RESUMO
Introduction: vaccination is one of the strategies the World Health Organization recommends to reduce the burden of COVID-19. However, many African countries like Cameroon have low COVID-19 vaccination coverage. The purpose of this study was to investigate the reasons for the refusal of the population of the city of Douala to be vaccinated against COVID-19. Methods: we conducted a cross-sectional and analytical study in Douala from February 10 to May 31, 2022. Participants, aged at least 21 years and residing in the city of Douala, were interviewed. Associations between the variables of interest were measured using Chi-square and Fisher tests, with a 95% confidence interval. Results: a total of 1555 people were included in the study. Only 168 (11%) had been vaccinated. The proportion of vaccine refusal was high, with 711 (45.7%) refusing, 640 participants (41.1%) hesitating, and 204 people (13.2%) being in favor of COVID-19 vaccination. The main reasons for refusing anti-COVID-19 vaccination were fear of adverse effects (406; 44.8%), lack of information about vaccines (331; 36.5%), and lack of confidence (302; 33.3%). Factors associated with vaccine refusal were religion (p=0.026) and level of education (p=0.002). Conclusion: this study revealed low COVID-19 vaccination coverage in Douala, with a significant proportion of refusal and hesitation towards vaccination. Communication strategies should take into account the reasons and factors associated with refusal.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Hesitação Vacinal , Recusa de Vacinação , Vacinação , Humanos , Camarões , Estudos Transversais , COVID-19/prevenção & controle , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Vacinas contra COVID-19/administração & dosagem , Adulto Jovem , Vacinação/estatística & dados numéricos , Recusa de Vacinação/estatística & dados numéricos , Recusa de Vacinação/psicologia , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Idoso , Cobertura Vacinal/estatística & dados numéricos , MedoRESUMO
BACKGROUND: This study aimed to explore the reasons adults in the general population, influenza risk groups (RGs) and health care workers (HCWs) in Norway give for their vaccination choices and whether these reasons vary between groups or over time in order to further improve influenza vaccination coverage. METHODS: Respondents of a nationally representative telephone survey conducted by Statistics Norway were asked "What was the most important reason why you did/did not get vaccinated?". The question on influenza non-vaccination was included in 2016 and in 2020 to 2023 and the question on influenza vaccination in 2021 to 2023. RESULTS: The study included 9 705 individuals aged 18-79 years. Influenza vaccination coverage in the RGs increased from 20.6% in 2016 to 63.1% in 2022, before a reduction to 58.3% in 2023. Common reasons for non-vaccination were similar in all groups. The most cited reasons were "no need" for the vaccine and "no specific reason", followed by "not recommended/offered the vaccine", "worry about side effects" and "vaccine refusal". The most frequent reasons for vaccination among the general population and RGs were protection against influenza and belonging to a RG, while the most frequent responses among HCWs were being offered the vaccine at work/work in health care, followed by a desire for protection against influenza. Receiving a vaccine recommendation from a health professional was mentioned in all groups. We also observed that the proportion reporting "no need" for the vaccine decreased over time, especially among HCWs, and that the proportions reporting vaccine refusal and worry about side effects as reasons for non-vaccination were temporarily reduced during the COVID-19 pandemic. CONCLUSIONS: The general population and RGs cite protection against influenza as their primary incentive for vaccination, while HCWs mainly refer to their professional role or workplace vaccination. For non-vaccination we see a similar pattern in all groups, with "no need" and "no specific reason" as the main reasons. Of note, worry about side effects and vaccine refusal is as frequent among HCWs as in other groups. Continued efforts to maintain and increase vaccine confidence are needed.
Assuntos
Vacinas contra Influenza , Influenza Humana , Humanos , Pessoa de Meia-Idade , Adulto , Noruega , Vacinas contra Influenza/administração & dosagem , Masculino , Adolescente , Feminino , Influenza Humana/prevenção & controle , Idoso , Adulto Jovem , Inquéritos e Questionários , Vacinação/estatística & dados numéricos , Vacinação/psicologia , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Pessoal de Saúde/estatística & dados numéricos , Pessoal de Saúde/psicologia , Estações do AnoRESUMO
Background: Cervical cancer is the fourth most common cancer among women, HPV vaccine can reduce the incidence of cervical cancer by approximately 70%. Sexual behavior is a direct risk factor for HPV infection, and sexually active college students, therefore, receive attention for HPV vaccination. This study aimed to investigate the awareness of HPV and its vaccine among college students in Zhengzhou, and to explore the factors influencing their awareness of HPV vaccine, to understand college students' willingness to receive the vaccine. The findings of this study will lay a foundation for cervical cancer prevention. Methods: Using a multistage random sampling method, 650 college students from four universities in Zhengzhou were selected. A self-administered questionnaire on the awareness of HPV and its vaccine, and willingness to receive HPV vaccination was carried out. Logistic regression was used to analyze the factors influencing students' awareness of the HPV vaccine. Results: 58.0% of college students had heard of HPV, and 72.8% of college students had heard of HPV vaccine. Logistic regression showed that gender, major, grade, mean monthly consumption level, sexual history, and mother cervical cancer screening participation significantly influenced the awareness of HPV vaccine (p < 0.05). Only 27(4.2%) college students had received the HPV vaccine. 63.2% of college students expressed their willingness to get vaccinated. Conclusion: The awareness of HPV and its vaccine among college students in Zhengzhou needs improvement. Although the vaccination rate is low, most college students are willing to be vaccinated. Diverse health education programs should be conducted for different groups to improve awareness of cervical cancer prevention and promote vaccination.
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Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Estudantes , Neoplasias do Colo do Útero , Humanos , Feminino , Vacinas contra Papillomavirus/administração & dosagem , China , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Masculino , Universidades , Inquéritos e Questionários , Adulto Jovem , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Vacinação/psicologiaRESUMO
Importance: Disparities in COVID-19 vaccination rates by race and ethnicity are well documented. Less is known about primary language and COVID-19 vaccine uptake. Objective: To describe the time to COVID-19 primary series vaccination and booster doses by primary language and country of origin. Design, Setting, and Participants: This retrospective cohort study included patients aged 6 months or older with at least 1 health encounter from July 1, 2019, to June 30, 2023, at a single health care system serving patients across Minnesota and western Wisconsin. Exposure: Primary language and country of origin documented in the electronic health record. Main Outcomes and Measures: Three COVID-19 vaccine coverage outcomes were evaluated: (1) primary series (1 Ad26.COV.S vaccine or 2 mRNA COVID-19 vaccines), (2) first-generation booster (primary series Ad26.COV.S vaccine plus 1 Ad26.COV.S or mRNA COVID-19 vaccine at least 2 months after the second dose or primary series mRNA vaccine plus 1 mRNA vaccine at least 5 months after the second dose), and (3) bivalent booster. Vaccine coverage was described by patient characteristics. Associations of primary language, race and ethnicity, and other patient characteristics with COVID-19 vaccine uptake were evaluated using time-to-event analysis in multivariable Cox proportional hazards regression models, and adjusted hazard ratios (AHRs) with 95% CIs were reported. Results: There were 1â¯001â¯235 patients included (53.7% female). Most patients reported English as a primary language (94.1%) and were born in the US (91.8%). Primary series coverage was 63.7%; first-generation booster coverage, 64.4%; and bivalent booster coverage, 39.5%. Coverage for all outcomes was lower among those with a non-English primary language compared with English as the primary language (56.9% vs 64.1% for primary series; 47.5% vs 65.3% for first-generation booster; 26.2% vs 40.3% for bivalent booster). Those with a non-English primary language had lower COVID-19 vaccine uptake for the primary series (AHR, 0.85; 95% CI, 0.84-0.86), first-generation booster (AHR, 0.74; 95% CI, 0.73-0.75), and bivalent booster (AHR, 0.65; 95% CI, 0.64-0.67) compared with patients with English as their primary language. Non-US-born patients had higher primary series uptake compared with US-born patients (AHR, 1.19; 95% CI, 1.18-1.20) but similar first-generation booster (AHR, 1.01; 95% CI, 0.99-1.02) and bivalent booster (AHR, 1.00; 95% CI, 0.98-1.02) uptake. Conclusions and Relevance: In this retrospective cohort study, patients with a non-English primary language had both lower coverage and delays in receiving COVID-19 vaccines compared with those with English as their primary language. Reporting on language may identify health disparities that can be addressed with language-specific interventions.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Idioma , SARS-CoV-2 , Humanos , Feminino , COVID-19/prevenção & controle , Masculino , Estudos Retrospectivos , Vacinas contra COVID-19/uso terapêutico , Pessoa de Meia-Idade , Adulto , SARS-CoV-2/imunologia , Minnesota , Adolescente , Idoso , Wisconsin , Vacinação/estatística & dados numéricos , Criança , Adulto Jovem , Pré-Escolar , Cobertura Vacinal/estatística & dados numéricos , Lactente , Imunização Secundária/estatística & dados numéricosRESUMO
BACKGROUND: Hesitancy about vaccination during pregnancy posed challenges to SARS-CoV-2 vaccination efforts. We aimed to examine rates of SARS-CoV-2 vaccination among Ontario residents who gave birth in early 2022, and to compare rates of SARS-CoV-2 vaccine uptake with rates of tetanus, diphtheria, and pertussis (Tdap) and influenza vaccination during pregnancy in 2019, 2021, and 2022. METHODS: We conducted a population-based retrospective cohort study to describe vaccination rates among pregnant and comparable nonpregnant populations in Ontario using linked administrative data. Provincially insured females who had a live, in-hospital birth from Jan. 1 to Mar. 31 in 2019, 2021, or 2022 were our primary cohort. Using log-binomial regression, we tested associations between SARS-CoV-2 (2022) and Tdap and influenza (2019, 2021, 2022) vaccination status, with birth group and covariates. We compared SARS-CoV-2 vaccination status with the status of a matched cohort of nonpregnant females and conducted subgroup analyses by age and prenatal clinician type. RESULTS: Among birthing people, 78.7% received their first SARS-CoV-2 vaccine dose and 74.2% received a second dose. The rate was significantly higher among nonpregnant comparators (dose 1: relative risk [RR] 0.94, 95% confidence interval [CI] 0.93-0.94; dose 2: RR 0.91, 95% CI 0.90-0.91). However, the rate of SARS-CoV-2 vaccination uptake among birthing people was higher than uptake of Tdap or influenza vaccination. Tetanus, diphtheria, and pertussis vaccination increased over time from 22.2% in 2019 to 32.6% in 2022, and influenza vaccination rose to 35.3% in 2021 but returned to prepandemic levels in 2022 (27.7%). Vaccination rates were lower among pregnant people who were young, multiparous, or residents of rural or economically deprived areas for all 3 vaccines. INTERPRETATION: Rates of SARS-CoV-2 vaccination were lower among pregnant people than among nonpregnant comparators but were higher than rates of routinely recommended Tdap and influenza vaccinations. Pandemic urgency may have overcome a great deal of hesitancy about vaccinating against SARS-CoV-2 during pregnancy in 2022, but uptake of routinely recommended vaccines in pregnancy remains a challenge. TRIAL REGISTRATION: Clinicaltrials.gov, no. NCT05663762.
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COVID-19 , Vacinas contra Difteria, Tétano e Coqueluche Acelular , Vacinas contra Influenza , Influenza Humana , Humanos , Feminino , Gravidez , Ontário/epidemiologia , Estudos Retrospectivos , Adulto , Vacinas contra Influenza/administração & dosagem , COVID-19/prevenção & controle , COVID-19/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinação/estatística & dados numéricos , Vacinas contra COVID-19/administração & dosagem , Adulto Jovem , SARS-CoV-2 , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologiaRESUMO
PURPOSE: This research aimed to explore hesitation towards the COVID-19 booster vaccine among dialysis patients and study the association between COVID-19 pandemic-induced health behavior and vaccination hesitancy. METHODS: A self-administered online questionnaire evaluating dialysis patients' hesitation to take COVID-19 booster vaccination was conducted between March 24 and 22 April 2022 in Taizhou, China. The logistic regression method was applied to identify factors associated with vaccination hesitancy, and all data were analyzed using R software. RESULTS: Of the 365 study participants, 272 (74.5%) individuals hesitated to take the booster dose. Health behavior was found to be a significant factor for hesitation to take COVID-19 vaccines, with OR (95% CI) of 1.09 (1.02-1.17). Influenza vaccination history was also significantly associated with the hesitation (OR (95% CI) = 0.39 (0.21-0.74)). In addition, participants with higher education levels exhibited lower vaccine hesitancy compared to those with junior secondary or below, with ORs (95% CIs) of 0.49 (0.27-0.91) for senior secondary and 0.35 (0.14-0.89) for junior college or above, respectively. CONCLUSION: The proportion of hesitancy for taking the booster vaccination of the COVID-19 vaccine was high among dialysis patients. Health behaviors, influenza vaccination history, and education levels were risk factors in their vaccination hesitancy. These findings may aid efforts to help vaccinate people with underlying diseases against future pandemics.
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Vacinas contra COVID-19 , COVID-19 , Imunização Secundária , Diálise Renal , SARS-CoV-2 , Hesitação Vacinal , Humanos , Masculino , China/epidemiologia , Estudos Transversais , Feminino , Pessoa de Meia-Idade , COVID-19/prevenção & controle , COVID-19/epidemiologia , Imunização Secundária/estatística & dados numéricos , Diálise Renal/estatística & dados numéricos , Vacinas contra COVID-19/administração & dosagem , Idoso , Inquéritos e Questionários , SARS-CoV-2/imunologia , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Adulto , Vacinação/estatística & dados numéricos , Vacinação/psicologia , Comportamentos Relacionados com a SaúdeRESUMO
Surveys often estimate vaccination intentions using dichotomous ("Yes"/"No") or trichotomous ("Yes," "Unsure," "No") response options presented in different orders. Do survey results depend on these variations? This controlled experiment randomized participants to dichotomous or trichotomous measures of vaccine intentions (with "Yes" and "No" options presented in different orders). Intentions were measured separately for COVID-19, its booster, and influenza vaccines. Among a sample of U.S. adults (N = 4,764), estimates of vaccine intention varied as much as 37.5 ± 17.4 percentage points as a function of the dichotomous or trichotomous response set. Among participants who had not received the COVID-19 vaccine, the "Unsure" option was more likely to reduce the share of "No" (versus "Yes") responses, whereas among participants who had received the COVID-19 vaccine, the "Unsure" option was more likely to reduce the share of "Yes" (versus "No") responses. The "Unsure" category may increase doubt and decrease reliance on past vaccination behavior when forming intentions. The order of "Yes" and "No" responses had no significant effect. Future research is needed to further evaluate why the effects of including the "Unsure" option vary in direction and magnitude.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Vacinas contra Influenza , Intenção , Vacinação , Humanos , Masculino , Vacinação/estatística & dados numéricos , Feminino , Adulto , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , COVID-19/epidemiologia , Pessoa de Meia-Idade , Vacinas contra Influenza/administração & dosagem , Inquéritos e Questionários , SARS-CoV-2/imunologia , Adulto Jovem , Idoso , Adolescente , Influenza Humana/prevenção & controleRESUMO
Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.
Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.
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Humanos , Masculino , Feminino , Adolescente , Confiança , Pesquisa Qualitativa , Vacinas contra COVID-19/administração & dosagem , Argentina , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Entrevistas como Assunto , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Tomada de Decisões , COVID-19/prevenção & controle , Hesitação Vacinal/psicologia , Hesitação Vacinal/estatística & dados numéricos , Instalações de Saúde , Acessibilidade aos Serviços de SaúdeRESUMO
Seroepidemiological characteristics of human papillomavirus (HPV) in community residents reflect natural infection and can guide the reform of vaccination programs. A population-based serological survey was conducted in Guangdong Province. Serum anti-HPV IgG antibody levels were determined by an ELISA. Neutralizing antibodies against HPV6, 11, 16, and 18 were detected via a pseudovirus-based neutralization assay (PBNA). A total of 5122 serum samples were collected from community residents, including 1989 males and 3133 females, in three cities of Guangdong Province. The rate of HPV IgG antibody positivity in females was 5.39% (95% CI: 4.6-6.2), which was greater than that in males (2.36%; 95% CI: 1.7-3.1). HPV IgG antibodies were more frequently detected in females aged 51-60 years (11.30%; 95% CI: 7.6-16.0), whereas in males, the detection increased with age and reached 4.94% (95% CI: 2.8-6.9) in the group aged ≥71 years. The seropositivity of neutralizing antibodies against HPV6 and 11 was greater than that against HPV16 and 18. The serum neutralizing antibody titers in individuals who received three doses of a vaccine were 7- to 12-fold greater than those in individuals who did not receive the vaccine. The neutralizing antibody titers slightly decreased within 40 months and ranged from 0.038 to 0.057 log ED50 per month. A moderate consistency between the HPV ELISA and PBNA results was observed (Kappa score = 0.49, r = 0.249, 0.635, 0.382, and 0.466 for HPV6, 11, 16, and 18, respectively). The HPV seropositivity rate among healthy residents of Guangdong Province was found to be low among children and adolescents and to increase with age. The serum neutralizing antibody titers were significantly greater in the vaccine group than that in the control group, and this difference persisted over time, which indicated promising protection against HPV infection.
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Anticorpos Neutralizantes , Anticorpos Antivirais , Ensaio de Imunoadsorção Enzimática , Imunoglobulina G , Infecções por Papillomavirus , Humanos , China/epidemiologia , Estudos Soroepidemiológicos , Masculino , Feminino , Anticorpos Antivirais/sangue , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/virologia , Adulto , Pessoa de Meia-Idade , Anticorpos Neutralizantes/sangue , Adulto Jovem , Idoso , Adolescente , Criança , Imunoglobulina G/sangue , Pré-Escolar , Vacinas contra Papillomavirus/imunologia , Vacinas contra Papillomavirus/administração & dosagem , Papillomaviridae/imunologia , Papillomaviridae/genética , Papillomaviridae/classificação , Testes de Neutralização , Vacinação/estatística & dados numéricos , Idoso de 80 Anos ou mais , Lactente , Papillomavirus HumanoRESUMO
INTRODUCTION: Despite being highly preventable, cervical cancer (CC) is the eighth most prevalent form of female cancer in Armenia and the second most common malignancy among those aged 15 to 44. In Armenia, there is an age-standardized incidence of 7.8 per 100,000 females, and an age-standardized mortality of 4.6 per 100,000 females. Globally, the CC is the 4th most common cancer among women. Its incidence was 604,127 new cases and 341,831 deaths in 2020. We conducted a retrospective, observational cohort study using clinical data to verify the influence of HPV vaccine (Gardasil, Merck&CO) on fertility function in women, vaccinated in RA since 2017 year in the limits of anti-HPV vaccination Program (included in National Vaccination Calendar). MATERIALS AND METHODS: For the study, we analyzed data received from Armenian-American Wellness Center (Yerevan, Armenia). 98 female volunteers vaccinated with the 4vHPV who attended AAWC and were examined for reproductive function. The subjects were divided into 3 age groups - 1st group - 15 years -24 years 11 months, 2nd group - 25 years -34 years 11 months, 3rd group - 35 -40 years. Each control group was composed of randomly selected 30 healthy women in age identical to the main group who applied AAWC for regular checkup in the same time frame and have never been exposed to anti HPV vaccine. RESULTS: The current research is aimed to reveal any negative impact of 4vHPV vaccine on fertility indicators in Armenian cohort. The performed comparative statistical analysis of the assessed indicators has revealed the ORs<1 for POI, late fertilization disorders of menstrual cycle and anovulation prevalence indicators. The chance of investigated disorders' development in 4vHPV vaccine exposed cohort did not exaggerate that in non-exposed sample cohort. The significant difference was not observed in Anti-Mullerian Hormone, FSH basal levels, as well as in mean ovarian volume and number of antral follicles indicators between clinical and respective control groups (p<.05). CONCLUSION: The data obtained make us to conclude about absence of any negative impact of 4vHPV vaccine on fertility function indicators in 4vHPV vaccinated cohort in RA. The study results contribute to perception of the 4vHPV vaccine safety concept, what in its turn can trigger increase of vaccination coverage leading to CC control efficiency.
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Fertilidade , Humanos , Feminino , Adulto , Armênia/epidemiologia , Adolescente , Estudos Retrospectivos , Adulto Jovem , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/estatística & dados numéricos , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18/administração & dosagem , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18/uso terapêutico , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18/imunologia , Estudos de Coortes , Infecções por Papillomavirus/prevenção & controleRESUMO
BACKGROUND: Measles remains a major public health burden worldwide. Parents often hesitate to vaccinate children with chronic diseases. We investigated the association between the percentage of vaccination and chronic diseases and explore hospital infections' role in the 2017-2019 measles outbreak across northern Vietnam provinces. METHODS: A total of 2,064 children aged 0-15 years old admitted for measles to the National Children's Hospital during the outbreak were included in the study. Demographic information, clinical characteristics, vaccination statuses and laboratory examination were extracted from electronic medical records, vaccination records, or interviews with parents when other sources were unavailable. RESULTS: The incidence rate that provincial hospitals sent to the National Children's Hospital was proportional to the population density of their provinces of residence. Early nosocomial transmission of measles was observed before community-acquired cases emerged in many provinces. Among patients aged over 18 months, those with chronic diseases had a proportion of vaccination of 9.4%, lower than patients without chronic diseases at 32.4%. Unvaccinated patients had a higher proportion of hospital-acquired infections with aOR = 2.42 (1.65-3.65), p < 0.001 relative to vaccinated patients. The proportion of hospital-acquired infections was higher among children with chronic diseases compared to those without, with aOR = 3.81 (2.90-5.02), p < 0.001. CONCLUSION: Measles spread in healthcare settings prior to community cases that occurred in several provinces. We recommend enhancing hospital infection control by increasing staff training and improving early detection and isolation during non-outbreak periods. Measles patients with chronic diseases exhibited lower proportions of vaccination and faced a higher risk of hospital-acquired infections. It is crucial to establish comprehensive vaccination guidelines and enhance parental awareness regarding the significance and safety of measles vaccination to protect these vulnerable individuals.
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Infecção Hospitalar , Surtos de Doenças , Vacina contra Sarampo , Sarampo , Vacinação , Humanos , Vietnã/epidemiologia , Sarampo/epidemiologia , Sarampo/prevenção & controle , Pré-Escolar , Criança , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Masculino , Lactente , Adolescente , Feminino , Doença Crônica/epidemiologia , Vacinação/estatística & dados numéricos , Recém-Nascido , Vacina contra Sarampo/administração & dosagem , IncidênciaRESUMO
OBJECTIVE: to map scientific evidence about perceptions, beliefs, knowledge and attitudes of parents or legal guardians of children under 5 years of age regarding routine childhood vaccination. METHODS: a scoping review, conducted in accordance with the JBI framework. The searches were carried out in the PubMed/MEDLINE, Web of Science, Scopus and LILACS databases. A total of 5,535 studies were returned and 77 were selected, which met the inclusion criteria. RESULTS: perceptions related to interaction with healthcare professionals and services, with family organization and structure, with social interaction and public policies, cultural, religious and personal beliefs, knowledge about vaccination schedule, vaccination and immunization process and sources of information are the main factors mapped and which can positively or negatively influence parents' or legal guardians' attitudes towards vaccinating children. CONCLUSIONS: the findings allow us to identify factors related to parents' perception and beliefs about childhood vaccination.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Tutores Legais , Pais , Vacinação , Humanos , Pais/psicologia , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Tutores Legais/psicologiaRESUMO
BACKGROUND: Streptococcus pneumoniae, a major contributor to global morbidity and mortality, disproportionately affects children, the elderly, and immunocompromised individuals. Despite vaccination efforts, the challenge of serotype replacement highlights the ongoing struggle against invasive pneumococcal diseases (IPD) in Morocco, emphasizing the need for updated public health strategies and vaccine efficacy assessments. METHODS: This study was conducted at the Ibn Rochd University Hospital Center and the Mohammed VI University Hospital Center from 2019 to 2022, focusing on hospitalized children. It involved the analysis of 74 strains of IPD, assessing the distribution of pneumococcal serotypes and their antibiotic sensitivity in the post-vaccination era. RESULTS: The prevalence of meningitis or meningo-encephalitis was found to be 66% among the study subjects, with the most frequent serotypes being 3, 19A, 6B, 14, and 11. These serotypes varied significantly by age and location. Coverage rates for the pneumococcal conjugate vaccines, PCV-10 and PCV-13, were 20.27% and 56.75%, respectively. Notably, 43% of the strains were non-vaccine serotypes, with serotypes 3 and 19 accounting for 36% of the infections in children, indicating a lack of vaccine efficacy against these types. Additionally, 31.3% of the strains were Penicillin non-susceptible Streptococcus pneumoniae (PNSP), with 81.25% associated with non-vaccine serotypes. CONCLUSIONS: This study highlights the persistence of IPD in Moroccan children, revealing significant challenges despite vaccination efforts. With the reintroduction of PCV-13, concerns about the efficacy against non-vaccine serotypes, particularly 3 and 19A, remain. Continuous surveillance and adaptable vaccination strategies are essential to combat these serotype replacements and ensure the effectiveness of future preventive measures.
Assuntos
Infecções Pneumocócicas , Vacinas Pneumocócicas , Sorogrupo , Streptococcus pneumoniae , Humanos , Marrocos/epidemiologia , Vacinas Pneumocócicas/administração & dosagem , Vacinas Pneumocócicas/imunologia , Infecções Pneumocócicas/prevenção & controle , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Pré-Escolar , Streptococcus pneumoniae/imunologia , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/isolamento & purificação , Lactente , Criança , Masculino , Feminino , Vacinação/estatística & dados numéricos , Adolescente , Antibacterianos/uso terapêutico , PrevalênciaRESUMO
Importance: To inform the design and implementation of targeted interventions to reduce the future burden of human papillomavirus (HPV)-related cancers in Texas, it is necessary to examine the county and health service region (HSR) levels of (1) the proportion of children and teenagers aged 9 to 17 years who initiated and were up to date for HPV vaccination series and (2) HPV-related cancer incidence rates (IRs). Objective: To evaluate temporal trends and geospatial patterns of HPV vaccination initiation and up-to-date status as well as HPV-related cancer rates at county and HSR levels in Texas. Design, Setting, and Participants: This population-based cross-sectional study used data from the Texas Immunization Registry, the National Cancer Institute's Surveillance, Epidemiology, and End Results Program database, and Texas Department of State Health Services annual population counts from 2006 to 2022. The analysis of HPV vaccination rates was conducted among children and teenagers aged 9 to 17 years; the analysis of HPV-related cancer rates was conducted among adults aged 20 years and older. Data were extracted between June and July 2023 and statistical analysis was performed from February to April 2024. Main Outcomes and Measures: HPV vaccination initiation and up-to-date status rates and HPV-related cancer IR at county and HSR levels. Results: A total of 32â¯270â¯243 children and teenagers (65.8% female individuals and 34.2% male individuals) and 22â¯490â¯105 individuals aged 20 years and older (50.7% female individuals and 49.3% male individuals) were included. The mean 2021 to 2022 county-level HPV vaccination series initiation estimates ranged from 6.3% to 69.1% for female and from 7.0% to 77.6% for male children and teenagers aged 9 to 17 years. County-level vaccination up-to-date estimates were generally lower compared with those of initiation estimates and ranged from 1.6% to 30.4% for female and from 2.1% to 34.8% for male children and teenagers. The pattern of HPV vaccination rates stratified by sex were similar across counties and HSRs. The age-adjusted annual HPV-related cancer IR by county for years 2016 to 2020 ranged from 0 to 154.2 per 100â¯000 for female individuals and from 0 to 60.1 per 100â¯000 for male individuals. The counties located in North Texas, HSRs 2/3 and 4/5N, had lower HPV vaccination rates and higher IRs of HPV-related cancers for both female and male individuals compared with other regions. Conclusions and Relevance: In this study, the incidence of HPV-related cancers varied widely across the counties and HSRs of Texas. More counties in North Texas, HSRs 2/3 and 4/5N, had higher IRs of HPV-related cancers and a lower proportion of HPV vaccination rates than counties in other regions. Designing and implementing targeted interventions to increase uptake and completion of HPV vaccination series across counties with low HPV vaccination rates may help to reduce future the burden of HPV-related cancers.
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Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Adolescente , Feminino , Vacinas contra Papillomavirus/administração & dosagem , Texas/epidemiologia , Criança , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/epidemiologia , Masculino , Estudos Transversais , Adulto , Incidência , Adulto Jovem , Vacinação/estatística & dados numéricos , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Papillomavirus HumanoRESUMO
BACKGROUND: Diabetes mellitus (DM) is associated with severe outcomes of coronavirus disease (COVID-19), including death. COVID-19 vaccination is crucial for preventing infection and severe disease in the general population, but most importantly, among high-risk populations such as persons with DM. However, while COVID-19 vaccination uptake in the general population is regularly tracked, information on vaccination behavior specific to persons with DM is scarce. This study aimed to identify factors associated with the uptake of full COVID-19 vaccination among persons living with DM at Kiruddu National Referral Hospital (KRH). METHODS: We employed a cross-sectional study design and administered a structured questionnaire on a systematically selected random sample of 340 people with DM attending Kiruddu National Referral Hospital from March 08 to May 25, 2023. We used a Modified Poisson Regression model to identify the factors associated with full COVID-19 vaccination and present adjusted prevalence ratios, along with their 95% confidence intervals. Full COVID-19 vaccination in this study was defined as having completed the last dose in the primary series of a COVID-19 vaccine. RESULTS: We administered the questionnaire to 340 participants, with 75% (255 of 340) being female. The mean age of the participants was 52 years (± 12 years) and their median duration with diabetes mellitus was 5 years (± 7.3 years). Overall, 195 out of 340 participants (57.35%, 95% CI: 52-63%) completed the last dose in the primary series of a COVID-19 vaccine. The likelihood of receiving full vaccination was higher when a health provider advised one to receive a vaccine (aPR = 1.91, 95% CI: 1.20-3.02), when one reported having a comorbidity (aPR = 1.26, 95% CI: 1.06-1.53), and when one had a strong perceived benefit of vaccination (aPR = 1.76, 95% CI: 1.23-2.53). However, having a strong perceived barrier to vaccination was negatively associated with the likelihood of being fully vaccinated (aPR = 0.71, 95% CI: 0.60-0.84). CONCLUSION: The uptake of COVID-19 vaccines among persons with DM at KRH is low, with only 57% having a full COVID-19 vaccination status. This underscores the progress in meeting the WHO recommendation of having a 100% COVID-19 vaccination uptake among people with underlying health conditions, including diabetes mellitus. At the policy level, the Ugandan Ministry of Health (MoH) may implement a provider-initiated vaccination strategy where healthcare providers who attend to DM patients during their routine clinic visits initiate the idea of vaccinating, sensitize, and spearhead myth-bursting around COVID-19 vaccines.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Diabetes Mellitus , Humanos , Estudos Transversais , Feminino , Masculino , Vacinas contra COVID-19/administração & dosagem , Pessoa de Meia-Idade , COVID-19/prevenção & controle , COVID-19/epidemiologia , Adulto , Uganda/epidemiologia , Diabetes Mellitus/epidemiologia , Inquéritos e Questionários , Idoso , Vacinação/estatística & dados numéricos , SARS-CoV-2RESUMO
BACKGROUND: Several cases of renal complications, including acute kidney injury (AKI), after influenza vaccination have been reported, but the association remains unproven. We evaluated the association between influenza vaccination and AKI occurrence among the Korean elderly in the 2018-2019 and 2019-2020 seasons. METHODS: We used a large database combining vaccination registration data from the Korea Disease Control and Prevention Agency and claims data from the National Health Insurance Service. The study subjects were patients hospitalized with AKI for the first-time following vaccination among those who received one influenza vaccine in the 2018-2019 or 2019-2020 season. Only those aged 65 or older at the date of vaccination were included. We performed a self-controlled case series study, designating the risk period as 1 to 28 days post-vaccination and the observation period as each influenza season. The adjusted incidence rate ratio (aIRR) was calculated by adjusting for nephrotoxic drug use and influenza infection that may influence AKI occurrence using a conditional Poisson regression model. RESULTS: A total of 16 713 and 16 272 AKI events were identified during the 2018-2019 and 2019-2020 seasons, respectively. The aIRR for AKI was 0.83 (95% confidence interval [CI] = 0.79-0.87) in the 2018-2019 season. The aIRR for the 2019-2020 influenza season was similar to the 2018-2019 season (aIRR = 0.86; 95% CI = 0.82-0.90). CONCLUSIONS: Influenza vaccination is associated with a lower risk of AKI in the elderly over 65. This evidence supports the recommendation of annual influenza vaccination for the elderly. Further studies are needed to determine the biological mechanisms linking the influenza vaccine and AKI.
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Injúria Renal Aguda , Vacinas contra Influenza , Influenza Humana , Humanos , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/administração & dosagem , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/etiologia , Idoso , Masculino , Feminino , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , República da Coreia/epidemiologia , Idoso de 80 Anos ou mais , Incidência , Vacinação/efeitos adversos , Vacinação/estatística & dados numéricos , Bases de Dados Factuais , Hospitalização/estatística & dados numéricos , Estações do Ano , Fatores de RiscoRESUMO
BACKGROUND: This study aimed to investigate the relationship between parent and child COVID-19 immunization series completion using vaccine records. METHODS: A cross-sectional chart review was performed on parent and child patients at the Albany Medical Center Internal Medicine and Pediatrics practice. Patient and parent demographic data, COVID-19 immunization status, and health care worker status was collected. Patient data was further separated into 2 cohorts to account for vaccine eligibility among child age groups, with 5-11 years and 6 months-4 years cohorts. Chi square or Fisher's exact test was used where appropriate. RESULTS: Across both cohorts, 371 child patients were identified and cross-matched with corresponding parents. Neither cohort offered evidence linking child immunization series completion with the child's race, ethnicity, or county of residence. However, rates of series completion were higher for children with private insurance versus public options in both the 5-11 years and 6 months-4 years cohorts (both p < 0.001). Children were more likely to be immunized against COVID-19 if their parents were fully immunized against COVID-19 (both p < 0.05). Children aged 6 months-4 years were more likely to be immunized against COVID-19 if their parent was a health care worker (p = 0.038). CONCLUSIONS: This study demonstrates a significance between child insurance status, as well as between parental vaccination status and child vaccination status. Only children under 5 years were more likely to be vaccinated against COVID-19 if their parent was a health care worker.
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Vacinas contra COVID-19 , COVID-19 , Pais , Humanos , Criança , Estudos Retrospectivos , Pré-Escolar , Estudos Transversais , Masculino , COVID-19/prevenção & controle , Feminino , Lactente , Vacinas contra COVID-19/administração & dosagem , New York , Vacinação/estatística & dados numéricos , SARS-CoV-2/imunologia , Cobertura Vacinal/estatística & dados numéricosRESUMO
Routine childhood vaccination is a crucial component of public health in Canada and worldwide. To facilitate catch-up from the global decline in routine vaccination caused by the COVID-19 pandemic, and toward the ongoing pursuit of coverage goals, vaccination programs must understand barriers to vaccine access imposed or exacerbated by the pandemic. We conducted a regionally representative online survey in January 2023 including 2036 Canadian parents with children under the age of 18. We used the COM-B model of behaviour to examine factors influencing vaccination timeliness during the pandemic. We assessed Capability with measures of vaccine understanding and decision difficulty, and Motivation with a measure of vaccine confidence. Opportunity was assessed through parents' self-reported experience with barriers to vaccination. Twenty-four percent of surveyed parents reported having missed or delayed one of their children's scheduled routine vaccinations since the beginning of the pandemic, though most parents reported having either caught up or the intention to catch up soon. In the absence of opportunity barriers, motivation was associated with timely vaccination for children aged 0-4 years (aOR = 1.81, 95 % CI: 1.14-2.84). However, experience with one or more opportunity barriers, particularly clinic closures and difficulties getting an appointment, eliminated this relationship, suggesting perennial and new pandemic-associated barriers are a critical challenge to vaccine coverage goals in Canada.
Assuntos
COVID-19 , Pais , Vacinação , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Canadá/epidemiologia , Pré-Escolar , Lactente , Masculino , Feminino , Criança , Vacinação/estatística & dados numéricos , Vacinação/psicologia , Adulto , Pais/psicologia , Adolescente , Inquéritos e Questionários , Motivação , SARS-CoV-2/imunologia , Recém-Nascido , Vacinas contra COVID-19/administração & dosagem , Pandemias/prevenção & controle , Programas de Imunização , Pessoa de Meia-Idade , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Adulto JovemRESUMO
BACKGROUND: The demand for COVID-19 vaccines has diminished as the pandemic lingers. Understanding vaccine hesitancy among essential workers is important in reducing the impact of future pandemics by providing effective immunization programs delivered expeditiously. METHOD: Two surveys exploring COVID-19 vaccine acceptance in 2021 and 2022 were conducted in cohorts of health care providers (HCP) and education workers participating in prospective studies of COVID-19 illnesses and vaccine uptake. Demographic factors and opinions about vaccines (monovalent and bivalent) and public health measures were collected in these self-reported surveys. Modified multivariable Poisson regression was used to determine factors associated with hesitancy. RESULTS: In 2021, 3 % of 2061 HCP and 6 % of 3417 education workers reported hesitancy (p < 0.001). In December 2022, 21 % of 868 HCP and 24 % of 1457 education workers reported being hesitant to receive a bivalent vaccine (p = 0.09). Hesitance to be vaccinated with the monovalent vaccines was associated with earlier date of survey completion, later receipt of first COVID-19 vaccine dose, no influenza vaccination, and less worry about becoming ill with COVID-19. Factors associated with hesitance to be vaccinated with a bivalent vaccine that were common to both cohorts were receipt of two or fewer previous COVID-19 doses and lower certainty that the vaccines were safe and effective. CONCLUSION: Education workers were somewhat more likely than HCP to report being hesitant to receive COVID-19 vaccines but reasons for hesitancy were similar. Hesitancy was associated with non-receipt of previous vaccines (i.e., previous behaviour), less concern about being infected with SARS-CoV-2, and concerns about the safety and effectiveness of vaccines for both cohorts. Maintaining inter-pandemic trust in vaccines, ensuring rapid data generation during pandemics regarding vaccine safety and effectiveness, and effective and transparent communication about these data are all needed to support pandemic vaccination programs.
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Vacinas contra COVID-19 , COVID-19 , Pessoal de Saúde , SARS-CoV-2 , Hesitação Vacinal , Humanos , Vacinas contra COVID-19/administração & dosagem , Pessoal de Saúde/psicologia , Masculino , COVID-19/prevenção & controle , COVID-19/epidemiologia , Feminino , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Adulto , Canadá , Pessoa de Meia-Idade , Inquéritos e Questionários , SARS-CoV-2/imunologia , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Pessoal de Educação/psicologia , Estudos ProspectivosRESUMO
BACKGROUND: While hepatitis B virus (HBV) infection in children has declined dramatically in China due to the vaccination strategy for newborns, HBV infection in high-risk adults is receiving an increasing attention. The number of people who use drugs (PWUD) in China is huge, but their status of HBV infection and vaccination is less reported, especially from large samples. The related knowledge can help decision makers develop the further strategy of HBV prevention and control. METHODS: A seroepidemiological survey was conducted in all four compulsory isolated detoxification centers (CIDCs) and all eight methadone maintenance treatment (MMT) clinics located in Xi'an, China. All PWUD who were undergoing detoxification or treatment in these settings were included. A questionnaire was designed to obtain the information of HBV vaccination history of participants, and sociodemographic and behavioral data of participants were obtained from the registration records of their respective CIDCs or MMT clinics. RESULTS: A total of 4705 PWUD participated in the survey. Positive rates of HBsAg (current infection) and HBsAg or anti-HBc (current/past infection) were 5.50% and 58.02%, notably higher than those reported for the general adult population in the same province during the same period. As age increased, the anti-HBc positive rate increased with statistically significant trend. The all-negative for HBsAg, anti-HBc, and anti-HBs accounted for 28.82%. Only 18.49% were identified by the questionnaire as having received HBV vaccine. The logistic regression found that compared with identified vaccinated PWUD, those unsure if having been vaccinated and those identified non-vaccinated had a significantly higher HBV current/past infection rate, with an increasing trend. CONCLUSION: PWUD are a high-risk adult group of HBV infection in China. Of them, more than half have not received HBV vaccine, and a significant portion are susceptible to HBV. Catch-up vaccination is need for this population to prevent and control HBV transmission.