01
Impact of the COVID-19 pandemic on self-paid vaccination intentions for children: a cross-sectional study in China
This study was published in BMJ Open. The study analyzed changes in parental intentions toward self-paid vaccination based on a cross-sectional survey of 2,212 parents of children under six years of age in Zhejiang Province. The results showed that 19.32% of respondents increased their intention to immunize their children with self-paid vaccines after the COVID-19 epidemic, and 9.16% decreased their intention.
The major reason for increased intentions was ‘Vaccines are effective in preventing diseases’ (83.89%) and for decreased intentions was ‘Worried about the side effects of vaccines’ (65.95%). A higher hesitancy degree (OR=2.208, p=0.0001), reduced trust in vaccines after COVID-19 (OR=16.650, p<0.0001), doctors’ recommendation of NIP vaccines (OR=2.180, p=0.0076), and non-perfect satisfaction with vaccine information (all OR>1, all p<0.05) were considered to be drivers of decreased intention.
The study emphasized that education to enhance the knowledge of self-paid vaccines for caregivers should be implemented to increase their vaccination intentions and decrease the threat of infectious diseases to children’s health. The study concluded by suggesting that the relevant stakeholders should step up education and communication on self-paid vaccines to help parents better understand the benefits of vaccines, so as to improve vaccination coverage.
https://doi.org/10.1136/bmjopen-2023-083056
02
Exploring the future adult vaccine landscape—crowded schedules and new dynamics
This study was published in the npj Vaccines, reviewed the rapid growth of the U.S. adult vaccine market since the COVID-19 pandemic and the mismatched immunization infrastructure. Over the next 10 years, the number of approved vaccine products globally may triple and adult vaccination programs will see significant expansion. It is projected that the total annual volume for adult vaccines will surpass 500 million doses dispensed in the U.S. alone by 2032, which would necessitate a major paradigm-shift in our approach to vaccine administration and consumer vaccination behavior.
Through interviewing and surveying key adult vaccine market stakeholders, we found that many stakeholders may not fully aware of the impending wave of adult vaccines. In the absence of overriding policy body or cohesive national immunization plan in the U.S., the adult vaccine market has also seen a shift in focus to newer participants, whereas there are currently communication and synergy challenges between pharmacists and physicians, and the supply chain is unprepared for an increase in vaccine offerings. Secondly, lack of market standardization. No individual stakeholder group is willing to take responsibility for establishing priorities or developing schedules, a national information system for adult immunization is not yet in place, and insufficient training creates challenges for patient assessment by immunizers. Thirdly, the survey reported that the number of vaccinations a patient would be willing to receive in a single appointment and willingness to receive per year are very limited. As only seven vaccines are currently recommended by ACIP for adult immunization, administration is simple, and the expansion of the adult vaccine market means that consumers need to take more ownership of their vaccination schedules and vaccination records. Currently, stakeholders rely more on downstream interventions (e.g., improving public awareness) , often overlooking the upstream, structural issues that contribute to health disparities. The article calls for an integrated, cross-sectoral, chain-wide approach to improving vaccine equity.
More adult vaccines will be incorporated into the existing ecosystem, and consider the pivotal role of the consumer and their choices, along with improved coordination and accessibility in a currently fragmented landscape. Such measures encompass the elimination of barriers to vaccine access, streamlining processes for reimbursement and operations, enhancing record-keeping, and equipping immunizers and patients with the necessary tools to instill confidence in current and future vaccines.
**The author is employed by Pfizer Inc.
https://doi.org/10.1038/s41541-024-00809-z
03
Enhancing vaccination uptake through community engagement: evidence from China
This study, published in Scientific Reports, utilizing data from the 2021 Chinese General Social Survey (CGSS), and employing Ordinary Least Squares (OLS) regression and Propensity Score Matching (PSM) methods, examined the impact of community engagement on COVID-19 and flu vaccination uptake among 7281 individuals. Community engagement, measured by community vaccination notifications, serves as the key independent variable. Respondents were asked, “Were you informed about vaccinations by your community?” A positive response indicated active mobilization by the community for vaccination, resulting in a dummy variable.
The analysis reveals a positive association between community engagement and vaccination rates. Specifically, individuals receiving notifications were more likely to get the COVID-19 vaccine compared to non-recipients (vaccination rates: 100% vs. 53.3%), and flu vaccination rates were also significantly higher among those notified (2.7% vs. 1.9%). Mechanism analysis suggests that individuals receiving community notifications are more aware of the benefits of vaccination, leading to higher vaccination rates among this group. In addition, the heterogeneity analysis reveals that community engagement has a more pronounced impact on vaccination behavior among the elderly and those with lower education levels.
This study underscores the effectiveness of community engagement strategies in promoting positive vaccination behavior among individuals in China. These findings emphasize the importance of integrating community engagement approaches into public health interventions to address vaccination challenges.
https://doi.org/10.1038/s41598-024-61583-5
04
The urban-poor vaccination: Challenges and strategies in low-and-middle income countries
This study, published in Human Vaccines & Immunotherapeutics, discussed the challenges and strategies of urban-poor vaccination in LMICs.
The significant variations in the coverage of vaccination among the urban poor population stems from three main challenges: first, mobile populations and families migration for different reasons in cities make it difficult for health workers to accurately track children who have not fully vaccinated; second, most urban poor dwellers depend on the informal employment and have quite inflexible working schedule that prevent them from taking time to get vaccinated; third, the cultural and religious diversity of the city leads to differences in vaccine acceptance among people of different backgrounds.
To address challenges listed above, this study proposed three strategies. First, involving communities in designing health care intervention strategies, through cooperation with community leaders, community participation and uptake can be improved; second, employing multiple vaccination strategies and sites, such as opening vaccination sites at busy places like markets, churches,etc.; and providing vaccines on weekends when people are free; offering “Vaccine Express” services. Finally, the establishment of an adaptable and flexible system of immunization services, such as the provision of flexible vaccination opening hours as well as innovative ways to trace defaulters, ensures that all people have access to vaccination services.
https://doi.org/10.1080/21645515.2023.2295977
05
Long-term impact of rotavirus vaccination on all-cause and rotavirus-specific gastroenteritis and strain distribution in Central Kenya: An 11-year interrupted time-series analysis
This study was published in Vaccine. Kenya introduced a monovalent rotavirus vaccine administered orally at 6 and 10 weeks of age into her National Immunization Program in July 2014. The study evaluated the long-term impact of the vaccine on hospitalization for all-cause and rotavirus-specific acute gastroenteritis (AGE) and strain epidemiology in Kenya.
Data on all-cause and rotavirus-specific AGE and strain distribution were derived from an eleven-year hospital-based surveillance of AGE among children aged <5 years at Kiambu County Teaching and Referral Hospital (KCTRH) in Central Kenya between 2009 and 2020. Fecal samples were screened for group A rotavirus using ELISA and genotyped using multiplex semi-nested RT-PCR. Trends in all-cause and rotavirus-related AGE and strain distribution were compared between the pre-vaccine (2009–2014), early post-vaccine (2014–2016) and late post-vaccine (2019–2020) periods.
Rotavirus-specific AGE was detected at 27.5% in the pre-vaccine period; 13.8% in the early post-vaccine period ; and 12.0% in the late post-vaccine period. This amounted to a decline of 49.8% in rotavirus-specific AGE in the early post-vaccine period and 53.4% in the late post-vaccine period when compared to the pre-vaccine period. All-cause AGE hospitalizations declined by 40.2% and 75.3% in the early post-vaccine and late post-vaccine periods, respectively, when compared to the pre-vaccine period. G3P [8] was the predominant strain in the late post-vaccine period, replacing G1P[8] which had predominated in the pre-vaccine and early post-vaccine periods. Additionally, considerable proportions of uncommon strains G3P[6] and G12P[6] were detected in the post-vaccine era.
The study revealed that rotavirus vaccination has resulted in a significant decline in all-cause and rotavirus-specific AGE, and thus, provides strong evidence for public health policy makers in Kenya to support the sustained use of the rotavirus vaccine in routine immunization. However, the shift in strain dominance and age distribution of rotavirus AGE in the post-vaccine era underscores the need for continued surveillance to assess any possible vaccine-induced selective pressure that could diminish the vaccine effectiveness over time.
https://doi.org/10.1016/j.vaccine.2024.126210
06
Trends and factors associated with receipt of human papillomavirus (HPV) vaccine in private, public, and alternative settings in the United States
This study was published in Vaccine. One of the goals of the President’s Cancer Panel was to maximize access to human papillomavirus (HPV) vaccination through expansion of alternative settings for receiving the vaccine in the United States, such as in public health settings, schools, and pharmacies.
In a cross-sectional analysis, the study utilized the National Immunization Survey-Teen data from 2014 to 2020 (n = 74,645) to describe trends and factors associated with HPV vaccine uptake in private, public, and alternative settings. The study calculated annual percent change (APC) between 2014 and 2020, estimating rate of HPV vaccine uptake across settings, and using multinomial logistic regression, the study estimated the odds of receipt of HPV vaccine in public health settings and other alternative settings compared to private healthcare settings, adjusting for socio- demographic covariates.
The study found a 5% annual increase in the use of private facilities between 2014–2018 (APC = 5.3; 95 % CI: 3.4, 7.1), and almost 7% between 2018–2020 (APC = 6.7; 95 % CI:1.4, 12.3). Adjusted multinomial logistic regression analyses found that odds of receiving vaccinations at a public facility vs. a private facility increased almost two times for adolescents living below poverty (aOR = 1.82, 95% CI: 1.60, 2.08) compared to above poverty. However, adolescents without physician recommendations had lower odds of receiving vaccines at public versus private facilities (aOR = 1.75, 95% CI: 1.44, 2.12). Additionally, odds of receiving HPV vaccines at public facilities vs. private facilities decreased by 33% for White adolescents (aOR = 0.67, 95% CI: 0.57, 0.78) versus Black adolescents.
The study suggested that sociodemographic factors such as race, and socioeconomic factors such as poverty level, and receipt of physician HPV recommendations are associated with receiving the vaccine at private settings vs. public health facilities and alternative settings. This information is important in strengthening alternative settings for HPV vaccine uptake to increase access to the vaccine among disadvantaged individuals.
https://doi.org/10.1016/j.vaccine.2024.06.004
Content Editor: Ziqi Liu
Page Editor: Ziqi Liu
