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Wei X, Han G, Wang Q. China's policies: post-COVID-19 challenges for the older population. Glob Health Action 2024; 17:2345968. [PMID: 38717833 PMCID: PMC11080668 DOI: 10.1080/16549716.2024.2345968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
On 7 December 2022, the State Council of China released 'Measures to Further Optimize the Implementation of the Prevention and Control of the New Coronavirus Epidemic'. The previous three-year dynamic zero epidemic prevention policy was then replaced with a full liberalization policy. On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a 'public health emergency of international concern.' However, given the ongoing prevalence of coronavirus, emerging mutations, and the liberalization of restrictions, there are increased risks of vulnerable people contracting new variants. Low vaccination coverage among older people with compromised immune systems, puts them at further risk. The policy shift will increase pressure on already stretched health infrastructure and medical resources. This short article adds to the current debate arguing that the Chinese government should take commensurate preventive measures, including strengthening medical facilities and equipment and targeting ongoing vaccination in older people.
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Affiliation(s)
- Xuezhi Wei
- Law School, Shandong University, Weihai, China
| | - Guoqing Han
- Law School, Shandong University, Weihai, China
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2
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Tzanakaki G, Cabrnochová H, Delić S, Draganescu A, Hilfanova A, Onozó B, Pokorn M, Skoczyńska A, Tešović G. Invasive meningococcal disease in South-Eastern European countries: Do we need to revise vaccination strategies? Hum Vaccin Immunother 2024; 20:2301186. [PMID: 38173392 PMCID: PMC10773623 DOI: 10.1080/21645515.2023.2301186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024] Open
Abstract
Invasive meningococcal disease (IMD) is an acute life-threatening infection caused by the gram-negative bacterium, Neisseria meningitidis. Globally, there are approximately half a million cases of IMD each year, with incidence varying across geographical regions. Vaccination has proven to be successful against IMD, as part of controlling outbreaks, and when incorporated into national immunization programs. The South-Eastern Europe Meningococcal Advocacy Group (including representatives from Croatia, the Czech Republic, Greece, Hungary, Poland, Romania, Serbia, Slovenia and Ukraine) was formed in order to discuss the potential challenges of IMD faced in the region. The incidence of IMD across Europe has been relatively low over the past decade; of the countries that came together for the South-Eastern Meningococcal Advocacy Group, the notification rates were lower than the European average for some country. The age distribution of IMD cases was highest in infants and children, and most countries also had a further peak in adolescents and young adults. Across the nine included countries between 2010 and 2020, the largest contributors to IMD were serogroups B and C; however, each individual country had distinct patterns for serogroup distribution. Along with the variations in epidemiology of IMD between the included countries, vaccination policies also differ.
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Affiliation(s)
- Georgina Tzanakaki
- Public Health Microbiology, National Meningitis Reference Laboratory, Laboratory for Surveillance of Infectious Diseases, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Hana Cabrnochová
- Center of children vaccination in Thomayer University Hospital, and Department of Pediatrics, First Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | | | - Anca Draganescu
- National Institute for Infectious Diseases “Prof.Dr.Matei Bals”, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Anna Hilfanova
- Department of Pediatrics, Immunology, Infectious and Rare Diseases, European Medical School of the International European University, Kyiv, Ukraine
| | - Beáta Onozó
- Pediatric Department of County Hospital, Miskolc, Hungary
| | - Marko Pokorn
- Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Goran Tešović
- University of Zagreb, and Pediatric Infectious Diseases Department, University Hospital for Infectious Diseases, Zagreb, Croatia
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3
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Achterbergh RCA, McGovern I, Haag M. Co-Administration of Influenza and COVID-19 Vaccines: Policy Review and Vaccination Coverage Trends in the European Union, UK, US, and Canada between 2019 and 2023. Vaccines (Basel) 2024; 12:216. [PMID: 38400199 PMCID: PMC10891656 DOI: 10.3390/vaccines12020216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
Recommending co-administration of influenza and COVID-19 vaccines has emerged as a strategy to enhance vaccination coverage. This study describes the policy on co-administration and uptake of influenza and COVID-19 vaccination in Europe, the United Kingdom, the United States, and Canada between 2019 and 2023. We collected co-administration policy data from governmental websites, national health organizations, and newspapers. Influenza vaccination coverage among persons ≥65 years and COVID-19 vaccination coverage rates among persons ≥60 years or the general population were collected using national databases, the ECDC database, or ourworldindata.org between 2019 and 2023. Descriptive analyses were used. We collected data from 30/32 (94%) countries on vaccination policy in seasons 2021-2022 and 2022-2023, with most countries (25/30 to 30/30) having policies recommending co-administration. For influenza vaccination coverage, we collected data from 29/32 (91%, 2019-2020), 28/32 (88%, 2020-2021), 27/32 (84%, 2021-2022), and 6/32 (19%, 2022-2023) countries. COVID-19 vaccination was collected from 32/32 (2020-2021), 31/32 (97%, 2021-2022), and 24/32 (75%, 2022-2023) countries. Influenza vaccination coverage increased from 2019-2020 to 2021-2022. COVID-19 vaccination coverage was higher among countries with higher influenza vaccination coverage. By 2022-2023, all countries included implemented a policy supporting co-administration. A positive correlation existed between higher influenza vaccination coverage and higher COVID-19 vaccination rates.
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Affiliation(s)
| | - Ian McGovern
- Center for Outcomes Research and Epidemiology, CSL Seqirus, Waltham, MA 02451, USA;
| | - Mendel Haag
- Center for Outcomes Research and Epidemiology, CSL Seqirus, 1105 BJ Amsterdam, The Netherlands
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4
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Pham-Huy A, Zafack J, Primeau C, Baclic O, Salvadori M, Deeks S. A National Advisory Committee on Immunization (NACI) update on invasive meningococcal disease (IMD) epidemiology and program-relevant considerations for preventing IMD in individuals at high risk of exposure. Can Commun Dis Rep 2023; 49:358-367. [PMID: 38463903 PMCID: PMC10919448 DOI: 10.14745/ccdr.v49i09a01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Following recent outbreaks of invasive meningococcal disease (IMD) in Canada and updates to provincial vaccination guidelines, the National Advisory Committee on Immunization (NACI) conducted a targeted review of evidence with a focus on immunization of adolescents and young adults. NACI reviewed national and international immunization recommendations for populations at high-risk of IMD, national IMD epidemiology and program-relevant considerations. Given the varied IMD epidemiology, NACI determined that recommending a pan-Canadian targeted program is currently challenging and that regional programs may be better suited to prevent IMD in population groups considered to be at high-risk of exposure. Further data is needed to ascertain contemporary risk factors for IMD (including activities and settings associated with bacterial acquisition, carriage and transmission) and estimate the true cost of meningococcal vaccine-preventable infections in Canada. To support provinces and territories in their decision-making, an outline of program-relevant elements for provincial and territorial consideration is provided.
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Affiliation(s)
- Anne Pham-Huy
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON
| | - Joseline Zafack
- Centre for Immunization Programs, Public Health Agency of Canada, Ottawa, ON
| | - Courtney Primeau
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - Oliver Baclic
- Centre for Immunization Programs, Public Health Agency of Canada, Ottawa, ON
| | - Marina Salvadori
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
- Department of Pediatrics, McGill University, Montréal, QC
| | - Shelley Deeks
- Nova Scotia Department of Health and Wellness, Halifax, NS
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5
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Peano A, Politano G, Gianino MM. Determinants of COVID-19 vaccination worldwide: WORLDCOV, a retrospective observational study. Front Public Health 2023; 11:1128612. [PMID: 37719735 PMCID: PMC10501313 DOI: 10.3389/fpubh.2023.1128612] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/19/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction The COVID-19 pandemic has resulted in numerous deaths, great suffering, and significant changes in people's lives worldwide. The introduction of the vaccines was a light in the darkness, but after 18 months, a great disparity in vaccination coverage between countries has been observed. As disparities in vaccination coverage have become a global public health issue, this study aimed to analyze several variables to identify possible determinants of COVID-19 vaccination. Methods An ecological study was conducted using pooled secondary data sourced from institutional sites. A total of 205 countries and territories worldwide were included. A total of 16 variables from different fields were considered to establish possible determinants of COVID-19 vaccination: sociodemographic, cultural, infrastructural, economic and political variables, and health system performance indicators. The percentage of the population vaccinated with at least one dose and the total doses administered per 100 residents on 15 June 2022 were identified as indicators of vaccine coverage and outcomes. Raw and adjusted values for delivered vaccine doses in the multivariate GLM were determined using R. The tested hypothesis (i.e., variables as determinants of COVID-19 vaccination) was formulated before data collection. The study protocol was registered with the grant number NCT05471635. Results GDP per capita [odds = 1.401 (1.299-1.511) CI 95%], access to electricity [odds = 1.625 (1.559-1.694) CI 95%], political stability, absence of violence/terrorism [odds = 1.334 (1.284-1.387) CI 95%], and civil liberties [odds = 0.888 (0.863-0.914) CI 95%] were strong determinants of COVID-19 vaccination. Several other variables displayed a statistically significant association with outcomes, although the associations were stronger for total doses administered per 100 residents. There was a substantial overlap between raw outcomes and their adjusted counterparts. Discussion This pioneering study is the first to analyze the association between several different categories of indicators and COVID-19 vaccination coverage in a wide complex setting, identifying strong determinants of vaccination coverage. Political decision-makers should consider these findings when organizing mass vaccination campaigns in a pandemic context to reduce inequalities between nations and to achieve a common good from a public health perspective.
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Affiliation(s)
- Alberto Peano
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Gianfranco Politano
- Department of Control and Computer Engineering, Polytechnic of Turin, Turin, Italy
| | - Maria Michela Gianino
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
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Burns S, Bhoyroo R, Leavy JE, Portsmouth L, Millar L, Jancey J, Hendriks J, Saltis H, Tohotoa J, Pollard C. The Impact of the No Jab No Play and No Jab No Pay Legislation in Australia: A Scoping Review. Int J Environ Res Public Health 2023; 20:6219. [PMID: 37444067 PMCID: PMC10341108 DOI: 10.3390/ijerph20136219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
Australia has a long history of population-based immunisation programs including legislations. This paper reports on a review of evaluations of the impact of the federal No Jab No Pay (NJNPay) and state implemented No Jab No Play (NJNPlay) legislations on childhood immunisation coverage and related parental attitudes. Five databases were searched for peer-review papers (Medline (Ovid); Scopus; PsycInfo; ProQuest; and CINAHL). Additional searches were conducted in Google Scholar and Informit (Australian databases) for grey literature. Studies were included if they evaluated the impact of the Australian NJNPay and/or NJNPlay legislations. Ten evaluations were included: nine peer-review studies and one government report. Two studies specifically evaluated NJNPlay, five evaluated NJNPay, and three evaluated both legislations. Findings show small but gradual and significant increases in full coverage and increases in catch-up vaccination after the implementation of the legislations. Full coverage was lowest for lower and higher socio-economic groups. Mandates are influential in encouraging vaccination; however, inequities may exist for lower income families who are reliant on financial incentives and the need to enrol their children in early childhood centres. Vaccine refusal and hesitancy was more evident among higher income parents while practical barriers were more likely to impact lower income families. Interventions to address access and vaccine hesitancy will support these legislations.
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Affiliation(s)
- Sharyn Burns
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Ranila Bhoyroo
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Justine E. Leavy
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Linda Portsmouth
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Lynne Millar
- Telethon Kids Institute, Perth, WA 6102, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Jacqueline Hendriks
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Hanna Saltis
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Jenny Tohotoa
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Christina Pollard
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
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7
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Mahameed H, Al-Mahzoum K, AlRaie LA, Aburumman R, Al-Naimat H, Alhiary S, Barakat M, Al-Tammemi AB, Salim NA, Sallam M. Previous Vaccination History and Psychological Factors as Significant Predictors of Willingness to Receive Mpox Vaccination and a Favorable Attitude towards Compulsory Vaccination. Vaccines (Basel) 2023; 11:vaccines11050897. [PMID: 37243001 DOI: 10.3390/vaccines11050897] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
During the ongoing multi-country monkeypox (Mpox) outbreak, healthcare workers (HCWs) have represented a key group in mitigating disease spread. The current study aimed to evaluate the attitude of nurses and physicians in Jordan towards Mpox vaccination, as well as their attitude towards compulsory vaccination against coronavirus disease 2019 (COVID-19), influenza, and Mpox. An online survey was distributed in January 2023 based on the previously validated 5C scale for psychological determinants of vaccination. Previous vaccination behavior was assessed by inquiring about the history of getting the primary and booster COVID-19 vaccination, influenza vaccine uptake during COVID-19, and any history of influenza vaccine uptake. The study sample consisted of 495 respondents: nurses (n = 302, 61.0%) and physicians (n = 193, 39.0%). Four hundred and thirty respondents (86.9%) had heard of Mpox before the study, and formed the final sample considered for Mpox knowledge analysis. Deficiencies in Mpox knowledge were reflected in a mean knowledge score of 13.3 ± 2.7 (out of 20.0 as the maximum score), with significantly lower knowledge among nurses and females. The intention to receive Mpox vaccination was reported by 28.9% of the participants (n = 143), while 33.3% were hesitant (n = 165), and 37.8% were resistant (n = 187). In multivariate analysis, Mpox vaccine acceptance was significantly associated with previous vaccination behavior, reflected in higher vaccine uptake and with higher 5C scores, while Mpox knowledge was not correlated with Mpox vaccination intention. The overall attitude towards compulsory vaccination was neutral, while a favorable attitude towards compulsory vaccination was associated with higher 5C scores and a history of previous vaccination uptake. The current study showed a low intention to get Mpox vaccination in a sample of nurses and physicians practicing in Jordan. The psychological factors and previous vaccination behavior appeared as the most significant determinants of Mpox vaccine acceptance and of attitudes towards compulsory vaccination. The consideration of these factors is central to policies and strategies aiming to promote vaccination among health professionals in efforts to prepare for future infectious disease epidemics.
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Affiliation(s)
- Haneen Mahameed
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | | | | | - Hala Al-Naimat
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Sakher Alhiary
- Nursing Department, Jordan University Hospital, Amman 11942, Jordan
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan
- MEU Research Unit, Middle East University, Amman 11831, Jordan
| | - Ala'a B Al-Tammemi
- Migration Health Division, International Organization for Migration (IOM), The UN Migration Agency, Amman 11953, Jordan
| | - Nesreen A Salim
- Prosthodontic Department, School of Dentistry, The University of Jordan, Amman 11942, Jordan
- Prosthodontic Department, Jordan University Hospital, Amman 11942, Jordan
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
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8
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Farias JP, Pinheiro JR, Andreata-Santos R, Fogaça MMC, da Silva Brito RD, da Cruz EF, de Castro-Amarante MF, Pereira SS, Dos Santos Almeida S, Moreira LM, da Conceição Simões R, Luiz WB, Birbrair A, Belmok A, Ribeiro BM, Maricato JT, Braconi CT, de Souza Ferreira LC, Janini LMR, Amorim JH. The third vaccine dose significantly reduces susceptibility to the B.1.1.529 (Omicron) SARS-CoV-2 variant. J Med Virol 2023; 95:e28481. [PMID: 36609686 DOI: 10.1002/jmv.28481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/15/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023]
Abstract
The main coronavirus disease 2019 (COVID-19) vaccine formulations used today are mainly based on the wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein as an antigen. However, new virus variants capable of escaping neutralization activity of serum antibodies elicited in vaccinated individuals have emerged. The Omicron (B.1.1.529) variant caused epidemics in regions of the world in which most of the population has been vaccinated. In this study, we aimed to understand what determines individual's susceptibility to Omicron in a scenario of extensive vaccination. For that purpose, we collected nasopharynx swab (n = 286) and blood samples (n = 239) from flu-like symptomatic patients, as well as their vaccination history against COVID-19. We computed the data regarding vaccine history, COVID-19 diagnosis, COVID-19 serology, and viral genome sequencing to evaluate their impact on the number of infections. As main results, we showed that vaccination in general did not reduce the number of individuals infected by Omicron, even with an increased immune response found among vaccinated, noninfected individuals. Nonetheless, we found that individuals who received the third vaccine dose showed significantly reduced susceptibility to Omicron infections. A relevant evidence that support this finding was the higher virus neutralization capacity of serum samples of most patients who received the third vaccine dose. In summary, this study shows that boosting immune responses after a third vaccine dose reduces susceptibility to COVID-19 caused by the Omicron variant. Results presented in this study are useful for future formulations of COVID-19 vaccination policies.
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Affiliation(s)
- Jéssica P Farias
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil
| | - Josilene R Pinheiro
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil.,Department of Biological Sciences, State University of Santa Cruz, Ilhéus, Brazil
| | - Robert Andreata-Santos
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Mayanna M C Fogaça
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil
| | - Ruth D da Silva Brito
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil
| | - Edgar F da Cruz
- Division of Infectology, Medicine Department, Federal University of São Paulo, São Paulo, Brazil
| | - Maria F de Castro-Amarante
- Vaccine Development Laboratory, Microbiology Department, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, University of São Paulo, São Paulo, SP, Brazil
| | - Samuel S Pereira
- Vaccine Development Laboratory, Microbiology Department, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | - Shirley Dos Santos Almeida
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Ludimila M Moreira
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil
| | | | - Wilson B Luiz
- Department of Biological Sciences, State University of Santa Cruz, Ilhéus, Brazil
| | - Alexander Birbrair
- Department of Dermatology, School of Medicine and Public Health, University of Wisconsin-Madison, Wisconsin, Madison, USA.,Department of Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Department of Radiology, Columbia University Medical Center, New York, New York, USA
| | - Aline Belmok
- Laboratory of Baculoviruses, Cell Biology Department, University of Brasilia, Brasília, Brazil
| | - Bergmann M Ribeiro
- Laboratory of Baculoviruses, Cell Biology Department, University of Brasilia, Brasília, Brazil
| | - Juliana T Maricato
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Carla T Braconi
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Luís C de Souza Ferreira
- Vaccine Development Laboratory, Microbiology Department, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, University of São Paulo, São Paulo, SP, Brazil
| | - Luiz M R Janini
- Department of Microbiology, Immunology and Parasitology, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Division of Infectology, Medicine Department, Federal University of São Paulo, São Paulo, Brazil
| | - Jaime Henrique Amorim
- Center of Biological Sciences and Health, Federal University of Western Bahia, Barreiras, Brazil.,Department of Biological Sciences, State University of Santa Cruz, Ilhéus, Brazil
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9
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Takeuchi J, Kawamura T. Comparison Among Conventional Multivariable Analysis, Proxy Exposure Analysis, and Instrumental Variable Analysis: Effectiveness of Two-or-More-Dose Vaccination for Measles and Rubella in University Students. Jpn J Infect Dis 2023; 76:34-38. [PMID: 36047176 DOI: 10.7883/yoken.jjid.2022.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A catch-up campaign for measles and rubella (MR) vaccinations was conducted among third-year high school (MR-4) students between 2008 and 2012 as part of governmental policy. We examined three analytical methodologies to assess the vaccination policies. We measured the antibody titers of the first-year students involved and not involved in the catch-up campaign and analyzed the levels of antibody titers after two-or-more-dose vaccination using conventional regression analysis, the individual's birth year using proxy exposure analysis, and the birth fiscal year using two-stage least square (2SLS) regression as instrumental variables. Of the 379 students invited to participate in the study, 220 (58.0%) vaccinated against measles and 213 (56.2%) vaccinated against rubella were included in the analysis. Conventional regression analysis revealed that two-or-more-dose vaccination produced 0.27 (95% confidence interval [CI], 0.04-0.49) greater log-antibody titers for measles. Proxy exposure analysis of the birth year revealed that two-or-more-dose vaccination produced 0.40 (95% CI, 0.18-0.63) greater log-scale antibody titers against measles. According to the two-stage least squares regression analysis, two-or-more-dose vaccination produced 0.72 (95% CI, 0.31-1.13) greater log-scale antibody titers against measles. All three analyses showed similar trends, but no findings were reported for rubella. These results were consistent across the three analytical methodologies used to assess the vaccination policies.
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Affiliation(s)
- Jiro Takeuchi
- Department of Clinical Epidemiology, Hyogo Medical University, Japan
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10
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Kitamura N, Hoan TT, Do HM, Dao TA, Le LT, Le TTT, Doan TTT, Chau TN, Dinh HT, Iwaki M, Senoh M, Efstraciou A, Ho NM, Pham DM, Dang DA, Toizumi M, Fine P, Do HT, Yoshida LM. Seroepidemiology and Carriage of Diphtheria in Epidemic-Prone Area and Implications for Vaccination Policy, Vietnam. Emerg Infect Dis 2023; 29:70-80. [PMID: 36573549 PMCID: PMC9796191 DOI: 10.3201/eid2901.220975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In 2019, a community-based, cross-sectional carriage survey and a seroprevalence survey of 1,216 persons 1-55 years of age were conducted in rural Vietnam to investigate the mechanism of diphtheria outbreaks. Seroprevalence was further compared with that of an urban area that had no cases reported for the past decade. Carriage prevalence was 1.4%. The highest prevalence, 4.5%, was observed for children 1-5 years of age. Twenty-seven asymptomatic Coerynebacterium diphtheriae carriers were identified; 9 carriers had tox gene-bearing strains, and 3 had nontoxigenic tox gene-bearing strains. Child malnutrition was associated with low levels of diphtheria toxoid IgG, which might have subsequently increased child carriage prevalence. Different immunity patterns in the 2 populations suggested that the low immunity among children caused by low vaccination coverage increased transmission, resulting in symptomatic infections at school-going age, when vaccine-induced immunity waned most. A school-entry booster dose and improved infant vaccination coverage are recommended to control transmissions.
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11
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Moradpour J, Chit A, Besada-Lombana S, Grootendorst P. Overview of the global vaccine ecosystem. Expert Rev Vaccines 2023; 22:749-763. [PMID: 37608523 DOI: 10.1080/14760584.2023.2250433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Vaccination is an effective, relatively inexpensive, and easy to deliver approach to combating infectious diseases. Widespread vaccination of children has led to the eradication of smallpox and allowed for regional elimination or control of diseases like polio, measles, mumps, tetanus, diphtheria, and whooping cough. But, as we learned from efforts to combat the COVID-19 pandemic, a successful global vaccination program must overcome several hurdles. Failure at any stage can limit vaccine uptake and disease control. AREAS COVERED In this review, we break down the vaccine journey from research and development to delivery into several steps. We also list all the important international organizations trying to support this ecosystem. Then we identify the role of each of these organizations in supporting each of the necessary steps for a successful vaccination program. EXPERT OPINION The bottlenecks in vaccination can be different for different countries, based on their income and geography. Policy makers need to identify the weaknesses of this ecosystem in different regions of the world and make sure there is adequate global and local support to fill the gaps in the system.
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Affiliation(s)
- Javad Moradpour
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Ayman Chit
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Medical, Medical Head for International Region Sanofi, Lyon, France
| | | | - Paul Grootendorst
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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Ghazy RM, Okeh DU, Sallam M, Hussein M, Ismail HM, Yazbek S, Mahboob A, Abd ElHafeez S. Psychological Antecedents of Healthcare Workers towards Monkeypox Vaccination in Nigeria. Vaccines (Basel) 2022; 10. [PMID: 36560561 DOI: 10.3390/vaccines10122151] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The ongoing monkeypox (MPX) outbreak has been declared a public health emergency of international concern. People in close contact with active MPX cases, including healthcare workers (HCWs), are at higher risk of virus acquisition since the MPX virus can be transmitted by skin contact or respiratory secretions. In this study, we aimed to assess the psychological antecedents of MPX vaccination among Nigerian HCWs using the 5C scale. We used an anonymous online cross-sectional survey to recruit potential participants using snowball sampling. The questionnaire aimed to assess the geo/socioeconomic features and the 5C psychological antecedents of vaccine acceptance (confidence, complacency, constraints, calculation, and collective responsibility). A total of 389 responses were included, with a median age of 37 years (IQR: 28−48), 55.5% males, and 60.7% married participants. Among the studied Nigerian HCWs, only 31.1% showed confidence in MPX vaccination, 58.4% expressed complacency towards vaccination, 63.8% perceived constraints towards MPX vaccination, 27.2% calculated the benefits and risks of vaccination, and 39.2% agreed to receive MPX vaccination to protect others. The determinants of MPX vaccine confidence were being single (OR = 5.07, 95% CI: 1.26−20.34, p = 0.022), a higher education level (with pre-college/high school as a reference, professional/technical: OR = 4.12, 95% CI: 1.57−10.73, p = 0.004, undergraduate: OR = 2.94, 95% CI: 1.32−6.55, p = 0.008, and postgraduate degree (OR = 3.48, 95% CI: 1.51−8.04, p = 0.003), and absence of chronic disease (OR = 2.57, 95% CI: 1.27−5.22, p = 0.009). The significant complacency predictors were having a middle-income (OR = 0.53, 95% CI: 0.33−0.89, p = 0.008), having a bachelor’s degree (OR = 2.37, 95% CI: 1.10−5.11, p = 0.027), and knowledge of someone who died due to MPX (OR = 0.20, 95% CI: 0.05−0.93, p = 0.040). Income was associated with perceived vaccination constraints (OR = 0.62, 95% CI: 0.39−0.99, p = 0.046). Participants aged 46−60 years had decreased odds in the calculation domain (OR = 0.52, 95% CI: 0.27−0.98, p = 0.044). Middle-income and bachelor degree/postgraduate education significantly influenced the collective responsibility domain (OR = 2.10, 95% CI: 1.19−3.69, p = 0.010; OR = 4.17, 95% CI: 1.85−9.38, p < 0.001; and OR = 3.45, 95% CI: 1.50−7.90, p = 0.003, respectively). An investigation of the 5C pattern-based psychological antecedents of MPX vaccination in a sample of Nigerian HCWs revealed low levels of vaccine confidence and collective responsibility with high levels of constraints and complacency. These psychological factors are recommended to be considered in any efforts aiming to promote MPX vaccination needed in a country where MPX is endemic.
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Komada MT, Lee JS, Watanabe E, Nakazawa E, Mori K, Akabayashi A. Factors of influenza vaccine inoculation and non-inoculation behavior of community-dwelling residents in Japan: suggestions for vaccine policy and public health ethics after COVID-19. Vaccine X 2022; 13:100245. [PMCID: PMC9744486 DOI: 10.1016/j.jvacx.2022.100245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022] Open
Abstract
The aim of this study is to provide basic information that contributes to vaccine inoculation policy after COVID-19. We used the secondary data of the influenza vaccine inoculation behavior survey for community-dwelling adults conducted in 2011, before the COVID-19 pandemic, but after the 2009 novel influenza A (H1N1) pdm 09 pandemic. All factors such as socio-demographic characteristics, health-related behaviors, family environment, physical and social environment, and area of residence were adjusted, and factors related to vaccine inoculation behavior were analyzed. Those living with pregnant women had a significantly higher odds ratio of inoculation; this was self-evident in that those people considered infection to their family. Regarding the social environment, those aged 20–64 years with a significantly higher adjusted odds ratio of inoculation were those with “at least five people with which they interacted in the neighborhood”. This result can be interpreted in two ways relating to altruism in Japan. Finally, we indicated the importance of learning from the past, including the case of 2009.
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Affiliation(s)
- Mayuko T. Komada
- Division of Nursing, Higashigaoka Faculty of Nursing, Tokyo Healthcare University, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8558, Japan
| | - Jung Su Lee
- Postgraduate School of Healthcare, Tokyo Healthcare University 4-1-17 Higashigotanda, Shinagawa-ku, Tokyo 141-8648, Japan
| | - Etsuko Watanabe
- Postgraduate School of Healthcare, Tokyo Healthcare University 4-1-17 Higashigotanda, Shinagawa-ku, Tokyo 141-8648, Japan
| | - Eisuke Nakazawa
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Katsumi Mori
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Akira Akabayashi
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Division of Medical Ethics, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, USA
- Corresponding author at: Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Kuznetsova L, Diago-Navarro E, Mathu R, Trilla A. Effectiveness of COVID-19 Vaccination Mandates and Incentives in Europe. Vaccines (Basel) 2022; 10:1714. [PMID: 36298578 DOI: 10.3390/vaccines10101714] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022] Open
Abstract
During 2021-2022 many countries in the European region of the World Health Organization (WHO) adopted mandatory and incentive-based vaccination measures to stimulate immunization against COVID-19. The measures ranged from positive incentive-based programs (i.e., cash incentives, meal discounts, and lotteries) to introducing COVID-19 certificates and enforcing the universal mandatory vaccination with fines. We assessed the effect of such interventions on COVID-19 vaccine uptake in the population of eight countries within the region. An interrupted time series (ITS) analysis was performed using an autoregressive integrated moving average (ARIMA) approach to account for autocorrelation and seasonality. The results showed the immediate positive impact of vaccination incentives on vaccine uptake in most cases, with the highest impact being cash incentives for the population (1197 per million population per day). Discount incentives did not show any significant impact. The introduction of COVID-19 certificates was associated with a significant immediate or gradual increase in daily administered vaccine doses in all the countries included in the study, up to 117,617 doses gained per million per month. The effect of mandatory vaccination for all or some groups of the population varied from a continuous decrease in daily administered doses (332 per million capita per day), no significant effect, or a delayed or temporary increase (1489 per million capita per day).
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Valmas C, Arcà E, Hensen M, Rashid H. A policy review of the introduction of the MenACWY vaccine in toddlers across multiple countries. Expert Rev Vaccines 2022; 21:1637-1646. [PMID: 36222056 DOI: 10.1080/14760584.2022.2128771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Immunization is the best strategy to protect individuals from invasive meningococcal disease (IMD). To support decision-making around immunization, this paper considers what has led four countries and regions of two more to introduce the quadrivalent MenACWY vaccine in toddlers (ages 12-24 months). AREAS COVERED A narrative literature review was conducted to identify countries that have introduced a MenACWY vaccination program for toddlers. Information from peer-reviewed publications, reports, and policy documents for each identified country was extracted. Australia, Chile, the Netherlands, Switzerland, and regions of Italy and Spain have introduced the MenACWY vaccine in their toddler programs, driven by the rising incidence of MenW and MenY and the vaccine's ability to provide protection against other serogroups. Australia and the Netherlands considered the economic impacts of implementing a MenACWY toddler vaccination program. Vaccination uptake and effects are reported for three countries; however, in two, isolating the vaccine's effect from the collateral effect of COVID-related measures is difficult. EXPERT OPINION Increased convergence of vaccination policies and programs is needed internationally, as IMD recognizes no borders.PL AIN LANGUAGE SUMMARYVaccination is the best defense against meningitis, a deadly disease. While someone of any age can contract it, children 0-24 months of age are disproportionately affected. The increasing number of cases of meningitis has led four countries plus regions of two more to introduce into their vaccination schedules for toddlers (ages 12-24 months) a vaccine that protects against four different serogroups rather than one serogroup alone. This paper considers what has driven that shift.
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Affiliation(s)
| | - Emanuele Arcà
- Research Consultant, Strategic Market Access, OPEN Health, Rotterdam, The Netherlands
| | - Marja Hensen
- Senior Director, Strategic Market Access, OPEN Health, Rotterdam, The Netherlands
| | - Habeeda Rashid
- Value & Access Associate, Market Access Department, Sanofi, Reading, UK
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Attwell K, Drislane S. Australia's 'No Jab No Play' policies: history, design and rationales. Aust N Z J Public Health 2022; 46:640-646. [PMID: 35980171 DOI: 10.1111/1753-6405.13289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/01/2022] [Accepted: 06/01/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Since 2014, five Australian states have enacted 'No Jab, No Play' policies requiring children to be fully vaccinated to attend childcare and early education services. We review the five policies and their implications for implementers - including healthcare and childcare service providers - and analyse factors that shaped the design of state policies. METHODS We employed documentary analysis and analysed key informant interviews in NVivo 12. RESULTS Our findings reveal similarities and differences between state provisions regarding exemptions, grace periods, responsibilities of service providers and sanctions for non-compliance. We elaborate on five factors of influence that have shaped No Jab, No Play policies: i) impetus for change; ii) policy normalisation, growing concurrence and stringency; iii) increased co-optation of childcare providers into vaccination governance; iv) policy influence and lessons; and v) partisan politics and the development of party ideologies over time. CONCLUSION A range of factors contribute to how and why Australia's NJNPlay policies have taken their current forms. IMPLICATIONS FOR PUBLIC HEALTH NJNPlay policies impact families and healthcare providers as part of the broader policy ecosystem concerned with maintaining high immunisation rates in Australia. Increased coercion of parents over time has been tempered by partisan positions on exemptions for disadvantage.
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Affiliation(s)
- Katie Attwell
- School of Social Sciences, University of Western Australia
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Mouter N, Boxebeld S, Kessels R, van Wijhe M, de Wit A, Lambooij M, van Exel J. Public Preferences for Policies to Promote COVID-19 Vaccination Uptake: A Discrete Choice Experiment in The Netherlands. Value Health 2022; 25:1290-1297. [PMID: 35527162 PMCID: PMC9069307 DOI: 10.1016/j.jval.2022.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/18/2022] [Accepted: 03/13/2022] [Indexed: 05/12/2023]
Abstract
OBJECTIVES The COVID-19 pandemic forms an unprecedented public health, economic, and social crisis. Uptake of vaccination is critical for controlling the pandemic. Nevertheless, vaccination hesitancy is considerable, requiring policies to promote uptake. We investigate Dutch citizens' preferences for policies that aim to promote vaccination through facilitating choice of vaccination, profiling it as the norm, making vaccination more attractive through rewards, or punishing people who reject vaccination. METHODS We conducted a discrete choice experiment in which 747 respondents were asked to choose between policies to promote vaccination uptake and their impacts on the number of deaths, people with permanent health problems, households with income loss, and a tax increase. RESULTS Respondents generally had a negative preference for policies that promote vaccination. They particularly disliked policies that punish those who reject the vaccine and were more favorable toward policies that reward vaccination, such as awarding additional rights to vaccinated individuals through vaccination passports. Respondents who reject vaccination were in general much more negative about the policy options than respondents who consider accepting the vaccine. Nevertheless, vaccination passports are supported by both respondents who accept the vaccine, those who reject vaccination, and those who are unsure about vaccination. CONCLUSIONS This study provides concrete directions for governments attempting to increase the vaccination uptake in ways that are supported by the public. Our results could encourage policy makers to focus on policy options that make vaccination easier and reward people who take the vaccine, as especially the implementation of vaccination passports was supported.
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Affiliation(s)
- Niek Mouter
- Faculty of Technology, Policy and Management, Transport and Logistics Group, Delft University of Technology, Delft, The Netherlands.
| | - Sander Boxebeld
- Department of Health Economics, Erasmus School of Health Policy & Management, Erasmus Centre for Health Economics Rotterdam, and Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Roselinde Kessels
- Department of Data Analytics and Digitalization, School of Business and Economics, Maastricht University, Maastricht, The Netherlands; Department of Economics, City Campus, University of Antwerp, Antwerp, Belgium
| | - Maarten van Wijhe
- Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Ardine de Wit
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
| | - Mattijs Lambooij
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Job van Exel
- Department of Health Economics, Erasmus School of Health Policy & Management, Erasmus Centre for Health Economics Rotterdam, and Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Nomoto H, Hayakawa K, Ohmagari N. Impact of prioritized vaccinations for the elderly on the COVID-19 pandemic in Japan. Glob Health Med 2022; 4:129-132. [PMID: 35586768 PMCID: PMC9066456 DOI: 10.35772/ghm.2022.01015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/25/2022] [Accepted: 04/02/2022] [Indexed: 06/15/2023]
Abstract
The Japanese government implemented a large-scale vaccination policy against the coronavirus disease 2019 (COVID-19) pandemic, primarily using messenger RNA vaccines in 2021. Its hallmark was prioritized vaccination for the elderly after healthcare workers in a short period of time. Vaccination for the elderly, vulnerable to infection and severe disease, was carried out rapidly in approximately 4 months since April 2021. We evaluated the impact of Japan's vaccination policy against COVID-19 during the pandemic, with a particular focus on how prioritized vaccination for the elderly affected the pandemic. We observed a remarkable decrease in the number of infections, cluster events in long-term care facilities, and severe disease among the elderly during the fifth wave (August 2021) despite rising incidence of infections in the overall population. In conclusion, we think that prioritized vaccination for the elderly was efficacious in preventing infections and severe COVID-19 among the elderly during the fifth wave in Japan.
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Affiliation(s)
- Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Miyagi, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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Huang Z, Feng Z. Public Health and Private Life Under COVID-19 Vaccination Policies in China: A Legal Analysis. Risk Manag Healthc Policy 2021; 14:4627-4638. [PMID: 34849038 PMCID: PMC8619791 DOI: 10.2147/rmhp.s336434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/31/2021] [Indexed: 01/04/2023] Open
Abstract
Vaccination against SARS-CoV-2 has been the most significant measure in the preventing and controlling the spread of COVID-19. The COVID-19 vaccination rate in China is relatively high worldwide. However, the vaccination policies behind China's effective containment of COVID-19 are not well known. Some local governments have mandated vaccination for citizens and limited the freedom of movement and other fundamental rights of the unvaccinated. This paper examines the legitimacy of mandatory vaccination policies and their institutional logic within the Chinese legal framework. China prioritizes collective rights such as health over individual rights such as privacy. However, the mandatory vaccination policies lack statutory authorization and will restrict Chinese citizens' autonomy and compromise their privacy.
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Affiliation(s)
- Zhengzong Huang
- Law School, Hainan University, Haikou, People's Republic of China
| | - Zehua Feng
- School of Law, Guangdong University of Finance & Economics, Guangzhou, People's Republic of China
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Tretter M, Ehrlich DB, von Ulmenstein U. Easing Restrictions During Vaccine Scarcity. How Mitigation Measures Help Tackling Associated Moral and Behavioral Challenges. Public Health Rev 2021; 42:1604269. [PMID: 34909235 PMCID: PMC8588827 DOI: 10.3389/phrs.2021.1604269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background: When vaccines became first available during the Covid-19 pandemic, their demand significantly exceeded their supply. In consequence, the access to vaccines, initially, was distributed unequally. At the same time, governments started easing pandemic restrictions for vaccinated and recovered persons and restoring their freedoms since their risk of transmitting the virus is significantly reduced. Evidence: We show that restoring freedoms for vaccinated and recovered persons - while upholding restrictions for the rest of the population - is morally unfair during vaccine scarcity. Further, it may yield unintended side-effects, including perverse incentives, growing rifts in society, and the expansion of marginalization. Policy Options & Recommendations: We recommend accompanying easing for vaccinated and recovered individuals by mitigation measures for those who are neither vaccinated nor recovered. We propose, first, to temporarily lift the same restrictions for negative-tested individuals, as for vaccinated or recovered people. Second, the state must ensure broad and easy access to testing for everyone - free of charge. Conclusion: If done right, these mitigation measures create (at least temporarily) equal access to freedom for everybody - solving the moral problem of unfair access to freedoms and counteracting possible negative consequences.
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Affiliation(s)
- Max Tretter
- Department of Theology, University of Erlangen Nuremberg, Erlangen, Germany
| | - David B. Ehrlich
- Department of Economics and Management, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
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21
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Chaudhari VL, Godbole CJ, Gandhe PP, Gogtay NJ, Thatte UM. Association of Bacillus Calmette Guerin Vaccine Strains with COVID-19 Morbidity and Mortality - Evaluation of Global Data. Indian J Community Med 2021; 46:727-730. [PMID: 35068744 PMCID: PMC8729294 DOI: 10.4103/ijcm.ijcm_103_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Literature suggests that the presence of the current Bacillus Calmette Guerin (BCG) policy appears to mitigate COVID-19 disease burden but no information exists on the nature of the BCG strain and disease burden. OBJECTIVES To study the association between type of BCG strain, BCG coverage (%), and COVID-19 disease burden. METHODOLOGY An audit of global data on strains and disease burden was done. Country-specific data for COVID-19 cases and deaths, BCG-related data, and income level were obtained from the online databases, and the association was analyzed using linear regression. RESULTS Data of 139 countries were studied and 117 (84%) had a current BCG policy. Data on BCG strains were available for 51 countries and 18/51 (35%) used the Danish strain. While the choice of strain did not impact COVID-19-related disease burden, the presence of a current BCG policy was significantly associated with lower COVID-19 mortality. CONCLUSION The presence of current BCG policy is associated with decreased COVID-19-related disease burden, but the type of strain used by a country in its vaccination program does not impact disease burden.
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Affiliation(s)
- Vijaya Laxman Chaudhari
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
| | - Charuta Jaykumar Godbole
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
| | - Prajakta Parag Gandhe
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
| | - Nithya Jaideep Gogtay
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
| | - Urmila Mukund Thatte
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
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Rackimuthu S, Hasan MM, Bardhan M, Essar MY. COVID-19 vaccination strategies and policies in India: The need for further re-evaluation is a pressing priority. Int J Health Plann Manage 2021; 37:1847-1850. [PMID: 34510541 PMCID: PMC8652663 DOI: 10.1002/hpm.3321] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022] Open
Abstract
India is one of the worst‐hit nations by the COVID‐19 pandemic and witnessed a devastating impact across cities in the country. Although behavioral measures like wearing a face mask, maintaining social distance, and hand hygiene helped to control the spread of the disease initially, but a long‐term action by vaccinating the population is a promising solution. On 16 January 2021, India undertook the challenge to vaccinate 300 million people by August 2021 against COVID‐19, the largest vaccination campaign globally. India has been lauded by several prominent organizations around the world for its efforts. But catering to India's massive population is not without its own set of complex challenges. As of 29 July 2021, a mere 9.82 million (approximately 7.03 percent of the total Indian population) people have been fully vaccinated against COVID‐19 with the first and second dose, and only 352.5 million (roughly 25.28 percent of the total Indian population) have been partly vaccinated with the first dose. This shows, India's current COVID‐19 vaccination policies and plans are still inadequate and not undisputedly equitable even after several amendments in the guidelines. However, even with the second wave abating slowly and steadily in India, there is a need to further re‐strategize the current vaccination policy and plans in India against COVID‐19 to help achieve long‐term positive outcomes in the shortest feasible time frame hoping to evade a third wave.
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Affiliation(s)
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Mainak Bardhan
- Department of Neurology, National Institute of Mental Health And Neurosciences (NIMHANS), Bengaluru, India
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Xu Y, Liu Y, Wang J, Che X, Zhang X, Jiang W, Du J, Zhang X, Gu W. Hepatitis B virus infection seromarkers among college freshmen and their immune responses to different vaccination policies of hepatitis B vaccine. Hum Vaccin Immunother 2021; 17:4587-4594. [PMID: 34407383 DOI: 10.1080/21645515.2021.1959829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND College students are one of the susceptible population of Hepatitis B virus (HBV) infection. We aim to delineate HBV infection seromarkers among college freshmen and to evaluate immunological response of vaccination immunization for hepatitis B vaccine (HepB). METHODS A simple random sampling method was adopted to select subjects and who met the "inclusion and exclusion criteria" and who with history of vaccination were selected as the observation objects. HBsAg and anti-HBs levels were detected before revaccination. Subjects with negative anti-HBs before immunization were inoculated with 20 ug HepB according to the 0-1-6 procedure and those with weak positive anti-HBs before immunization were inoculated with 1-dose 20 ug HepB. Anti-HBs levels were detected after HepB booster. Combined with the results of anti-HBs, their immune response to HepB and influencing factors in freshmen were investigated. Anti-HBs before immunization was negative and ≥10 m IU/ml after immunization was considered positive conversion; anti-HBs before immunization was weak positive and anti-HBs≥100 m IU/ml after immunization was also considered positive conversion. RESULTS A total of 10645 freshmen were included. The total rate of HBsAg carriers was 0.6% (63/10645), and the strong positive rate of anti-HBs was 16.1% (1706/10645), the weak positive rate was 14.4% (1526/10645).1286 freshmen were vaccinated with HepB and completed the questionnaire survey. About 79.0% (154/195) of freshmen's anti-HBs turned strong positive after receiving 1-dose HepB and 100.0% (1091/1091) turned positive after receiving 3-doses HepB. The Geometrical Mean Titer (GMT) of anti-HBs was significantly influenced by gender, registration and the immunization doses of HepB. CONCLUSION The HBsAg carrying rate and anti-HBs positive rate of college freshmen were low, and the HepB has a good effect on the immunity of college freshmen. Increasing the immunization rate of HepB is very important for the prevention and control of hepatitis B.
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Affiliation(s)
- Yuyang Xu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yan Liu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jun Wang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xinren Che
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xuechao Zhang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wei Jiang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jian Du
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiaoping Zhang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wenwen Gu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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O'Doherty KC, Crann S, Bucci LM, Burgess MM, Chauhan A, Goldenberg MJ, McMurtry CM, White J, Willison DJ. Deliberation on Childhood Vaccination in Canada: Public Input on Ethical Trade-Offs in Vaccination Policy. AJOB Empir Bioeth 2021; 12:253-265. [PMID: 34328070 DOI: 10.1080/23294515.2021.1941416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input. METHODS We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood vaccination. RESULTS 25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children. CONCLUSIONS We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination.
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Affiliation(s)
| | - Sara Crann
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Lucie Marisa Bucci
- Immunize Canada, c/o Canadian Public Health Association, Ottawa, Ontario, Canada
| | - Michael M Burgess
- W. Maurice Young Centre for Applied Ethics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Apurv Chauhan
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Maya J Goldenberg
- Department of Philosophy, University of Guelph, Guelph, Ontario, Canada
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Jessica White
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Donald J Willison
- Department of Psychology, University of Guelph, Guelph and Pediatric Chronic Pain Program, McMaster Children's Hospital, Hamilton, Ontario, Canada
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25
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Kontturi A, Kekomäki S, Soini H, Ollgren J, Salo E. Paediatric tuberculosis during universal and selective Bacillus Calmette-Guérin vaccination policy: a nationwide population-based retrospective study, Finland, 1995-2015. ACTA ACUST UNITED AC 2021; 26. [PMID: 33739257 PMCID: PMC7976386 DOI: 10.2807/1560-7917.es.2021.26.11.1900711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction In 2006, the Bacillus Calmette–Guérin (BCG) vaccination policy in Finland changed from universal to selective. Aim We assessed the impact of the policy change on tuberculosis (TB) morbidity in children under 5 years and epidemiological trends of paediatric TB in Finland. Methods We conducted a nationwide, population-based, retrospective registry study of all newly diagnosed active TB cases younger than 15 years in Finland from 1995 to 2015 by linking data from the National Infectious Diseases Register, Finnish Care Register for Health Care, medical patient records and Finnish Population Information System. We compared the TB incidence rate ratio of under 5 year-olds with universal and selective BCG vaccinations with a Poisson log-linear model and analysed incidence trends among those younger than 15 years with a negative binomial model. Results We identified 139 paediatric TB cases: 50 native (including 24 second-generation migrants) and 89 foreign-born children. The TB rate of under 5 year-olds remained stable after changing to selective BCG vaccination (incidence rate ratio (IRR): 1.3; 95% confidence interval (CI): 0.7–2.3). TB rate in the native population under 15 years increased slightly (IRR = 1.06; 95% CI: 1.01–1.11). Discussion Paediatric TB cases in Finland were concentrated in families with migrant background from high-TB incidence countries. The native TB morbidity in under 5-year-olds did not increase after the BCG policy revision, suggesting that selective vaccinations can prevent TB in the most vulnerable age group in low-incidence settings. Second-generation migrants under 15 years in Finland with high TB risk are probably increasing.
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Affiliation(s)
- Antti Kontturi
- Doctoral Programme in Population Health, University of Helsinki, Helsinki, Finland
| | - Satu Kekomäki
- Department of Pediatrics, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Soini
- Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland
| | - Jukka Ollgren
- Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland
| | - Eeva Salo
- Department of Pediatrics, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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26
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Verger P, Dualé C, Scronias D, Lenzi N, Pulcini C, Launay O. Attitudes of hospital physicians toward childhood mandatory vaccines in France: A cross-sectional survey. Hum Vaccin Immunother 2021; 18:1870393. [PMID: 33616464 PMCID: PMC8920152 DOI: 10.1080/21645515.2020.1870393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Due to a decades-long crisis of confidence in vaccination, in 2017 France extended the number of mandatory early childhood vaccines from 3 to 11. Aims To describe the opinions of hospital staff physicians (HSPs) regarding this measure, quantify the proportion who would have preferred measures based on education, and study the factors associated with the latter opinion. Methods Cross-sectional nationwide survey with a standardized questionnaire in 2018–2019 among HSPs in 14 French public hospitals. The factors associated with HSPs’ preference for education and persuasion over mandatory vaccination were analyzed with simple and multiple Poisson regressions. Results The analyses included 1,795 HSPs (participation rate of 86%). Among them, 84% considered the extension of mandatory childhood vaccination essential given the epidemiological context at the time; in a later question, 40% would have preferred education and persuasion. Multiple regressions showed that the latter tended to be younger and less trustful of sources of information about vaccination. They were more likely to think that information on the rationale behind the national vaccination policy lacked clarity and that the extension of mandatory vaccines was not essential, even in the current epidemiologic situation. Conclusion Although most HSPs agreed that the extension of mandatory childhood vaccines was essential, some were ambivalent about its coercive philosophy. Further research is necessary to better understand the reasons of this ambivalence. A fraction did not understand the French vaccination strategy well. Efforts to explain its details to HSPs and an overhaul of their initial training on vaccination are still needed.
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Affiliation(s)
- Pierre Verger
- Research Department, Southeastern Health Regional Observatory (Observatoire Régional De La Santé Paca), Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France
| | - Christian Dualé
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Centre Hospitalo-universitaire, Clermont-Ferrand, Centre d'Investigation Clinique, INSERM, Clermont-Ferrand, France
| | - Dimitri Scronias
- Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Nezha Lenzi
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Céline Pulcini
- PEMAC, équipe MICS, Université de Lorraine, Nancy, France.,Infectious Diseases Department, Université de Lorraine, CHRU-Nancy, Nancy, France
| | - Odile Launay
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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27
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Hollingsworth R, El Guerche-Séblain C, Tsai T, Vasiliev Y, Lee S, Bright H, Barbosa P. Assessment of the benefits of seasonal influenza vaccination: Elements of a framework to interpret estimates of vaccine effectiveness and support robust decision-making and communication. Influenza Other Respir Viruses 2020; 15:164-174. [PMID: 32885610 PMCID: PMC7767949 DOI: 10.1111/irv.12786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/03/2022] Open
Abstract
Systematic reviews and meta‐analyses confirm that influenza vaccination reduces the risk of influenza illness by between about 40% and 60% in seasons when circulating influenza stains are well matched to vaccine strains. Influenza vaccine effectiveness (IVE) estimates, however, are often discordant and a source of confusion for decision makers. IVE assessments are increasingly publicized and are often used by policy makers to make decisions about the value of seasonal influenza vaccination. But there is limited guidance on how IVE should be interpreted or used to inform policy. There are several limitations to the use of IVE for decision‐making: (a) IVE studies have methodological issues that often complicate the interpretation of their value; and (b) the full impact of vaccination will almost always be greater than the impact assessed by a point estimate of IVE in specific populations or settings. Understanding the strengths and weaknesses of study methodologies and the fundamental limitations of IVE estimates is important for the accuracy of interpretations and support of policy makers’ decisions. Here, we review a comprehensive set of issues that need to be considered when interpreting IVE and determining the full benefits of influenza vaccination. We propose that published IVE values should be assessed using an evaluative framework that includes influenza‐specific outcomes, types of VE study design, and confounders, among other factors. Better interpretation of IVE will improve the broader assessment of the value of influenza vaccination and ultimately optimize the public health benefits in seasonal influenza vaccination.
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Affiliation(s)
| | | | | | - Yuri Vasiliev
- St. Petersburg Research Institute of Vaccines and Sera, Krasnoe Selo, Russian Federation
| | - Sam Lee
- Sanofi Pasteur, Swiftwater, PA, USA
| | | | - Paula Barbosa
- International Federation of Pharmaceutical Manufacturers and Associations, Geneva, Switzerland
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28
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Abstract
Objective Success of any vaccination program and uptake of children's vaccines largely depends upon the parents' perceptions and attitudes. This study provides a snapshot of parents' views towards vaccines included in the nationally-funded vaccination program, together with two unfunded vaccines in Kocaeli, Turkey. Methods Data were gathered from a convenience sample through a questionnaire that explored the socio-demographic factors of the parents and the vaccination status of their children. The survey content was based on Health Belief Model. Mann-Whitney test was used for comparisons as there is no prior information regarding data distribution and the dependent variable is represented on an ordinal scale. Out of 300 parents who brought their children into the pediatrics polyclinics, 262 parents responded positively and took part. The questionnaires were filled out by mothers alone 67.6 % (n=177), 28.6 % (n=75) by fathers and mothers (both present), 3.1% (n=8) by fathers alone and the remaining 0.8% (n=2) were filled by other relatives. Results While the majority of diseases prevented by the vaccines were perceived to be serious, pneumococcal infection and chickenpox were considered to be less serious and there was no strong opinion for the rotavirus vaccine. The main reasons that influenced parents' decisions towards unfunded vaccines were advice from a pediatrician and the cost. Lastly, demographic factors such as family income, mothers' education and job types of mothers were important in contrast to previously published studies. Conclusions The acceptance of a new vaccine depends on a complex interaction of factors, but parents' perceptions may vary considerably. The main factors influencing parental acceptance are the availability of information and the cost. Therefore, for a new vaccination program to succeed, it should be funded by the government and a specific public health education program should be undertaken.
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29
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Zhou S, Greene CM, Song Y, Zhang R, Rodewald LE, Feng L, Millman AJ. Review of the status and challenges associated with increasing influenza vaccination coverage among pregnant women in China. Hum Vaccin Immunother 2020; 16:602-611. [PMID: 31589548 DOI: 10.1080/21645515.2019.1664230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Influenza vaccination coverage in pregnant women in China remains low. In this review, we first provide an overview of the evidence for the use of influenza vaccination during pregnancy. Second, we discuss influenza vaccination policy and barriers to increased seasonal influenza vaccination coverage in pregnant women in China. Third, we provide case studies of successes and challenges of programs for increasing seasonal influenza vaccination in pregnant women from other parts of Asia with lessons learned for China. Finally, we assess opportunities and challenges for increasing influenza vaccination coverage among pregnant women in China.
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Affiliation(s)
- Suizan Zhou
- Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carolyn M Greene
- Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ying Song
- Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ran Zhang
- Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lance E Rodewald
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Luzhao Feng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alexander J Millman
- Influenza Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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30
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Wong A, Opinel A, Combes SJB, Toubiana J, Brisse S. Determining Factors for Pertussis Vaccination Policy: A Study in Five EU Countries. Vaccines (Basel) 2020; 8:vaccines8010046. [PMID: 31991855 PMCID: PMC7158661 DOI: 10.3390/vaccines8010046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 01/26/2023] Open
Abstract
Pertussis vaccination policy varies across Europe, not only in the type of vaccine-whole cell (wP) vs. acellular (aP1/2/3/5)-but also in the schedule and recommendation for parents. This study aims to investigate the determining factors for the type of vaccine, immunization schedule and maternal immunization recommendation. From March to May 2019, experts in national health agencies and major academic or research institutions from Denmark, France, Poland, Sweden and the UK were invited to a semi-structured interview. Thematic analysis was performed on the transcripts using a codebook formulated by three coders. Inter-coder agreement was assessed. Fifteen expert interviews were conducted. The identified driving factors for pertussis vaccine policy were classified into three domains: scientific factors, sociological factors, and pragmatic factors. The determining factors for the type of vaccine were prescriber's preference, concern of adverse events following immunization (AEFI), effectiveness, and consideration of other vaccine components in combined vaccines. The determining factors for infant schedule were immunity response and the potential to improve coverage and timeliness. The determining factors for maternal immunization were infant mortality and public acceptability. To conclude, socio-political and pragmatic factors were, besides scientific factors, important in determining the pertussis vaccine type, schedule of childhood immunization and recommendations for parents.
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Affiliation(s)
- Anabelle Wong
- Institut Pasteur/INSERM/University of Versailles Saint Quentin, UMR 1181 Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases, 25 rue du Dr Roux, CEDEX 15, F-75724 Paris, France;
- EHESP French School of Public Health, F-35000 Rennes, France
- ScHARR, The University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK
- Correspondence:
| | - Annick Opinel
- Institut Pasteur/INSERM/University of Versailles Saint Quentin, UMR 1181 Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases, 25 rue du Dr Roux, CEDEX 15, F-75724 Paris, France;
| | - Simon Jean-Baptiste Combes
- Univ Rennes, EHESP, CNRS, ARENES—UMR 6051, F-35000 Rennes, France;
- French Collaborative Institute on Migration, 93322 Aubervilliers, France
| | - Julie Toubiana
- Institut Pasteur, Unit Biodiversity and Epidemiology of Bacterial Pathogens, 25 rue du Dr Roux, CEDEX 15, F-75724 Paris, France; (J.T.); (S.B.)
- National Reference Center for Whooping Cough and OtherBordetella Infections, Institut Pasteur, 25 rue du Dr Roux, CEDEX 15, F-75724 Paris, France
- Department of General Paediatrics and Infectious Diseases, Necker-Enfants malades University Hospital, Université de Paris, AP-HP, 135 rue de Sevres, 75015 Paris, France
| | - Sylvain Brisse
- Institut Pasteur, Unit Biodiversity and Epidemiology of Bacterial Pathogens, 25 rue du Dr Roux, CEDEX 15, F-75724 Paris, France; (J.T.); (S.B.)
- National Reference Center for Whooping Cough and OtherBordetella Infections, Institut Pasteur, 25 rue du Dr Roux, CEDEX 15, F-75724 Paris, France
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Abstract
Background In 2005 in England, universal Bacillus Calmette–Guérin (BCG) vaccination of school-age children was replaced by targeted BCG vaccination of high-risk neonates. Aim Estimate the impact of the 2005 change in BCG policy on tuberculosis (TB) incidence rates in England. Methods We conducted an observational study by combining notifications from the Enhanced Tuberculosis Surveillance system, with demographic data from the Labour Force Survey to construct retrospective cohorts relevant to both the universal and targeted vaccination between 1 January 2000 and 31 December 2010. We then estimated incidence rates over a 5-year follow-up period and used regression modelling to estimate the impact of the change in policy on TB. Results In the non-United Kingdom (UK) born, we found evidence for an association between a reduction in incidence rates and the change in BCG policy (school-age incidence rate ratio (IRR): 0.74; 95% credible interval (CrI): 0.61 to 0.88 and neonatal IRR: 0.62; 95%CrI: 0.44 to 0.88). We found some evidence that the change in policy was associated with an increase in incidence rates in the UK born school-age population (IRR: 1.08; 95%CrI: 0.97 to 1.19) and weaker evidence of an association with a reduction in incidence rates in UK born neonates (IRR: 0.96; 95%CrI: 0.82 to 1.14). Overall, we found that the change in policy was associated with directly preventing 385 (95%CrI: −105 to 881) cases. Conclusions Withdrawing universal vaccination at school age and targeting vaccination towards high-risk neonates was associated with reduced incidence of TB. This was largely driven by reductions in the non-UK born with cases increasing in the UK born.
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Affiliation(s)
- Sam Abbott
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Hannah Christensen
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Nicky J Welton
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Ellen Brooks-Pollock
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
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Abstract
CONTEXT This research examines the development of vaccination policy in Britain, the United States, and Australia to begin to understand the different forms of coercion that industrialized states utilize to achieve vaccination compliance from the majority of their citizens. METHODS This research applies a comparative-historical analysis of the three countries listed, using a combination of primary and secondary documents. FINDINGS The different degrees of compulsion in the vaccination policies of Britain, the United States, and Australia is explained through an analysis of the path-dependent ways that each nation adapted coercion in response to civil society resistance. Each nation has moved up and down a continuum of coercion searching for a policy that balances overcoming passive noncompliance without engendering active resistance. Arriving at different balancing points between these two objectives, the three nations have now institutionalized policies with different degrees of coercion. CONCLUSIONS This research shows that vaccination policy is not just created top-down by the state, but through an ongoing interactive process with citizens and civil society. Furthermore, as vaccination is a "wicked problem" that faces ongoing civil society resistance, states will need to perpetually adapt the coerciveness of their policies into the foreseeable future.
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Bester JC. Not a matter of parental choice but of social justice obligation: Children are owed measles vaccination. Bioethics 2018; 32:611-619. [PMID: 30229958 DOI: 10.1111/bioe.12511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/26/2018] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
This article presents arguments that reframe the discussion on vaccination ethics. The correct starting point for discussions on vaccination ethics is not what society owes parents, but rather what society owes children. Drawing on the justice theory of Powers and Faden, two conclusions are defended by presenting and defending a set of arguments. First, a just society is obligated to protect its children against serious vaccine-preventable diseases such as measles through adequate levels of vaccination. Second, this obligation of the just society rests on identifiable individuals and institutions: parents, healthcare professionals, government, and vaccine producers have important obligations in this regard. This removes vaccination out of the realm of individual or parental discretion, and situates it in the realm of societal obligation. Children are owed vaccination, society is obligated to provide it. If parents cannot or will not provide it, society ought to respond.
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Affiliation(s)
- Johan C Bester
- University of Nevada, Las Vegas, School of Medicine, Las Vegas, Nevada, United States
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34
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McDonald SA, van Asten L, van der Hoek W, Donker GA, Wallinga J. The impact of national vaccination policy changes on influenza incidence in the Netherlands. Influenza Other Respir Viruses 2016; 10:76-85. [PMID: 26648343 PMCID: PMC4746562 DOI: 10.1111/irv.12366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2015] [Indexed: 12/01/2022] Open
Abstract
Background We assessed the impact of two major modifications of the Dutch National Influenza Prevention Programme – the introduction in 1997 of free‐of‐charge vaccination to persons aged ≥65 years and to high‐risk groups (previously only advised, and not free of charge), and the lowering of the eligible age to 60 years in 2008 – on the estimated incidence of influenza infection leading to influenza‐like illness (ILI). Methods Additive negative‐binomial segmented regression models were fitted to ILI data from GP sentinel surveillance in two‐eight‐season intervals (1993/4 to 2000/1, 2004/5 to 2011/12, comparing pre‐ and post‐policy‐change periods within each interval), with laboratory virological reporting of samples positive for influenza or other ILI‐causing pathogens as covariates. Results For the 2008 policy change, there was a significant step decrease in influenza contribution considering all ages (=−111 per 100 positives; 95% CI: −162, −65·0), <60 years and 60–64 years age groups (B = −92·1 per 100; 95% CI: −134, −55·5; B = −5·2; 95% CI: −10·3, −1·2, respectively). There was no evidence for a decrease associated with the 1997 policy change targeting the ≥65 years age group. Conclusions In the Netherlands, a 56% reduction in influenza contribution was associated with the 2008 policy targeting 60–64 year‐olds, but there was no effect of the earlier policy targeting ≥65‐year‐olds, for whom vaccination coverage was already rising before the policy change.
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Affiliation(s)
- Scott A McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Liselotte van Asten
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Gé A Donker
- NIVEL Primary Care Database, Sentinel Practices, Utrecht, The Netherlands
| | - Jacco Wallinga
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Abstract
BACKGROUND The recent increase in whooping cough incidence (primarily caused by Bordetella pertussis) presents a challenge to both public health practitioners and scientists trying to understand the mechanisms behind its resurgence. Three main hypotheses have been proposed to explain the resurgence: 1) waning of protective immunity from vaccination or natural infection over time, 2) evolution of B. pertussis to escape protective immunity, and 3) low vaccine coverage. Recent studies have suggested a fourth mechanism: asymptomatic transmission from individuals vaccinated with the currently used acellular B. pertussis vaccines. METHODS Using wavelet analyses of B. pertussis incidence in the United States (US) and United Kingdom (UK) and a phylodynamic analysis of 36 clinical B. pertussis isolates from the US, we find evidence in support of asymptomatic transmission of B. pertussis. Next, we examine the clinical, public health, and epidemiological consequences of asymptomatic B. pertussis transmission using a mathematical model. RESULTS We find that: 1) the timing of changes in age-specific attack rates observed in the US and UK are consistent with asymptomatic transmission; 2) the phylodynamic analysis of the US sequences indicates more genetic diversity in the overall bacterial population than would be suggested by the observed number of infections, a pattern expected with asymptomatic transmission; 3) asymptomatic infections can bias assessments of vaccine efficacy based on observations of B. pertussis-free weeks; 4) asymptomatic transmission can account for the observed increase in B. pertussis incidence; and 5) vaccinating individuals in close contact with infants too young to receive the vaccine ("cocooning" unvaccinated children) may be ineffective. CONCLUSIONS Although a clear role for the previously suggested mechanisms still exists, asymptomatic transmission is the most parsimonious explanation for many of the observations surrounding the resurgence of B. pertussis in the US and UK. These results have important implications for B. pertussis vaccination policy and present a complicated scenario for achieving herd immunity and B. pertussis eradication.
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Abstract
The universal health care system in Japan is facing a historical turning point as a result of the increasing fiscal burden, rapidly aging society, and a decreasing population. To understand the challenges and opportunities in the Japanese pharmaceutical market, which occupies one tenth of the global share, this review highlights several issues related to the benefit-risk assessment that is unique to the modern Japanese society: 1) regulatory system for new drug development; 2) health hazards related to pharmaceuticals ("Yakugai" in Japanese); 3) drug lag; 4) problems and controversies in the vaccination policy; and 5) clinical study misconduct. The regulatory process places a significant importance on Japanese data collection regardless of data accumulation from other countries. Because Yakugai has repeatedly caused tragedies and social disputes historically, the regulatory judgments generally tend to be more prudential when safety concerns are raised for new and emerging pharmaceuticals. Such a regulatory system has caused more than several years of approval delays compared to delays in other countries. The problem of drug lag still lingers on despite several regulatory system revisions, while the solution is incompatible with the elimination of Yakugai because the lag potentially reduces the risk of unpredictable adverse events. The Japanese vaccination policy has also received a lot of criticism, and needs improvements so that the decision-making process can be more transparent and scientifically based. Additionally, repeated clinical study misconduct damaged the reputation of Japanese clinical studies with unnecessary defrayment in health insurance; therefore, the medical community must change its inappropriate relationship with the industry. The problems surrounding pharmaceuticals are related to centralized, strict drug pricing control under the universal health coverage. Although the current government attempts to facilitate innovative research and development of novel therapeutics in Japan, further reforms should be explored for patients who need new and emerging pharmaceuticals.
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Affiliation(s)
- Tetsuya Tanimoto
- Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
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Levine H, Zarka S, Ankol OE, Rozhavski V, Davidovitch N, Aboudy Y, Balicer RD. Seroprevalence of measles, mumps and rubella among young adults, after 20 years of universal 2-dose MMR vaccination in Israel. Hum Vaccin Immunother 2015; 11:1400-5. [PMID: 25891446 PMCID: PMC4514436 DOI: 10.1080/21645515.2015.1032489] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/26/2015] [Accepted: 03/15/2015] [Indexed: 10/23/2022] Open
Abstract
Evidence-based vaccination policy is important for the global and local efforts of achieving control over measles. In 2007, the first Israeli birth cohort to be twice vaccinated during childhood with Measles-Mumps-Rubella vaccine reached adulthood. In parallel, Israel experienced its largest measles outbreak since 1994. We aimed to assess the seroprevalence of measles IgG antibodies and concordance with rubella and mumps seroprevalence among young Israeli adults born 1988-9 in comparison to previous birth cohorts, in order to inform evidence based prevention policy. We conducted a seroprevalence study of IgG antibodies among 439 Israeli adults born in 1988-9, based on a representative sample of sera collected at age 18-19 upon recruitment to mandatory military service in 2007. In total, 85.7% were seropositive for measles as compared with 95.6% in the 1996 recruitment (P < 0.001). The absolute decline was significant both for males (8.8%, P = 0.001) and females (12.1%, P < 0.001). There were no significant differences in seropositivity by gender, years of education, country of birth or smoking status. Rubella seropositivity among measles seropositives was 90.4%, significantly (P < 0.001) higher than 72.1% among measles seronegatives. Mumps seropositivity among measles seropositives was 87.0%, significantly (P < 0.001) higher than 62.3% among measles seronegatives. Results were similar for Israeli-born only. Our findings indicate that measles seroprevalence decreased after the last change in vaccination policy and reach sub-optimal level. Until global eradication is reached, a proactive vaccination program to supplement routine childhood vaccination program should be considered in Israel and in other countries.
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Affiliation(s)
- Hagai Levine
- Israeli Defense Force, Medical Corps; Tel Hashomer, Israel
- Braun School of Public Health and Community Medicine; Hebrew University-Hadassah Medical Organization; Jerusalem, Israel
| | - Salman Zarka
- Israeli Defense Force, Medical Corps; Tel Hashomer, Israel
- Haifa University School of Public Health; Haifa, Israel
| | - Omer E Ankol
- Israeli Defense Force, Medical Corps; Tel Hashomer, Israel
- Department of Health Management; School of Health Sciences; Ariel University; Ariel, Israel
| | | | - Nadav Davidovitch
- Israeli Defense Force, Medical Corps; Tel Hashomer, Israel
- Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva, Israel
| | - Yair Aboudy
- Central Virology Laboratory; Ministry of Health; Sheba Medical Center; Tel Hashomer, Israel
| | - Ran D Balicer
- Israeli Defense Force, Medical Corps; Tel Hashomer, Israel
- Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva, Israel
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38
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Wu LA, Kanitz E, Crumly J, D'Ancona F, Strikas RA. Adult immunization policies in advanced economies: vaccination recommendations, financing, and vaccination coverage. Int J Public Health 2013; 58:865-74. [PMID: 23354183 PMCID: PMC3840285 DOI: 10.1007/s00038-012-0438-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 11/16/2012] [Accepted: 11/29/2012] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES While many countries have robust child immunization programs and high child vaccination coverage, vaccination of adults has received less attention. The objective of this study was to describe the adult vaccination policies in developed countries. METHODS From 2010 to 2011, we conducted a survey of 33 advanced economies as defined by the International Monetary Fund. The survey asked about national recommendations for adults for 16 vaccines or vaccine components, funding mechanisms for recommended adult vaccines, and the availability of adult vaccination coverage estimates. RESULTS Thirty-one of 33 (93.9 %) advanced economies responded to the survey. Twelve of 31 (38.7 %) reported having a comprehensive adult immunization schedule. The total number of vaccines or vaccine components recommended for adults ranged from one to 15 with a median of 10. Seasonal influenza (n = 30), tetanus (n = 28), pneumococcal polysaccharide (n = 27), and hepatitis B (n = 27) were the most frequently recommended vaccines or components. CONCLUSIONS Approximately two-thirds of survey respondents do not have a comprehensive adult vaccine schedule, and most do not measure vaccination coverage. We found that a funding mechanism is available for most recommended adult vaccines.
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Affiliation(s)
- Lauren A Wu
- National Vaccine Program Office, U.S. Department of Health and Human Services, Washington, DC, USA,
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Mimouni D, Levine H, Tzurel Ferber A, Rajuan-Galor I, Huerta-Hartal M. Secular trends of chickenpox among military population in Israel in relation to introduction of varicella zoster vaccine 1979-2010. Hum Vaccin Immunother 2013; 9:1303-7. [PMID: 23412473 DOI: 10.4161/hv.23943] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Chickenpox is a contagious disease caused by the varicella zoster virus. There is scarce data on long-term trends of chickenpox and its relation to vaccinations practices. We aimed to evaluate trends of chickenpox in a military population during the period 1979-2010 and to assess temporal associations in relation with the introduction of varicella zoster vaccine to the civilian population in Israel in 2000. The archives of the Epidemiology Section of the Israel Defense Forces, where chickenpox is a notifiable disease, were reviewed for all cases of chickenpox from January 1, 1979-December 31, 2010. Annual and monthly incidence rates were calculated and analyzed in relation to vaccine introduction. Between 1979-2000, incidence rates fluctuated around 10 cases per 10,000 soldiers without a clear trend. Since 2000 there has been a dramatic 10-fold decline in incidence, especially notable since 2008, from eight per 10,000 soldiers in 2000 to the lowest rate ever recorded, in 2009, of 0.57 cases per 10,000 soldiers. A seasonal sinusoidal pattern was clearly demonstrated, with rising incidence from November to May followed by a gradual decline to October. The results of this long-term study suggest that the rates of chickenpox in the military population have significantly declined since the introduction of the vaccine to the civilian population in Israel and almost disappeared completely since 2008 as the vaccine was included in the state-funded routine childhood immunization schedule. These findings underscore the need for a strong surveillance system and will aid in determing vaccination policies.
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Affiliation(s)
- Daniel Mimouni
- Army Health Branch; Medical Corps; Israeli Defense Forces; Tel Hashomer, Isreal; Sackler Faculty of Medicine;Tel Aviv University; Tel Aviv, Israel; Department of Dermatology; Rabin Medical Center; Beilinson Campus; Petach Tikva, Israel; These authors contributed equally to this work
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40
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Bégué P. [Varicella and zoster vaccines]. Virologie (Montrouge) 2006; 10:407-14. [PMID: 34753241 DOI: 10.1684/vir.2011.8640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The varicella vaccine (OKA strain) first used in Japan in 70's was introduced into the routine infants immunisation schedule of United States in 1995. Two other new varicella vaccines have been just licensed: a tetravalent measles-mumps-rubella-varicella vaccine (MMRV) and a zoster vaccine for more than 60 years old adults. In Europe varicella vaccine is not introduced in routine infant schedule, except in Germany, and only used for targeted aims. This reluctance is justified by several considerations: the fear of a shift of varicella to adults by low vaccine coverage, the risk of increasing zoster in adults by a mass vaccination. Several recent varicella outbreaks in highly vaccinated children stress the possible need for a routine second dose of vaccine in infants. The cost-effectiveness studies results are not similar in different countries and the benefits are indirect (time off work).Varicella is often considered as a mild disease, in spite of a better knowledge of complications and health benefits in United-States, where vaccination has resulted in a dramatic decline of deaths, hospitalisations and varicella-related complications. The new tetravalent MMRV vaccine could stimulate Europe to implement routine vaccination, provided that an efficient surveillance for varicella and shingles be instituted.
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