Journal Content Recommendation
01
National vaccination policies for health workers – A cross-sectional global overview
This article was published in Vaccine. Immunization is essential to protect healthcare workers from occupational exposure to vaccine-preventable diseases (VPDs). This study used the World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) Joint Reporting Form (JRF) on Immunization to distribute a one-time supplemental questionnaire to each WHO member country. Respondent countries described their immunization policies for health workers nationally in 2020, detailing VPD policies, technical and financial support, monitoring and evaluation activities, and provisions for vaccinating health workers in emergencies.
The study showed that “A total of 53 % (103/194) Member States responded and described health worker policies: 51 had a national policy for vaccinating health workers; 10 reported plans to introduce a national policy within 5 years; 20 had subnational/institutional policies; 22 had no policy for vaccinating health workers. Most national policies were integrated with occupational health and safety policies (67 %) and included public and private providers (82 %).” Following, Hepatitis B, seasonal influenza, and measles were most often included in the policies. Regardless of a national immunization policy, 43 countries indicated that they monitored and reported on the vaccination status of health workers; 53 countries promoted vaccination; 25 countries assessed the vaccine needs, vaccination status, or reasons for non-vaccination of health workers; and 62 countries have established mechanisms for vaccinating medical personnel in emergencies.
Studies have shown that national immunization policies for health workers are complex and vary by region and income level. There are future opportunities for “developing and strengthening national health worker immunization programmes”, and existing health worker immunization programmes may “provide a foothold on which broader health worker vaccination policies can be built and strengthened.”
https://doi.org/10.1016/j.vaccine.2023.04.083
02
Current status and outlook for vaccination of pregnant women
This study was published in Vaccines and Immunization in China. It systematically evaluated the safety and efficacy of vaccines widely recommended for pregnant women, the burden of vaccine-targeted diseases, and the current status of vaccination for pregnant women in selected countries, including China. It discusses the challenges for pregnant women’s participation in vaccine clinical research and vaccination and also looks forward to implementing vaccination for pregnant women in China.
Pregnant women who receive vaccinations against influenza, COVID-19, pertussis, and tetanus have been shown to have a significantly lower incidence of disease infections and serious complications in both themselves and their newborns. Additionally, vaccinations protect the newborns through maternally transmitted antibodies and reduce the risk of the infants contracting diseases during the immunization gap period after birth. While the United States and the United Kingdom have widely imposed vaccination policies for pregnant women, China’s vaccination rate remains low and requires immediate attention. The main challenges facing vaccination for pregnant women include the inability to participate in clinical studies related to vaccines mainly due to the sensitivity of pregnant women and fetuses to drugs and vaccines as well as limitations of ethical review; the low vaccination rate caused by pregnant women’s concerns about the effectiveness and safety of vaccination; the lack of doctors’ knowledge about vaccines and their concerns about its safety, which lowers their willingness to recommend vaccination to pregnant women; the inadequate protection provided by policies and regulations; the absence of influenza vaccination from the national immunization plan; and the weak legal effect of vaccination guidelines.
The article suggests that China should formulate and promote vaccination policies for pregnant women, strengthen clinical research data collection on vaccines for pregnant women in China, and encourage vaccination among pregnant women through multifaceted collaboration to improve the health of pregnant women and newborns and reduce the disease burden.
03
The impact of strategies for increasing vaccination coverage in children: A community clinical trial
This study was published in Vaccine. The State Health Department of Minas Gerais (DHMG), in collaboration with the School of Nursing of the Federal University of Minas Gerais (UFM), carried out an intervention to increase the coverage of immunization among children in participating municipalities by combining work sessions with the creation of a Plan of Action (POA). This was done in response to the pandemic’s primary effects on vaccination coverage in Brazil and the challenges faced by the Brazilian National Immunization Program (PNI). This study is a community-based clinical trial aimed at evaluating
the impact of “intervention on vaccination coverage in children under 2 years of age and on indicators of immunization work processes”, and was conducted in 212 municipalities in the state of Minas Gerais. Vaccination coverage data were obtained from the National Immunization Program Information System (SIPNI).
The results showed statistically significant improvements in most indicators in the first post-intervention monitoring (T2) and the second post-intervention monitoring (T3) relative to T1, using the pre-intervention (T1) as the baseline, as well as an increase in the median and interquartile range of the vaccination coverage data. Immunization indicators related to Community Health Agents (CHA) performed particularly well. Community Health Agents (CHA) are dedicated personnel in the Brazilian primary healthcare system responsible for home visits, family interactions, and ensuring the completeness of children’s immunization records in their jurisdictions. With the exception of hepatitis A, “there was an increase in the percentage of municipalities that reached targets when comparing the years 2022 and 2021”. The study showed that the intervention “had a positive impact on vaccine coverage of children under 2 years of age and on indicators of immunization work processes in municipalities in the state of Minas Gerais, Brazil.”
https://doi.org/10.1016/j.jvacx.2024.100429
04
Long-term impact of 10-valent pneumococcal conjugate vaccine in Kenya: Nasopharyngeal carriage among children in a rural and an urban site six years after introduction
This article was published in Vaccine. The Synflorix™ 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in Kenya in 2011 using a three-dose baseline immunization with supplemental vaccination in selected districts. This study was conducted in November-December 2017 in Kibera (an informal settlement in Nairobi without supplementary immunization) and Asombo (a rural area in Western Kenya where children aged 1-4 years received 2 doses of supplementary immunization), with cross-sectional surveys of pneumococcal carriage among children under 5 years of age. Participants were randomly selected through the Continuous Basic Population Surveillance platform.
The study involved 504 children, including 252 from each site; >90 % of participants had received 3 doses of PCV10-GSK. It was reported that Pneumococcal colonization was detected in “210 (83.3 %) participants in Kibera and 149 (59.1 %) in Asembo, which was significantly lower than the prevalence observed in 2013 (92.9 % and 85.7 %, respectively).” Compared to the 2013 vaccine type carriage rates (17.3% and 13.3%, respectively), the PCV10 serotype was found in 35/252 (13.9%) participants in Kibera and 23/252 (9.1%) participants in Asombo; however, the difference was not statistically significant. In both regions, “serotypes 3, 6A, 19A, 19F, and 35B were among the most common serotypes.”
The study showed that the rate of pneumococcal colonization in children had declined six years after the introduction of PCV10, while the effect of PCV10 on vaccine-type carriage rates stabilized. Recently, Kenya replaced the PCV10 vaccine with the 10-valent PCV Pneumosil™ (produced by the Serum Institute of India) containing serotypes 6A and 19A. These data provide a “historical context for interpreting changes in vaccine-type carriage following the PCV formulation switch.”
https://www.doi.org/10.1016/j.vaccine.2024.07.021
05
The role of vaccines in reducing antimicrobial resistance: A review of potential impact of vaccines on AMR and insights across 16 vaccines and pathogens
This study was published in Vaccine. Anti-microbial resistance (AMR) is a major challenge for global public health, with approximately 4.95 million AMR-related deaths globally in 2019, with low- and middle-income countries being particularly vulnerable. The study aimed to assess the role of vaccines in reducing AMR, based on Vaccine Value Profiles (VVPs), which analyze the effects of vaccines on 16 pathogens (Mycobacterium tuberculosis, Escherichia coli, Klebsiella pneumoniae, group B Streptococcus, Neisseria gonorrhoeae, Salmonella paratyphi type A, Shigella, non-typhoidal Salmonella, and entero-producing virulent Escherichia coli, extra-intestinal pathogenic E. coli, respiratory syncytial virus, influenza virus, norovirus, malaria, leishmaniasis, and toxoplasmosis) and to explore how the vaccine reduced AMR.
The results show that vaccines “reduce the incidence of infections with drug-susceptible and drug-resistant pathogens, leading to a reduction in cases and deaths, but also economic costs associated with treating infections.” The role of vaccines is vital in mitigating the impact of infectious diseases and curbing the development of AMR; yet, their place in a comprehensive strategy to combat AMR is not fully understood. Therefore, a combination of other preventive and control strategies, such as improved hygiene, optimized use of antimicrobials, vector control, and behavioral change, are required to effectively curb AMR. In addition, “Continued investment in research and development including new vaccines, along with the implementation of other prevention and control strategies”.
https://doi.org/10.1016/j.vaccine.2024.06.017
06
Modeling the impact of vaccination for the immunization Agenda 2030: Deaths averted due to vaccination against 14 pathogens in 194 countries from 2021 to 2030
This study, published in Vaccine, aimed to estimate “the number of deaths averted due to an ambitious vaccination coverage scenario from 2021 to 2030 in 194 countries” by achieving the goals of the Immunization Agenda 2030 (IA2030). The study used annual age-specific mortality estimates based on demographic models to project the number of deaths averted in 194 countries globally under vaccination scenarios, using vaccine data from the Vaccine Impact Modeling Consortium (VIMC) for 10 pathogens in 110 countries, as well as estimates for an additional four pathogens from the 2019 Global Burden of Disease Study.
The study projects that approximately 51.5 million (95% CI: 44.0 million-63.2 million) deaths would be averted by vaccination between 2021 and 2030. The average number of deaths averted by vaccination is 5.2 million (4.4 million-6.3 million) per year, with 4.4 million (3.9 million-5.1 million) in 2021 rising to 5.8 million (4.9 million-7.5 million) in 2030. The measles and hepatitis B vaccines are projected to avert the largest number of deaths, “accounting for 18.8 million (17.8–20.0) and 14.0 million (11.5–16.9) of total deaths averted respectively.” The results show that deaths from vaccine-preventable diseases will be significantly reduced globally, especially in low- and middle-income countries in the African region if the IA2030 targets are met. Globalization of vaccine advancements is helping achieve the IA2030 vision, although data on certain regions and pathogens still needs to be further refined.
https://doi.org/10.1016/j.vaccine.2023.07.033
Policy Updates
07
Canada’s vaccine advisers now recommend 1 dose of HPV shot for younger groups
New guidelines recently released by Canada’s National Committee on Immunization (NACI) strongly recommend that “individuals nine to 20 years of age should receive one dose of the vaccine for human papillomavirus,” replacing the two-dose regimen that had previously been implemented in this age group. The NACI still recommends a two-dose regimen for 21-26-year-olds, and a three-dose regimen for people who are immunocompromised or living with HIV.
The World Health Organization is updating its HPV vaccine position paper in 2022 based on evidence from multiple previous studies, to recommend a single-dose immunization schedule for people aged 9-20. To date, the HPV vaccine immunization schedule for younger age groups has been modified to a single-dose vaccination schedule in more than 40 countries worldwide, including the UK, Australia, and Ireland.
https://www.cbc.ca/news/health/hpv-shot-children-youth-canada-1.7274408
Content Editor: Linjing(Grace) Zhang
Page Editor: Ziqi Liu
