Special Issue "Health Technology Assessment (HTA) of New vaccines and New Target Groups and Impact Evaluation and Effectiveness of Current Vaccination Strategies"

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Vaccines and Society".

Deadline for manuscript submissions: 30 September 2021.

Special Issue Editors

Prof. Dr. Paolo Bonanni
E-Mail Website
Guest Editor
University of Florence, Health Sciences, Florence, Italy
Interests: epidemiology and prevention of infectious diseases; health technology assessment of new vaccines and new vaccination strategies; seroepidemiology studies of vaccine-preventable infectious diseases; public-health policies.
Dr. Angela Bechini
E-Mail Website
Guest Editor
Department of Health Sciences, Section of Hygiene, Preventive Medicine, and Public Health, University of Florence, Florence, Italy
Interests: epidemiology and prevention of infectious diseases; surveillance of infectious diseases; seroepidemiology studies of vaccine-preventable infectious diseases; impact assessment of vaccination strategies in the general population and risk groups (healthcare workers, pregnant women, diabetic patients, asplenic patients, adolescents)
Dr. Sara Boccalini
E-Mail Website
Guest Editor
Department of Health Sciences, University of Florence, 50134 Florence, Italy
Interests: epidemiology and prevention of infectious diseases; health technology assessment (HTA) and pharmaeconomic evaluations; seroepidemiology studies of vaccine-preventable infectious diseases.

Special Issue Information

Dear colleagues,

In the current global health scenario, there is a strong need for evidence-based choices to rationalize the use of limited available resources and maximize results in terms of health, especially for prevention activities.

The use of clear, robust, and shared criteria to provide the most effective and efficient prevention interventions against infectious diseases is summarized into multidisciplinary analysis, such as the approach of health technology assessment (HTA). In addition, when a prevention program is implemented, it is also necessary to assess the impact of immunization activities on the target population.

The aim of the current Special issue is to collect HTA studies on vaccination that can provide careful and indepth analysis of both epidemiological/clinical data and organization vaccination practices, also including the economic evaluations (budget-impact, cost-effectiveness, cost-utility, and cost-benefit analyses) of new vaccines (such as RSV and SARS-CoV-2) or new vaccination strategies.

Moreover, the Special Issue focuses on the impact assessment of vaccination programs already in place with the aim to provide evidence-based research on the effectiveness of vaccination programs.

Particularly, to measure the impact of prevention activities, research articles on the impact of vaccination programs analyzing the reduction of notifications, hospitalizations, or deaths due to vaccine-preventable diseases (measles, rubella, varicella, pneumococcal and meningococcal diseases, HPV-related diseases, influenza, rotavirus, and herpes zoster) would be appreciated. Monitoring studies of vaccination coverage trends over time and seroepidemiological studies are also welcome to support health authorities in reassessing their national immunization plans (NIP), considering new vaccination strategies for vaccines already included in the NIP.

The final objective is to give voice to all vaccination practices that, at an acceptable and sustainable cost, can improve the quality of life of all people, from children to adolescents, adults and the elderly, including risk groups (healthcare workers, pregnant women, adolescents and the elderly, and people with comorbidities such as diabetes and asplenia).

Prof. Dr. Angela Bechini
Prof. Paolo Bonanni
Prof. Sara Boccalini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaccine
  • vaccination strategies
  • prevention
  • health technology assessment
  • vaccine effectiveness
  • cost-effectiveness analysis
  • budget-impact analysis
  • vaccination coverage
  • seroprevalence

Published Papers (8 papers)

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Research

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Article
The Perception and Attitudes toward COVID-19 Vaccines: A Cross-Sectional Study in Poland
Vaccines 2021, 9(4), 382; https://doi.org/10.3390/vaccines9040382 - 14 Apr 2021
Cited by 1 | Viewed by 2133
Abstract
Vaccine hesitancy is a major threat to the success of COVID-19 vaccination programs. The present cross-sectional online survey of adult Poles (n = 1020) expressing a willingness to receive the COVID-19 vaccine was conducted between February and March 2021 and aimed to [...] Read more.
Vaccine hesitancy is a major threat to the success of COVID-19 vaccination programs. The present cross-sectional online survey of adult Poles (n = 1020) expressing a willingness to receive the COVID-19 vaccine was conducted between February and March 2021 and aimed to assess (i) the general trust in different types of vaccines, (ii) the level of acceptance of the COVID-19 vaccines already in use in Poland (BNT162b2 by BioNTech/Pfizer, mRNA-1273 by Moderna and AZD1222 by Oxford/AstraZeneca) as well as eight vaccines approved outside European Union (EU) or in advanced stages of clinical trials, (iii) level of fear of vaccination against COVID-19, and (iv) main sources of information on COVID-19 vaccination. Among all major vaccine technology, the highest level of trust was observed for the mRNA platform, with a considerable number of surveyed (>20%) not aware of the existence of vaccines produced using the traditional approach (inactivated and live attenuated vaccines). The age of participants was the main factor differentiating the level of trust in a particular vaccine type. Both BNT162b and mRNA-1273 received a high level of acceptance, contrary to AZD1222. From eight vaccines unauthorized in the EU at the moment of study, the CVnCoV (mRNA; CureVac) was met with the highest level of trust, followed by Ad26.COV2.S (vector; Janssen/Johnson&Johnson) and NVX-CoV2373 (protein; Novavax). Sputnik V (vector; Gamaleya Research Institute) was decidedly the least trusted vaccine. The median level of fear (measured by the 10-point Likert-type scale) in the studied group was 4.0, mostly related to the risk of serious allergic reactions, other severe adverse events and unknown long-term effects of vaccination. Female, individuals with a lower level of education and those not seeking any information on the COVID-19 vaccines revealed a higher fear of vaccination. Experts’ materials were the major source of information on COVID-19 vaccines in the studied group. The study shows the level of trust in COVID-19 vaccines can vary much across the producers while the mRNA vaccines are received with a high level of acceptance. It also emphasizes the need for effective and continuous science communication when fighting the pandemic as it may be an ideal time to increase the general awareness of vaccines. Full article
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Article
Model Comparisons of the Cost Effectiveness of Rubella Vaccination Method in Japanese Adults
Vaccines 2021, 9(3), 233; https://doi.org/10.3390/vaccines9030233 - 08 Mar 2021
Viewed by 602
Abstract
The number of rubella cases has increased in Japan, especially among adults. Rubella infection in pregnant females can lead to congenital rubella syndrome (CRS). The Japanese government is promoting vaccination to prevent CRS. This study performs a cost-effectiveness analysis of the following four [...] Read more.
The number of rubella cases has increased in Japan, especially among adults. Rubella infection in pregnant females can lead to congenital rubella syndrome (CRS). The Japanese government is promoting vaccination to prevent CRS. This study performs a cost-effectiveness analysis of the following four methods: (1) females who wished to become pregnant and partners, with an antibody-titer test; (2) females only, with an antibody-titer test; (3) females and males, without an antibody-titer test; (4) females only, without an antibody-titer test. A decision tree model with a hypothetical cohort of 500 males and 500 females was used for the analysis, and the parameters were obtained from previous studies. The number of avoidances of CRS was defined as the effect. Compared to the case where methods were not implemented, the number of CRS cases that can be prevented by implementing the methods was 0.0115589 by (1) and (3) and 0.0147891 by (2) and (4). The cost effectiveness of (1) to (4) was 287,413,677 JPY, 135,050,529 JPY, 388,524,974 JPY, and 197,744,219 JPY, respectively (1 JPY = 0.00963247 USD). Method (2) was the most cost-effective and did not change by sensitivity analysis. We conclude that the vaccination for females only with an antibody-titer test is recommended. Full article
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Article
Attitude and Behaviors towards SARS-CoV-2 Vaccination among Healthcare Workers: A Cross-Sectional Study from Poland
Vaccines 2021, 9(3), 218; https://doi.org/10.3390/vaccines9030218 - 04 Mar 2021
Cited by 16 | Viewed by 1494
Abstract
Healthcare workers are particularly exposed to biological risk during their daily occupational activities. Nowadays, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become one of the most widespread infectious agents. In the current study, we performed a survey on the attitude and behavior [...] Read more.
Healthcare workers are particularly exposed to biological risk during their daily occupational activities. Nowadays, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become one of the most widespread infectious agents. In the current study, we performed a survey on the attitude and behavior of Polish healthcare workers (HCW), which comprise physicians (MD) and administrative healthcare assistants (HA) towards the Coronavirus Disease 2019 (COVID-19) vaccination. Our study involved 2300 subjects (42.17% female; 10.96% MD; 5.87% HA). The evaluation was conducted using a Google Forms survey based on original questions and the Depression, Anxiety and Stress Scale—21 Items questionnaire. HCW significantly more often demonstrated their willingness to get vaccinated against the SARS-CoV-2 as compared to the control group (82.95% vs. 54.31%, respectively). The main concern, as regards all groups, was the development of long-term side effects after getting COVID-19 vaccine. The study revealed that depression significantly affects the willingness to get vaccinated. The readiness was significantly strengthened by positive medical history of recommended vaccinations, fear of catching COVID-19, as well as fear of passing on the disease to the relatives. Overall, the percentage of HCW, who want to be vaccinated against COVID-19 remains unsatisfactory. Further works exploring this subject are needed to take a step closer to achieving the herd immunity in the era of the COVID-19 pandemic. Full article
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Article
Medical Students and SARS-CoV-2 Vaccination: Attitude and Behaviors
Vaccines 2021, 9(2), 128; https://doi.org/10.3390/vaccines9020128 - 05 Feb 2021
Cited by 17 | Viewed by 1847
Abstract
Since physicians play a key role in vaccination, the initial training of medical students (MS) should aim to help shape their attitude in this regard. The beginning of vaccination programs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an excellent time to [...] Read more.
Since physicians play a key role in vaccination, the initial training of medical students (MS) should aim to help shape their attitude in this regard. The beginning of vaccination programs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an excellent time to assess the attitudes held by both medical and non-medical students regarding vaccination. A 51- to 53-item questionnaire including the Depression, Anxiety and Stress Scale was administered to 1971 students (49.21% male; 34.86% MS); two career-related questions were also addressed to the MS. The majority of surveyed students indicated a desire to get vaccinated against SARS-CoV-2, with more medical than non-medical students planning to get vaccinated (91.99% vs. 59.42%). The most common concern about SARS-CoV-2 infection was the risk of passing on the disease to elderly relatives. While conspiracy theories regarding the COVID-19 vaccine are less popular among MS, both groups indicated concerns that vaccines may cause autism is equally common (~5%). Further studies exploring social attitudes towards the SARS-CoV-2 vaccine are a necessary first step to optimizing vaccination programs and achieving herd immunity. Full article
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Article
Knowledge, Attitudes and Practices of Flu Vaccination in Hemodialysis Patients
Vaccines 2021, 9(2), 77; https://doi.org/10.3390/vaccines9020077 - 22 Jan 2021
Viewed by 1172
Abstract
Background: Hemodialysis (HD) patients have an increased risk of morbidity and mortality due to infections. Despite the positive effect of vaccinations, the implementation of this method of prophylaxis is low. Objectives: This study aimed to explore the knowledge, attitudes and practices of flu [...] Read more.
Background: Hemodialysis (HD) patients have an increased risk of morbidity and mortality due to infections. Despite the positive effect of vaccinations, the implementation of this method of prophylaxis is low. Objectives: This study aimed to explore the knowledge, attitudes and practices of flu vaccination among HD patients of two different dialysis centers. Methods: A total of 193 patients (mean age 63.6 years), who voluntarily agreed to participate in an anonymous survey related to influenza vaccination, were enrolled in this cross-sectional study. Results: A total of 45% of patients declared that they took regular, annual flu vaccination. In this group, 87.4% believed that vaccinations were effective. This opinion strongly correlated with the frequency of regular vaccinations (r = 0.56, p < 0.01). Multivariate logistic regression revealed that this opinion is an independent predictor of regular vaccinations with adjusted OR 9.86 (95% CI 4.36, 22.33). Groups of patients who had been irregularly or never vaccinated reject vaccinations for the following reasons: fear of adverse events—29.2%, conviction that vaccination was ineffective—26.4%, and lack of information about vaccination—22.6%. Conclusion: Knowledge among HD patients about the benefits of vaccinations is poor. Therefore, educational activities are required. Active vaccination promotion and education of patients rejecting this method of prevention play a key role in improving standards of care for HD patients. Full article
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Review

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Review
Thrombotic Thrombocytopenia after COVID-19 Vaccination: In Search of the Underlying Mechanism
Vaccines 2021, 9(6), 559; https://doi.org/10.3390/vaccines9060559 - 27 May 2021
Viewed by 2006
Abstract
The rollout of COVID-19 vaccines brings hope for successful pandemic mitigation and getting the transmission of SARS-CoV-2 under control. The vaccines authorized in Europe displayed a good safety profile in the clinical trials. However, during their post-authorization use, unusual thrombotic events associated with [...] Read more.
The rollout of COVID-19 vaccines brings hope for successful pandemic mitigation and getting the transmission of SARS-CoV-2 under control. The vaccines authorized in Europe displayed a good safety profile in the clinical trials. However, during their post-authorization use, unusual thrombotic events associated with thrombocytopenia have rarely been reported for vector vaccines. This led to the temporary suspension of the AZD1222 vaccine (Oxford/AstraZeneca) in various European countries and the Ad26.COV2 vaccine (Janssen/Johnson&Johnson) in the United States, with regulatory bodies launching investigations into potential causal associations. The thromboembolic reactions were also rarely reported after mRNA vaccines. The exact cause of these adverse effects remains to be elucidated. The present paper outlines the hypotheses on the mechanisms behind the very rare thrombotic thrombocytopenia reported after the COVID-19 vaccination, along with currently existing evidence and future research prospects. The following are discussed: (i) the role of antibodies against platelet factor 4 (PF4), (ii) the direct interaction between adenoviral vector and platelets, (iii) the cross-reactivity of antibodies against SARS-CoV-2 spike protein with PF4, (iv) cross-reactivity of anti-adenovirus antibodies and PF4, (v) interaction between spike protein and platelets, (vi) the platelet expression of spike protein and subsequent immune response, and (vii) the platelet expression of other adenoviral proteins and subsequent reactions. It is also plausible that thrombotic thrombocytopenia after the COVID-19 vaccine is multifactorial. The elucidation of the causes of these adverse events is pivotal in taking precautionary measures and managing vaccine hesitancy. It needs to be stressed, however, that the reported cases are currently sporadic and that the benefits of COVID-19 vaccines vastly outweigh their potential risks. Full article
Review
The Strategies to Support the COVID-19 Vaccination with Evidence-Based Communication and Tackling Misinformation
Vaccines 2021, 9(2), 109; https://doi.org/10.3390/vaccines9020109 - 01 Feb 2021
Cited by 9 | Viewed by 3426
Abstract
COVID-19 vaccinations are about to begin in various countries or are already ongoing. This is an unprecedented operation that is also met with a loud response from anti-vaccine communities—currently using all available channels to manipulate public opinion. At the same time, the strategy [...] Read more.
COVID-19 vaccinations are about to begin in various countries or are already ongoing. This is an unprecedented operation that is also met with a loud response from anti-vaccine communities—currently using all available channels to manipulate public opinion. At the same time, the strategy to educate on vaccinations, explain their mechanism of action, and build trust in science is subdued in different world parts. Such actions should go much beyond campaigns promoting the COVID-19 vaccines solely on the information provided by the health institutions and national authorities. In this paper, actions provided by independent expert groups needed to counteract the anti-vaccine propaganda and provide scientific-based information to the general public are offered. These actions encompass organizing groups continuously communicating science on COVID-19 vaccines to the general public; tracking and tackling emerging and circulating fake news; and equipping celebrities and politicians with scientific information to ensure the quality of messages they communicate, as well as public letters, and statements of support for vaccination by healthcare workers, recognized scientists, VIPs, and scientific societies; and no tolerance to false and manipulated claims on vaccination spread via traditional and social media as well as by health professionals, scientists, and academics. These activities should be promptly implemented worldwide, regardless of the current status and availability of the COVID-19 vaccine in a particular region. If we are about to control the pandemic for the sake of public benefit, it is high time to collectively speak out as academic and medical societies with support from decision-makers. Otherwise, the battle will be lost to those who stand against scientific evidence while offering no feasible solution to the problem. Full article
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Review
Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review
Vaccines 2021, 9(1), 16; https://doi.org/10.3390/vaccines9010016 - 30 Dec 2020
Cited by 43 | Viewed by 10489
Abstract
While COVID-19 continues raging worldwide, effective vaccines are highly anticipated. However, vaccine hesitancy is widespread. Survey results on uptake intentions vary and continue to change. This review compared trends and synthesized findings in vaccination receptivity over time across US and international polls, assessing [...] Read more.
While COVID-19 continues raging worldwide, effective vaccines are highly anticipated. However, vaccine hesitancy is widespread. Survey results on uptake intentions vary and continue to change. This review compared trends and synthesized findings in vaccination receptivity over time across US and international polls, assessing survey design influences and evaluating context to inform policies and practices. Data sources included academic literature (PubMed, Embase, and PsycINFO following PRISMA guidelines), news and official reports published by 20 October 2020. Two researchers independently screened potential peer-reviewed articles and syndicated polls for eligibility; 126 studies and surveys were selected. Declining vaccine acceptance (from >70% in March to <50% in October) with demographic, socioeconomic, and partisan divides was observed. Perceived risk, concerns over vaccine safety and effectiveness, doctors’ recommendations, and inoculation history were common factors. Impacts of regional infection rates, gender, and personal COVID-19 experience were inconclusive. Unique COVID-19 factors included political party orientation, doubts toward expedited development/approval process, and perceived political interference. Many receptive participants preferred to wait until others have taken the vaccine; mandates could increase resistance. Survey wording and answer options showed influence on responses. To achieve herd immunity, communication campaigns are immediately needed, focusing on transparency and restoring trust in health authorities. Full article
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