Impact of an accelerated measles-mumps-rubella (MMR) vaccine schedule on vaccine coverage: An ecological study among London children, 2012–2018

Background: Vaccination hesitancy and skepticism among parents hinders progress in achieving full vaccination coverage. Swedish measles, mumps and rubella (MMR) vaccine coverage is high however some areas with low vaccination coverage risk outbreaks. This study aimed to explore factors influencing the decision of Somali parents living in the Rinkeby and Tensta districts of Stockholm, Sweden, on whether or not to vaccinate their children with the measles, mumps and rubella (MMR) vaccine. Method: Participants were 13 mothers of at least one child aged 18 months to 5 years, who were recruited using snowball sampling. In-depth interviews were conducted in Somali and Swedish languages and the data generated was analysed using qualitative content analysis. Both written and verbal informed consent were obtained from participants. Results: Seven of the mothers had not vaccinated their youngest child at the time of the study and decided to postpone the vaccination until their child became older (delayers). The other six mothers had vaccinated their child for MMR at the appointed time (timely vaccinators). The analysis of the data revealed two main themes: (1) barriers to vaccinate on time, included issues surrounding fear of the child not speaking and unpleasant encounters with nurses and (2) facilitating factors to vaccinate on time, included heeding vaccinating parents’ advice, trust in nurses and trust in God. The mothers who had vaccinated their children had a positive impact in influencing other mothers to also vaccinate. Conclusions: Fear, based on the perceived risk that vaccination will lead to autism, among Somali mothers in Tensta and Rinkeby is evident and influenced by the opinions of friends and relatives. Child Healthcare Center nurses are important in the decision-making process regarding acceptance of MMR vaccination. There is a need to address mothers’ concerns regarding vaccine safety while improving the approach of nurses as they address these concerns.

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Trends in mumps incidence and first dosage of MMR vaccine coverage in Montenegro from 2009 to 2018

Zdravstvena zastita ◽

10.5937/zz2001015o ◽

2020 ◽

Vol 49 (1) ◽

pp. 15-23

Author(s):

Aleksandar Obradović ◽

Sandra Šipetić-Grujičić

Keyword(s):

Vaccine Coverage ◽

Mmr Vaccine

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Seroepidemiology of mumps in Europe (1996–2008): why do outbreaks occur in highly vaccinated populations?

Epidemiology and Infection ◽

10.1017/s0950268812001136 ◽

2012 ◽

Vol 141 (3) ◽

pp. 651-666 ◽

Cited By ~ 33

Author(s):

J. ERIKSEN ◽

I. DAVIDKIN ◽

G. KAFATOS ◽

N. ANDREWS ◽

C. BARBARA ◽

...

Keyword(s):

Odds Ratio ◽

Vaccine Coverage ◽

International Comparisons ◽

Igg Antibodies ◽

Multivariable Model ◽

Mmr Vaccine ◽

High Coverage ◽

Vaccination Strategies ◽

Seroprevalence Data ◽

Antibody Titres

SUMMARYMumps outbreaks have recently been recorded in a number of highly vaccinated populations. We related seroprevalence, epidemiological and vaccination data from 18 European countries participating in The European Sero-Epidemiology Network (ESEN) to their risk of mumps outbreaks in order to inform vaccination strategies. Samples from national population serum banks were collected, tested for mumps IgG antibodies and standardized for international comparisons. A comparative analysis between countries was undertaken using age-specific mumps seroprevalence data and information on reported mumps incidence, vaccine strains, vaccination programmes and vaccine coverage 5–12 years after sera collection. Mean geometric mumps antibody titres were lower in mumps outbreak countries [odds ratio (OR) 0·09, 95% confidence interval (CI) 0·01–0·71)]. MMR1 vaccine coverage ⩾95% remained protective in a multivariable model (P < 0·001), as did an interval of 4–8 years between doses (OR 0·08, 95% CI 0·01–0·85). Preventing outbreaks and controlling mumps probably requires several elements, including high-coverage vaccination programmes with MMR vaccine with 4–8 years between doses.

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Fall in MMR vaccine coverage reported in the United Kingdom as further evidence of vaccine safety is published

Weekly releases (1997–2007) ◽

10.2807/esw.03.26.01379-en ◽

1999 ◽

Vol 3 (26) ◽

Author(s):

J White

Keyword(s):

United Kingdom ◽

Vaccine Coverage ◽

Vaccine Safety ◽

Mmr Vaccine ◽

The United Kingdom

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Annual Immunisation Coverage Report 2016

Communicable Diseases Intelligence ◽

10.33321/cdi.2019.43.44 ◽

2019 ◽

Vol 43 ◽

Cited By ~ 5

Author(s):

Brynley Hull ◽

Alexandra Hendry ◽

Aditi Dey ◽

Frank Beard ◽

Julia Brotherton ◽

...

Keyword(s):

Vaccine Coverage ◽

Hpv Vaccination ◽

Immunisation Coverage ◽

Mmr Vaccine ◽

Age Assessment ◽

Quarterly Data ◽

Percentage Points ◽

National Human ◽

Indigenous Children ◽

Data Point

This tenth annual immunisation coverage report shows data for the calendar year 2016 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. After a decade of being largely stable at around 90%, ‘fully immunised’ coverage at the 12-month assessment age increased in 2016 to reach 93.7% for the age assessment quarterly data point in December 2016, similar to the 93.4% for the age assessment quarterly data point in December 2016 for 60 months of age. Implementation of the ‘No Jab No Pay’ policy may have contributed to these increases. While ‘fully immunised’ coverage at the 24-month age assessment milestone decreased marginally from 90.8%, in December 2015, to 89.6% for the age assessment quarterly data point in December 2016, this was likely due to the assessment algorithm being amended in December 2016 to include four doses of DTPa vaccine instead of three, following reintroduction of the 18-month booster dose. Among Indigenous children, the gap in coverage assessed at 12 months of age decreased fourfold, from 6.7 percentage points in March 2013 to only 1.7 percentage points lower than non-Indigenous children in December 2016. Since late 2012, ‘fully immunised’ coverage among Indigenous children at 60 months of age has been higher than for non-Indigenous children. Vaccine coverage for the nationally funded seasonal influenza vaccine program for Indigenous children aged 6 months to <5 years, which commenced in 2015, remained suboptimal nationally in 2016 at 11.6%. Changes in MMR coverage in adolescents were evaluated for the first time. Of the 411,157 ten- to nineteen-year-olds who were not recorded as receiving a second dose of MMR vaccine by 31 December 2015, 43,103 (10.5%) of them had received it by the end of 2016. Many of these catch-up doses are likely to have been administered as a result of the introduction on 1 January 2016 of the Australian Government’s ‘No Jab No Pay’ policy. In 2016, 78.6% of girls aged 15 years had three documented doses of HPV vaccine (jurisdictional range 67.8–82.9%), whereas 72.9% of boys (up from 67.1 % in 2015) had received three doses.

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Preventing congenital rubella infection in the European Region of WHO: 2010 target

Eurosurveillance ◽

10.2807/esm.09.04.00455-en ◽

2004 ◽

Vol 9 (4) ◽

pp. 3-4 ◽

Cited By ~ 7

Author(s):

J. S. Spika ◽

F X Hanon ◽

S Wassilak ◽

R G Pebody ◽

N Emiroglu

Keyword(s):

Vaccine Coverage ◽

Policy Decision ◽

World Health Organisation ◽

Congenital Rubella Syndrome ◽

World Health ◽

Measles Vaccine ◽

Mmr Vaccine ◽

Regional Office ◽

Rubella Infection ◽

Congenital Rubella

The World Health Organisation (WHO) Regional Office for Europe has recently published a strategic plan and surveillance guidelines for measles and congenital rubella infection. The strategy prioritises measles control activities but encourages the introduction of rubella vaccine when measles vaccine coverage has reached >90 %; although, many western European countries with suboptimal measles vaccine coverage are already using the combined measles, mumps and rubella (MMR) vaccine. Women in these countries may have an especially high risk of having an infant with congenital rubella syndrome. WHO is seeking to improve the surveillance for rubella and congenital rubella syndrome as a means to obtain better information on the burden of these diseases and engage policy decision makers in the need to support the WHO European Region's strategies for rubella.

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What school-level and area-level factors influenced HPV and MenACWY vaccine coverage in England in 2016/2017? An ecological study

BMJ Open ◽

10.1136/bmjopen-2019-029087 ◽

2019 ◽

Vol 9 (7) ◽

pp. e029087 ◽

Cited By ~ 3

Author(s):

Karen Tiley ◽

Joanne White ◽

Nick Andrews ◽

Elise Tessier ◽

Mary Ramsay ◽

...

Keyword(s):

Secondary Schools ◽

Outcome Measures ◽

Ecological Study ◽

Vaccine Coverage ◽

Religious Affiliation ◽

School Level ◽

Secondary Outcome ◽

School Type ◽

Special Schools ◽

Jewish Schools

ObjectiveTo describe school-level and area-level factors that influence coverage of the school-delivered human papillomavirus (HPV) and meningococcal A, C, W and Y (MenACWY) programmes among adolescents.DesignEcological study.Setting and participantsAggregated 2016/2017 data from year 9 pupils were received from 1407 schools for HPV and 1432 schools for MenACWY. The unit of analysis was the school.Primary and secondary outcome measuresOutcome measures were percentage point (pp) difference in vaccine coverage by schools’ religious affiliation, school type, urban/rural, single sex/mixed and region. A subanalysis of mixed-sex, state-funded secondary schools also included deprivation, proportion of population from black and ethnic minorities, and school size.ResultsMuslim and Jewish schools had significantly lower coverage than schools of no religious character for HPV (24.0 (95% CI −38.2 to −9.8) and 20.5 (95% CI −30.7 to −10.4) pp lower, respectively) but not for MenACWY. Independent, special schools and pupil referral units had increasingly lower vaccine coverage compared with state-funded secondary schools for both HPV and MenACWY. For both vaccines, coverage was 2 pp higher in rural schools than in urban schools and lowest in London. Compared with mixed schools, HPV coverage was higher in male-only (3.7 pp, 95% CI 0.2 to 7.2) and female-only (4.8 pp, 95% CI 2 to 7.6) schools. In the subanalysis, schools located in least deprived areas had the highest coverage for both vaccines (3.8 (95% CI 0.9 to 6.8) and 10.4 (95% CI 7.0 to 13.8) pp for HPV and MenACWY, respectively), and the smallest schools had the lowest coverage (−10.4 (95% CI −14.1 to −6.8) and −7.9 (95% CI −12 to −3.8) for HPV and MenACWY, respectively).ConclusionsTailored approaches are required to improve HPV vaccine coverage in Muslim and Jewish schools. In addition, better ways of reaching pupils in smaller specialist schools are needed.

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Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak—Iowa, 2015–2016

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy199 ◽

2018 ◽

Vol 5 (10) ◽

Cited By ~ 2

Author(s):

Mona Marin ◽

Tricia L Kitzmann ◽

Lisa James ◽

Patricia Quinlisk ◽

Wade K Aldous ◽

...

Keyword(s):

Public Health ◽

Vaccine Coverage ◽

The United States ◽

Mmr Vaccine ◽

Public Health Response ◽

University Of Iowa ◽

Outbreak Control ◽

Response Planning ◽

Health Response ◽

The University

Abstract Background The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015–2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Methods Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs. Results Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administered and 1920 miles traveled. The total cost was >$649 000, roughly equally distributed between standard outbreak control activities and third-dose MMR vaccination (55% and 45%, respectively). Conclusions Public health response to the mumps outbreak at the University of Iowa required important amounts of personnel time and other resources. Associated costs were sizable enough to affect other public health activities.

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BCG Vaccination and Mortality of COVID-19 across 173 Countries: An Ecological Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155589 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5589 ◽

Cited By ~ 3

Author(s):

Mitsuyoshi Urashima ◽

Katharina Otani ◽

Yasutaka Hasegawa ◽

Taisuke Akutsu

Keyword(s):

Urban Population ◽

Ecological Study ◽

Randomized Clinical Trials ◽

Vaccine Coverage ◽

Bcg Vaccine ◽

Bacillus Calmette Guerin ◽

Ecological Studies ◽

Bcg Vaccination ◽

Insufficient Physical Activity ◽

Pcr Test

Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette–Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently—more than four months after declaration of the pandemic—the BCG-hypothesis needs reexamining. An ecological study was conducted by obtaining data of 61 factors in 173 countries, including BCG vaccine coverage (%), using morbidity and mortality as outcomes, obtained from open resources. ‘Urban population (%)’ and ‘insufficient physical activity (%)’ in each country was positively associated with morbidity, but not mortality, after adjustment for PCR-tests. On the other hand, recent BCG vaccine coverage (%) was negatively associated with mortality, but not morbidity, even with adjustment for percentage of the population ≥ 60 years of age, morbidity, PCR-tests and other factors. The results of this study generated a hypothesis that a national BCG vaccination program seems to be associated with reduced mortality of COVID-19, although this needs to be further examined and proved by randomized clinical trials.

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