Vaccines

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22 pages, 8241 KiB

Open AccessArticle

COVID-19 Impact on DTP Vaccination Trends in Africa: A Joinpoint Regression Analysis

by Ines Aguinaga-Ontoso, Sara Guillen-Aguinaga, Laura Guillen-Aguinaga, Rosa Alas-Brun, Luc Onambele, Enrique Aguinaga-Ontoso and Francisco Guillen-Grima

Vaccines 2023, 11(6), 1103; https://doi.org/10.3390/vaccines11061103 - 15 Jun 2023

Cited by 8 | Viewed by 2449

Abstract

Background: Deaths due to vaccine-preventable diseases are one of the leading causes of death among African children. Vaccine coverage is an essential measure to decrease infant mortality. The COVID-19 pandemic has affected the healthcare system and may have disrupted vaccine coverage. Methods: DTP [...] Read more.

Background: Deaths due to vaccine-preventable diseases are one of the leading causes of death among African children. Vaccine coverage is an essential measure to decrease infant mortality. The COVID-19 pandemic has affected the healthcare system and may have disrupted vaccine coverage. Methods: DTP third doses (DTP3) Vaccine Coverage was extracted from UNICEF databases from 2012 to 2021 (the last available date). Joinpoint regression was performed to detect the point where the trend changed. The annual percentage change (APC) with 95% confidence intervals (95% CI) was calculated for Africa and the regions. We compared DTP3 vaccination coverage in 2019–2021 in each country using the Chi-square test. Result: During the whole period, the vaccine coverage in Africa increased with an Annual Percent change of 1.2% (IC 95% 0.9–1.5): We detected one joinpoint in 2019. In 2019–2021, there was a decrease in DTP3 coverage with an APC of −3.5 (95% −6.0; −0,9). (p < 0.001). Vaccination rates decreased in many regions of Sub-Saharan Africa, especially in Eastern and Southern Africa. There were 26 countries (Angola, Cabo Verde, Comoros, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Djibouti, Ethiopia, Eswatini, The Gambia, Guinea-Bissau, Liberia, Madagascar, Malawi, Mauritania, Mauritius, Mozambique, Rwanda, Senegal, Seychelles, Sierra Leone, Sudan, Tanzania, Togo, Tunisia, Uganda, and Zimbabwe) where the vaccine coverage during the two years decreased. There were 10 countries (Angola, Cabo Verde, Comoros, Democratic Republic of the Congo, Eswatini, The Gambia, Mozambique, Rwanda, Senegal, and Sudan) where the joinpoint regression detected a change in the trend. Conclusions. COVID-19 has disrupted vaccine coverage, decreasing it all over Africa. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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17 pages, 811 KiB

Open AccessArticle

Examining the Impact of Key Factors on COVID-19 Vaccination Coverage in India: A PLS-SEM Approach

by Veena Dhawan, Mahesh Kumar Aggarwal, Pritu Dhalaria, Preeti Kharb, Deepika Sharma, Kamala Kannan Dinesh, Sanjay Dhir, Sushil, Gunjan Taneja and Raj Shankar Ghosh

Vaccines 2023, 11(4), 868; https://doi.org/10.3390/vaccines11040868 - 19 Apr 2023

Cited by 2 | Viewed by 2506

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, numerous factors determined the performance of COVID-19 vaccination coverage. The purpose of this study is to examine the influence of factors such as government stewardship, planning and implementation, and community participation on COVID-19 vaccination coverage. This [...] Read more.

During the coronavirus disease 2019 (COVID-19) pandemic, numerous factors determined the performance of COVID-19 vaccination coverage. The purpose of this study is to examine the influence of factors such as government stewardship, planning and implementation, and community participation on COVID-19 vaccination coverage. This study applied partial least square structured equation modeling (PLS-SEM) by analyzing 187 responses from the stakeholders involved in vaccination programs in four select states of India. This study empirically validates a framework for improving vaccination coverage by confirming the significant impact of planning and implementation on vaccination coverage followed by government stewardship and community participation. Additionally, this study highlights the individual impact of each factor on vaccination coverage. Based on the findings, strategic recommendations were proposed that can be utilized for formulating policy-level actions to facilitate the vaccination program. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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13 pages, 613 KiB

Open AccessArticle

BNT162b2 COVID-19 Vaccine Safety among Healthcare Workers of a Tertiary Hospital in Italy

by Flavia Beccia, Luca Regazzi, Eleonora Marziali, Viria Beccia, Domenico Pascucci, Nadia Mores, Giuseppe Vetrugno and Patrizia Laurenti

Vaccines 2023, 11(2), 477; https://doi.org/10.3390/vaccines11020477 - 17 Feb 2023

Cited by 2 | Viewed by 2018

Abstract

Millions of people have died because of the COVID-19 pandemic. The vaccination campaign helped tackle the pandemic and saved millions of lives. In a retrospective pharmacovigilance study, we explored the safety of the BNT162b2 (Comirnaty) vaccine among healthcare workers (HCWs) in a large [...] Read more.

Millions of people have died because of the COVID-19 pandemic. The vaccination campaign helped tackle the pandemic and saved millions of lives. In a retrospective pharmacovigilance study, we explored the safety of the BNT162b2 (Comirnaty) vaccine among healthcare workers (HCWs) in a large Italian teaching hospital, and 2428 Adverse Events Reports (AERs) filed by HCWs after the administration of the first dose of vaccine were collected and analyzed, reporting the results quantitively and comparing them to the vaccine Summary of Product Characteristics (SPC). Spearman’s correlation coefficients were computed to investigate the correlation among reported adverse effects, and recurrent clusters of symptoms were investigated through the Principal Component Analysis (PCA) and k-means Cluster Analysis. The BNT162b2 vaccine’s safety profile was favorable, with predominant reports of early onset, mild, non-serious and short-term resolved symptoms. We observed higher than the expected frequency for various non-serious undesirable effects, especially among those listed and classified as less common in the SPC. Furthermore, we identified three clusters of adverse effects that were frequently reported together, defined by the presence/absence of fatigue, malaise, localized pain, chills, pyrexia, insomnia, nausea and injection site pain. Post-marketing pharmacovigilance activities, together with targeted public health interventions, can be valuable tools to promote vaccination and improve the control of the spread of the pandemic, especially in sensitive settings and populations such as hospitals and healthcare professionals. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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18 pages, 667 KiB

Open AccessArticle

Communicating with Patients about COVID-19 Vaccination: A Qualitative Study on Vaccinators in Tuscany Region, Italy

by Giorgia Alderotti, Martina Felicia Corvo, Primo Buscemi, Lorenzo Stacchini, Duccio Giorgetti, Chiara Lorini, Guglielmo Bonaccorsi, Maria José Caldés Pinilla and Vieri Lastrucci

Vaccines 2023, 11(2), 223; https://doi.org/10.3390/vaccines11020223 - 19 Jan 2023

Cited by 5 | Viewed by 2524

Abstract

The rapid development of the vaccine and the infodemia have challenged communication about COVID-19 vaccines. This study aims to characterize—through the experience of vaccinators—the challenges faced during COVID-19 vaccination consultations and the communication strategies adopted. A qualitative study was conducted on COVID-19 vaccinators [...] Read more.

The rapid development of the vaccine and the infodemia have challenged communication about COVID-19 vaccines. This study aims to characterize—through the experience of vaccinators—the challenges faced during COVID-19 vaccination consultations and the communication strategies adopted. A qualitative study was conducted on COVID-19 vaccinators in Tuscany, Italy. Face-to-face interviews were conducted and examined by thematic analysis. In total, 30 vaccinators were interviewed. Four main themes emerged. The first highlighted distinct profiles of users’ attitudes toward COVID-19 vaccination. Barriers and promoters of vaccine uptake emerged in the second theme: concerns over the vaccine, excessive exposure to information, and a lack of clear guidance from institutions were the main factors behind hesitancy. The third theme highlighted users’ information-seeking behaviors; vaccinators observed that users ideologically opposed to the vaccine (IOV) unconsciously seek information that confirms their theories. The last theme comprised communication strategies for dealing with hesitancy. Empathy, first-hand examples, transparency, and tailored communication style appear to be effective in building vaccine trust. Lastly, the impossibility of developing a decision-making partnership with IOVs was noticed. These findings may help to better characterize public attitudes toward COVID-19 vaccination and highlight key communication principles and strategies to foster vaccine confidence. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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13 pages, 1525 KiB

Open AccessArticle

Serological Responses up to 9 Months following COVID-19 mRNA Vaccination in Residents and Health-Care Workers of Long-Term Care Facilities: A Multicenter Prospective Cohort Study in Northern Italy

by Costanza Vicentini, Carla Maria Zotti, Alessandro Roberto Cornio, Jacopo Garlasco, Noemi Marengo, Davide Meddis, Savina Ditommaso, Monica Giacomuzzi, Gabriele Memoli, Valerio Bordino, Maria Michela Gianino and on behalf of the Collaborating Group

Vaccines 2022, 10(12), 2183; https://doi.org/10.3390/vaccines10122183 - 19 Dec 2022

Cited by 2 | Viewed by 1784

Abstract

Long-term care facilities (LTCFs) were severely affected by COVID-19, in particular in Northern Italy. We aimed to assess antibody responses among residents and healthcare workers (HCWs) of 13 LTCFs through serum samples collected at three time points: prior to, two weeks, and 9 [...] Read more.

Long-term care facilities (LTCFs) were severely affected by COVID-19, in particular in Northern Italy. We aimed to assess antibody responses among residents and healthcare workers (HCWs) of 13 LTCFs through serum samples collected at three time points: prior to, two weeks, and 9 months after receiving Pfizer/BNT162b2 SARS-CoV-2 mRNA vaccine (respectively t0, t1, and t2). IgG antibodies targeted towards the S1 domain of the spike protein were measured, and results were expressed in binding antibody units (BAU/mL). Friedman’s average rank test was performed to compare antibody titres between the three time points. Two logistic regression models were built to identify independent predictors of (1) developing and (2) maintaining a significant antibody response to vaccination, using a previously identified threshold. In total, 534 subjects were enrolled (371 HCWs and 163 residents). The antibody titres at t1 were the highest; at t2, the IgG titres significantly decreased, remaining however 10 times higher compared to titres at t0. Previous infection was the only significant predictor of developing and maintaining a response over threshold in both models. Results of this study provided further insights on the humoral response elicited by vaccination, and on host factors determining variations in its magnitude and kinetics. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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13 pages, 995 KiB

Open AccessArticle

Understanding Parental Attitudes toward Vaccination: Comparative Assessment of a New Tool and Its Trial on a Representative Sample in Hungary

by Zsófia Gács and Júlia Koltai

Vaccines 2022, 10(12), 2006; https://doi.org/10.3390/vaccines10122006 - 25 Nov 2022

Cited by 1 | Viewed by 1955

Abstract

Background: Last year’s epidemic experience proved that measurement of vaccine hesitancy is undeniably important. Existing methods for measuring this propensity are still either too specific, concerning a single vaccine, or only describe the general attitude towards vaccination. When a specific, but previously unknown [...] Read more.

Background: Last year’s epidemic experience proved that measurement of vaccine hesitancy is undeniably important. Existing methods for measuring this propensity are still either too specific, concerning a single vaccine, or only describe the general attitude towards vaccination. When a specific, but previously unknown infection and vaccine (such as SARS-CoV2) appear, these limitations are meaningful. Methods: Based on a method used to identify social prejudice, we created a new tool to assess vaccine hesitancy assessment and to study parental attitudes toward existing and non-existing (‘Piresian’) vaccines. After validating it with traditional tools for the measurement of vaccine hesitancy, we used the new tool for the demographic characterisation of different vaccine hesitant parent groups in Hungary. The data collected in 2017 on 430 parents, sorted by type of settlement and by geographic region, are representative of Hungarian households with children aged 0 to 18 years. Results: Our results show that attitudes towards a non-existing (‘Piresian’) vaccine have strong correlations with those towards existing vaccines (p < 0.001). No gender differences in vaccine hesitancy were found using either method. Notably, rejection was significantly higher among parents with low educational levels. Conclusion: The Piresian measurement of vaccine hesitancy offers a simple way to detect vaccine-hesitant groups, reliably quantitating vaccine hesitancy as measured for real vaccinations. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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13 pages, 543 KiB

Open AccessArticle

Geographic and Socioeconomic Inequalities in Delays in COVID-19 Vaccinations: A Cross-Sectional Study in Indonesia

by Hario Megatsari, Dian Kusuma, Ernawaty Ernawaty and Nuzulul K. Putri

Vaccines 2022, 10(11), 1857; https://doi.org/10.3390/vaccines10111857 - 2 Nov 2022

Cited by 7 | Viewed by 1959

Abstract

Background: Previous studies have provided evidence of inequalities in the coverage of COVID-19 vaccination. However, evidence of such inequalities in delays in vaccinations is lacking. Our study examined the socioeconomic and geographic disparities in terms of days to get the first and second [...] Read more.

Background: Previous studies have provided evidence of inequalities in the coverage of COVID-19 vaccination. However, evidence of such inequalities in delays in vaccinations is lacking. Our study examined the socioeconomic and geographic disparities in terms of days to get the first and second dose of COVID-19 vaccinations in Indonesia. Methods: We conducted a cross-sectional study using the WhatsApp messaging app and social media platforms during December 2021–February 2022. We distributed the questionnaire through our university network to reach all regions. We included 3592 adults aged 15+ years in our analysis. We used two main dependent variables: days to receive the first dose (after national vaccine rollout) and days to receive the second dose (after receiving the first dose). We examined a range of socioeconomic and geographic indicators, including education level, income level, formal employment, working in health facilities, being a health worker, and region. We controlled for sex, age, religion, and urbanicity. We performed multivariate logistic regressions in STATA 15. Results: Our findings show considerable delays in getting the first dose among participants (160.7 days or about 5.4 months on average) from Indonesia’s national COVID-19 vaccination rollout on 13 January 2021. However, we found a shorter period to receive the second dose after receiving the first dose (41.1 days on average). Moreover, we found significant socioeconomic (i.e., education, income, formal employment, working in health facilities, and being a health worker) and geographic (i.e., in and out of the Java region) inequalities in terms of delays in getting the first dose. However, we did not find significant inequalities in getting the second dose for most inequality indicators, except for working in health facilities. By region, we found that participants living in more deprived areas (out of the Java region) received the second dose 4.9 days earlier. One of the study’s key limitations is that there may be an inherent bias with respect to socioeconomics factors since it was conducted online (web-based). Conclusions: While there were considerable delays in getting the first dose, especially among those of a lower socioeconomic status and those in more deprived areas, the waiting time for the second dose was relatively similar for everyone once they were in the system. Effective efforts to address inequalities are essential to ensuring the effectiveness of the national COVID-19 vaccination rollout. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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15 pages, 1617 KiB

Open AccessArticle

Effect of Lockdowns on Hospital Staff in a COVID Center: A Retrospective Observational Study

by Giuseppe Vetrugno, Maurizio Sanguinetti, Rita Murri, Michela Sali, Simona Marchetti, Rosaria Santangelo, Massimo Fantoni, Antonella Cingolani, Giancarlo Scoppettuolo, Michele Di Donato, Vincenzo M. Grassi, Federica Foti, Luca Marchese, Fabio De-Giorgio, Antonio Oliva, Domenico Staiti, Francesco Maria De Simone, Domenico Pascucci, Fidelia Cascini, Roberta Pastorino, Denise Pires Marafon, Andrea Cambieri, Patrizia Laurenti, Stefania Boccia, Walter Ricciardi, Francesco Franceschi and on behalf of Gemelli-Against-COVID Group Show full author list Hide full author list

Vaccines 2022, 10(11), 1847; https://doi.org/10.3390/vaccines10111847 - 31 Oct 2022

Cited by 1 | Viewed by 1851

Abstract

At the onset of the SARS-CoV-2 pandemic, individual and social measures were strengthened through restrictive non-pharmaceutical interventions, labelled with the term “lockdown”. In Italy, there were two lockdowns (9 March 2020–3 May 2020 and 3 November 2020–27 March 2021). As part of preventive [...] Read more.

At the onset of the SARS-CoV-2 pandemic, individual and social measures were strengthened through restrictive non-pharmaceutical interventions, labelled with the term “lockdown”. In Italy, there were two lockdowns (9 March 2020–3 May 2020 and 3 November 2020–27 March 2021). As part of preventive measures, healthcare workers and the administrative staff population of Policlinico A. Gemelli underwent nasopharyngeal swab tests from 1 March 2020 to 9 February 2022, a long time interval that includes the two aforementioned lockdowns. The population included 8958 people from 1 March 2020 to 31 December 2020; 8981 people from 1 January 2021 to 31 December 2021; and 8981 people from 1 January 2022 to 9 February 2022. We then analysed pseudo-anonymized data, using a retrospective observational approach to evaluate the impact of the lockdown on the incidence of SARS-CoV-2 infections within the population. Given the 14 day contagious period, the swab positivity rate (SPR) among the staff decreased significantly at the end of the first lockdown, every day prior to 18 May 2020, by 0.093 (p < 0.0001, CI = (−0.138–−0.047)). After the fourteenth day post the end of the first lockdown (18 May 2020), the SPR increased daily at a rate of 0.024 (p < 0.0001, 95% CI = (0.013–0.034)). In addition, the SPR appeared to increase significantly every day prior to 17 November 2020 by 0.024 (p < 0.0001, CI = (0.013–0.034)). After the fourteenth day post the start of the second lockdown (17 November 2020), the SPR decreased daily at a rate of 0.039 (p < 0.0001, 95% CI = (−0.050–−0.027)). These data demonstrate that, in our Institution, the lockdowns helped to both protect healthcare workers and maintain adequate standards of care for COVID and non-COVID patients for the duration of the state of emergency in Italy. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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12 pages, 520 KiB

Open AccessArticle

Evaluation of the Perceptions, Attitudes and Practices among Greek Non-Professional Athletes Visiting a Public Hospital during March 2022, towards COVID-19 Vaccination and Its Consequences on Sports Training and Sports Activity

by Georgios Marinos, Dimitrios Lamprinos, Panagiotis Georgakopoulos, Nikiforos Kavoukidis, Evangelos Oikonomou, Georgios Zoumpoulis, Gerasimos Siasos, Dimitrios Schizas, Alexandros Nikolopoulos, Petros G. Botonis, Christos Damaskos, Georgios Rachiotis, Pagona Lagiou and Philippos Orfanos

Vaccines 2022, 10(11), 1821; https://doi.org/10.3390/vaccines10111821 - 28 Oct 2022

Cited by 2 | Viewed by 1801

Abstract

Sports have been majorly impacted by the COVID-19 pandemic. After the lockdown period, vaccination and protocols were implemented to return to normality. We aimed to assess the attitudes and practices related to COVID-19 vaccination among athletes, and to record adverse effects of vaccination, [...] Read more.

Sports have been majorly impacted by the COVID-19 pandemic. After the lockdown period, vaccination and protocols were implemented to return to normality. We aimed to assess the attitudes and practices related to COVID-19 vaccination among athletes, and to record adverse effects of vaccination, if any. A questionnaire was distributed to 1012 male and female athletes, 15+ years old, within the region of Athens. Vaccination coverage with at least one dose was 93.5%, whereas 53.9% were fully vaccinated. More than half of the participants were infected with SARS-CoV-2 at the time of the study. More than 90% of the participants, considered the vaccines as safe, effective and important for public health. Concern about potential side-effects was raised especially by women athletes (59.1% of women compared to 42.2% of men, p < 0.001). The main reasons for avoiding vaccination were fear of vaccine safety, concern about the short time period for vaccine development and testing and doubt of risk of being exposed to SARS-CoV-2 infection. The main reported side-effects were pain at the injection site, fatigue, fever and headache. Approximately two thirds of the participants reported that vaccination did not affect their training, and none reported missing participation in scheduled athletic events. Participants reported high compliance to preventive measures by themselves and fellow athletes, but low satisfaction regarding the implementation of public protocols and the flow of information provided by the authorities. Athletes of older age and those less concerned about potential side-effects were more likely to get fully vaccinated. Nevertheless, the vast majority of the athletes in our study were vaccinated for COVID-19 despite any hesitation regarding effectiveness, safety, or potential side-effects from the vaccines. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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11 pages, 1311 KiB

Open AccessArticle

Differential Kinetics of Effector and Memory Responses Induced by Three Doses of SARS-CoV-2 mRNA Vaccine in a Cohort of Healthcare Workers

by Federica Bergami, Francesca Arena, Josè Camilla Sammartino, Alessandro Ferrari, Federica Zavaglio, Paola Zelini, Stefania Paolucci, Giuditta Comolli, Elena Percivalle, Daniele Lilleri, Irene Cassaniti and Fausto Baldanti

Vaccines 2022, 10(11), 1809; https://doi.org/10.3390/vaccines10111809 - 27 Oct 2022

Cited by 3 | Viewed by 1525

Abstract

We reported the long-term kinetics of immune response after vaccination and evaluated the immunogenicity after a third dose of mRNA vaccine in 86 healthcare workers. Humoral response was analyzed by measuring anti-spike IgG and SARS-CoV-2 NTAbs titer; cell-mediated response was measured as frequency [...] Read more.

We reported the long-term kinetics of immune response after vaccination and evaluated the immunogenicity after a third dose of mRNA vaccine in 86 healthcare workers. Humoral response was analyzed by measuring anti-spike IgG and SARS-CoV-2 NTAbs titer; cell-mediated response was measured as frequency of IFN-γ producing T-cells and cell proliferation. Memory B cells secreting SARS-CoV-2 RBD-IgG were measured by B-spot assay. At three weeks after the third dose (T4), the frequency of subjects showing NT-Abs titer at the upper detection limit (≥640) was significantly higher than that observed at three weeks after the second dose (26/77; 33.7% vs. 9/77; 11.6%; p = 0.0018). Additionally, at T4, all the subjects reached positive levels of T-cell mediated response (median 110 SFU/10⁶ PBMC, IQR 73-231). While the number of IFNγ-producing T-cells decreased between second and third dose administration, the T-cell proliferative response did not decrease but was sustained during the follow-up. Among T-cell subsets, a higher proliferative response was observed in CD4+ than in CD8+ population. Moreover, even if a decline in antibody response was observed between the second and third dose, a sustained persistence of memory B cells was observed. Subsequently, the third dose did not affect the frequency of memory B cells, while it restored or increased the peak antibody levels detected after the second dose. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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17 pages, 337 KiB

Open AccessArticle

Factors Influencing the Choice to Advise for or against COVID-19 Vaccination in the Physicians and Dentists of an Italian Region

by Eleonora Marziali, Alberto Lontano, Luca Regazzi, Andrea Paladini, Leonardo Villani, Giovanna Elisa Calabrò, Gianfranco Damiani, Patrizia Laurenti, Walter Ricciardi and Chiara Cadeddu

Vaccines 2022, 10(11), 1793; https://doi.org/10.3390/vaccines10111793 - 25 Oct 2022

Cited by 4 | Viewed by 1815

Abstract

Healthcare workers (HCWs), particularly physicians, are a relevant and trusted source of information for patients, especially when health-related choices such as vaccination are concerned. Between July and November 2022, we administered a web-based survey to physicians and dentists living in the Latio region [...] Read more.

Healthcare workers (HCWs), particularly physicians, are a relevant and trusted source of information for patients, especially when health-related choices such as vaccination are concerned. Between July and November 2022, we administered a web-based survey to physicians and dentists living in the Latio region of Italy to explore whether their background might affect their willingness to recommend the COVID-19 vaccination to their patients (RCVtoPat) and their relatives (RCVtoRel). We performed a multivariable logistic regression to study the association between the two outcomes (RCVtoPat and RCVtoRel) and their potential determinants in our sample (n = 1464). We found that being a dentist, an increasing fear of COVID-19, and having been previously vaccinated against flu are positively associated with both RCVtoPat and RCVtoRel, while a better self-rated knowledge of COVID-19 vaccines is associated only with RCVtoRel. No role was found for age, sex, civil status, education level, information sources, previous SARS-CoV-2 infection, and chronic diseases. A sub-group analysis of physicians alone (n = 1305) demonstrated a positive association with RCVtoRel of being specialized in diagnostic/therapeutic services and a negative effect on RCVtoPat of being trained in general practice. We provide useful insights about the factors that should be addressed to ensure HCWs exert a positive influence on their patients and communities. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

11 pages, 1813 KiB

Open AccessArticle

Epidemiological Characteristics of Varicella under Different Immunisation Strategies in Suzhou Prefecture, Jiangsu Province

by Zhuoyu Zhang, Na Liu, Jun Zhang, Juan Xu, Wenyu Wang, Jiaqi Xiao, Tianyu Wang, Lin Luan and Yunyan Zhang

Vaccines 2022, 10(10), 1745; https://doi.org/10.3390/vaccines10101745 - 19 Oct 2022

Cited by 3 | Viewed by 2569

Abstract

Background: The varicella vaccine is excluded from the Chinese national immunisation programme but is included in the local expanded programme on immunisation (EPI) in the Suzhou Prefecture. This study investigated the epidemiological characteristics of the varicella cases during the implementation of different immunisation [...] Read more.

Background: The varicella vaccine is excluded from the Chinese national immunisation programme but is included in the local expanded programme on immunisation (EPI) in the Suzhou Prefecture. This study investigated the epidemiological characteristics of the varicella cases during the implementation of different immunisation strategies in the Suzhou Prefecture, Jiangsu Province. Methods: In this study, we used descriptive statistics. Information on reported instances from 2012 to 2021 was first retrieved. Data on varicella cases were collected from the China Information System for Disease Control and Prevention (CISDCP). Similarly, information on vaccinated children was obtained from the Jiangsu Province Vaccination Integrated Service Management Information System (JPVISMIS). The census data in this study was procured from the Suzhou Bureau of Statistics. Results: From 2012 to 2021, a total of 118,031 cases of varicella were reported in Suzhou, and the average annual reported incidence was 91.35 per 100,000. The average yearly incidence after implementing the two-dose varicella vaccination decreased by 41.57% compared with the implementation of one dose. This study demonstrates two annual incidence peaks, a small peak between April and July and a prominent peak between October and January. It is also possible that this seasonal distribution is related to the geography of Suzhou. The average annual reported incidence between districts with a statistically significant difference (χ² = 98.077, p < 0.05). The one-dose varicella vaccination coverage gradually increased from 55.34% in 2012 to 89.06% in 2021 and the two-dose varicella vaccination coverage gradually increased from 0.27% in 2012 to 82.17% in 2021. Conclusions: Administering the varicella vaccine in the local EPI has significantly decreased the incidence rate and the total number of cases. A two-dose vaccination schedule is still the best vaccination strategy for varicella vaccine effectiveness. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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9 pages, 479 KiB

Open AccessArticle

COVID-19 Vaccine Acceptance among Vulnerable Groups: Syrian Refugees in Jordan

by Qusai M. Talafha, Amal Al-Haidose, Ala Y. AlSamman, Saja A. Abdallah, Rasha Istaiteyeh, Wisam Nabeel Ibrahim, Ma’mon M. Hatmal and Atiyeh M. Abdallah

Vaccines 2022, 10(10), 1634; https://doi.org/10.3390/vaccines10101634 - 28 Sep 2022

Cited by 15 | Viewed by 2399

Abstract

Despite the wide distribution of COVID-19 vaccines, refugees remain last in line for the intake of vaccines. Syrian refugees in Jordan reach up to 700,000 registered and almost up to 700,000 unregistered refugees. This study aims to assess the willingness of Syrian refugees [...] Read more.

Despite the wide distribution of COVID-19 vaccines, refugees remain last in line for the intake of vaccines. Syrian refugees in Jordan reach up to 700,000 registered and almost up to 700,000 unregistered refugees. This study aims to assess the willingness of Syrian refugees in Jordan to take the COVID-19 vaccine. Participants in the Zaatari refugee camp in Jordan were invited through social media to complete the survey between January and March 2022. A total of 230 refugees participated in our study, with almost half the participants of male gender. The majority of the participants had secondary school as their highest education level and were unemployed, being below the social poverty line. Interestingly, Syrian refugees showed a high vaccine acceptance rate, as 89.6% were willing to take the vaccine. Moreover, they showed high knowledge regarding the vaccine, the disease, and the virus. Our findings highlight the importance of knowledge and awareness of the COVID-19 vaccine to increase the acceptance rate. This is very important as refugees represent a vulnerable group to infection and complications and require close attention, especially with their significant numbers in Jordon and challenges of providing adequate vaccine supplies at their camps. We hope that, with proper dissemination of knowledge and awareness and with easy accessibility to the vaccines, it will ensure high immunization to reach herd immunity in Jordan. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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13 pages, 1543 KiB

Open AccessArticle

Indoxyl Sulfate Alters the Humoral Response of the ChAdOx1 COVID-19 Vaccine in Hemodialysis Patients

by Yi-Chou Hou, Chia-Lin Wu, Kuo-Cheng Lu and Ko-Lin Kuo

Vaccines 2022, 10(9), 1378; https://doi.org/10.3390/vaccines10091378 - 24 Aug 2022

Cited by 1 | Viewed by 2096

Abstract

Background and aims: Vaccination for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is strongly recommended. The efficacy of SARS-CoV-2 vaccine for patients with end-stage renal disease is low. Indoxyl sulfate (IS) is a representative protein bound uremic toxin arousing immune dysfunction in CKD patients. [...] Read more.

Background and aims: Vaccination for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is strongly recommended. The efficacy of SARS-CoV-2 vaccine for patients with end-stage renal disease is low. Indoxyl sulfate (IS) is a representative protein bound uremic toxin arousing immune dysfunction in CKD patients. It is unknown whether IS impairs the efficacy of vaccines for SARS-CoV-2. Materials and Methods: From 1 June 2021, to 31 December 2021, hemodialysis patients (n = 358) and a control group (n = 59) were eligible to receive the first dose of the ChAdOx1 COVID-19 vaccine. Titer measurements indicative of the humoral response (anti-S1 IgG and surrogate virus neutralization test (sVNT) results) and indoxyl sulfate concentration measurement were performed 4 weeks after ChAdOx1 vaccine injection. Results: The serum concentrations of anti-S1 IgG were 272 ± 1726 AU/mL and 2111 ± 4424 AU/mL in hemodialysis patients and control group (p < 0.05), respectively. The sVNT values were 26.8 ± 21.1% and 54.0 ± 20.2% in the hemodialysis and control groups (p < 0.05), respectively. There was a decreasing trend for the anti-S1 IgG titer from the lowest to highest quartile of IS (p < 0.001). The patients with higher concentrations of IS had lower sVNT (p for trend < 0.001). Conclusion: Hemodialysis patients had weaker humoral immunity after the first dose of the ChAdOx1 vaccine. Higher concentration of IS altered the development of anti-S1 antibodies and sVNT-measured neutralization. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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12 pages, 2683 KiB

Open AccessArticle

Routine Immunization Programs for Children during the COVID-19 Pandemic in Ecuador, 2020—Hidden Effects, Predictable Consequences

by Gianina Lizeth Suárez-Rodríguez, José Salazar-Loor, Jackson Rivas-Condo, Alfonso J. Rodríguez-Morales, Juan-Carlos Navarro and José Rubén Ramírez-Iglesias

Vaccines 2022, 10(6), 857; https://doi.org/10.3390/vaccines10060857 - 27 May 2022

Cited by 6 | Viewed by 3467

Abstract

The COVID-19 pandemic has led to a global disruption of several services, including routine immunizations. This effect has been described in several countries, but there are few detailed studies in Latin America and no reports in Ecuador. Therefore, this work aims to quantify [...] Read more.

The COVID-19 pandemic has led to a global disruption of several services, including routine immunizations. This effect has been described in several countries, but there are few detailed studies in Latin America and no reports in Ecuador. Therefore, this work aims to quantify the reduction in routine immunizations for infants during the 2020 COVID-19 pandemic in Ecuador. 2018, 2019, and 2020 data were obtained from the Ministry of Health, Ecuador. The number of doses and the extent of immunization coverage was descriptively compared for four vaccines: rotavirus (ROTA), poliovirus (PV), pneumococcal (PCV), and pentavalent (PENTA) vaccines. There was no significant difference in doses applied during the 2018 and 2019 years. However, a significant (p < 0.05) drop of 137,000 delivered doses was observed in 2020 compared to the pre-pandemic years. Reductions in the percentage of coverage were more pronounced for the PENTA vaccine (17.7%), followed by PV (16.4%), ROTA (12%), and PCV vaccines (10.7%). Spatial analysis shows a severe impact on vaccination coverage on provinces from the Coast and Highland regions of the country. The pandemic has significantly impacted the immunization programs for infants across Ecuador. This retrospective analysis shows an urgent need to protect vulnerable zones and populations during public health emergencies. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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7 pages, 245 KiB

Open AccessArticle

Increased Influenza Vaccination Coverage among Members of the Athens Medical Association Amidst COVID-19 Pandemic

by Georgios Marinos, Dimitrios Lamprinos, Panagiotis Georgakopoulos, Evangelos Oikonomou, Georgios Zoumpoulis, Gerasimos Siasos, Dimitrios Schizas, Christos Damaskos, Nikolaos Garmpis, Anna Garmpi, George Patoulis, Fotios Patsourakos, Ioannis Datseris, Efstathios Tsoukalos, Ioannis D. Anyfantis, Dimitrios Papagiannis, Emmanouil K. Symvoulakis and Georgios Rachiotis

Vaccines 2022, 10(5), 797; https://doi.org/10.3390/vaccines10050797 - 18 May 2022

Cited by 7 | Viewed by 2374

Abstract

Healthcare workers are at high risk of influenza virus infection as well as of transmitting the infection to vulnerable patients who may be at high risk of severe illness. The aim of this cross-sectional study was to investigate the prevalence and related factors [...] Read more.

Healthcare workers are at high risk of influenza virus infection as well as of transmitting the infection to vulnerable patients who may be at high risk of severe illness. The aim of this cross-sectional study was to investigate the prevalence and related factors of influenza vaccination coverage (2020–2021flu season), among members of the Athens Medical Association in Greece. This survey employed secondary analysis data from a questionnaire-based dataset on COVID-19 vaccination coverage and associated factors from surveyed doctors, registered within the largest medical association in Greece. All members were invited to participate in the anonymous online questionnaire-based survey over the period of 25 February to 13 March 2021. Finally, 1993 physicians (60% males; 40% females) participated in the study. Influenza vaccination coverage was estimated at 76%. Logistic regression analysis demonstrated that older age (OR = 1.02; 95% C.I. = 1.01–1.03), history of COVID-19 vaccination (OR = 2.71; 95% C.I. = 2.07–3.56) and perception that vaccines in general are safe (OR = 16.49; 95% C.I. = 4.51–60.25) were found to be independently associated factors with the likelihood of influenza vaccination coverage. Public health authorities should maximize efforts and undertake additional actions in order to increase the percentage of physicians/health care workers (HCWs) being immunized against influenza. The current COVID-19 pandemic offers an opportunity to focus on tailored initiatives and interventions aiming to improve the influenza vaccination coverage of HCWs in a spirit of synergy and cooperation. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

22 pages, 1039 KiB

Open AccessArticle

COVID-19 Vaccination in Health Care Workers in Italy: A Literature Review and a Report from a Comprehensive Cancer Center

by Chiara Maura Ciniselli, Mara Lecchi, Mariangela Figini, Cecilia C. Melani, Maria Grazia Daidone, Daniele Morelli, Emanuela Zito, Giovanni Apolone and Paolo Verderio

Vaccines 2022, 10(5), 734; https://doi.org/10.3390/vaccines10050734 - 7 May 2022

Viewed by 2012

Abstract

The coronavirus disease 2019 pandemic still represents a global public health emergency, despite the availability of different types of vaccines that reduced the number of severe cases, the hospitalization rate and mortality. The Italian Vaccine Distribution Plan identified healthcare workers (HCWs) as the [...] Read more.

The coronavirus disease 2019 pandemic still represents a global public health emergency, despite the availability of different types of vaccines that reduced the number of severe cases, the hospitalization rate and mortality. The Italian Vaccine Distribution Plan identified healthcare workers (HCWs) as the top-priority category to receive access to a vaccine and different studies on HCWs have been implemented to clarify the duration and kinetics of antibody response. The aim of this paper is to perform a literature review across a total of 44 studies of the serologic response to COVID-19 vaccines in HCWs in Italy and to report the results obtained in a prospective longitudinal study implemented at the Fondazione IRCCS Istituto Nazionale Tumori (INT) of Milan on 1565 HCWs. At INT we found that 99.81% of the HCWs developed an antibody response one month after the second dose. About six months after the first serology evaluation, 100% of the HCWs were still positive to the antibody, although we observed a significant decrease in its levels. Overall, our literature review results highlight a robust antibody response in most of the HCWs after the second vaccination dose. These figures are also confirmed in our institutional setting seven months after the completion of the cycle of second doses of vaccination. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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13 pages, 578 KiB

Open AccessArticle

Factors Predicting Rubella Vaccination and Antibody in Pregnant Women in Japan: A Report from Pregnant Women Health Initiative

by Akiko Iwata, Kentaro Kurasawa, Kazumi Kubota, Mizuha Odagami, Shigeru Aoki, Mika Okuda and Etsuko Miyagi

Vaccines 2022, 10(5), 638; https://doi.org/10.3390/vaccines10050638 - 19 Apr 2022

Cited by 2 | Viewed by 2652

Abstract

This study aimed to identify the factors predicting rubella vaccination status based on self-reported data and the presence of sufficient rubella antibody titers in pregnant women in Japan. We used the results of the nationwide questionnaire survey conducted at obstetric facilities in the [...] Read more.

This study aimed to identify the factors predicting rubella vaccination status based on self-reported data and the presence of sufficient rubella antibody titers in pregnant women in Japan. We used the results of the nationwide questionnaire survey conducted at obstetric facilities in the Pregnant Women Health Initiative Project (PWHI), with 23 participating hospitals recruiting pregnant women from June 2018–November 2019. We extracted age, the number of deliveries, educational level, household income, pre-pregnancy smoking, and knowledge of rubella from questionnaires and medical records. We analyzed the association of rubella vaccination status and antibodies with each of these factors. We found that the number of previous deliveries, educational level, annual household income, smoking before pregnancy, and knowledge of rubella were factors predicting self-reported rubella vaccination status, while age and the number of previous deliveries were identified as factors predicting the presence of sufficient rubella antibody titers (32 folds or higher). Women considering pregnancy should be immunized against rubella to prevent congenital rubella syndrome in the future. Furthermore, social policies are needed to strongly encourage vaccination, especially for all citizens who were not given the opportunity or missed the chance to be vaccinated against rubella. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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Review

Jump to: Research, Other

9 pages, 271 KiB

Open AccessReview

COVID-19 Vaccination in Migrants and Refugees: Lessons Learnt and Good Practices

by Palmira Immordino, Davide Graci, Alessandra Casuccio, Vincenzo Restivo and Walter Mazzucco

Vaccines 2022, 10(11), 1965; https://doi.org/10.3390/vaccines10111965 - 19 Nov 2022

Cited by 10 | Viewed by 2472

Abstract

The COVID-19 pandemic has exacerbated inequalities between low- and high-income countries. Within the latter, a greater impact is seen in the poorest and most vulnerable people, including refugees, asylum seekers, and migrants. They all may experience poor access to quality healthcare or have [...] Read more.

The COVID-19 pandemic has exacerbated inequalities between low- and high-income countries. Within the latter, a greater impact is seen in the poorest and most vulnerable people, including refugees, asylum seekers, and migrants. They all may experience poor access to quality healthcare or have suboptimal health-seeking behavior, distrust of governments, or fear of detention and deportation if seeking healthcare. Some refugees and migrants may face multiple barriers to vaccination and access to health systems that are relevant to the administration of COVID-19 vaccines, despite the growing inclusion of these populations in public health policies. Several good practices have emerged to ensure the inclusion of these populations in vaccination and healthcare for COVID-19 globally. However, inequalities persist between high-income and low-/middle-income populations. The inequalities in COVID-19 vaccination reflect the already existing ones in common health services worldwide. Further efforts are necessary to reduce such disparities, to protect the vulnerable, and, by extension, the general population. The initiatives organized, both at global and local levels, to support vaccination campaigns represent a notable example of how complex multilevel structures, such as health systems, as well as limited resource health services, can successfully face, even during a health emergency, the challenges related to global health issues. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

Other

Jump to: Research, Review

7 pages, 484 KiB

Open AccessCase Report

Uneventful Coadministration of Seasonal Influenza and COVID-19 BNT162b2 Vaccines Two Weeks Post-Influenza Vaccination in an Egg-Allergic Subject: A Case Report

by Anwar A. Sayed

Vaccines 2023, 11(5), 950; https://doi.org/10.3390/vaccines11050950 - 5 May 2023

Viewed by 1805

Abstract

The COVID-19 pandemic took the world by storm, and although it has taken the world’s attention, it did not stop the spread of other communicable diseases. Seasonal influenza is a viral infection that could cause severe disease; therefore, annual influenza vaccination is highly [...] Read more.

The COVID-19 pandemic took the world by storm, and although it has taken the world’s attention, it did not stop the spread of other communicable diseases. Seasonal influenza is a viral infection that could cause severe disease; therefore, annual influenza vaccination is highly recommended, especially among patients with a weakened immune system. However, such vaccination is contraindicated for people with hypersensitivity to the vaccine or any of its components, e.g., eggs. This paper describes a case of an egg-allergic individual who received an influenza vaccine containing egg protein, which only caused mild tenderness at the site of injection. Two weeks later, the subject received a double vaccination of a second booster dose of Pfizer-BioNTech and the seasonal influenza vaccine. The patient reported no local or systemic adverse reactions to the vaccine. This case report suggests vaccination safety for subjects with mild allergies to vaccine components. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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8 pages, 245 KiB

Open AccessBrief Report

Influenza Vaccination among Patients with Diabetes or Ischemic Heart Disease in Thailand: Coverage, Knowledge and Associated Factors

by Surarong Chinwong, Suthinee Taesotikul, Duangruthai Koenkaew, Thanannat Thanomjit, Arintaya Phrommintikul and Dujrudee Chinwong

Vaccines 2023, 11(4), 794; https://doi.org/10.3390/vaccines11040794 - 4 Apr 2023

Cited by 3 | Viewed by 1824

Abstract

An influenza vaccination is recommended for patients with diabetes mellitus (DM) or ischemic heart disease (IHD) to prevent cardiovascular events, but the vaccination coverage remains low. This cross-sectional study sought to investigate vaccination coverage, knowledge level on influenza and factors associated with influenza [...] Read more.

An influenza vaccination is recommended for patients with diabetes mellitus (DM) or ischemic heart disease (IHD) to prevent cardiovascular events, but the vaccination coverage remains low. This cross-sectional study sought to investigate vaccination coverage, knowledge level on influenza and factors associated with influenza vaccination in patients with DM or IHD treated at a tertiary hospital in northern Thailand. Patients were interviewed from August to October 2017. Of 150 patients interviewed (51.3% women, mean age of 66.7 ± 8.3 years, 35.3% DM, 35.3% IHD, 29.3% DM and IHD), 45.3% (68/150) were vaccinated against influenza. The mean knowledge score was 9.68 ± 1.35 (total: 11) and did not differ between those receiving the immunization and those who did not (p = 0.056). Two factors remained significantly associated with their vaccination after multivariable logistic regression analysis: knowing their right to receive free vaccinations (adjusted OR 2.32, 95% CI: 1.06–5.10, p-value: 0.035), and needing to be vaccinated (adjusted OR 3.50, 95% CI: 1.51–8.12, p-value: 0.003). Overall, the vaccine coverage was low; less than one-half of patients received the influenza vaccine, but their knowledge level was high. Possessing the right and having a need were two factors associated with vaccination. Such factors should be carefully considered to encourage patients with DM and IDH to receive the influenza vaccination. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

10 pages, 597 KiB

Open AccessBrief Report

Breakthrough SARS-CoV-2 Infections after Vaccination in North Carolina

by Diane Uschner, Matthew Bott, William H. Lagarde, Joseph Keating, Hazel Tapp, Andrea A. Berry, Austin L. Seals, Iqra Munawar, John Schieffelin, Joshua Yukich, Michele Santacatterina, Mihili Gunaratne, Lida M. Fette, Brian Burke, Greg Strylewicz, Sharon L. Edelstein, Amina Ahmed, Kristen Miller, John W. Sanders, David Herrington, William S. Weintraub, Michael S. Runyon and on behalf of the COVID-19 Community Research Partnership Show full author list Hide full author list

Vaccines 2022, 10(11), 1922; https://doi.org/10.3390/vaccines10111922 - 13 Nov 2022

Cited by 9 | Viewed by 2886

Abstract

We characterize the overall incidence and risk factors for breakthrough infection among fully vaccinated participants in the North Carolina COVID-19 Community Research Partnership cohort. Among 15,808 eligible participants, 638 reported a positive SARS-CoV-2 test after vaccination. Factors associated with a lower risk of [...] Read more.

We characterize the overall incidence and risk factors for breakthrough infection among fully vaccinated participants in the North Carolina COVID-19 Community Research Partnership cohort. Among 15,808 eligible participants, 638 reported a positive SARS-CoV-2 test after vaccination. Factors associated with a lower risk of breakthrough in the time-to-event analysis included older age, prior SARS-CovV-2 infection, higher rates of face mask use, and receipt of a booster vaccination. Higher rates of breakthrough were reported by participants vaccinated with BNT162b2 or Ad26.COV2.S compared to mRNA-1273, in suburban or rural counties compared to urban counties, and during circulation of the Delta and Omicron variants. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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19 pages, 735 KiB

Open AccessSystematic Review

The Association of Health Literacy with Intention to Vaccinate and Vaccination Status: A Systematic Review

by Leonardo Maria Siena, Claudia Isonne, Antonio Sciurti, Maria Roberta De Blasiis, Giuseppe Migliara, Carolina Marzuillo, Corrado De Vito, Paolo Villari and Valentina Baccolini

Vaccines 2022, 10(11), 1832; https://doi.org/10.3390/vaccines10111832 - 29 Oct 2022

Cited by 16 | Viewed by 3620

Abstract

Despite health literacy (HL) being recognized as a driver of health-promoting behavior, its influence on the vaccination decision-making process remains unclear. This study summarized current evidence on the association between HL and both intention to vaccinate and vaccination status. We searched PubMed, Scopus, [...] Read more.

Despite health literacy (HL) being recognized as a driver of health-promoting behavior, its influence on the vaccination decision-making process remains unclear. This study summarized current evidence on the association between HL and both intention to vaccinate and vaccination status. We searched PubMed, Scopus, and Web of Science, retrieving observational studies published until January 2022 that used HL-validated tools to investigate the above associations for any vaccine. Quality was assessed using the Newcastle–Ottawa scale. Twenty-one articles were included; of these, six investigated the intention to vaccinate and the remainder vaccination status. Articles on intention looked at SARS-CoV-2 vaccination using heterogeneous HL tools and were of high/fair quality. Vaccination status, mainly for influenza or pneumococcal vaccines, was explored using various HL tools; the quality was generally high. We found inconsistent results across and within vaccine types, with no clear conclusion for either vaccination intention or status. A weak but positive association was reported between a high HL level and influenza vaccination uptake for individuals aged more than 65 years. HL did not seem to significantly influence behavior towards vaccination. Differences in the methods used might explain these results. Further research is needed to investigate the role of HL in the vaccination decision-making process. Full article

(This article belongs to the Special Issue Epidemiology, Vaccination and Public Health)

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