Parental preferences for a mandatory vaccination scheme in England; a discrete choice experiment

Background: Mandatory vaccination has been mooted to combat falling childhood vaccine uptake rates in England. This study investigated parental preferences for a mandatory vaccination scheme. Methods: Discrete choice experiment. Six attributes were investigated: vaccine (MMR, 6-in-1), child age group (2 years and older, 5 years and older), incentive (130 GBP cash incentive for parent, 130 GBP voucher incentive for child, no incentive), penalty (450 GBP fine, parent not able to claim Child Benefits for an unvaccinated child, unvaccinated child not able to attend school or day care), ability to opt out (medical exemption only, medical and religious belief exemption), and compensation scheme (not offered, offered). Mixed effects conditional logit regression models were used to investigate parental preferences and relative importance of attributes. Findings: Participants were 1,001 parents of children aged 5 years and under (53% female, mean age=33.6 years, SD=7.1, 84% white British). Parental preferences were mostly based on incentives (slight preference for cash pay-out for the parent versus a voucher for the child) and penalties (preference for schemes that did not allow unvaccinated children to attend school or day care and those that withheld financial benefits for parents of unvaccinated children). Parents also preferred schemes that: offered a compensation scheme, mandated the 6-in-1 vaccine, mandated vaccination in children aged 2 years and older, and that offered only medical exemptions. Interpretation: Results can inform policymakers' decisions about how best to implement a mandatory childhood vaccination scheme in England. Funding: Data collection was funded by a British Academy/Leverhulme Small Research Grants (SRG1920\101118).

Problems of administrative and legal protection of the rights of participants in the educational process.

This article describes the problems of administrative and legal protection of the rights of participants in the educational process. The normative legal acts regulating the issues of vaccination of the participants of the educational process, creation of a safe educational environment, abidance of the constitutional rights and freedoms of humans and citizens, provision of their guarantees are indicated in the article. Also mentioned the urgency of the problem of bullying in the education, which became more actively discussed in society during the global «coronavirus» pandemic, when the risk of contamination by the virus was high. A new type of bullying has been reported - coronavirus bullying - a situation where students bully other children or teachers because they are sick or have been infected by covid, or in cases of provoking bullying of parents who have not given their consent to vaccinate their children. This paper analyzes the case law, which leads to the conclusion that there is still a legal problem of distinguishing the jurisdiction of administrative courts from other types of judicial jurisdiction. Also, the lack of unity of case law in appealing decisions, action or inaction of subjects of power, particularly, in matters concerning the right of an unvaccinated child to education, which is extremely relevant today. The legal positions of national courts and decisions of the European Court of Human Rights on the matter of vaccination of participants in the educational process were studied in the article. For further implementation of these problems, the feasibility of further scientific development of this topic was substantiated.

Predictors of time-to-death on children in Tigray regional state, Ethiopia: a retrospective cross sectional study

Background Although, the clinical and socioeconomic condition of Tigray Regional State mothers has been improved along with the decline in the child death rate. However, children’s death rate is still one of the main community serious challenging issues of public health concern. Thus, the main objective of this current investigation was to identify the major predictor factors for short time-to-death in Children in the Tigray Regional State. Methods The study used a secondary data with cross-sectional study design. The information gathered was from 1018 childbirths 5 years prior to the survey. Independent variables such as mother’s demographic variables, child demographic variables, healthiness and environmental factors were considered major hazard predictors of children’s short time-to-death rate. This current investigation used bivariable and multivariable Cox regression model analysis to identify the major statistically significant associations with children’s time-to-death rate. Results One thousand eighteen children under 5 years of age were included in the study. Of them, 50% of the children were males, and the median survival time-to-death of children was 26 months. Overall, the prevalence of experiencing child’s death rate in the Tigray Regional State was 4.2%. The multivariable Cox regression model analysis showed that living rural place of residence (AHR = 19.8; 95% CI: (7.25–54.049)), being unvaccinated child (no) (AHR = 2.76; 95% CI: (1.071–7.11)), and poor wealth index (AHR = 15.4; 95% CI: (2.83–84)) were statistically significant predictors of time-to-death rate of children’s. Conclusion The study recognized that being a rural place of residence, unvaccinated child status (no) and poor wealth index were statistically significant predictors of children’s short time-to-death rate.

Clinically Mild Encephalopathy with a Reversible Splenial Lesion Caused by Influenza B Virus in an Unvaccinated Child

Reversible lesions involved in the splenium of corpus callosum (RESLES) are a rare clinic-radiological condition, whose pathogenesis could be related to infectious events (such as in mild encephalopathy with reversible splenial lesion—MERS), epilepsy or metabolic/electrolyte disorders. MERS is characterized by an acute mild encephalopathy associated with lesions in the splenium of corpus callosum on brain magnetic resonance imaging. Viral infections are commonly associated with this condition and type A influenza is the most common cause. The prognosis is generally favorable with spontaneous resolution of clinical and radiological abnormalities. We report a case report of type B influenza MERS in an 8-year-old unvaccinated girl with complete clinical and radiological recovery.

Molecular and epidemiological characterisation of toxigenic and non-toxigenic C. diphtheriae, C. belfantii and C. ulcerans isolates identified in Spain from 2014 to 2019

This study examines the microbiological and epidemiological characteristics of toxigenic and non-toxigenic Corynebacterium isolates submitted to the national reference laboratory in Spain, between 2014 and 2019, in order to describe the current situation and improve our knowledge regarding these emerging pathogens. Epidemiological information was extracted from the Spanish Surveillance System. Microbiological and molecular characterisation was carried out using phenotypic methods, multilocus sequence typing (MLST), whole genome sequencing (WGS) and core genome MLST (cgMLST). Thirty-nine isolates were analysed. Twenty-one were identified as C. diphtheriae (six toxigenic), 14 as C. belfantii and four as C. ulcerans (three toxigenic). One C. diphtheriae isolate was identified as non-toxigenic tox gene-bearing (NTTB). Ages of patients ranged from one to 89 years, with 10% (3/30) of non-toxigenic and 22% (2/9) of toxigenic isolates collected from children less than 15 years. Twenty-five of the patients were males (17/30 in non-toxigenic; 8/9 in toxigenic). MLST identified 28 sequence types (STs) of which seven were described for the first time in Spain. WGS analysis showed that 10 isolates, including three toxigenic isolates, harbored a variety of antibiotic resistance genes in addition to the high prevalence of penicillin resistance phenotypically demonstrated. Phylogenetic analysis revealed one cluster of isolates from family members. Risk information was available for toxigenic isolates (9/39); three patients reported recent travels to endemic countries and three had contact with cats/dogs. One unvaccinated child with respiratory diphtheria had a fatal outcome. Including non-toxigenic Corynebacterium infections in the disease surveillance and using WGS could further improve current surveillance.

Molecular Characterisation of a Rare Reassortant Porcine-Like G5P[6] Rotavirus Strain Detected in an Unvaccinated Child in Kasama, Zambia

A human-porcine reassortant strain, RVA/Human-wt/ZMB/UFS-NGS-MRC-DPRU4723/2014/G5P[6], was identified in a sample collected in 2014 from an unvaccinated 12 month old male hospitalised for gastroenteritis in Zambia. We sequenced and characterised the complete genome of this strain which presented the constellation: G5-P[6]-I1-R1-C1-M1-A8-N1-T1-E1-H1. The genotype A8 is often observed in porcine strains. Phylogenetic analyses showed that VP6, VP7, NSP2, NSP4, and NSP5 genes were closely related to cognate gene sequences of porcine strains (e.g., RVA/Pig-wt/CHN/DZ-2/2013/G5P[X] for VP7) from the NCBI database, while VP1, VP3, VP4, and NSP3 were closely related to porcine-like human strains (e.g., RVA/Human-wt/CHN/E931/2008/G4P[6] for VP1, and VP3). On the other hand, the origin of the VP2 was not clear from our analyses, as it was not only close to both porcine (e.g., RVA/Pig-tc/CHN/SWU-1C/2018/G9P[13]) and porcine-like human strains (e.g., RVA/Human-wt/LKA/R1207/2009/G4P[6]) but also to three human strains (e.g., RVA/Human-wt/USA/1476/1974/G1P[8]). The VP7 gene was located in lineage II that comprised only porcine strains, which suggests the occurrence of independent porcine-to-human reassortment events. The study strain may have collectively been derived through interspecies transmission, or through reassortment event(s) involving strains of porcine and porcine-like human origin. The results of this study underline the importance of whole-genome characterisation of rotavirus strains and provide insights into interspecies transmissions from porcine to humans.

Influenza associated with circulatory collapse and atrioventricular block in an unvaccinated child with repaired CHD

Symptomatic, circulatory collapse occurred in an unvaccinated child with repaired congenital heart and a backup pacemaker during an Influenza B viral infection with complete atrioventricular block and pacemaker non-capture. Ventricular arrhythmias occurred during her collapse. Atrioventricular conduction recovered within 24 hours. Influenza-associated cardiac inflammation can adversely affect patients with repaired CHD. Proactive immunisation is strongly recommended.

Implementation of Lot Quality Assurance Sampling Using Mobile Data Collection Tools to Assess Vaccination Coverage After Synchronized Polio Vaccination in the Province of Camiguin, Philippines

ABSTRACTObjectivesThe study assessed immunization coverage after one round of synchronized Polio vaccination in Camiguin, Philippines. It included classifying the coverage level, identifying the level of awareness and source of information for the campaign, describing the reasons for non-vaccination, and pilot a mobile data collection platform.MethodsLot Quality Assurance Sampling (LQAS) is a household survey using a multi-stage clustered technique. Sixty respondents per municipality, divided into 6 clusters, with one barangay considered as one cluster. Barangays were selected with probability proportional to size. Households were taken by systematic sampling. One child was randomly selected if there were multiple children in a household. Data collection was done using KoBo Toolbox.ResultsThe municipalities of Mahinog and Sagay had two unvaccinated children each. Guinsiliban and Mambajao only had one unvaccinated child each. Catarman did not have any unvaccinated child. The reasons for non-vaccination were the lack of means of validation, fear of side effects, and the absence of a caregiver at the time of vaccination. The most common sources of information were health workers and television.DiscussionCoverage for all five municipalities of the province passed the decision value. The main reason for non-vaccination was the lack of means of validation, which emphasizes the need for high quality finger marking and the provision of vaccination cards. Only Mahinog did not pass the threshold for campaign awareness. LQAS is useful for validating areas with concerns on the set target population and administrative coverage. Mobile data collection through KoBo ToolBox is a useful method for field use. It is easily adaptable, user-friendly, and allows for immediate data validation and analysis.