Childhood vaccination as a part of the National Immunization Schedule during the COVID-19: problems and potential solutions

Aim: to compare monthly implementation of immunization plan as a part of the National Immunization Schedule in 2019 and 2020 in children aged 0–18 years. Patients and Methods: monthly and annual form No. 5 “Information on prophylactic immunization” (from January 2019 to December 2020) was analyzed. Monthly implementation of immunization plan for each vaccine-preventable disease (whooping cough, poliomyelitis, mumps, rubella, measles, diphtheria tetanus and other) were analyzed separately. Results: in the beginning of the COVID-19 pandemic, a significant (8.8-fold) reduction in the coverage of children with immunization against vaccine-preventable diseases was reported compared to 2019 (р<0.0001). The reduction in the implementation of immunization schedule required urgent solutions to maintain a high level of herd immunity. The recovery of the required implementation of immunization plan against whooping cough and poliomyelitis was achieved by the end of 2020. The recovery of the required implementation of immunization plan against diphtheria and tetanus, measles, rubella, and mumps will be achieved in September 2020 (considering the National Immunization Schedule that includes revaccinations in preschool and school years). Conclusions: timely identification of the drawbacks of the organization of immunization and the prompt development of effective measures and implementation into clinical practice allowed for full implementation of immunization plan in children in 2020, despite the ongoing COVID-19 pandemic. KEYWORDS: vaccination, children, National Immunization Schedule, revaccination, COVID-19 pandemic. FOR CITATION: Girina A.A., Zaplatnikov A.L., Petrovskiy F.I., Tandalova L.P. Childhood vaccination as a part of the National Immunization Schedule during the COVID-19: problems and potential solutions. Russian Journal of Woman and Child Health. 2021;4(1):85–89. DOI: 10.32364/2618-8430-2021-4-1-85-89.

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The effect of opinion clustering on disease outbreaks

Journal of The Royal Society Interface ◽

10.1098/rsif.2008.0271 ◽

2008 ◽

Vol 5 (29) ◽

pp. 1505-1508 ◽

Cited By ~ 110

Author(s):

Marcel Salathé ◽

Sebastian Bonhoeffer

Keyword(s):

Vaccination Coverage ◽

Belief Systems ◽

Herd Immunity ◽

Disease Outbreaks ◽

Disease Outbreak ◽

High Income ◽

Opinion Formation ◽

Vaccine Preventable Diseases ◽

Vaccination Rates ◽

High Level

Many high-income countries currently experience large outbreaks of vaccine-preventable diseases such as measles despite the availability of highly effective vaccines. This phenomenon lacks an explanation in countries where vaccination rates are rising on an already high level. Here, we build on the growing evidence that belief systems, rather than access to vaccines, are the primary barrier to vaccination in high-income countries, and show how a simple opinion formation process can lead to clusters of unvaccinated individuals, leading to a dramatic increase in disease outbreak probability. In particular, the effect of clustering on outbreak probabilities is strongest when the vaccination coverage is close to the level required to provide herd immunity under the assumption of random mixing. Our results based on computer simulations suggest that the current estimates of vaccination coverage necessary to avoid outbreaks of vaccine-preventable diseases might be too low.

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Meningococcal Vaccines of New Generations – the First 20 Years of Use

Epidemiology and Vaccinal Prevention ◽

10.31631/2073-3046-2021-20-4-103-113 ◽

2021 ◽

Vol 20 (4) ◽

pp. 103-113

Author(s):

N. N. Kostyukova ◽

V. A. Bekhalo

Keyword(s):

Outer Membrane Proteins ◽

Herd Immunity ◽

Practical Interest ◽

Protein Composition ◽

Immune Protection ◽

Immunization Schedule ◽

Immunization Programs ◽

Protein Antigens ◽

Meningococcal Vaccines ◽

National Immunization

Relevance. Meningococcal vaccine refers to any of the vaccines used to prevent infection by Neisseria meningitidis. Therefore, there is a great scientific and practical interest in the existing and developed menicococcal vaccines.Aims the review is to provide an analysis: literature data on the effectiveness of meningococcal vaccines of new generations - conjugated polysaccharide serogroups A, C, W and Y and protein serogroup B.Conclusions. With regard to conjugated vaccines, there are a large number of reliable observations confirming the high immunological and epidemiological effectiveness of these vaccine preparations, including the prevention of bacterial carriage and the development of herd immunity. These vaccines are weakly reactogenic, and in many countries, they are introduced into national immunization programs and in some countries are used as mandatory (UK) or in connection with the existing epidemic indications. The protein «vesicle» vaccine based on serogroup B meningococcal outer membrane proteins, showed high efficacy only in those cases when the protein composition of the strain that caused the morbidity corresponded to the composition (mainly in terms of the PorA subtype antigen) of the vaccine. Genetic-engineered vaccines containing only a few serogroup B meningococcal protein antigens with or without the addition of «vesicle» proteins are difficult to evaluate due to the small number of observations associated with low serogroup В prevalence, but in Great Britain, such vaccine was also introduced as mandatory in the national immunization schedule for babies. At the same time, new vaccines of serogroup B induce immune protection against some strains of meningococcus of other serogroups C, W, and Y, and even against other species of Neisseria, in particular - gonococcus. This circumstance gives rise to hope for the development of protein meningococcal vaccines with a wider spectrum of specificity than the group, and even than the species.

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Vaccine-Induced Cellular Immunity against Bordetella pertussis: Harnessing Lessons from Animal and Human Studies to Improve Design and Testing of Novel Pertussis Vaccines

Vaccines ◽

10.3390/vaccines9080877 ◽

2021 ◽

Vol 9 (8) ◽

pp. 877

Author(s):

Anja Saso ◽

Beate Kampmann ◽

Sophie Roetynck

Keyword(s):

Whooping Cough ◽

Vaccine Coverage ◽

Current Knowledge ◽

Herd Immunity ◽

Cell Mediated Immunity ◽

Improve Design ◽

Vaccine Preventable Diseases ◽

Key Factor ◽

Cellular Immune ◽

Design And Testing

Pertussis (‘whooping cough’) is a severe respiratory tract infection that primarily affects young children and unimmunised infants. Despite widespread vaccine coverage, it remains one of the least well-controlled vaccine-preventable diseases, with a recent resurgence even in highly vaccinated populations. Although the exact underlying reasons are still not clear, emerging evidence suggests that a key factor is the replacement of the whole-cell (wP) by the acellular pertussis (aP) vaccine, which is less reactogenic but may induce suboptimal and waning immunity. Differences between vaccines are hypothesised to be cell-mediated, with polarisation of Th1/Th2/Th17 responses determined by the composition of the pertussis vaccine given in infancy. Moreover, aP vaccines elicit strong antibody responses but fail to protect against nasal colonisation and/or transmission, in animal models, thereby potentially leading to inadequate herd immunity. Our review summarises current knowledge on vaccine-induced cellular immune responses, based on mucosal and systemic data collected within experimental animal and human vaccine studies. In addition, we describe key factors that may influence cell-mediated immunity and how antigen-specific responses are measured quantitatively and qualitatively, at both cellular and molecular levels. Finally, we discuss how we can harness this emerging knowledge and novel tools to inform the design and testing of the next generation of improved infant pertussis vaccines.

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Trial design and protocol of randomized controlled trial comparing the efficacy of oral mefenamic acid, paracetamol and placebo for analgesic prophylaxis in childhood vaccination (MAP VaC trial)

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20212844 ◽

2021 ◽

Vol 8 (3) ◽

pp. 218

Author(s):

Rachna Pasi ◽

Thirunavukkarasu Arun Babu ◽

Vinoth Kumar Kallidoss

Keyword(s):

Randomized Controlled Trial ◽

Mefenamic Acid ◽

Vaccine Coverage ◽

Controlled Trial ◽

Childhood Vaccination ◽

Vaccine Hesitancy ◽

Immunization Schedule ◽

Vaccine Administration ◽

Randomized Controlled ◽

National Immunization

Background: Needle related pain has been one of the most important concerns for parents of children receiving vaccination. Non-steroidal anti-inflammatory drugs (NSAIDs) like paracetamol and mefenamic acid have been commonly used as analgesics in pediatric population. However, prophylactic administration of these drugs for analgesia during vaccination has not been studied. The main objective of this study is to compare the efficacy of prophylactic paracetamol, mefenamic acid and placebo on needle pain associated with vaccination.Methods: This is a three-arm parallel, triple blind, randomized controlled trial. Children aged 6 weeks to 7 years who need immunization as per national immunization schedule and reporting to pediatric outpatient department (OPD) at tertiary level hospital, AIIMS Mangalagiri, Andhra Pradesh, will be included. All participants will be randomly allotted to any of the three groups by computer based block randomization. Each participant will be given any one of the three drugs as per their allocation. Vaccination will be done as per national immunization schedule after 30 minutes of drug administration. Face, legs, activity, cry, consolability (FLACC) scoring will be done immediately after vaccine administration and repeated at 15 minutes and 30 minutes. All personnel involved in randomization, drug and vaccine administration, FLACC scoring and statistical analysis will be blinded along with parents and children enrolled in the study.Conclusions: If this intervention study shows evidence of a difference between drug and placebo signifying reduction in vaccine related pain with these drugs, this will have a huge impact on National Immunization programme by improving compliance, vaccine coverage and by reducing vaccine hesitancy.Trial registration: Clinical trials registration number is CTRI/2021/01/030239.

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SARS-CoV-2 Biology Insights, Part IV.Antibody-Dependent Enhancement (ADE) and the tricky “Herd Immunity”: narrative review (Preprint)

10.2196/preprints.21599 ◽

2020 ◽

Author(s):

Laura Lafon-Hughes

Keyword(s):

Viral Infection ◽

Viral Entry ◽

Neutralizing Antibodies ◽

Vaccine Development ◽

Whooping Cough ◽

Common Knowledge ◽

Herd Immunity ◽

Life Quality ◽

Host Cells ◽

System P

BACKGROUND It is common knowledge that vaccination has improved our life quality and expectancy since it succeeded in achieving almost eradication of several diseases including chickenpox (varicella), diphtheria, hepatitis A and B, measles, meningococcal, mumps, pneumococcal, polio, rotavirus, rubella, tetanus and whooping cough (pertussis) Vaccination success is based on vaccine induction of neutralizing antibodies that help fight the infection (e.g. by a virus), preventing the disease. Conversely, Antibody-dependent enhancement (ADE) of a viral infection occurs when anti-viral antibodies facilitate viral entry into host cells and enhance viral infection in these cells. ADE has been previously studied in Dengue and HIV viruses and explains why a second infection with Dengue can be lethal. As already reviewed in Part I and Part II, SARS-Cov-2 shares with HIV not only 4 sequences in the Spike protein but also the capacity to attack the immune system. OBJECTIVE As HIV presents ADE, we wondered whether this was also the case regarding SARS-CoV-2. METHODS A literature review was done through Google. RESULTS SARS-CoV-2 presents ADE. As SARS, which does not have the 4 HIV-like inserts, has the same property, ADE would not be driven by the HIV-like spike sequences. CONCLUSIONS ADE can explain the failure of herd immunity-based strategies and will also probably hamper anti-SARS-CoV-2 vaccine development. As reviewed in Part I, there fortunately are promising therapeutic strategies for COVID-19, which should be further developed. In the meantime, complementary countermeasures to protect mainly the youth from this infection are presented to be discussed in Part V Viewpoint.

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Hepatitis A virus knowledge and immunization attitudes and practices in the United Arab Emirates community

Scientific Reports ◽

10.1038/s41598-020-80089-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kamel A. Samara ◽

Hiba J. Barqawi ◽

Basant H. Aboelsoud ◽

Moza A. AlZaabi ◽

Fay T. Alraddawi ◽

...

Keyword(s):

United Arab Emirates ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Immunization Schedule ◽

National Immunization Program ◽

Immunization Program ◽

Attitudes And Practices ◽

Awareness Campaigns ◽

Positive Attitudes ◽

National Immunization

AbstractAnnually, 1.5 million cases of hepatitis A infection occur worldwide. The United Arab Emirates (U.A.E.) has seen a decrease in infection rates and seroprevalence coupled with an increase in the average age of infection. This study aimed to assess the U.A.E. society’s hepatitis A knowledge, and attitudes and vaccination practices, with the applicability of its introduction into the local immunization schedule. A self-administered, 50-item questionnaire was used to collect data from the four most populous cities in the U.A.E., between January and March 2020. A total of 458 responses were collected and analysed using IBM-SPSS-26, R-4.0.0 and Matplotlib-v3.2.1. Females had better attitudes (P = 0.036), practices (P < 0.0005), immunization schedule knowledge (AOR = 3.019; CI 1.482–6.678), and appreciation of the immunization schedule (AOR = 2.141; CI 1.310–3.499). A higher level of perceived knowledge was associated with an actual better knowledge (P < 0.0005), better practices (P = 0.011), and increased willingness to get vaccinated (AOR = 1.988; CI 1.032–3.828). Respondents were more likely to vaccinate their children against HAV if the vaccine were introduced into the National Immunization Program (P < 0.0005). Overall, disease knowledge was lacking but with positive attitudes and poor practices. There is high trust in the National Immunization Program and a potential for improving poor practices through local awareness campaigns.

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Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽

10.3390/vaccines9030256 ◽

2021 ◽

Vol 9 (3) ◽

pp. 256

Author(s):

Pedro Plans-Rubió

Keyword(s):

Vaccination Coverage ◽

Action Plan ◽

Herd Immunity ◽

World Health ◽

Immunization Programs ◽

National Immunization ◽

The World ◽

Measles Vaccination ◽

The Mean ◽

Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

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Factors Influencing SARS-CoV-2 Vaccine Acceptance and Hesitancy in a Population-Based Sample in Italy

Vaccines ◽

10.3390/vaccines9060633 ◽

2021 ◽

Vol 9 (6) ◽

pp. 633

Author(s):

Marco Del Riccio ◽

Sara Boccalini ◽

Lisa Rigon ◽

Massimiliano Alberto Biamonte ◽

Giuseppe Albora ◽

...

Keyword(s):

Online Survey ◽

Adult Population ◽

Herd Immunity ◽

Population Based ◽

Vaccine Hesitancy ◽

Convenience Sample ◽

Major Barrier ◽

Trust In Institutions ◽

General Adult Population ◽

High Level

Vaccination against SARS-CoV-2 represents an effective and safe tool to protect the population against the disease; however, COVID-19 vaccine hesitancy could be a major barrier to achieving herd immunity. Despite the severity of the current pandemic, the population’s intention to get vaccinated against COVID-19 is still not clear. The aim of this study was to evaluate the intention to get vaccinated against COVID-19 among a convenience sample of the general population resident in Italy and the factors associated with hesitancy and acceptance of the vaccine in the context of the current pandemic before the rolling out of COVID-19 vaccines. An anonymous online survey was diffused among a general adult population living in Italy. Participants aged 18 or older and living in Italy were considered eligible. Incomplete questionnaires were excluded. Overall, 7605 valid questionnaires were collected. Most of the participants (81.9%) were inclined to get vaccinated; male sex (OR 1.38, 95% CI 1.12–1.71), a high level of trust in institutions (OR 3.93, 95% CI 2.04–7.83), and personal beliefs about high safety of COVID-19 vaccines (OR 56.33, 95% CI 31.57–105.87) were found to be among the significant predictors of COVID-19 acceptance. These data could help design larger studies to address the problem of COVID-19 vaccine hesitancy in the current pandemic.

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Child Saving and Child Spacing in Africa: The Evolution of a Concept

International Journal of Health Services ◽

10.2190/p4fe-fqkb-gtky-wj3n ◽

1973 ◽

Vol 3 (4) ◽

pp. 765-768

Author(s):

Robert D. Wright

Keyword(s):

Family Planning ◽

Child Health ◽

Maternal And Child Health ◽

Child Death ◽

Child Health Services ◽

Tropical Africa ◽

Low Visibility ◽

Child Spacing ◽

High Level ◽

And Child Health

In tropical Africa the primordial presence of enormous young child death rates precludes a successful frontal attack on birth rates through specialized programs. Experience in Nigeria indicates that gradual, quiet pressure can influence the power structure to tolerate and eventually espouse child spacing as an integral part of a program of services for child saving. The approach involves four phases: a low visibility start; obtaining high level acceptance; establishment of a federal training center to train cadres for state training programs; and deployment of trained primary care auxiliaries as a local maternal and child health-family planning service. In tropical Africa governmental attitudes toward family planning range from positive policy, to neutrality, to strong opposition. At present most Anglophone countries are favorable. Most Francophone countries are opposed. The general trend is toward a more favorable attitude toward family planning when it is a part of maternal and child health services.

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The Fluctuation of Serum PTH Level of Type 2 Diabetes mellitus’ Patient on Oral Dapagliflozin

Austin Journal of Endocrinology and Diabetes ◽

10.26420/austinjendocrinoldiabetes.2021.1082 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Jiang G ◽

◽

Wenzhou Jiang ◽

Jin Zhou ◽

◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Injection ◽

Diabetes Mellitus Patient ◽

Sglt2 Inhibitors ◽

Case Presentation ◽

Risk Factor Management ◽

Serum Pth ◽

High Level ◽

In The Beginning

Background: Sodium-Glucose co-Transporter 2 (SGLT2) inhibitors, a set of relatively new medicines treating type 2 diabetes showed a great number of merits in control of glycemia and cardiovascular risk factor management, but also attracted attention on bone fracture. One of those major effects on skeleton might be Parathyroid Hormone (PTH). Case Presentation: We present the case of a 68-year-old female patient with type 2 diabetes on insulin injection and oral acarbose therapy who was admitted with constant hyperglycemia to our hospital. In the beginning, she showed a high level of serum PTH. In the process of oral dapagliflozin treatment, PTH concentration firstly increased and then decreased to the normal range. Diagnostic tests are completed to exclude hyperparathyroidism. Conclusions: The use of SGLT2 inhibitors among diabetes and nondiabetic populations is increasing, a great deal of undiscovered influence, such as hormone and ion fluctuation needs further investigation.

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