Polio eradication: interrupting transmission, towards a polio-free world

Attitudes of health care professionals towards COVID-19 vaccine - a sequence from Turkey

The purpose of this study is to evaluate the attitudes of healthcare professionals toward the COVID -19 vaccine, which has been introduced to healthcare professionals at the beginning of 2021 and give information to them on the disease and vaccine. This cross-sectional analytical study has been performed by conducting an online survey to the healthcare professionals who work at the healthcare institutions in the province of Samsun in Turkey between December 2020 and January 2021. In addition to sixteen questions about the demographic characteristics, the "Attitudes towards the COVID -19 vaccine" scale has been used. MANOVA test and Spearman rho correlation coefficient were used in analytical examinations. A total of 1426 healthcare professional have been reached. 64.3% of participants were female, 44.1% were nurse/midwife and 66.6% were public employees. Regarding the questions in the sub-dimension of positive attitude, the rate of response of "I agree/I strongly agree" was between 40.6% and 54.6%. Positive attitude mean values differ according to gender, age, institution, presence of children, smoking status, being a relative who died due to COVID -19, and profession (respectively p < .001, p < .001, p < .001, p < .001, p = .002, p = .019, p < .001). It has been observed that positive and negative attitudes toward COVID -19 vaccination are almost equally distributed and some demographic factors affect the attitude. The opinions of healthcare professionals on the safety and effectiveness of the vaccine, which are the main elements of the vaccination effort, may affect the public perception of vaccination.

Acceptability of Vaccination Against COVID-19 Among Healthcare Workers in the Democratic Republic of the Congo

PURPOSE

This study aims to estimate the acceptability of a future vaccine against COVID-19 and associated factors if offered in Congolese health-care workers (HCWs), since they have the highest direct exposure to the disease.

PATIENTS AND METHODS

We conducted an analytical cross-sectional study among 23 Congolese referral hospitals, including three university hospitals, located in three towns from March through 30 April 2020. The main outcome variable was healthcare workers' acceptance of a future vaccine against COVID-19. The associated factors of vaccination willingness were identified through a logistic regression analysis.

RESULTS

A sample of 613 HCWs participated in the study and completed the study questionnaire, including 312 (50.9%) men and 301 (49.1%) women. Only 27.7% of HCWs said that they would accept a COVID-19 vaccine if it was available. From the logistic regression analysis, male healthcare workers (ORa=1.17, 95% CI: 1.15-2.60), primarily doctors (ORa=1.59; 95% CI:1.03-2.44) and having a positive attitude towards a COVID-19 vaccine (ORa=11.49; 95% CI: 5.88-22.46) were significantly associated with reporting willingness to be vaccinated.

CONCLUSION

For acceptability of vaccination against COVID-19 among others education among HCWs is crucial because health professionals' attitudes about vaccines are an important determinant of their own vaccine uptake and their likelihood of recommending the vaccine to their patients.

Prevalence of influenza vaccine hesitancy at a tertiary care hospital in Riyadh, Saudi Arabia

BACKGROUND

Influenza vaccine hesitancy is a major problem worldwide, with significant public health consequences. We aimed to determine the prevalence of influenza vaccine hesitancy and the effect of vaccine awareness campaigns on vaccine acceptance among three groups (parents, adult patients, and healthcare workers [HCWs]) at King Abdulaziz Medical City, a tertiary care hospital in Riyadh, Saudi Arabia.

METHODS

The study was conducted during the 2015-2016 winter season. Participants anonymously completed a validated questionnaire on influenza vaccine hesitancy.

RESULTS

Of the 300 study participants, 17% (n=51) expressed vaccine hesitancy. The most common reasons given for vaccine refusal were: "It doesn't have any positive effect or benefit" (n=11 [21%]), "I don't need it because I'm healthy" (n=9 [17%]), and "I think it causes serious side effects" (n=7 [13%]). The most common sources of information about the vaccine were awareness campaigns (98/267 [36%]) and medical staff (98/267 [36%]). One hundred and sixty-three [54%] respondents knew that the effect of the influenza vaccine lasts up to 1year. There was no significant relationship between education level and receiving influenza vaccination. The study showed that confidence towards the Saudi Ministry of Health and medical doctors among three groups of participants was very high; 97% of adults, 95% of parents, and 93% of HCWs expressed trusted information provided to them by the Ministry of Health, and 97% of adults, 99% of parents, and 90% of HCWs trusted their physicians' information.

CONCLUSION

Influenza vaccine hesitancy was low at KAMC. The most common reason for vaccine refusal was believing that it had no positive effect and that it is unnecessary. The most common sources of information for influenza vaccine were awareness campaigns and medical staff. Participants had high levels of trust in both the Saudi Ministry of Health and doctors.

Measuring vaccine confidence: analysis of data obtained by a media surveillance system used to analyse public concerns about vaccines

BACKGROUND

The intensity, spread, and effects of public opinion about vaccines are growing as new modes of communication speed up information sharing, contributing to vaccine hesitancy, refusals, and disease outbreaks. We aimed to develop a new application of existing surveillance systems to detect and characterise early signs of vaccine issues. We also aimed to develop a typology of concerns and a way to assess the priority of each concern.

METHODS

Following preliminary research by The Vaccine Confidence Project, media reports (eg, online articles, blogs, government reports) were obtained using the HealthMap automated data collection system, adapted to monitor online reports about vaccines, vaccination programmes, and vaccine-preventable diseases. Any reports that did not meet the inclusion criteria--any reference to a human vaccine or vaccination campaign or programme that was accessible online--were removed from analysis. Reports were manually analysed for content and categorised by concerns, vaccine, disease, location, and source of report, and overall positive or negative sentiment towards vaccines. They were then given a priority level depending on the seriousness of the reported event and time of event occurrence. We used descriptive statistics to analyse the data collected during a period of 1 year, after refinements to the search terms and processes had been made.

FINDINGS

We analysed data from 10,380 reports (from 144 countries) obtained between May 1, 2011, and April 30, 2012. 7171 (69%) contained positive or neutral content and 3209 (31%) contained negative content. Of the negative reports, 1977 (24%) were associated with impacts on vaccine programmes and disease outbreaks; 1726 (21%) with beliefs, awareness, and perceptions; 1371 (16%) with vaccine safety; and 1336 (16%) with vaccine delivery programmes. We were able to disaggregate the data by country and vaccine type, and monitor evolution of events over time and location in specific regions where vaccine concerns were high.

INTERPRETATION

Real-time monitoring and analysis of vaccine concerns over time and location could help immunisation programmes to tailor more effective and timely strategies to address specific public concerns.

FUNDING

Bill & Melinda Gates Foundation.

Polio eradication in India: progress, but environmental surveillance and vigilance still needed

Poliomyelitis has appeared in epidemic form, become endemic on a global scale, and has been reduced to near elimination, all within the span of documented medical history. Nevertheless, effective vaccinations, global surveillance network, development of accurate viral diagnosis prompted the historical challenge, global polio eradication initiative (GPEI). Environmental surveillance of poliovirus means monitoring of wild polio virus (WPV) and vaccine derived polio virus (cVDPV) circulation in human populations by examining environmental specimens supposedly contaminated by human feces. The rationale for surveillance is based on the fact that PV-infected individuals, whether presenting with disease symptoms or not, shed large amounts of PV in the feces for several weeks. As the morbidity: infection ratio of PV infection is very low, and therefore this fact contributes to the sensitivity of poliovirus surveillance, which under optimal conditions can be better than that of the standard acute flaccid paralysis (AFP) surveillance. The World Health Organization (WHO) has included environmental surveillance of poliovirus in the new Strategic Plan of the Global Polio Eradication Initiative for years 2010-2012 to be increasingly used in PV surveillance, supplementing AFP surveillance and the strategic advisory group of experts on immunization (SAGE) recommended a switch from tOPV-bOPV to remove the threat of cVDPV2 and to accelerate the elimination of WPV type 1 and 3 as bOPV is a more immunogenic vaccine and to introduce one dose of IPV in their vaccination schedule prior to OPV cessation.

Oral polio vaccines and their role in polio eradication in India

Although the oral polio vaccine has reduced the incidence of polio in India, the current polio scenario indicates that oral polio vaccine cannot eradicate polio from Uttar Pradesh and Bihar, two states that have approximately 32% of the total Indian population and report more than 96% of polio cases that occur in India. Poor response to oral polio vaccine by some children from these two states could be due to genetic factors. Thus, for polio eradication in India, inactivated polio vaccine is needed.

A vision of a world without polio: The OPV cessation strategy

Once the eradication of wild poliovirus has been confirmed, the public health benefits of routine immunization with OPV will no longer outweigh the burden of disease either due to paralysis caused by OPV (vaccine associated paralytic polio), or by outbreaks caused by circulating vaccine-derived polioviruses. The eventual cessation of OPV use in routine immunization programmes worldwide will become necessary to assure a lasting eradication of polio. As the world moves towards polio eradication and its certification, preparations are therefore being intensified for OPV cessation, and the risk management framework for safe OPV cessation is being put in place. The framework includes bio-containment of all known poliovirus and potentially infected substances, development of an international stockpile of oral polio vaccine, ensuring a mechanism for continued global surveillance and response for polio after eradication has been certified, and national policies if countries decide to continue vaccinating with inactivated polio vaccine (IPV). It is ironic that the vaccine on which the world has depended for polio eradication will itself become a risk to eradication once the transmission of wild poliovirus has been interrupted. Final preparations for the eventual global and simultaneous cessation of OPV will require the same level of international cooperation and coordination that has brought the world to the verge of polio eradication.