties. We enrolled HCWs delivering services directly at maternal and child health (MCH) departments in selected health facilities (frontline HCWs) and health management officers (HMOs). Of the 106 respondents, 94 (88.7%) were frontline HCWs, while 12 were HMOs. Two of the HMOs were members of the Kenya National Immunization Technical Advisory Group (KENITAG). Of the 104 non-KENITAG HCWs, only 41 (39.4%) had heard about RSV disease, and 38/41 (92.7%) felt that pregnant women should be vaccinated against RSV. Most participants would recommend a single-dose vaccine schedule (n = 62, 58.5%) for maximal adherence and compliance (n = 38/62, 61.3%), single dose/device vaccines (n = 50/86, 58.1%) to prevent wastage and contamination, and maternal vaccination through antenatal care clinics (n = 53, 50%). We found the need for increased knowledge about RSV disease and prevention among Kenyan HCWs.
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Affiliation(s)
- Bryan O. Nyawanda
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Victor A. Opere
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Joyce U. Nyiro
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi P.O. Box 230-80108, Kenya
| | - Elisabeth Vodicka
- Program for Appropriate Technology in Health—PATH, Seattle, WA 98121, USA
| | - Jessica A. Fleming
- Program for Appropriate Technology in Health—PATH, Seattle, WA 98121, USA
| | - Ranju Baral
- Program for Appropriate Technology in Health—PATH, Seattle, WA 98121, USA
| | - Sadaf Khan
- Program for Appropriate Technology in Health—PATH, Seattle, WA 98121, USA
| | - Clint Pecenka
- Program for Appropriate Technology in Health—PATH, Seattle, WA 98121, USA
| | - Jorim O. Ayugi
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Raphael Atito
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - James Ougo
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Godfrey Bigogo
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Gideon O. Emukule
- US Centers for Disease Control and Prevention, Nairobi P.O. Box 606-00621, Kenya
| | - Nancy A. Otieno
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu P.O. Box 1578-40100, Kenya
| | - Patrick K. Munywoki
- US Centers for Disease Control and Prevention, Nairobi P.O. Box 606-00621, Kenya
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