Assessment of the impact of the extension of vaccination mandates on vaccine coverage after 1 year, France, 2019

One year after the extension of the childhood vaccination mandates to the 11 routine vaccinations for children under 2 years old, we estimated vaccination coverage through vaccine reimbursement data. Coverage for children born in 2018 has notably increased. Moreover, vaccine coverage for children and for vaccines not concerned by the law have also shown an increasing trend, supporting a positive impact of the ongoing communication strategy on vaccination, beyond the extension of vaccination mandates.

Download Full-text

Vaccine Coverage Across the Life Course in Michigan During the COVID-19 Pandemic: January–September 2020

American Journal of Public Health ◽

10.2105/ajph.2021.306474 ◽

2021 ◽

pp. e1-e9

Author(s):

Angela K. Shen ◽

Cristi A. Bramer ◽

Lynsey M. Kimmins ◽

Robert Swanson ◽

Patricia Vranesich ◽

...

Keyword(s):

Life Course ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Childhood Vaccination ◽

Local Health ◽

Immunization Registry ◽

Immunization Services ◽

Vaccines For Children ◽

The Life Course ◽

The Impact

Objectives. To assess the impact of the COVID-19 pandemic on immunization services across the life course. Methods. In this retrospective study, we used Michigan immunization registry data from 2018 through September 2020 to assess the number of vaccine doses administered, number of sites providing immunization services to the Vaccines for Children population, provider location types that administer adult vaccines, and vaccination coverage for children. Results. Of 12 004 384 individual vaccine doses assessed, 48.6%, 15.6%, and 35.8% were administered to children (aged 0–8 years), adolescents (aged 9–18 years), and adults (aged 19–105 years), respectively. Doses administered overall decreased beginning in February 2020, with peak declines observed in April 2020 (63.3%). Overall decreases in adult doses were observed in all settings except obstetrics and gynecology provider offices and pharmacies. Local health departments reported a 66.4% decrease in doses reported. For children, the total number of sites administering pediatric vaccines decreased while childhood vaccination coverage decreased 4.4% overall and 5.8% in Medicaid-enrolled children. Conclusions. The critical challenge is to return to prepandemic levels of vaccine doses administered as well as to catch up individuals for vaccinations missed. (Am J Public Health. Published online ahead of print October 7, 2021: e1–e9. https://doi.org/10.2105/AJPH.2021.306474 )

Download Full-text

Introduction of new and reinforcement of existing compulsory vaccinations in Italy: first evaluation of the impact on vaccination coverage in 2017

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.22.1800238 ◽

2018 ◽

Vol 23 (22) ◽

Cited By ~ 17

Author(s):

Fortunato D’Ancona ◽

Claudio D’Amario ◽

Francesco Maraglino ◽

Giovanni Rezza ◽

Walter Ricciardi ◽

...

Keyword(s):

Vaccination Coverage ◽

Positive Impact ◽

Long Term Effects ◽

Rubella Vaccine ◽

The Law ◽

The Impact

In June 2017, a decree-law to increase the number of mandatory vaccinations from 4 to 10 for minors up to 16-years-old was issued in Italy. The vaccination coverage for 2017 showed a positive impact for all the vaccines, particularly for the measles, mumps and rubella vaccine at 91.6% for the year 2017, showing a 4.4% increase compared with 2016 (87.2%). Continued monitoring is needed to evaluate the medium to long-term effects of the law.

Download Full-text

The Impact of War in Yemen on Immunization Coverage of Children Under One Year of Age: Descriptive Study

JMIR Public Health and Surveillance ◽

10.2196/14461 ◽

2019 ◽

Vol 5 (4) ◽

pp. e14461

Author(s):

Amr Torbosh ◽

Mohammed Abdulla Al Amad ◽

Abdulwahed Al Serouri ◽

Yousef Khader

Keyword(s):

Vaccination Coverage ◽

Negative Impact ◽

Vaccine Coverage ◽

National Health System ◽

Immunization Coverage ◽

Measles Vaccine ◽

One Year ◽

Expanded Program On Immunization ◽

The Impact ◽

Marked Drop

Background After 2 years of war that crippled the capacity of the Yemeni National Health System and left only 45% of health facilities functioning, Yemen faced increasing vaccine-preventable disease (VPD) outbreaks and may be at high risk of polio importation. Objective The aim of this study was to determine the impact of the 2015 war on the immunization coverage of children under 1 year. Methods Data on vaccination coverage for 2012-2015 were obtained from the national Expanded Program on Immunization (EPI). The vaccination coverage was calculated at the national and governorate levels by dividing the number of actually vaccinated children by the estimated population of children under 1 year. Results Although there was an increase from 2012 to 2014 in the national coverage for penta-3 vaccine (82% in 2012 vs 88% in 2014) and measles vaccine (70% in 2012 vs 75% in 2014), the coverage was still below the national target (≥95%). Furthermore, the year 2015 witnessed a marked drop in the national coverage compared with 2014 for the measles vaccine (66% in 2015 vs 75% in 2014), but a slight drop in penta-3 vaccine coverage (84% in 2015 vs 88% in 2014). Bacillus Calmette–Guérin vaccine also showed a marked drop from 73% in 2014 to 49% in 2015. These reductions were more marked in governorates that witnessed armed confrontations (eg, Taiz, Lahj, and Sa’dah governorates). On the other hand, governorates that did not witness armed confrontations showed an increase in coverage (eg, Raymah and Ibb), owing to an increase in their population because of displacement from less secure and confrontation-prone governorates. Conclusions This analysis demonstrated the marked negative impact of the 2015 war on immunization coverage, especially in the governorates that witnessed armed confrontations. This could put Yemen at more risk of VPD outbreaks and polio importation. Besides the ongoing efforts to stop the Yemeni war, strategies for more innovative vaccine delivery or provision and fulfilling the increasing demands are needed, especially in governorates with confrontations. Enhancing EPI performance through supportable investments in infrastructure that was destroyed by the war and providing decentralized funds are a prerequisite.

Download Full-text

Exploring online anti-vaccination movements: the role of social media in public health communications and reporting

European Journal of Public Health ◽

10.1093/eurpub/ckz185.683 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

B Soborg

Keyword(s):

Cervical Cancer ◽

Social Media ◽

Vaccination Coverage ◽

Vaccine Safety ◽

Target Group ◽

Communication Strategy ◽

Childhood Vaccination ◽

World Health ◽

Wide Range ◽

The Impact

Abstract Vaccination against Human Papilloma Virus (HPV) was successfully introduced in the Danish childhood vaccination program in 2009 for girls aged 12 with coverage reaching approximately 90%. However, media attention focusing on vaccine safety resulted in a rapid drop in vaccination coverage from 2015. In May 2017, a national campaign “Stop HPV - stop cervical cancer” with aim to regain trust in the official HPV vaccine recommendation and to increase vaccination coverage, was launched. The primary target group of the campaign are mothers in doubt whether to HPV vaccinate their daughter. One of the main elements of the campaign is the social media strategy which includes a Facebook (FB) page “Stop HPV - stop cervical cancer”. New content is made for the page one or twice weekly with a wide range of different post styles used. The FB page is staffed throughout the week and every comment made on the FB page personally answered by the staff. The communication strategy used for the campaign is “heart-brain” with a strategy of communicating “brain” facts about safety and effectiveness of the vaccine while on the other hand telling narrative “heart” stories, such as personal stories of women with cervical cancer. The strategy is in line with recommendations from World Health Organization (WHO) who acknowledge health communication related to vaccines is not only about telling facts, but also about eliciting emotions, creating trust and ensuring genuine understanding by the target group. Communicating on FB about the Childhood vaccination programme has not been used by the Danish Authorities before and there has been a keen interest to learn from the campaign initiative. To quantify and qualify the interaction on Facebook, engagement rates and sentiment analysis to the different types of FB posts have been evaluated and focus groups used to describe the preferred communication style. Data from the evaluation and the impact of the campaign will be presented at the workshop.

Download Full-text

The Impact of War in Yemen on Immunization Coverage of Children Under One Year of Age: Descriptive Study (Preprint)

10.2196/preprints.14461 ◽

2019 ◽

Author(s):

Amr Torbosh ◽

Mohammed Abdulla Al Amad ◽

Abdulwahed Al Serouri ◽

Yousef Khader

Keyword(s):

Vaccination Coverage ◽

Negative Impact ◽

Vaccine Coverage ◽

National Health System ◽

Immunization Coverage ◽

Measles Vaccine ◽

One Year ◽

Expanded Program On Immunization ◽

The Impact ◽

Marked Drop

BACKGROUND After 2 years of war that crippled the capacity of the Yemeni National Health System and left only 45% of health facilities functioning, Yemen faced increasing vaccine-preventable disease (VPD) outbreaks and may be at high risk of polio importation. OBJECTIVE The aim of this study was to determine the impact of the 2015 war on the immunization coverage of children under 1 year. METHODS Data on vaccination coverage for 2012-2015 were obtained from the national Expanded Program on Immunization (EPI). The vaccination coverage was calculated at the national and governorate levels by dividing the number of actually vaccinated children by the estimated population of children under 1 year. RESULTS Although there was an increase from 2012 to 2014 in the national coverage for penta-3 vaccine (82% in 2012 vs 88% in 2014) and measles vaccine (70% in 2012 vs 75% in 2014), the coverage was still below the national target (≥95%). Furthermore, the year 2015 witnessed a marked drop in the national coverage compared with 2014 for the measles vaccine (66% in 2015 vs 75% in 2014), but a slight drop in penta-3 vaccine coverage (84% in 2015 vs 88% in 2014). Bacillus Calmette–Guérin vaccine also showed a marked drop from 73% in 2014 to 49% in 2015. These reductions were more marked in governorates that witnessed armed confrontations (eg, Taiz, Lahj, and Sa’dah governorates). On the other hand, governorates that did not witness armed confrontations showed an increase in coverage (eg, Raymah and Ibb), owing to an increase in their population because of displacement from less secure and confrontation-prone governorates. CONCLUSIONS This analysis demonstrated the marked negative impact of the 2015 war on immunization coverage, especially in the governorates that witnessed armed confrontations. This could put Yemen at more risk of VPD outbreaks and polio importation. Besides the ongoing efforts to stop the Yemeni war, strategies for more innovative vaccine delivery or provision and fulfilling the increasing demands are needed, especially in governorates with confrontations. Enhancing EPI performance through supportable investments in infrastructure that was destroyed by the war and providing decentralized funds are a prerequisite.

Download Full-text

Perspectives on the Measles, Mumps and Rubella Vaccination among Somali Mothers in Stockholm

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15112428 ◽

2018 ◽

Vol 15 (11) ◽

pp. 2428 ◽

Cited By ~ 7

Author(s):

Asha Jama ◽

Mona Ali ◽

Ann Lindstrand ◽

Robb Butler ◽

Asli Kulane

Keyword(s):

Vaccination Coverage ◽

Perceived Risk ◽

Positive Impact ◽

Vaccine Coverage ◽

Qualitative Content Analysis ◽

Vaccine Safety ◽

Snowball Sampling ◽

Mmr Vaccine ◽

Rubella Vaccination ◽

Depth Interviews

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.

Download Full-text

Legal Gender Recognition in Portugal: A Path to Self-Determination

International Journal of Gender, Sexuality and Law ◽

10.19164/ijgsl.v1i1.991 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Carla Moleiro ◽

Nuno Pinto

Keyword(s):

Social Life ◽

Positive Impact ◽

Well Being ◽

Clinical Report ◽

Gender Recognition ◽

Online Questionnaire ◽

Psychological Well Being ◽

Trans People ◽

The Law ◽

The Impact

<p><br />This paper presents research on the enforcement and impact of the first legal gender recognition legislation in Portugal (Law no.7/2011). The study describes how the administrative process created by the law functioned during its initial 5-year period, and identifies challenges and processes of resistance to this legal innovation. Simultaneously, it seeks to assess the impact of the law on the social and psychological well-being of trans people, including in their access to vital spheres of social life such as education and employment. The research employs a mixed-methods approach and a multi-informant methodology: an online questionnaire was completed by 68 trans and non-binary people, and semi-structured in-depth interviews were carried out with various selected stakeholders: representatives of trans and LGBTIQ+ organisations (n=5), health professionals identified as experts in the topic and as gatekeepers in legal gender recognition processes (n=12), and trans people (n=6). Results show, on the one hand, the significant positive impact that legal gender recognition has on the psychological well-being and social welfare of the participants. On the other hand, results also show several challenges and forms of resistance to the implementation of the law, in particular those challenges resulting from the fact that legal gender recognition depended on a clinical diagnosis and the provision of a clinical report.</p>

Download Full-text

Identifying silent COVID-19 infections among children is critical for controlling the pandemic

10.1101/2021.01.06.21249349 ◽

2021 ◽

Author(s):

Seyed M. Moghadas ◽

Meagan C. Fitzpatrick ◽

Affan Shoukat ◽

Kevin Zhang ◽

Alison P. Galvani

Keyword(s):

Vaccination Coverage ◽

Vaccine Efficacy ◽

The United States ◽

Sensitivity Analyses ◽

Transmission Model ◽

Base Case ◽

Age Group ◽

One Year ◽

The Impact ◽

Targeted Approach

Importance: A significant proportion of COVID-19 transmission occurs silently during the pre-symptomatic and asymptomatic stages of infection. Children, while being important drivers of silent transmission, are not included in COVID-19 vaccination campaigns given their exclusion from clinical trials thus far. Objective: To investigate the impact of a targeted approach to identifying silent infections among children as a proxy for their vaccination. Design: This study used an age-structured disease transmission model to simulate the synergistic impact of interventions in reducing attack rates over the course of one year. Setting: A synthetic population representative of the demographics of the United States (US). Participants: Six age groups of 0-4, 5-10, 11-18, 19-49, 50-64, 65+ years old, stratified for their population size based on US census data. Exposures: Vaccination of adults, self-isolation of all symptomatic cases within 24 hours of symptom onset, and detection of silent infections. Main Outcomes and Measures: Vaccination of adults was implemented to reach a 40% coverage over the course of one year with a vaccine efficacy of 95% against symptomatic and severe COVID-19. Without vaccination of children, we determined the proportion and speed that would be required for identifying silent infections among this age group to suppress future attack rates below 5%. Results: A targeted approach that identifies 20.6% and 28.6% of silent infections among children within 2 or 3 days post-infection, respectively, would be required to bring attack rates under 5% with vaccination of adults. If silent infections among children remained undetected, achieving the same attack rates would require an unrealistically high vaccination coverage (at least 82%) of this age group, in addition to the base-case 40% vaccination coverage of adults. The results were robust in sensitivity analyses with respect to vaccine efficacy against infection and reduced susceptibility of children to infection. Conclusions and Relevance: In the absence of vaccine availability for children, a targeted approach to rapid identification of silent COVID-19 infections in this age group can significantly mitigate disease burden. Without measures to interrupt transmission chains from silent infections, vaccination of adults is unlikely to contain the outbreaks in the near term.

Download Full-text

The importance of sustained compliance with physical distancing during COVID-19 vaccination rollout

10.21203/rs.3.rs-390037/v1 ◽

2021 ◽

Author(s):

Alexandra Teslya ◽

Ganna Rozhnova ◽

Thi Mui Pham ◽

Daphne van Wees ◽

Hendrik Nunner ◽

...

Keyword(s):

Vaccination Coverage ◽

Vaccine Coverage ◽

Transmission Model ◽

Cumulative Number ◽

Vaccination Rates ◽

Contact Rates ◽

Health Authorities ◽

Public Health Authorities ◽

Vaccination Campaigns ◽

The Impact

Abstract Mass vaccination campaigns against SARS-CoV-2 are under way in many countries with the hope that increasing vaccination coverage will enable reducing current physical distancing measures. Compliance with these measures is waning, while more transmissible virus variants such as B.1.1.7 have emerged. Using SARS-CoV-2 transmission model we investigated the impact of the feedback between compliance, the incidence of infection, and vaccination coverage on the success of a vaccination programme in the population where waning of compliance depends on vaccine coverage. Our results suggest that the combination of fast waning compliance, slow vaccination rates, and more transmissible variants may result in a higher cumulative number of infections than in a situation without vaccination. These adverse effects can be alleviated if vaccinated individuals do not revert to pre-pandemic contact rates, and if non-vaccinated individuals remain compliant with physical distancing measures. Both require convincing, clear and appropriately targeted communication strategies by public health authorities.

Download Full-text

Mobile nudges and financial incentives to improve coverage of timely neonatal vaccination in rural areas (GEVaP trial): A 3-armed cluster randomized controlled trial in Northern Ghana

PLoS ONE ◽

10.1371/journal.pone.0247485 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0247485

Author(s):

Gillian Levine ◽

Amadu Salifu ◽

Issah Mohammed ◽

Günther Fink

Keyword(s):

Mobile Phone ◽

Vaccination Coverage ◽

Childhood Vaccination ◽

Northern Ghana ◽

Voice Call ◽

Infant Vaccination ◽

Randomized Controlled ◽

Cluster Randomized ◽

Voice Calls ◽

The Impact

Background Despite progress in vaccination coverage, timeliness of childhood vaccination remains a challenge in many settings. We aimed to assess if mobile phone-based reminders and incentives to health workers and caregivers could increase timely neonatal vaccination in a rural, low-resource setting. Methods We conducted an open-label cluster randomized controlled 1:1:1 trial with three arms in 15 communities in Northern Ghana. Communities were randomized to 1) a voice call reminder intervention; 2) a community health volunteer (CHV) intervention with incentivized rewards; 3) control. In the voice call reminder arm, a study staff member made voice calls to mothers shortly after birth to encourage vaccination and provide personalized information about available vaccination services. In the incentive arm, CHVs promoted infant vaccination and informed women with recent births about available vaccination opportunities. Both CHVs and women were provided small monetary incentives for on-time early infant vaccination in this arm, delivered using mobile phone-based banking applications. No study activities were conducted in control communities. A population-based survey compared vaccination coverage across arms in the pre-intervention and intervention periods. The primary endpoint was completion of at least one dose of Polio vaccine within 14 days of life and BCG vaccination within 28 days of life. Results Six-hundred ninety births were identified; 106, 88, and 88 from pre-intervention and 150, 135, and 123 in the intervention period, in the control, voice call reminder and CHV incentive arms, respectively. In adjusted intent-to-treat analysis, voice call reminders were associated with 10.5 percentage point (95% CI: 4.0, 17.1) higher coverage of on-time vaccination, while mobile phone-based incentives were associated with 49.5 percentage point (95% CI: 26.4, 72.5) higher coverage. Conclusion Community-based interventions using mobile phone technologies can improve timely early vaccination coverage. A CHV approach with incentives to community workers and caregivers was a more effective strategy than voice call reminders. The impact of vaccination “nudges” via voice calls may be constrained in settings where network coverage and phone ownership are limited. Trial registration This trial was registered at ClinicalTrials.gov; NCT03797950.

Download Full-text