Vaccine: X最新文献

Objectives

This study aims to investigate the factors influencing parental willingness in COVID-19 vaccination for children in Japan in light of the introduction of pediatric vaccines.

Methods

An online survey was conducted in February 2022, coinciding with the imminent start of pediatric COVID-19 vaccinations in Japan. It assessed attitudes toward vaccine uptake and included questions about health-related attributes, psychological considerations, and sources of COVID-19 information. Data from 2,419 respondents who had children under the age of 12 were analyzed using multinomial logistic regression to identify factors associated with parental willingness towards COVID-19 vaccination for children. The outcomes were “agree” (in favor of vaccination), “not sure” (undecided), with “disagree” (against vaccination) as the reference category.

Results

Among participants supportive of vaccination (“agree” compared to the “disagree” reference), salient determinants included: gender (Men in reference to women: odds ratio [OR] 1.54; 95 % confidence interval [CI] 1.11–2.15), highest educational level (Junior College/Vocational in reference to under high school: OR 0.61; 95 % CI 0.40–0.93, Bachelor’s /Master’s/Doctoral degree in reference to under high school: OR 0.59; 95 % CI 0.42–0.84), perception of benefits of COVID-19 vaccination (Significant in reference to Insignificant: OR 2.04; 95 % CI 1.26–3.28), perception of risks of COVID-19 vaccination (Significant in reference to Insignificant: OR 0.28; 95 % CI 0.19–0.42, Neutral in reference to Insignificant: OR 0.48; 95 % CI 0.33–0.71), the number of referenced information sources utilized for COVID-19 was associated with attitudes towards children’s vaccination (OR 1.02; 95 % CI 1.00–1.04).

Conclusion

The study highlights the multifaceted factors influencing parents’ COVID-19 vaccination attitudes for their children, encompassing socioeconomic, health, psychological, and informational aspects. Factors like cautious information gathering, vaccine concerns and diverse referenced information sources impact willingness. To facilitate informed decision-making, essential measures include government risk communication, widespread vaccine information dissemination, and enhancing parents’ health information accessibility and evaluation skills are important.

Background

China started to implement the HPV vaccination program for females in 2016. This study investigated associations between mothers’ decisional conflicts, satisfaction with governmental health promotion materials, and their daughters’ HPV vaccination uptake.

Methods

A cross-sectional online survey was conducted between July and October 2023 among mothers of girls aged 9–17 years in Shenzhen, China. Participants were mothers having a daughter aged 9–17 years at the survey date and a smartphone with internet access. About 3 % of all primary and secondary schools in Shenzhen were randomly selected by the research team (11 primary schools and 13 secondary schools). Teachers at the selected schools invited mothers of female students aged 9–17 years to complete an anonymous online questionnaire. Multivariate logistic regression was fitted.

Results

Among 11,728 mothers who completed the survey, 18.9% of their index daughters received at least one dose of HPV vaccination. In multivariate analysis, less decisional conflict about the choice of HPV vaccines for their daughters (AOR: 1.07, 95%CI: 1.05, 1.10), more satisfaction with the government’s health promotional materials related to HPV vaccines (AOR: 1.15, 95%CI: 1.12, 1.19), receiving more cue to action from significant others (AOR: 1.23, 95%CI: 1.19, 1.27), and perceived higher self-efficacy related to HPV vaccines (AOR: 1.79, 95%CI: 1.67, 1.92) were associated with a higher uptake of HPV vaccines. Perceived susceptibility to HPV (AOR: 0.79, 95%CI: 0.74, 0.85), perceived barriers to having the index daughter receive HPV vaccines (AOR: 0.82, 95%CI: 0.80, 0.84), and mothers who were hesitant to receive HPV vaccination (AOR: 0.75, 95%CI: 0.68, 0.84) were associated with a lower uptake.

Conclusion

HPV vaccination uptake was low among girls in China. Future health promotion should address mothers’ decisional conflicts about the choice of HPV vaccines for their daughters and improve the health promotional materials. School-based HPV vaccination programs might be useful.

Background

To reduce burden of pneumonia, India has introduced Pneumococcal Conjugate vaccine (PCV) in routine immunization programme. The state of West Bengal, India introduced PCV in 2021. Uptake of new vaccines depends a lot on knowledge of caregivers on the disease and vaccine. This study aimed to assess the knowledge of caregivers regarding pneumococcal diseases and PCV. The study will inform programme managers to develop a comprehensive demand generation strategy for improving uptake of PCV and other new vaccines.

Methods

It is an observational, cross-sectional study using a predesigned, pretested and structured questionnaire conducted among 353 caregivers of children who has received at least one dose of PCV. The children were aged between 6 weeks to 20 months, residing in rural and urban areas of Howrah district of West Bengal. Sample size was calculated considering 95 % confidence interval and 5 % margin of error.

Results

Results are analysed taking into consideration rural/urban divide, socioeconomic status and other factors influencing vaccine uptake. Study findings suggest lack of knowledge of caregivers regarding pneumococcal diseases and PCV. Most of respondents have no idea about any other pneumococcal diseases apart from pneumonia. More than 40 % does not know about what causes pneumonia and more than 47 % does not know how to prevent pneumonia. They also have poor knowledge about injection site, number of doses, schedule and when to start PCV.

Conclusions

Limited knowledge among caregivers may cause negative impact on vaccine coverage and jeopardise the goal of government to reduce morbidity and mortality due to pneumonia.

The study findings suggest that there is dearth of knowledge regarding pneumococcal diseases and PCV among caregivers. Therefore the policy makers need to develop a comprehensive plan for awareness generation for improving PCV uptake and strategy developed for this purpose can be implemented in future new vaccine introduction also.

Multiple concerning reports have emerged of cardiovascular complications, particularly thrombosis, following mRNA vaccination against the SARS-CoV-2 pathogen. The presence of serologically persistent anti-phospholipid antibodies is a characteristic of antiphospholipid syndrome, which presents with clinical manifestations including thrombosis or pregnancy morbidity. Anti-SARS-CoV-2 mRNA vaccines pose a theoretical risk of cross-reactivity between the SARS-CoV-2 spike protein and phospholipids in host tissues. In this study, serum anti-phospholipid antibody titers before and after SARS-CoV-2 mRNA vaccination were compared among 184 hospital staff members. Although no significant differences were found in terms of antibody titers targeting cardiolipin and β2-glycoprotein I, post-vaccination antibody titers targeting phosphatidylethanolamine were found to be significantly increased compared to pre-vaccination levels (p = 0.008). Anti-phosphatidylethanolamine antibodies are the most common anti-phospholipid antibodies detected in patients with recurrent miscarriages at < 10 weeks of gestation. However, the association between vaccination and these types of adverse events remains unknown, thus warranting further investigation.

This cohort study, conducted between July and August 2023, evaluated the adverse events (AEs) and immune response to a bivalent mRNA-1273.222 (containing sequences of the original Wuhan-H1 strain and the Omicron BA.4/5 variant) booster vaccine in 122 participants. The study included individuals with diverse vaccination histories, and their responses were assessed based on anti-receptor binding domain (RBD) IgG levels and neutralizing antibodies against the wild-type, Omicron BA.5, and XBB.1.16 variants. Following administration of the BA.4/5 bivalent vaccine, AEs were generally mild to moderate and well-tolerated within a few days. There were no reports of vomiting and no serious AEs or death. The findings demonstrated robust immune responses, with significant increases in anti-RBD IgG levels, particularly in groups that had received 3 –6 doses before the booster dose. The BA.4/5 bivalent booster effectively induced neutralizing antibodies against the vaccine strains, providing robust neutralization, including the XBB.1.16 strain. The study also highlighted that individuals with hybrid immunity, especially those assumed infected with the BA.5 strain or who had been infected twice, showed higher levels of robust neutralizing activity against Omicron XBB.1.16. Overall, these results indicate that the BA.4/5 bivalent booster vaccines can induce potent and good antibody responses in emerging Omicron subvariants, supporting its efficacy as a booster in individuals with diverse vaccination histories.

Vaccination is the most efficient and cost-effective public health intervention. Prison population, for its low social distancing, constant turnover, and high percentage of migrants, should be an important target of vaccination campaign. However, vaccination coverage in prison is low. In this study we estimated vaccine hesitancy and vaccine literacy among the prison population and staff and assessed their correlation.

We conducted a cross-sectional study in 13 prisons of 4 European countries. The sample included 847 people living in prison and 755 staff members. Through a structured questionnaire we assessed vaccine hesitancy, vaccine literacy, general health literacy, previous vaccine refusal and socio-demographic characteristics of participants. Exploratory factor analysis was used to extract three components of vaccine hesitancy. Logistic regression was applied to assess the association between previous vaccine refusal and vaccine hesitancy; linear regression was applied to assess the association between vaccine hesitancy and vaccine and general health literacy. All analyses were adjusted for socio-demographic variables.

We identified three components of vaccine hesitancy explaining 49% of the total variance: Mistrust, Concern and Conspiracy. In both people living in prison and staff, all the components were associated to previous vaccine refusal (p-value < 0.001) and presented good internal consistency (Cronbach’s alpha = 0.90, 0.73 and 0.78). Young participants presented the highest levels of vaccine hesitancy; migrant people living in prison had the lower levels of Mistrust and the higher level of Concern; all three factors were lower among participants with the highest degree of education. Mistrust and Concern were inversely associated with vaccine literacy while all three subscales were inversely associated with general health literacy (all p-values < 0.001).

This study suggests that educational interventions aimed at increasing vaccine literacy in people living and working in prison could decrease vaccine hesitation and consequently increase vaccination uptake among the prison population and staff.

Current lead coronavirus vaccines require continuous cold or ultra-cold storage from the manufacturing site to the field to maintain protective efficacy. Since cold chain capacity is limited and complex, logistics planning is crucial to limit vaccine wastage.[1] The restrictive storage concerns also make it difficult to share vaccines between public health departments and neighboring states, leading to increased vaccine wastage.[2] A Newcastle Disease Virus (NDV) vector-based severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) vaccine candidate, NDV-HXP-S, offers a cost-effective alternative which aims to improve global access to SARS CoV-2 vaccines.[3] The NDV-HXP-S vaccine candidate can be mass-produced in chicken eggs and has demonstrated efficacy in preclinical studies, as well as acceptable safety and potent immunogenicity in clinical studies.[3,4–10] To further advance the NDV-HXP-S vaccine candidate, this manuscript describes work focused on the development of multidose thermotolerant vaccine formulations (i.e., those which would not require continuous extended refrigeration), making it convenient to use and store, and simplifying transport and distribution logistics, especially in outbreak settings. Liquid and lyophilized formulations for parenteral administration were rigorously screened for the vaccine formulation’s ability to maintain S-antigen stability after exposure to temperature stress at 40 °C, 25 °C, and 2 °C to 8 °C storage for six months. Preservative efficacy was evaluated to enable a multidose liquid vaccine format as well as endotoxin testing in lyophilized formulations. Lead liquid vaccine formations were identified that were able to maintain S-antigen content at 2 °C to 8 °C and 25 °C storage for the entire six-month study. Lead lyophilized vaccine formulations were identified which were able to maintain S-antigen content for six months at 2 °C to 8 °C, 25 °C, and 40 °C. Both the liquid and lyophilized formulations identified are improved thermotolerant SARS-CoV-2 vaccine formulations.

Evidence on determinants of vaccine delivery costs can inform program design and planning. Given the dearth of this evidence for human papillomavirus (HPV) vaccine, we conducted an analysis to identify programmatic and operational factors that are statistically associated with variations in economic costs for HPV vaccine delivery, within and across six low- and middle-income countries.

HPV vaccine program operations and cost data were collected from Ethiopia, Guyana, Rwanda, Senegal, Sri Lanka, and Uganda. An ordinary least square regression analysis was done using data from 279 health facilities in these six countries. We ran country-specific and pooled multivariate linear regressions. A conditional regression including 228 facilities was also run. The dependent variable was the estimated total economic costs for HPV vaccine delivery per facility, excluding vaccine procurement costs. Explanatory variables included number of HPV vaccine doses delivered; numbers of vaccination sessions conducted, and schools served; distance traveled by health workers for vaccine delivery; intensity of conducting program activities; human resource (health workers, school staff, etc.) utilization rates; and categorical variables indicating whether per diems were paid, and for country-specific dummies;

Explanatory variables such as the number of program activities or meetings held, receipt of per diems, and utilization rates of health workers, were all positively and statistically significantly associated with economic costs in the pooled sample, for both the unconditional and conditional regressions. Variables such as the doses delivered, and number of sessions conducted were statistically significant in the unconditional regression. The within-country regression found that only variations in utilization rates of health workers were statistically significant in all countries.

Our analysis provides evidence to HPV vaccination program stakeholders on which program context variables impact costs, which can inform program adjustment to improve cost efficiency, especially as programs managers work to revitalize and rebuild HPV vaccine coverage after the COVID-19 pandemic.

Objective

This study aims to assess the risk of neonatal susceptibility to COVID-19 among pregnant women.

Methods

We conducted a retrospective cohort study involving 1089 pregnant women ≥28 weeks of gestational age, who were categorized into infected and uninfected groups. Data for all participants were collected through a comprehensive review of electronic medical records and follow-up phone calls. The primary outcome was neonatal infection with SARS-CoV-2, while secondary outcomes included delivery patterns and gestational age at delivery.

Results

Maternal vaccination (OR 95%CI:0.63[0.46, 0.85]) and maternal infection with SARS-CoV-2 (OR 95%CI: 0.45[0.34, 0.60]) were found to be associated with a decreased risk of neonatal infection. The infected group exhibited a lower neonatal SARS-CoV-2 infection rate (25.93%) compared to the uninfected group (45.15%). Logistic regression analysis identified several risk factors associated with an increased risk of neonatal infection, including pregnancy BMI (OR 95%CI: 1.04[1.01, 1.08]), age at first pregnancy (OR 95%CI: 1.05[1.01, 1.10]), age at menarche (OR 95%CI: 1.13[1.02, 1.26]), and parturition (Yes vs. No) (OR 95%CI:1.4 [1.04,1.88]).

Conclusion

Maternal vaccination and perinatal infection with SARS-CoV-2 play a protective role in preventing neonatal SARS-CoV-2 infection.

Introduction

Despite over 15 years of real-world data that supports the safety and efficacy of the human papillomavirus (HPV) vaccine, in the United States vaccine hesitancy persists. Many studies have focused on vaccine-hesitant parents, but fewer have examined provider perspectives on how to address HPV vaccine hesitancy.

Methods

Between July 2021-April 2022, we recruited providers in Maryland and the broader Mid-Atlantic region who practiced pediatrics, primary care, family medicine, or adolescent medicine and who provided outpatient care for children ages 10–17. Semi-structured virtual interviews focused on provider-reported strategies to address HPV vaccine-hesitant parents, as well as perceived barriers to successful vaccination and provider perspectives on specific interventions to address parental hesitancy. Audio recordings were transcribed and analyzed via a combination of deductive and inductive coding. Higher-level themes within the domains of strategies, barriers, and perspectives on specific proposed interventions were identified.

Results and discussion

A total of sixteen providers completed an interview. Within the domain of provider-reported strategies, the following themes emerged: 1) leveraging continuity of care and established parental trust, 2) supporting parental autonomy, 3) tailoring the approach to specific concerns of vaccine-hesitant parents, 4) normalizing the HPV vaccine, and 5) focusing on health prevention and cancer prevention. Barriers providers identified were: 1) limited time, 2) lack of common ground with parents, 3) parent–child decision discordance, 4) availability of misinformation, and 5) parental concerns such as safety and necessity. In the domain for proposed interventions, providers favored interventions that saved time or were not resource-intense, that did not single out the HPV vaccine as different, were patient friendly, and leveraged efficiency through the electronic medical record. The insights from this study can help inform the development of provider-acceptable and feasible tools and interventions to address parental HPV vaccine hesitancy.