Sero-Prevalence Surveillance to Predict Vaccine-Preventable Disease Outbreaks; A Lesson from the 2014 Measles Epidemic in Northern Vietnam

AbstractBackgroundDuring the first half of 2014, a severe outbreak of measles occurred in northern Vietnam, causing 15 033 confirmed cases and 146 deaths.MethodsTo evaluate the population-level seroprevalence of protection against measles in the period before the outbreak, we made use of an existing age-stratified serum bank, collected over the year before the outbreak, between November 2012 and December 2013, from 4 sites across the country (Hanoi, Hue, Dak Lak, and Ho Chi Minh City). Data from the UNICEF’s Multiple Indicator Clustered Surveys (MICS), carried out in Vietnam during the first quarter of 2014, were used to assess the vaccine coverage in 6 ecological regions of Vietnam.ResultsResults revealed a large discrepancy between levels of protection, as estimated from the serology and vaccine coverage estimated by UNICEF’s MICS. Variation in seroprevalence across locations and age groups corresponded with reported numbers of measles cases, most of which were among the 0–2-year-old age group and in the northern part of the country.ConclusionsOur study presents a strong case in favor of a serosurveillance sentinel network that could be used to proactively tune vaccination policies and other public health interventions.

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P033 POPULATION-LEVEL HPV VACCINATION COVERAGE AMONG U.S. ADULT IBD PATIENTS: STILL NOT ENOUGH

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.167 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S65-S65

Author(s):

Ryan Suk ◽

Heetae Suk ◽

Keith Sigel ◽

Kalyani Sonawane ◽

Ashish Deshmukh

Keyword(s):

Vaccination Coverage ◽

Hpv Vaccine ◽

Vaccine Coverage ◽

Hpv Vaccination ◽

Age Groups ◽

Population Level ◽

Vaccine Uptake ◽

Population Estimate ◽

Age Group ◽

Old Patients

Abstract Background Evidence suggests that the inflammatory bowel disease (IBD) patients may have an elevated risk of Human papillomavirus (HPV)-associated cancers when compared with those without IBD. HPV vaccination has been recommended for 11 to 26 years old males and females. Recently, the Centers for Disease Control and Prevention (CDC) has updated the guideline to include adults aged 27 to 45 who are not adequately vaccinated. To the best of our knowledge, population-level HPV vaccine uptake rates among patients with IBD remains unknown. Methods We used 2015–2016 National Health Information Survey (NHIS) data to assess the HPV vaccination coverage among people with IBD in the US. Weighted counts and percentages were estimated using survey design for the population-level results. We identified those who reportedly were told by a doctor or healthcare professional that they have IBD. Then we stratified the patients into two age groups: HPV-vaccine eligible age group (age 18–26) and newly approved age group (age 27–45). Our outcome was vaccine coverage status assessed as vaccine initiation age and number of doses. When the initiation age was less than 15, two doses were defined as “completed” and when the age was 15 and older, three doses were defined as “completed”. When the participants had initiated the vaccine but have not completed all the required doses according to their initiation age, it was defined as “incomplete” while no dose was defined as “no vaccine”. We estimated the coverage rate by age group and sex. We used Wald chi-square test to examine differences in completion rate by sex. Results We identified 951 participants (population estimate: 3,121,387) who self-reportedly had IBD. Among those, 51 persons (population estimate: 191,830) were HPV vaccine-eligible aged and 219 persons (population estimate: 859,711) were newly approved aged. Only 3.2% men while 63.2% of eligible women completed vaccination series as recommended. Eligible men had higher rates of incompletion compared to women (13.8% vs 1.3%). A higher proportion of vaccine-eligible men (83.0%) did not initiate the HPV vaccine compared to women (35.5%) (p=0.001). Among the newly approved age group, only 0.5% of men completed vaccine and 1.3% did not complete their doses. In women, 2.3% was complete with the doses and 9.6% initiated but did not complete the vaccine (p <0.001). Conclusion IBD patients might greatly benefit from receiving HPV vaccination given the possibly high risk of HPV-associated cancers. However, the coverage for vaccine-eligible IBD patients was not enough and much lower than the goal of 80% coverage in Healthy People 2020. Moreover, according to the updated guideline, 27 to 45 years old patients who are not adequately vaccinated would be able to catch up their vaccination. Further study needs to be focused on promoting and informing HPV vaccination in IBD patients, for both currently vaccine-eligible patients and those who are aged between 27 and 45 and not adequately vaccinated.

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Monitoring sociodemographic inequality in COVID-19 vaccination coverage in England: a national linked data study

10.1101/2021.10.07.21264681 ◽

2021 ◽

Author(s):

Ted Dolby ◽

Katie Finning ◽

Allan Baker ◽

Leigh Dowd ◽

Kamlesh Khunti ◽

...

Keyword(s):

Language Proficiency ◽

Vaccination Coverage ◽

English Language ◽

Age Groups ◽

Population Level ◽

Lower Percentage ◽

Area Deprivation ◽

Sociodemographic Characteristics ◽

Age Group ◽

Vaccination Rates

Background: The UK began an ambitious COVID-19 vaccination programme on 8th December 2020. This study describes variation in vaccination coverage by sociodemographic characteristics between December 2020 and August 2021. Methods: Using population-level administrative records linked to the 2011 Census, we estimated monthly first dose vaccination rates by age group and sociodemographic characteristics amongst adults aged 18 years or over in England. We also present a tool to display the results interactively. Findings: Our study population included 35,223,466 adults. A lower percentage of males than females were vaccinated in the young and middle age groups (18-59 years) but not in the older age groups. Vaccination rates were highest among individuals of White British and Indian ethnic backgrounds and lowest among Black Africans (aged ≥80 years) and Black Caribbeans (18-79 years). Differences by ethnic group emerged as soon as vaccination roll-out commenced and widened over time. Vaccination rates were also lower among individuals who identified as Muslim, lived in more deprived areas, reported having a disability, did not speak English as their main language, lived in rented housing, belonged to a lower socio-economic group, and had fewer qualifications. Interpretation: We found inequalities in COVID-19 vaccination rates by sex, ethnicity, religion, area deprivation, disability status, English language proficiency, socio-economic position, and educational attainment, but some of these differences varied by age group. Research is urgently needed to understand why these inequalities exist and how they can be addressed.

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Context-specific complementary feeding recommendations developed using Optifood could improve the diets of breast-fed infants and young children from diverse livelihood groups in northern Kenya

Public Health Nutrition ◽

10.1017/s1368980016003116 ◽

2016 ◽

Vol 20 (6) ◽

pp. 971-983 ◽

Cited By ~ 11

Author(s):

Marieke Vossenaar ◽

Frances A Knight ◽

Alison Tumilowicz ◽

Christine Hotz ◽

Peter Chege ◽

...

Keyword(s):

Young Children ◽

Complementary Feeding ◽

Age Groups ◽

Population Level ◽

Age Group ◽

Northern Kenya ◽

Pastoralist Communities ◽

Context Specific ◽

Breast Fed ◽

Infants And Young Children

AbstractObjectiveTo formulate age- and context-specific complementary feeding recommendations (CFR) for infants and young children (IYC) and to compare the potential of filling population-level nutrient gaps using common sets of CFR across age groups.DesignLinear programming was used to develop CFR using locally available and acceptable foods based on livelihood- and age-group-specific dietary patterns observed through 24 h dietary recalls. Within each livelihood group, the nutrient potential of age-group-specific v. consolidated CFR across the three age groups was tested.SettingThree food-insecure counties in northern Kenya; namely, settled communities from Isiolo (n 300), pastoralist communities from Marsabit (n 283) and agro-pastoralist communities from Turkana (n 299).SubjectsBreast-fed IYC aged 6–23 months (n 882).ResultsAge-specific CFR could achieve adequacy for seven to nine of eleven modelled micronutrients, except among 12–23-month-old children in agro-pastoralist communities. Contribution of Fe, Zn and niacin remained low for most groups, and thiamin, vitamin B6 and folate for some groups. Age-group-consolidated CFR could not reach the same level of nutrient adequacy as age-specific sets among the settled and pastoralist communities.ConclusionsContext- and age-specific CFR could ensure adequate levels of more modelled nutrients among settled and pastoralist IYC than among agro-pastoralist communities where use of nutrient-dense foods was limited. Adequacy of all eleven modelled micronutrients was not achievable and additional approaches to ensure adequate diets are required. Consolidated messages should be easier to implement as part of a behaviour change strategy; however, they would likely not achieve the same improvements in population-level dietary adequacy as age-specific CFR.

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Assessing real-world vaccine effectiveness against severe forms of SARS-CoV-2 infection from routine surveillance data in Switzerland

10.31219/osf.io/rxk9b ◽

2021 ◽

Author(s):

Nanina Anderegg ◽

Christian L Althaus ◽

Samuel Colin ◽

Anthony Hauser ◽

Anne Laube ◽

...

Keyword(s):

Relative Risk ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Age Groups ◽

Vaccine Effectiveness ◽

Surveillance Data ◽

Age Group ◽

Routine Surveillance ◽

Vaccination Campaigns ◽

Over Time

Background. In Switzerland, SARS-CoV-2 vaccination campaigns started early 2021. Vaccine coverage reached 65% of the population in December 2021, mostly using mRNA vaccines from Moderna and Pfizer-BioNtech. Simultaneously, the proportion of vaccinated among COVID-19-related hospitalizations and deaths rose, creating some confusion in the general population. We aim to assess vaccine effectiveness against severe forms of SARS-CoV-2 infection using routine surveillance data on the vaccination status of COVID-19-related hospitalizations and deaths and data on vaccination coverage in Switzerland.Methods. We consider all routine surveillance data on COVID-19-related hospitalizations and deaths received at the Swiss Federal Office of Public Health from 1 July 2021 to 1 December 2021. We estimate the relative risk of COVID-19 related hospitalization or death for non-fully vaccinated compared to fully vaccinated individuals, adjusted for the dynamics of vaccination coverage over time, by age and location. We stratify the analysis by age group and by calendar month. We assess variations in the relative risk of hospitalization associated with the time since vaccination.Results. We include a total of 5,948 COVID-19-related hospitalizations of which 1,245 (21%) were fully vaccinated, and a total of 739 deaths of which 259 (35%) were fully vaccinated. We find that the relative risk of COVID-19 related hospitalization is 12.5 (95%CI: 11.7 to 13.4) times higher for non-fully vaccinated than for fully vaccinated individuals. This translates into a vaccine effectiveness against hospitalization of 92.0% (95%CI: 91.4 to 92.5%). Vaccine effectiveness against death is estimated to 90.3% (95%CI: 88.6 to 91.8%). Effectiveness appears comparatively lower in age groups over 70 and during the months of October and November 2021. We also find evidence of a decrease in vaccine effectiveness against hospitalization for individuals vaccinated for 25 weeks or more, but this decrease only appears in age groups below 70.Conclusions. The observed proportions of vaccinated among COVD-19-related hospitalizations and deaths in Switzerland are compatible with a high effectiveness of mRNA vaccines from Moderna and Pfizer-BioNtech against hospitalization and death in all age groups. Effectiveness appears comparatively lower in older age groups, suggesting the importance of booster vaccinations. We find inconclusive evidence that vaccine effectiveness is waning over time. Repeated analyses will be able to better assess waning and the effect of boosters.

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Evaluation of outbreak response immunization in the control of pertussis using agent-based modeling

PeerJ ◽

10.7717/peerj.2337 ◽

2016 ◽

Vol 4 ◽

pp. e2337 ◽

Cited By ~ 5

Author(s):

Alexander Doroshenko ◽

Weicheng Qian ◽

Nathaniel D. Osgood

Keyword(s):

Public Health ◽

Vaccine Coverage ◽

Age Groups ◽

Sensitivity Analyses ◽

Age Group ◽

Outbreak Response ◽

Agent Based ◽

Waning Immunity ◽

Outbreak Response Immunization ◽

Immunization Campaign

BackgroundPertussis control remains a challenge due to recently observed effects of waning immunity to acellular vaccine and suboptimal vaccine coverage. Multiple outbreaks have been reported in different ages worldwide. For certain outbreaks, public health authorities can launch an outbreak response immunization (ORI) campaign to control pertussis spread. We investigated effects of an outbreak response immunization targeting young adolescents in averting pertussis cases.MethodsWe developed an agent-based model for pertussis transmission representing disease mechanism, waning immunity, vaccination schedule and pathogen transmission in a spatially-explicit 500,000-person contact network representing a typical Canadian Public Health district. Parameters were derived from literature and calibration. We used published cumulative incidence and dose-specific vaccine coverage to calibrate the model’s epidemiological curves. We endogenized outbreak response by defining thresholds to trigger simulated immunization campaigns in the 10–14 age group offering 80% coverage. We ran paired simulations with and without outbreak response immunization and included those resulting in a single ORI within a 10-year span. We calculated the number of cases averted attributable to outbreak immunization campaign in all ages, in the 10–14 age group and in infants. The count of cases averted were tested using Mann–WhitneyUtest to determine statistical significance. Numbers needed to vaccinate during immunization campaign to prevent a single case in respective age groups were derived from the model. We varied adult vaccine coverage, waning immunity parameters, immunization campaign eligibility and tested stronger vaccination boosting effect in sensitivity analyses.Results189 qualified paired-runs were analyzed. On average, ORI was triggered every 26 years. On a per-run basis, there were an average of 124, 243 and 429 pertussis cases averted across all age groups within 1, 3 and 10 years of a campaign, respectively. During the same time periods, 53, 96, and 163 cases were averted in the 10–14 age group, and 6, 11, 20 in infants under 1 (p< 0.001, all groups). Numbers needed to vaccinate ranged from 49 to 221, from 130 to 519 and from 1,031 to 4,903 for all ages, the 10–14 age group and for infants, respectively. Most sensitivity analyses resulted in minimal impact on a number of cases averted.DiscussionOur model generated 30 years of longitudinal data to evaluate effects of outbreak response immunization in a controlled study. Immunization campaign implemented as an outbreak response measure among adolescents may confer benefits across all ages accruing over a 10-year period. Our inference is dependent on having an outbreak of significant magnitude affecting predominantly the selected age and achieving a comprehensive vaccine coverage during the campaign. Economic evaluations and comparisons with other control measures can add to conclusions generated by our work.

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Emotional determinants of public responses to the risk of epidemics and pandemics: a systematic review

10.21203/rs.3.rs-1079281/v1 ◽

2021 ◽

Author(s):

Antonis A. Kousoulis ◽

Mark R. Francis ◽

Imogen Grant ◽

Heidi J Larson

Keyword(s):

Public Health ◽

Infectious Disease ◽

Systematic Review ◽

Public Health Intervention ◽

Disease Outbreaks ◽

Population Level ◽

Health Interventions ◽

Public Health Interventions ◽

Infectious Disease Outbreaks ◽

Intervention Uptake

Abstract Background Understanding how people’s emotions influence their health decisions and behaviours at a population level is fundamental to designing effective communication strategies and public health interventions for infectious disease outbreaks. This review identifies relevant research to assess the role of emotional determinants and their impact on public responses to the risk of infectious disease outbreaks, specifically in relation to the uptake of public health interventions. Methods A comprehensive systematic review was conducted exploring the differences in public responses by emotion, infection, outcome and region. A basic consensus approach was followed in which emotional stimuli were categorised as being either pleasant or unpleasant, and predisposing people to bivalent behaviour (i.e., approach or withdrawal). All primary research studies published in five global databases between 1988-2019 were eligible for inclusion. Binomial tests (against a test proportion of 0.5 or 50% for each study outcome) were performed using the direction of effect observed in each study, i.e., either favouring or not favouring intervention uptake. Results A total of 75 studies from 28 different nations were eligible for inclusion in the review. A total of 97 correlations were made between 12 emotions, 10 infectious diseases, and the uptake of seven types of public health interventions. Unpleasant emotions were evoked much more often than pleasant following public health risk communications, with fear and anxiety being the most common. Overall, moderate anxiety-related emotions (worry, anxiety, stress, concern) seemed to be much more significant motivators for public action compared to extreme unpleasant emotions (fear, panic, hopelessness, shame), which had a statistically significantly negative effect on the uptake of public health interventions in several cases. Pleasant emotions (empathy, hope) also showed promise as motivators for public health intervention uptake, but more research is needed to corroborate this. Conclusions The results of this review show that the public’s emotional responses to epidemics in the past 30 years have played a clear role in determining how successful the rollout of public health interventions has been. Emotions need to be considered in crisis communications, and these research findings can help inform communications strategies in the evolving context of the COVID-19 pandemic and future infectious disease outbreaks.

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Estimating age-specific vaccine effectiveness using data from a large measles outbreak in Berlin, Germany, 2014/15: evidence for waning immunity

Eurosurveillance ◽

10.2807/1560-7917.es.2019.24.17.1800529 ◽

2019 ◽

Vol 24 (17) ◽

Cited By ~ 4

Author(s):

Julia Bitzegeio ◽

Shannon Majowicz ◽

Dorothea Matysiak-Klose ◽

Daniel Sagebiel ◽

Dirk Werber

Keyword(s):

Scenario Analysis ◽

Vaccine Coverage ◽

Screening Method ◽

Age Groups ◽

Vaccine Effectiveness ◽

Natural Immunity ◽

Age Group ◽

Measles Outbreak ◽

Waning Immunity ◽

Using Data

Background Measles elimination is based on 95% coverage with two doses of a measles-containing vaccine (MCV2), high vaccine effectiveness (VE) and life-long vaccine-induced immunity. Longitudinal analysis of antibody titres suggests existence of waning immunity, but the relevance at the population-level is unknown. Aim We sought to assess presence of waning immunity by estimating MCV2 VE in different age groups (2–5, 6–15, 16–23, 24–30 and 31–42 years) in Berlin. Methods We conducted a systematic literature review on vaccination coverage and applied the screening-method using data from a large measles outbreak (2014/15) in Berlin. Uncertainty in input variables was incorporated by Monte Carlo simulation. In a scenario analysis, we estimated the proportion vaccinated with MCV2 in those 31-42 years using VE of the youngest age group, where natural immunity was deemed negligible. Results Of 773 measles cases (median age: 20 years), 40 had received MCV2. Average vaccine coverage per age group varied (32%–88%). Estimated median VE was > 99% (95% credible interval (CrI): 98.6–100) in the three youngest age groups, but lower (90.9%, 95% CrI: 74.1–97.6) in the oldest age group. In the scenario analysis, the estimated proportion vaccinated was 98.8% (95% CrI: 96.5–99.8). Conclusion VE for MCV2 was generally high, but lower in those aged 31-42 years old. The estimated proportion with MCV2 should have led to sufficient herd immunity in those aged 31-42 years old. Thus, lower VE cannot be fully explained by natural immunity, suggesting presence of waning immunity.

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Inequalities in initiation of COVID19 vaccination by age and population group in Israel- December 2020-April 2021

10.1101/2021.06.14.21258882 ◽

2021 ◽

Author(s):

Yanay Gorelik ◽

Michael Edelstein

Keyword(s):

Generational Differences ◽

Vaccine Coverage ◽

Demographic Data ◽

Relative Proportion ◽

Age Groups ◽

Population Group ◽

Orthodox Jews ◽

Age Group ◽

Population Groups ◽

Binomial Regression

Background: In Israel, COVID19 vaccination coverage varies widely by population group and age. Despite the vaccine being locally and freely available in the entire country. Comparing crude coverage between localities and population groups is misleading because of differing age structures in different population groups. In order to describe inequalities in COVID19 vaccine initiation we determined differences in age-specific dose 1 vaccine coverage between the main population groups in Israel, and characterised the influence of age on vaccine coverage within each of these groups. Methods: We obtained daily doses administered by municipality and age from the Ministry of Health, and demographic data from the Central Bureau of Statistics. We determined whether the relative proportion of people vaccinated in each age group (15-19, 20-29, 30-39, 40-49, 50-59, 60+) changed by population group (General Jewish, Ultra-Orthodox and Arab) using ANOVA and quantified association between age, population group and vaccine coverage using binomial regression. Results: 8,507,723 individuals in 268 localities were included. Compared with the General Jewish population, vaccine coverage was lower among the Arab and Ultra-Orthodox populations and lowest in the Ultra-Orthodox population in all age groups. Gaps between population groups differed according to age group (p<0.001). In all populations, coverage decreased with decreasing age (p<0.001). The Ultra-orthodox population was the least vaccinated in all age groups relatively to those aged 60 and over. Conclusions: In all age groups, the Ultra-Orthodox population had the lowest vaccine coverage. The younger the age group, the more Ultra-Orthodox Jews are diverging from their age peers in terms of initiating COVID19 vaccination. These findings suggest generational differences in terms of vaccination behaviour in this group. Qualitative studies understanding the causes behind this divergence can inform tailored vaccination strategies.

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Screening of more than 2000 Hungarian healthcare workers’ anti-measles antibody level: results and possible population-level consequences

Epidemiology and Infection ◽

10.1017/s0950268818002571 ◽

2018 ◽

Vol 147 ◽

Cited By ~ 3

Author(s):

G. Lengyel ◽

A. Marossy ◽

N. Ánosi ◽

S. L. Farkas ◽

B. Kele ◽

...

Keyword(s):

Healthcare Workers ◽

Vaccine Coverage ◽

Herd Immunity ◽

Population Level ◽

High Risk Group ◽

Age Group ◽

Imported Cases ◽

Protective Antibodies ◽

Healthcare Associated ◽

The Military

AbstractDue to the European measles epidemic and the increased number of imported cases, it can be theorised that the risk of exposure among Hungarian healthcare workers (HCWs) has increased. In 2017, the increased measles circulation in the region led to the emergence of smaller local and hospital epidemics. Therefore, our objective was to determine the herd immunity in the high-risk group of HCWs. A hospital-based study of detecting anti-measles IgG activity was performed in 2017 and included 2167 employees of the Military Medical Centre (Hungary). The screening of HCWs presented a good general seropositivity (90.6%). The highest seroprevalence value (99.1%) was found in the age group of 60 years or older. The lowest number of seropositive individuals was seen in the 41–45 years (86.2%) age group, indicating a significant herd immunity gap between groups. Regarding the Hungarian data, there might be gaps in the seroprevalence of the analysed HCWs, implying that susceptible HCWs may generate healthcare-associated infections. This study suggests that despite the extensive vaccination and high vaccine coverage, it is still important to monitor the level of protective antibodies in HCWs, or in a representative group of the whole population of Hungary, and possibly in other countries as well.

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Epidemiology of Measles in the Philippines

Acta Medica Philippina ◽

10.47895/amp.v52i4.385 ◽

2018 ◽

Vol 52 (4) ◽

Author(s):

Michelle C. Ylade

Keyword(s):

Birth Cohort ◽

Vaccine Coverage ◽

Age Distribution ◽

Age Groups ◽

The Philippines ◽

Incidence Rates ◽

Vaccine Effectiveness ◽

Age Group ◽

Measles Vaccine ◽

Measles Incidence

Background. Measles cases have decreased ever since vaccination has been introduced through the DOH Expanded Program on Immunization (DOH EPI) in the Philippines. Elimination is the current goal. However, despite high vaccine coverage, a nationwide outbreak occurred in 2013. Objectives. This study aimed to present measles incidence rates before and after the introduction of the measles vaccine, describe the changing epidemiology of measles, and assess the effectiveness of measles vaccination and baseline measles reporting. Methods. National data from 1960 to 2014 were used to determine incidence of measles and describe its epidemiology. Vaccine coverage and data on measles surveillance were used to estimate vaccine effectiveness by birth cohort and age group. Results. Reported measles incidence decreased after the introduction of measles vaccine compared to prevaccination levels (pre-vaccination: 36 per 100,000 to 73 per 100,000; 2008-2014 confirmed measles incidence: 1.47 to 23.76 per 100,000, suspected measles-5.7 to 58.08 per 100,000). A shift in the age distribution of cases was noted during the outbreak. Vaccine effectiveness by birth cohort ranged from 85-96% while the lowest VE estimate by age group was seen among those aged 26-30 years. Conclusion. Measles vaccine coverage should target wider age groups. Measles surveillance should be improved to help in evidence-based decisions for a more effective plan towards measles elimination.

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