Effects of the COVID-19 pandemic on routine pediatric vaccination in Brazil

Abstract Background In Ontario, Canada, PCV13 is covered for immunocompromised (IC) adults over 50y. PCV13 programs are thought not to be cost-effective in other adults because it is assumed that herd immunity from pediatric vaccination programs (PCV7 since 2005; PCV13 since 2010) will reduce PCV13 disease burden dramatically in adults. We analyzed data from the Toronto Invasive Bacterial Diseases Network (TIBDN) to ask whether PCV13-type invasive pneumococcal disease (IPD) in adults persists in our population. Methods TIBDN performs population-based surveillance for IPD in Toronto+Peel Region, Ontario (pop4.1M). All microbiology laboratories receiving specimens from residents report cases of IPD and submit isolates to a central study lab for serotyping; annual audits are conducted. Demographic, medical and vaccination information are obtained from patients, families and physicians. Population data are from Statistics Canada. Results Since 1995, 10,365 episodes of IPD have been identified; detailed medical information was available for 9,801 (95%) and serotyping for 9411 (91%). Among 8658 adult cases, 4,273 (49%) were in those aged 15–64 years, and 4,285 (51%) in those aged >645 years. The most common diagnoses were pneumonia (5,978/8,025, 74%) and bacteremia without focus (1,030, 13%); 470 (4.6%) cases had meningitis; the case fatality rate (CFR) was 21%. The incidence of disease due to STs in PCV13 in adults declined from 7.0/100,000/year 2001 to 2.9/100,000/year in 2015–2018 and was stable from 2015–2018 (Figure 1). The incidence was > 5/100,000/year in non-IC patients over 65 years, and younger patients with cancer and kidney disease (Figure 2). In IPD from 2015 to 2018, adult patients with PCV13 ST disease were younger (median age 64 years vs. 67 years, P = .03) than other patients; there was no significant difference in the proportion with at least one underlying chronic condition (253, 69% PCV13ST, vs. 541,74% other ST, P = 0.08), or in CFR (59, 16% PCV13 vs. 145, 20% other, P = 0.13). The ST distribution of cases due to PCV13 STs is shown in Figure 3. Conclusion A significant burden of IPD due to PCV13 serotypes persists in adults in our population despite 8 years of routine pediatric PCV13 vaccination. This burden needs to be considered in assessing the value and cost-effectiveness of PCV programs for adults. Disclosures All authors: No reported disclosures.

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Impact of school vaccination mandates on pediatric vaccination coverage: a systematic review

CMAJ Open ◽

10.9778/cmajo.20180191 ◽

2019 ◽

Vol 7 (3) ◽

pp. E524-E536 ◽

Cited By ~ 2

Author(s):

Devon Greyson ◽

Chris Vriesema-Magnuson ◽

Julie A. Bettinger

Keyword(s):

Systematic Review ◽

Vaccination Coverage ◽

Pediatric Vaccination

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PIN38 AN ECONOMIC EVALUATION OF THE PEDIATRIC VACCINATION SCHEDULE IN THE UNITED STATES

Value in Health ◽

10.1016/s1098-3015(11)72836-4 ◽

2010 ◽

Vol 13 (7) ◽

pp. A437

Author(s):

KM Clements ◽

DA Misurski ◽

J Miller ◽

ME Skornicki ◽

GJ Hill ◽

...

Keyword(s):

United States ◽

Economic Evaluation ◽

The United States ◽

Vaccination Schedule ◽

Pediatric Vaccination

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Association Between Local Pediatric Vaccination Rates and Patterns of Pneumococcal Disease in Adults

The Journal of Infectious Diseases ◽

10.1093/infdis/jiv431 ◽

2015 ◽

Vol 213 (4) ◽

pp. 509-515 ◽

Cited By ~ 6

Author(s):

Sundia Cassandra Pingali ◽

Joshua L. Warren ◽

Aimee M. Mead ◽

Nancy Sharova ◽

Susan Petit ◽

...

Keyword(s):

Pneumococcal Disease ◽

Vaccination Rates ◽

Pediatric Vaccination

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Ebola and Other Filoviruses

10.1093/med/9780190604813.003.0002 ◽

2018 ◽

Author(s):

Lisa M. Bebell

Keyword(s):

Ebola Virus ◽

Inflammatory Responses ◽

Virus Disease ◽

Treatment Strategies ◽

Disease Outbreaks ◽

Marburg Virus ◽

Residual Effects ◽

Long Term Outcomes ◽

Pediatric Vaccination

Congenital and pediatric Ebola virus disease (EVD) and Marburg virus disease (MVD) are severe, even lethal infections. Historically, children have been underrepresented in filovirus disease outbreaks, and evidence-based treatment strategies are lacking. Existing data suggest that case fatalities are highest among children under four years of age, which is partially explained by higher virus concentrations in young children. Prevention and aggressive resuscitation, nutrition, and supportive care are the mainstays of management until filovirus-specific therapies can be developed. Differences in pediatric immune and inflammatory responses may necessitate unique approaches to pediatric vaccination and treatment. There are minimal safety or immunogenicity data in children, a crucial knowledge gap that must be addressed in future trials. Studying pediatric survivors of the 2014–2016 West Africa EVD outbreak will provide much-needed data on long-term outcomes and residual effects of filovirus disease while we await effective filovirus-specific vaccines and therapies.

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Estimating Transmission Parameters for Respiratory Syncytial Virus and Predicting the Impact of Maternal and Pediatric Vaccination

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa424 ◽

2020 ◽

Vol 222 (Supplement_7) ◽

pp. S688-S694

Author(s):

Michiel van Boven ◽

Anne C Teirlinck ◽

Adam Meijer ◽

Mariëtte Hooiveld ◽

Christiaan H van Dorp ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Young Children ◽

Hospital Admissions ◽

Respiratory Infections ◽

Parameter Estimates ◽

Syncytial Virus ◽

And Shifts ◽

Pediatric Vaccination ◽

The Impact ◽

Transmission Models

Abstract Background Respiratory syncytial virus (RSV) is a leading cause of respiratory tract illness in young children and a major cause of hospital admissions globally. Methods Here we fit age-structured transmission models with immunity propagation to data from the Netherlands (2012–2017). Data included nationwide hospitalizations with confirmed RSV, general practitioner (GP) data on attendance for care from acute respiratory infection, and virological testing of acute respiratory infections at the GP. The transmission models, equipped with key parameter estimates, were used to predict the impact of maternal and pediatric vaccination. Results Estimates of the basic reproduction number were generally high (R0 > 10 in scenarios with high statistical support), while susceptibility was estimated to be low in nonelderly adults (<10% in persons 20–64 years) and was higher in older adults (≥65 years). Scenario analyses predicted that maternal vaccination reduces the incidence of infection in vulnerable infants (<1 year) and shifts the age of first infection from infants to young children. Conclusions Pediatric vaccination is expected to reduce the incidence of infection in infants and young children (0–5 years), slightly increase incidence in 5 to 9-year-old children, and have minor indirect benefits.

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Routine Pediatric Vaccination in Pakistan During COVID-19: How Can Healthcare Professionals Help?

Frontiers in Pediatrics ◽

10.3389/fped.2020.613433 ◽

2020 ◽

Vol 8 ◽

Author(s):

Amjad Khan ◽

Asima Bibi ◽

Khanzada Sheraz Khan ◽

Ayesha Raza Butt ◽

Hira Amin Alvi ◽

...

Keyword(s):

Healthcare Professionals ◽

Vaccine Coverage ◽

Vaccination Rate ◽

Rural Children ◽

Health Crisis ◽

Immunization Rate ◽

Vaccine Preventable Diseases ◽

The Government ◽

Low Coverage ◽

Pediatric Vaccination

Pakistan is still fighting to overcome vaccine-preventable diseases (VPD). The vaccination coverage in rural children remains unsatisfactory amid various barriers including price, hesitancy, and low level of awareness. COVID-19 has decreased the immunization rate in Pakistan due to restricted movements, shortage of vaccines, and low coverage. During the current pandemic, there are high risks that children may get VPD resulting in another infectious disease catastrophe. There is a dire need to put aggressive measures by the government of Pakistan in time to ensure the optimal vaccine coverage. Public education programs for immunization, telehealth services, the involvement of community pharmacies, and the drive-through vaccination system may help to enhance the vaccination rate during the ongoing health crisis.

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Pediatric vaccination appointment scheduling: experience from an Italian clinic

European Journal of Public Health ◽

10.1093/eurpub/ckz186.530 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

F Toscano ◽

C Cuccaro ◽

E Ceriale ◽

A Mercone ◽

S Rossi ◽

...

Keyword(s):

Electronic Health Record ◽

Appointment Scheduling ◽

Health Record ◽

Great Effort ◽

Use Of Resources ◽

Italian Government ◽

Telephone Calls ◽

Electronic Health ◽

Pediatric Vaccination

Abstract Issue/problem Since 2012 pediatric vaccination coverages in Italy have been decreasing. Negative trends have been recorded especially for hexavalent and MMR vaccines. In mid-2017 the Italian government passed an act making ten vaccines compulsory. Most recent data show the act is working, however other aspects of the process should be improved. Description of the problem Parents are invited to bring their children to the clinic through letters or telephone calls. Vaccination appointments are scheduled during weekdays, either in the morning, the afternoon, or both. Each session is carried out by a physician and a nurse, with a new patient scheduled every ten minutes. Appointments and vaccinations are registered on the vaccine-specific electronic health record (SISPC). Results In March 2019, the vaccination clinic worked 21 days for a total of 29 sessions. 823 appointments were available, 797 of them (96.8%) had a patient scheduled before the session started. 547 (68.6%) attended the vaccination appointment, 98.4% of them were vaccinated (538, 67.5% of the total patients scheduled). Among those who did not attend the scheduled appointment, only 108 (43.2%) agreed to reschedule. Eventually, only 58.3% of these patients attended the rescheduled appointment. No statistically significant differences among those who attended and those who did not attend the appointment were found among the variables retrieved from SISPC: day, time, vaccination planned (type, and if mandatory or not), sex, age. Lessons A third of available vaccination appointments in our clinic were lost. Despite the ease through which patients can reschedule an appointment, many choose not to and left their appointments unattended. Although missing a vaccination appointment can be appropriate - e.g. when the child is sick - and great effort should be put to achieve the goal of improving coverages, policymakers should also consider provisions to discourage such behaviors for a better use of resources. Key messages A third of available vaccination appointments in our clinic were lost in a month. Keeping in mind the goal of improving coverages, policymakers should aim for the best possible use of resources.

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