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Australian parents' experiences with adolescent age-based vaccinations during the COVID-19 pandemic 澳大利亚父母在 COVID-19 大流行期间为青少年按年龄接种疫苗的经历。
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-11-07 DOI: 10.1016/j.vaccine.2024.126498
Maryke S. Steffens , Katarzyna T. Bolsewicz , Catherine King , Bianca Bullivant , Ikram Abdi , Frank Beard

Purpose

In Australia, adolescents are scheduled to receive vaccinations against diphtheria, tetanus, pertussis, human papillomavirus, and meningococcal disease, delivered via school vaccination programs and general practitioners (GPs). Public health measures implemented in response to the COVID-19 pandemic impacted uptake of some adolescent age-based vaccinations. Limited information is available on parents' approaches to vaccinating their adolescent children during the pandemic. We aimed to explore parents' experiences of adolescent age-based vaccinations during the pandemic, and factors they perceived as hindering or facilitating vaccination.

Methods

In July 2022 we recruited 21 Australian parents of adolescent children eligible for age-based vaccinations in 2021. We recruited from metropolitan and regional settings, and from states where uptake was most and least affected by pandemic disruptions. We conducted 30-min virtual or phone interviews and analysed the data thematically.

Results

Parents described how experiences before and during the COVID-19 pandemic influenced their perspectives on and experiences with adolescent age-based vaccinations. Motivation to vaccinate their children was informed by personal beliefs and experiences with the healthcare system. Parents described practical issues, including ease of access to the school vaccination program or a GP, and knowledge about vaccination schedules and services. Parents suggested enhancing promotion of adolescent vaccination benefits and information sharing, and recommended improving access to vaccination services outside the school program.

Discussion

Findings have potential to improve delivery of adolescent age-based vaccinations, including during future pandemics. While this study was conducted in the Australian context, findings and recommendations have relevance to overseas adolescent age-based vaccination programs.
目的:在澳大利亚,青少年通过学校疫苗接种计划和全科医生 (GP) 接种白喉、破伤风、百日咳、人类乳头瘤病毒和脑膜炎球菌病疫苗。为应对 COVID-19 大流行而实施的公共卫生措施影响了一些青少年年龄段疫苗的接种率。有关大流行期间家长为其青少年子女接种疫苗的方法的信息十分有限。我们旨在探究大流行期间家长为青少年接种疫苗的经验,以及他们认为阻碍或促进接种疫苗的因素:2022 年 7 月,我们招募了 21 位澳大利亚家长,他们都是在 2021 年符合接种适龄疫苗条件的青少年儿童。我们从大都市和地区,以及受大流行病干扰影响最大和最小的州进行了招募。我们进行了 30 分钟的虚拟或电话访谈,并对数据进行了专题分析:结果:家长们描述了在 COVID-19 大流行之前和期间的经历如何影响了他们对青少年按年龄接种疫苗的看法和经验。为子女接种疫苗的动机来自于个人信仰和医疗保健系统的经验。家长们描述了一些实际问题,包括是否容易获得学校疫苗接种计划或全科医生的服务,以及对疫苗接种时间表和服务的了解。家长们建议加强宣传青少年接种疫苗的益处和信息共享,并建议改善学校计划之外的接种服务:讨论:研究结果有望改善青少年适龄疫苗接种服务,包括在未来的大流行期间。虽然这项研究是在澳大利亚的背景下进行的,但研究结果和建议对海外的青少年适龄疫苗接种计划也有借鉴意义。
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引用次数: 0
Effect of COVID-19 vaccination on the risk of developing post-COVID conditions: The VENUS study 接种 COVID-19 疫苗对罹患后 COVID 病症风险的影响:VENUS 研究
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-11-05 DOI: 10.1016/j.vaccine.2024.126497
Sung-a Kim , Megumi Maeda , Fumiko Murata , Haruhisa Fukuda

Introduction

Post-COVID-19 conditions have emerged as a global health challenge. This study examined the long-term effects of COVID-19 vaccination on the incidence and risk of post-COVID-19 conditions in Japan.

Methods

This retrospective cohort study was conducted using a database comprising medical claims, COVID-19 case information, and vaccination records of persons residing in four Japanese municipalities. The cohort included COVID-19 cases diagnosed between August 2020 and December 2022. Participants were classified according to the duration between their most recent COVID-19 vaccination and COVID-19 occurrence (≥365 days, 150–364 days, and 14–149 days). The incidences of 36 post-COVID-19 conditions were monitored for 3, 5, and 8 months after infection. Cox proportional hazards models were used to calculate the risk of developing each post-COVID-19 condition within 8 months after infection according to vaccination status.

Results

From among 84,464 participants, 9642 (11.4 %) developed post-COVID-19 conditions over 8 months. The 8-month risks of developing 28 (including various respiratory conditions, cardiovascular conditions, inflammatory and immune diseases, physical conditions, psychiatric conditions, and endocrine disorders) of the 36 target conditions were significantly lower when individuals had been recently vaccinated (14–149 days) before infection.

Conclusions

COVID-19 vaccination can reduce the incidence and risk of post-COVID-19 conditions if administered within 5 months before infection. Despite having the highest mean age and prevalence of comorbidities, individuals who were most recently vaccinated had a lower risk of developing post-COVID-19 conditions. These results provide important evidence for future COVID-19 vaccination strategies.
导言:COVID-19 后遗症已成为一项全球性的健康挑战。本研究探讨了 COVID-19 疫苗接种对日本 COVID-19 后遗症发病率和风险的长期影响。研究对象包括 2020 年 8 月至 2022 年 12 月期间确诊的 COVID-19 病例。根据最近一次接种COVID-19疫苗与COVID-19发生之间的持续时间对参与者进行了分类(≥365天、150-364天和14-149天)。在感染后的3、5和8个月中,对36种COVID-19后病症的发病率进行了监测。根据疫苗接种情况,使用 Cox 比例危险模型计算感染后 8 个月内出现每种 COVID-19 后疾病的风险。结果在 84,464 名参与者中,9642 人(11.4%)在 8 个月内出现了 COVID-19 后疾病。在感染前最近接种过疫苗(14-149 天)的人在 8 个月内患上 36 种目标疾病中的 28 种(包括各种呼吸系统疾病、心血管疾病、炎症和免疫疾病、身体疾病、精神疾病和内分泌失调)的风险显著较低。尽管平均年龄和合并症发病率最高,但最近接种过疫苗的人患 COVID-19 后遗症的风险较低。这些结果为未来的 COVID-19 疫苗接种策略提供了重要依据。
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引用次数: 0
Unraveling COVID-19 vaccine hesitancy in Europeans 50 and older through a lens of preventive practices 从预防性实践的角度解读欧洲 50 岁及以上人群对 COVID-19 疫苗的犹豫态度
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-11-05 DOI: 10.1016/j.vaccine.2024.126485
K. Delaruelle , E. Lermytte , M. Bockstal , P. Vuolanto , P. Bracke

Background

The COVID-19 pandemic underscored the issue of vaccine hesitancy, leading researchers to study the determinants of people's willingness to receive the COVID-19 vaccine. This study is the first to comprehensively investigate the role of preventive practices at both the individual and contextual level, drawing on the theoretical concept of “cultural health capital”.

Methods

Utilizing data from the Survey of Health, Ageing, and Retirement (SHARE), covering information from 18,454 individuals aged 50 years and above residing in 25 European countries, we examined the influence of past engagement in preventive practices and the prevalence of such practices within a country on the likelihood of COVID-19 vaccine uptake. Our analysis included (i) previous vaccination behaviors, (ii) other healthcare-related behaviors, and (iii) lifestyle factors at both the individual and contextual levels. Leveraging the longitudinal design of the SHARE, we accounted for the temporal ordering of the relationships.

Results

At the individual level, almost all preventive behaviors were significantly related to people's willingness to receive the COVID-19 vaccine. Individuals who (i) had received an influenza vaccination prior to the COVID-19 outbreak and during childhood, (ii) had regularly participated in dental and blood pressure check-ups throughout their lives, and (iii) did not engage in lifestyle-related risk behaviors, were more likely to accept the COVID-19 vaccine. Notably, alcohol use was not significantly associated. At the contextual level, only the vaccination coverage rate for influenza was found to be robustly related, indicating that individuals were more inclined to receive the COVID-19 vaccine in countries with higher influenza vaccination rates prior to the pandemic.

Conclusion

Active participation in preventive practices and effective implementation of vaccination campaigns can contribute to the development of (institutional) cultural health capital, which ultimately promotes a greater willingness to get vaccinated against COVID-19.
背景COVID-19大流行凸显了疫苗犹豫不决的问题,促使研究人员开始研究人们是否愿意接种COVID-19疫苗的决定因素。本研究借鉴 "文化健康资本 "的理论概念,首次从个人和环境两个层面全面研究了预防性实践的作用。方法利用健康、老龄化和退休调查(SHARE)的数据(涵盖居住在 25 个欧洲国家的 18,454 名 50 岁及以上人士的信息),我们研究了过去参与的预防性实践以及这些实践在一个国家的流行程度对接种 COVID-19 疫苗的可能性的影响。我们的分析包括:(i) 以前的疫苗接种行为;(ii) 其他医疗保健相关行为;(iii) 个人和环境层面的生活方式因素。结果在个人层面,几乎所有的预防行为都与人们接种 COVID-19 疫苗的意愿显著相关。(i)在 COVID-19 爆发前和儿童时期接种过流感疫苗的人,(ii)终生定期参加牙科和血压检查的人,以及(iii)没有与生活方式相关的危险行为的人,更有可能接受 COVID-19 疫苗。值得注意的是,酗酒与疫苗接种的关系不大。结论 积极参加预防性实践和有效开展疫苗接种活动有助于发展(制度性)文化健康资本,最终促进人们更愿意接种 COVID-19 疫苗。
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引用次数: 0
Corrigendum to “Evaluation of commercial quadrivalent foot-and-mouth disease vaccines against east African virus strains reveals limited immunogenicity and duration of protection” [Vaccine 42 (1–12) (2024) 126325] 针对东非病毒株的商用四价口蹄疫疫苗评估显示免疫原性和保护期有限》[疫苗 42 (1-12) (2024) 126325]更正
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-11-05 DOI: 10.1016/j.vaccine.2024.126480
Susan D. Kerfua , Daniel T. Haydon , Ginette Wilsden , Anna Ludi , Donald P. King , Rose Ademun Okurut , Stella Atim , Moses T. Dhikusooka , Ivan Kyakuwa , Paolo Motta , David J. Paton
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引用次数: 0
Cost effectiveness analysis of rotavirus vaccination in Indonesia 印度尼西亚轮状病毒疫苗接种的成本效益分析
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-11-04 DOI: 10.1016/j.vaccine.2024.126478
Jarir At Thobari , Emma Watts , Natalie Carvalho , Jonathan Hasian Haposan , Andrew Clark , Frédéric Debellut , Asal Wahyuni Erlin Mulyadi , Julitasari Sundoro , Mardiati Nadjib , Sri Redzeki Hadinegoro , Julie Bines , Yati Soenarto

Background

Rotavirus (RV) remains the most common cause of morbidity and mortality due to acute gastroenteritis (AGE) in children under five. In Indonesia, RV is responsible for 60 % of severe AGE and 40 % of non-severe AGE in these children. This study assessed the cost-effectiveness of introduction of rotavirus vaccines (RVV) into the National Immunization Program in Indonesia.

Methods

We conducted a cost-effectiveness analysis (CEA) of RVV introduction in Indonesia, assuming a three-dose vaccine schedule based on the planned introduction proposed by the Strategic Advisory Group of Experts on Immunization. The analysis involved an initial introduction of an imported RVV (Rotavac®, Bharat Biotech, India) followed by a staged implementation of the locally produced RVV (Bio Farma, Indonesia) from both health system and societal perspectives. The primary outcome measure was the incremental cost (2019 USD) per disability-adjusted life year (DALY) averted, compared to no vaccination. We took model inputs from an Indonesian cost-of-illness study, national information systems and scientific literature, covering disease incidence, hospitalization, mortality, healthcare costs, and vaccine related factors. Our analyses included univariate and probabilitistic sensitivity analyses to assess various parameters.

Findings

The cost of a 10-year vaccination program is 82.6 million USD and can potentially prevent 7.3 million cases of rotavirus and 0.42 million DALYs. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the staged program is 464 USD per DALY averted (12 % of Indonesia's gross domestic product (GDP) per capita). From a healthcare sector perspective, ICER is similar at 479 USD (13 % GDP per capita).

Interpretation

The introduction of RVV into the National Immunization Program is likely to be highly cost-effective in Indonesia.

Funding

This work was supported by funding agreement with the Murdoch Children's Research Institute (MCRI), PATH, and the Indonesian Technical Advisory Group on Immunization (ITAGI).
背景轮状病毒(RV)仍然是导致五岁以下儿童急性肠胃炎(AGE)发病和死亡的最常见原因。在印度尼西亚,60%的严重急性肠胃炎和 40%的非严重急性肠胃炎是由轮状病毒引起的。本研究评估了在印尼国家免疫计划中引入轮状病毒疫苗(RVV)的成本效益。方法我们对在印尼引入轮状病毒疫苗进行了成本效益分析(CEA),假定根据免疫战略专家顾问小组提出的计划引入三剂疫苗。分析从卫生系统和社会角度出发,首先引入进口 RVV(Rotavac®,印度巴拉特生物技术公司),然后分阶段引入本地生产的 RVV(Bio Farma,印度尼西亚)。主要结果指标是与不接种疫苗相比,每避免一个残疾调整生命年 (DALY) 的增量成本(2019 年美元)。我们从印尼疾病成本研究、国家信息系统和科学文献中获取模型输入,涵盖疾病发病率、住院率、死亡率、医疗成本和疫苗相关因素。我们的分析包括单变量和概率敏感性分析,以评估各种参数。研究结果为期 10 年的疫苗接种计划的成本为 8260 万美元,可潜在预防 730 万例轮状病毒病和 42 万个残疾调整寿命年。从社会角度来看,分阶段计划的增量成本效益比 (ICER) 为每避免 1 DALY 464 美元(占印度尼西亚人均国内生产总值 (GDP) 的 12%)。从医疗保健部门的角度来看,ICER 与之相近,为 479 美元(人均国内生产总值的 13%)。解释在印度尼西亚的国家免疫计划中引入 RVV 可能具有很高的成本效益。
{"title":"Cost effectiveness analysis of rotavirus vaccination in Indonesia","authors":"Jarir At Thobari ,&nbsp;Emma Watts ,&nbsp;Natalie Carvalho ,&nbsp;Jonathan Hasian Haposan ,&nbsp;Andrew Clark ,&nbsp;Frédéric Debellut ,&nbsp;Asal Wahyuni Erlin Mulyadi ,&nbsp;Julitasari Sundoro ,&nbsp;Mardiati Nadjib ,&nbsp;Sri Redzeki Hadinegoro ,&nbsp;Julie Bines ,&nbsp;Yati Soenarto","doi":"10.1016/j.vaccine.2024.126478","DOIUrl":"10.1016/j.vaccine.2024.126478","url":null,"abstract":"<div><h3>Background</h3><div>Rotavirus (RV) remains the most common cause of morbidity and mortality due to acute gastroenteritis (AGE) in children under five. In Indonesia, RV is responsible for 60 % of severe AGE and 40 % of non-severe AGE in these children. This study assessed the cost-effectiveness of introduction of rotavirus vaccines (RVV) into the National Immunization Program in Indonesia.</div></div><div><h3>Methods</h3><div>We conducted a cost-effectiveness analysis (CEA) of RVV introduction in Indonesia, assuming a three-dose vaccine schedule based on the planned introduction proposed by the Strategic Advisory Group of Experts on Immunization. The analysis involved an initial introduction of an imported RVV (Rotavac®, Bharat Biotech, India) followed by a staged implementation of the locally produced RVV (Bio Farma, Indonesia) from both health system and societal perspectives. The primary outcome measure was the incremental cost (2019 USD) per disability-adjusted life year (DALY) averted, compared to no vaccination. We took model inputs from an Indonesian cost-of-illness study, national information systems and scientific literature, covering disease incidence, hospitalization, mortality, healthcare costs, and vaccine related factors. Our analyses included univariate and probabilitistic sensitivity analyses to assess various parameters.</div></div><div><h3>Findings</h3><div>The cost of a 10-year vaccination program is 82.6 million USD and can potentially prevent 7.3 million cases of rotavirus and 0.42 million DALYs. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the staged program is 464 USD per DALY averted (12 % of Indonesia's gross domestic product (GDP) per capita). From a healthcare sector perspective, ICER is similar at 479 USD (13 % GDP per capita).</div></div><div><h3>Interpretation</h3><div>The introduction of RVV into the National Immunization Program is likely to be highly cost-effective in Indonesia.</div></div><div><h3>Funding</h3><div>This work was supported by funding agreement with the Murdoch Children's Research Institute (MCRI), PATH, and the Indonesian Technical Advisory Group on Immunization (ITAGI).</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"43 ","pages":"Article 126478"},"PeriodicalIF":4.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multi-level determinants of timely routine childhood vaccinations in The Gambia: Findings from a nationwide analysis 冈比亚儿童及时接种常规疫苗的多层面决定因素:全国性分析结果。
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-11-02 DOI: 10.1016/j.vaccine.2024.126500
Oghenebrume Wariri , Chigozie Edson Utazi , Uduak Okomo , Winfred Dotse-Gborgbortsi , Malick Sogur , Sidat Fofana , Kris A. Murray , Chris Grundy , Beate Kampmann

Introduction

Achieving the ambitious goals of the Immunisation Agenda 2030 (IA2030) requires a deeper understanding of factors influencing under-vaccination, including timely vaccination. This study investigates the demand- and supply-side determinants influencing the timely uptake of key childhood vaccines scheduled throughout the first year of life in The Gambia.

Methods

We used two nationally-representative datasets: the 2019–20 Gambian Demographic and Health Survey and the 2019 national immunisation facility mapping. Using Bayesian multi-level binary logistic regression models, we identified key factors significantly associated with timely vaccination for five key vaccines: birth dose of hepatitis-B (HepB0), first, second, and third doses of the pentavalent vaccine (Penta1, Penta2, Penta3), and first-dose of measles-containing vaccine (MCV1) in children aged 12–35 months. We report the adjusted Odds Ratios (aORs) and 95 % Credible Intervals (95 % CIs) in each case.

Results

We found that demand-side factors, such as ethnicity, household wealth status, maternal education, maternal parity, and the duration of the household's residency in its current location, were the most common drivers of timely childhood vaccination. However, supply-side factors such as travel time to the nearest immunisation clinic, availability of cold-storage and staffing numbers in the nearest immunisation clinic were also significant determinants. Furthermore, the determinants varied across specific vaccines and the timing of doses. For example, delivery in a health facility (aOR = 1.58, 95 %CI: 1.02–2.53), living less than 30 min (aOR = 2.11, 95 %CI: 1.2–8.84) and living between 30 and 60 min (aOR = 3.68, 95 %CI: 1.1–14.99) from a fixed-immunisation clinic was associated with timely HepB0, a time-sensitive vaccine that must be administered within 24 h of birth. On the other hand, children who received Penta1 and Penta2 on time were three- to five-fold more likely to receive subsequent doses on time (Penta2 and Penta3, respectively). Finally, proximity to an immunisation facility with functional vaccine cold-storage was a significant supply-side determinant of timely MCV1 (aOR = 1.4, 95 %CI: 1.09–1.99).

Conclusions

These findings provide valuable insights for programme managers and policymakers. By prioritising interventions and allocating scarce resources based on these identified determinants, they can maximize their impact and ensure children in The Gambia receive timely vaccinations throughout their first year of life, contributing to IA2030 goals.
导言:要实现《2030 年免疫议程》(IA2030)的宏伟目标,就必须深入了解接种不足的影响因素,包括及时接种疫苗。本研究调查了影响冈比亚儿童在出生后第一年及时接种主要儿童疫苗的需求方和供应方决定因素:我们使用了两个具有全国代表性的数据集:2019-20 年冈比亚人口与健康调查和 2019 年全国免疫接种设施分布图。利用贝叶斯多层次二元逻辑回归模型,我们确定了与及时接种五种关键疫苗显著相关的关键因素:出生时接种的乙肝疫苗(HepB0)、五价疫苗(Penta1、Penta2、Penta3)的第一、第二和第三剂,以及 12-35 个月儿童含麻疹成分疫苗(MCV1)的第一剂。我们报告了每种情况下调整后的几率比(aORs)和 95 % 可信区间(95 % CIs):我们发现,需求方因素,如种族、家庭财富状况、孕产妇教育程度、孕产妇均等以及家庭在当前地点的居住时间,是影响儿童及时接种疫苗的最常见因素。然而,供应方因素也是重要的决定因素,如前往最近免疫接种诊所的交通时间、冷藏库的可用性以及最近免疫接种诊所的工作人员数量。此外,不同疫苗和剂量时间的决定因素也各不相同。例如,在医疗机构分娩(aOR = 1.58,95 %CI:1.02-2.53)、距离固定免疫诊所不足 30 分钟(aOR = 2.11,95 %CI:1.2-8.84)和距离固定免疫诊所 30-60 分钟(aOR = 3.68,95 %CI:1.1-14.99)与及时接种乙肝疫苗(一种必须在出生后 24 小时内接种的时间敏感性疫苗)有关。另一方面,按时接种 Penta1 和 Penta2 的儿童按时接种后续剂量(分别为 Penta2 和 Penta3)的几率要高出三到五倍。最后,是否靠近具有疫苗冷藏功能的免疫接种设施是及时接种 MCV1 的一个重要供应方决定因素(aOR = 1.4,95 %CI: 1.09-1.99):这些发现为项目管理人员和政策制定者提供了宝贵的见解。通过根据这些已确定的决定因素确定干预措施的优先次序和分配稀缺资源,他们可以最大限度地发挥其影响,并确保冈比亚儿童在出生后第一年内及时接种疫苗,从而为实现 2030 年国际行动计划目标做出贡献。
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引用次数: 0
Parental decisions regarding the vaccination of children and adolescents against SARS-CoV-2 from 2020 to 2023: A descriptive longitudinal study of parents and children in Montreal, Canada 家长对 2020 年至 2023 年儿童和青少年接种 SARS-CoV-2 疫苗的决定:对加拿大蒙特利尔家长和儿童的描述性纵向研究。
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-11-02 DOI: 10.1016/j.vaccine.2024.126489
Katia Charland , Caroline Quach , Jesse Papenburg , Laura Pierce , Cat Tuong Nguyen , Adrien Saucier , Margot Barbosa Da Torre , Marie-Ève Hamelin , Julie Carbonneau , Guy Boivin , Kate Zinszer

Background

Given the growing evidence on the benefits of hybrid immunity, continued monitoring of vaccine uptake is warranted, particularly of socio-demographic subgroups with early vaccine hesitancy. Racial/ethnic and lower income groups experienced a high infection incidence, but few studies account for the child's history of SARS-CoV-2 infection on the parent's decision to vaccinate their child.

Methods

EnCORE is a SARS-CoV-2 pediatric cohort study comprising five rounds of data collection from 2020 to 2023, with parental questionnaires at each round. Parent's responses on their intention to vaccinate their child and their reasons were summarized descriptively. Vaccine uptake was estimated through time and in relation to participant characteristics, using multivariable regression to adjust for covariates including a history of PCR/serology-confirmed SARS-CoV-2 infection prior to vaccine eligibility. At study end, we estimated the average time lapsed from last vaccine dose.

Results

The samples for vaccine uptake and intention to vaccinate analyses were 631 and 1137 participants, respectively. At study end, uptake was 88 % but approximately 49 % of 2-to-4-year-olds remained unvaccinated (95 % CI 39.0, 58.1) and for vaccinated participants the median time since last vaccination was 353 days. In regression analyses, after adjusting for infection prior to vaccine eligibility and other covariates, we found approximately a two-fold increase in unvaccinated status associated with the parent's identification as a racial/ethnic minority and with household income in the lowest sample tercile (minority: adjusted relative risk [aRR] 2.45, 95 % CI 1.56, 3.86; income: aRR 1.76, 95 % CI 1.17, 2.66).

Conclusion

By mid-2023, most participants were not protected by vaccine-induced antibodies, because they were unvaccinated or several months had lapsed from their last dose. A COVID-19 infection prior to vaccine eligibility was associated with a greater risk of remaining unvaccinated but did not fully account for low uptake in ethnic/racial minorities and lower income groups.
背景:鉴于越来越多的证据表明混合免疫的益处,有必要对疫苗接种率进行持续监测,尤其是对早期对疫苗犹豫不决的社会人口亚群。种族/民族和低收入群体的感染率较高,但很少有研究考虑到儿童的 SARS-CoV-2 感染史会影响父母是否为其子女接种疫苗:EnCORE是一项SARS-CoV-2儿科队列研究,从2020年到2023年共收集了五轮数据,每轮都对家长进行了问卷调查。对家长关于是否打算为孩子接种疫苗及其原因的回答进行了描述性总结。疫苗接种率是通过时间和参与者特征来估算的,采用多变量回归法来调整协变量,包括在获得疫苗接种资格之前的 PCR/血清学证实的 SARS-CoV-2 感染史。研究结束时,我们估算了距最后一次接种疫苗的平均时间:用于疫苗接种率和接种意向分析的样本分别为 631 人和 1137 人。研究结束时,接种率为 88%,但仍有约 49% 的 2-4 岁儿童未接种疫苗(95 % CI 39.0, 58.1),接种过疫苗的参与者距上次接种疫苗的时间中位数为 353 天。在回归分析中,在调整了疫苗接种资格之前的感染情况和其他协变量后,我们发现未接种疫苗的情况大约增加了两倍,这与父母被认定为少数种族/族裔以及最低样本三元组中的家庭收入有关(少数种族:调整后相对风险 [aRR] 2.45,95 % CI 1.56,3.86;收入:aRR 1.76,95 % CI 1.17,2.66):到 2023 年中期,大多数参与者都没有受到疫苗诱导抗体的保护,因为他们没有接种疫苗,或者距离最后一次接种疫苗已经过去了几个月。在获得疫苗接种资格之前感染 COVID-19 与未接种疫苗的更大风险有关,但这并不能完全解释少数民族和低收入群体接种率低的原因。
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引用次数: 0
Burden of Lassa fever disease in pregnant women and children and options for prevention 孕妇和儿童的拉沙热疾病负担及预防方案。
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.vaccine.2024.126479
Manu Chaudhary , Clare L. Cutland , Mercedes Bonet , Angela Gentile , Christine E. Jones , Helen S. Marshall , Andy Stergachis , Gerald Voss , Delese Mimi Darko , Esperanca Sevene , Terri Hyde , Lee Fairlie , Beate Kampmann , Darcie Everett , Flor M. Munoz
Lassa fever is a serious epidemic viral disease in West Africa affecting an estimated 2 million people annually with about 5000–10,000 deaths, although supporting data is sparse. Lassa fever significantly affects neonates, children, and pregnant women, however, comprehensive data on its impact in these populations are lacking. We reviewed the available literature on Lassa fever to assess its prevalence and impact in these populations and implications for vaccine development. Clinical features in children were similar to those observed in adults, with complications such as bleeding. Altered mental status, anasarca (swollen baby syndrome), bleeding, and poor urine output were risk factors for death. The case fatality rate (CFR) in 16 paediatric studies ranged from 6 % to 63 % and was 66.7 % and 75.0 % in two neonatal studies. In a systematic review of studies on pregnant women the CFR was 33.73 %. The adverse foetal outcomes included miscarriage, stillbirth, and intrauterine death associated with maternal death. Since Lassa fever significantly affects neonates, children, and pregnant women, developing a safe and effective, single-dose vaccine for these high-risk populations is vital. Currently, there are four clinical trials assessing Lassa virus vaccines. Only one of these trials is enrolling children aged ≥18 months, and exclude pregnant and breast-feeding women. It is essential that pregnant and breast-feeding women and young children are included in clinical trials that incorporate robust safety surveillance and risk mitigation measures. In our review, potential approaches to address the specific gaps in the areas of diagnosis, management, and prevention of Lassa fever in these specific populations, such as disease surveillance systems and vaccine development, were identified. A comprehensive strategy with investment focused on addressing specific knowledge gaps will be essential in protecting the health of these specific populations in Lassa virus endemic regions.
拉沙热是西非一种严重的流行性病毒疾病,估计每年影响 200 万人,约有 5000-10000 人死亡,但相关数据很少。拉沙热对新生儿、儿童和孕妇的影响很大,但缺乏有关拉沙热对这些人群影响的全面数据。我们回顾了有关拉沙热的现有文献,以评估其在这些人群中的流行情况和影响,以及对疫苗开发的影响。儿童的临床特征与成人相似,并伴有出血等并发症。精神状态改变、婴儿浮肿综合症(asasarca)、出血和尿量少是导致死亡的危险因素。16 项儿科研究的病死率(CFR)从 6% 到 63% 不等,两项新生儿研究的病死率分别为 66.7% 和 75.0%。在对孕妇研究的系统回顾中,病死率为 33.73%。不良胎儿结局包括流产、死胎和与产妇死亡相关的宫内死亡。由于拉沙热严重影响新生儿、儿童和孕妇,因此为这些高危人群开发安全有效的单剂量疫苗至关重要。目前,有四项临床试验正在评估拉沙病毒疫苗。其中只有一项试验招募了年龄≥18 个月的儿童,且不包括孕妇和哺乳期妇女。将孕妇、哺乳期妇女和幼儿纳入临床试验至关重要,这些临床试验应纳入强有力的安全监测和风险缓解措施。在我们的审查中,确定了解决这些特定人群在诊断、管理和预防拉沙热方面存在的具体差距的潜在方法,如疾病监测系统和疫苗开发。在保护拉沙病毒流行地区的这些特定人群的健康方面,一项重点投资于解决特定知识差距的综合战略至关重要。
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引用次数: 0
Evaluation of test-negative design estimates of influenza vaccine effectiveness in the context of multiple, co-circulating, vaccine preventable respiratory viruses 在多种疫苗可预防的呼吸道病毒共同流行的情况下,评估流感疫苗有效性的试验阴性设计估计值。
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-30 DOI: 10.1016/j.vaccine.2024.126493
Aleda M. Leis , Abram Wagner , Brendan Flannery , Jessie R. Chung , Arnold S. Monto , Emily T. Martin
Test-negative design (TND) studies are cornerstones of vaccine effectiveness (VE) monitoring for influenza. The introduction of SARS-CoV-2 and RSV vaccines complicate the analysis of this design, with control selection restriction based on other pathogen diagnosis proposed as a solution. We conducted a simulation study and secondary analysis of 2017–18 and 2018–19 TND estimates from a Southeast Michigan ambulatory population to evaluate RSV-status-based control restriction. Simulations suggest that with vaccine-preventable RSV, influenza VE could be moderately biased with RSV prevalence ≥25 % of controls. Real-world analysis showed 151 influenza-negative adults (10.4 %) had RSV detected from the enrollment nasal swab. There were minimal differences in results of adjusted models with or without RSV exclusion from control groups. Findings suggest that inclusion of RSV cases in the control group of TND studies for influenza VE, particularly where RSV is not vaccine preventable, does not currently pose a major concern for bias in VE estimates.
阴性试验设计(TND)研究是流感疫苗有效性(VE)监测的基石。SARS-CoV-2 和 RSV 疫苗的引入使该设计的分析变得更加复杂,因此提出了基于其他病原体诊断的对照选择限制作为解决方案。我们开展了一项模拟研究,并对密歇根州东南部流动人口的 2017-18 年和 2018-19 年 TND 估计值进行了二次分析,以评估基于 RSV 状态的控制限制。模拟结果表明,对于可通过疫苗预防的 RSV,当 RSV 在控制人群中的流行率≥25% 时,流感 VE 可能会出现中度偏差。真实世界分析显示,151 名流感阴性成人(10.4%)从入学鼻拭子中检测到了 RSV。在对照组中排除或不排除 RSV 的调整模型结果差异很小。研究结果表明,将 RSV 病例纳入流感 VE TND 研究的对照组,尤其是在 RSV 无法通过疫苗预防的情况下,目前不会对 VE 估计值的偏差造成重大影响。
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引用次数: 0
The SARS-CoV-2 neutralising antibody profile of New Zealand adults in 2023: Impact of vaccination and infection. 2023 年新西兰成年人的 SARS-CoV-2 中和抗体概况:疫苗接种和感染的影响
IF 4.5 3区 医学 Q2 IMMUNOLOGY Pub Date : 2024-10-29 DOI: 10.1016/j.vaccine.2024.126482
Reuben McGregor , Aimee Paterson , Brittany Lavender , Caitlin Hooker , Chris Frampton , Kjesten Wiig , Graham Le Gros , James E. Ussher , Maia Brewerton , Nicole J. Moreland
The successive dominance of SARS-CoV-2 omicron sublineages presents challenges for vaccination strategies with respect to the antigenic content of boosters. New Zealand's COVID-19 elimination strategy (2020−2021) ensured the major vaccination campaign (Pfizer-BioNTech BNT162b2) was completed pre-omicron in an infection-naive population, providing a unique setting to explore the impact of omicron infection waves on vaccine responses. This study compared neutralising antibodies (NAb) to eight SARS-CoV-2 omicron sublineages 28-days and 11-months after a third dose. Participants (n = 219) were classified by antigen exposure in the intervening 10 months including additional vaccinations and/or infections. Both vaccination and infection boosted NAb levels to all sublineages. Antigenic maps showed infection had a major impact on NAb breadth, despite all participants being vaccinated with an ancestral-based vaccine.
While vaccination remains an important tool to boost immunity, the breadth of NAbs observed suggest that attempts to match booster specificity with current circulating variants may not always be necessary.
SARS-CoV-2 omicron 亚系的相继占据主导地位给疫苗接种策略带来了增强剂抗原含量方面的挑战。新西兰的 COVID-19 消除战略(2020-2021 年)确保了主要疫苗接种活动(辉瑞-生物技术公司 BNT162b2)在非典型肺炎感染人群中完成,为探索非典型肺炎感染波对疫苗反应的影响提供了一个独特的环境。这项研究比较了 8 种 SARS-CoV-2 omicron 亚系的中和抗体(NAb),分别在第三次接种后 28 天和 11 个月。参与者(n = 219)按其间 10 个月的抗原接触情况分类,包括额外的疫苗接种和/或感染。接种疫苗和感染都会提高所有亚系的 NAb 水平。抗原图显示,尽管所有参与者都接种了基于祖先的疫苗,但感染对 NAb 的广度有重大影响。虽然接种疫苗仍是提高免疫力的重要工具,但观察到的 NAb 广度表明,尝试将增强特异性与当前流行的变异株相匹配可能并不总是必要的。
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引用次数: 0
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