Search Results (145)

Free-roaming dogs (FRDs) pose significant public health and animal welfare challenges globally, particularly in developing nations, where they serve as major reservoirs for zoonotic diseases, especially rabies. Determining the population size of FRDs, their demographic characteristics, and the factors influencing population size is essential for effective dog population management, which constitutes a critical component of rabies control programs. This study aimed to estimate the size and describe the characteristics of the FRD population and evaluate temporal and spatial variations in FRD sightings on the Kasetsart University Kamphaeng Saen Campus, Thailand. Factors influencing population size were assessed using a negative binomial regression model. The campus area was divided into 52 accessible blocks for dog-counting purposes. In 2018 and 2019, each block was surveyed once annually for a comprehensive census. In 2021, each block was surveyed on six occasions, three in the morning and three in the evening, using a photographic recapture method. Dogs sighted were photographed, and their characteristics and spatial coordinates were recorded. The total population sizes of FRDs on campus were documented as 529, 577, and 531 in 2018, 2019, and 2021, respectively. Intact female dogs predominantly constituted the majority of the FRD population. Regression analysis indicated a significant association between the number of FRDs within a block and the number of intact adult female dogs. The percentage of dogs sighted per occasion was significantly higher during evening surveys compared to morning surveys. This study proposes a practical census approach that combines total block counts with photographic recapture to estimate the population of FRDs. The findings offer valuable insights for developing effective dog population management strategies and planning rabies vaccination campaigns. Full article

Introduction: In 2008, Mexico initiated its national HPV vaccination program targeting adolescent girls. This study aims to evaluate the current status of the program, analyzing trends in vaccine acquisition, administration, and coverage over a 16-year period. Materials and Methods: A retrospective longitudinal study was conducted using secondary data from 2008 to 2023. Official records from three major public health institutions—IMSS, ISSSTE, and SSA—were reviewed to assess HPV vaccine procurement and administration. Results: Significant fluctuations were identified in the number of doses acquired, administered, and the corresponding coverage rates. A marked decline was observed between 2019 and 2021, followed by a sharp increase in 2022 and 2023. Over the entire period, an estimated 6.8 million doses were not administered to the intended target population. Furthermore, 2.6 million doses were administered in excess of the number officially acquired, indicating possible discrepancies in data reporting or vaccine inventory management. Discussion: The findings revealed substantial inconsistencies in vaccine procurement, administration, and coverage across institutions. While IMSS and ISSSTE consistently reported coverage below the theoretical target, SSA occasionally exceeded expectations, potentially compensating for deficits elsewhere. Nevertheless, national coverage remained inadequate in several years, with notable disparities between institutions. These gaps highlight systemic weaknesses in program coordination, planning, and data transparency, contributing to millions of unvaccinated individuals. Conclusions: This study offers a comprehensive analysis of Mexico’s HPV vaccination program, uncovering critical irregularities in its implementation. Challenges include inaccurate target population estimation, inconsistencies between vaccine acquisition and administration, and limited data reliability. Despite some progress in recent years, particularly in the post-pandemic years, the program requires urgent restructuring. This includes implementing a national catch-up strategy, expanding vaccine eligibility, and strengthening surveillance systems to ensure equitable and effective coverage toward the elimination of cervical cancer. Full article

Background/Objectives: Porcine circovirus type 2d (PCV2d) is the predominant genotype associated with porcine circovirus-associated disease (PCVAD), leading to significant economic losses. In South Korea, current vaccine lot-release testing relies on a T/C-ratio-based guinea pig assay, which lacks scientific justification and methodological robustness. This study aimed to develop and validate a statistically defined in-house ELISA using rabbit-derived polyclonal antibodies against PCV2d for the standardized evaluation of immunogenicity. Methods: Polyclonal IgG was generated by immunizing a rabbit with inactivated PCV2d, and it was purified through Protein A chromatography. Guinea pigs (n = 18) were immunized with IMMUNIS^® DMVac, an inactivated PCV2d vaccine candidate developed by WOOGENE B&G, at different doses. In-house ELISA parameters were optimized (antigen coating, blocking agent, and substrate incubation), and analytical performance was evaluated by ROC, linearity, reproducibility, and specificity. Sera from guinea pigs and pigs were analyzed under validated conditions. Results: The optimal performance was achieved using 10⁵ genomic copies/mL of the antigen coating and a 5% BSA blocking agent. The assay showed strong diagnostic accuracy (AUC = 0.97), reproducibility (CVs < 5%), and linearity (R² = 0.9890). Specificity tests with PCV2a, PCV2b, and PRRSV showed minimal cross-reactivity (<7%). The cross-species comparison revealed a positive correlation (R² = 0.1815) and acceptable agreement (bias = −0.21) between guinea pig and porcine sera. The validated cut-off (S/P = 0.4) enabled accurate classification across both species and aligned well with commercial kits. Conclusions: The in-house ELISA offers a robust, reproducible, and scientifically validated platform for immunogenicity verification, supporting its application in Korea’s national lot-release system. Homologous competition assays with PCV2d are planned to further confirm antigen specificity. Full article

Background/Objectives: Emergency Medical Services (EMS) clinicians in the US have high COVID-19 vaccine hesitancy rates and often do not receive primary vaccinations or subsequent boosters. The extent of booster attrition following initial vaccination and first booster dose in EMS clinicians is unknown. Our objective was to evaluate the prevalence and drivers of COVID-19 booster attrition in EMS clinicians. We hypothesized that booster attrition is common among EMS clinicians and associated with various EMS characteristics. Methods: This study was a cross-sectional analysis of nationally certified civilian EMS clinicians aged 18–85 years old. An electronic survey was distributed, which included an evaluation of vaccination status, booster acceptance, willingness to receive future boosters, perceived risk of contracting COVID-19 from the Understanding America Survey (8 items), and mistrust of healthcare organizations using the Medical Mistrust Index (MMI) (7 items). These data were combined with demographic and work-related characteristics from the National Registry of EMTs dataset. A multivariable logistic regression model (OR, 95% CI) was used to describe booster attrition associations between demographics, work-related characteristics, perceived risk, and medical mistrust. Results: A total of 1902 respondents met initial inclusion criteria. Within this group, 78% were COVID-19 vaccinated, and an additional 65% received a booster. Of these, 37% reported not planning to receive any other booster treatments following the first booster. Primary reasons for not continuing with subsequent boosters include confusion among experts on efficacy (59%), severe side effects (38%), the belief that COVID-19 is not a threat (26%), the belief in natural immunity (25%), and the belief that boosters are not required (23%). Odds of planning to receive another booster increased with receiving a flu vaccine (5.03, 3.08–8.22) and urban environment (1.96, 1.19–3.24, referent rural). In comparison, the odds of planning to receive another booster were lower for paramedics (0.56, 0.38–0.83, referent EMT) and fire agencies (0.53, 0.31–0.89, referent hospital). As the perceived risk of COVID-19 and medical mistrust decrease, the odds of planning to receive another booster increase (perceived risk: 1.98, 1.41–2.78; trust: 4.12, 3.21–5.28). Conclusions: The rate of booster attrition following receipt of one booster is high, at 37%. While there are associations with EMS demographic and workforce characteristics, further exploration is necessary to define the drivers and potential consequences of high booster attrition in the EMS clinician community. Full article

Influenza poses a significant public health threat, causing millions of severe cases and hundreds of thousands of deaths annually. Vaccination remains the most effective measure to reduce transmission, complications, and the strain on healthcare systems. Despite its importance, vaccination uptake remains suboptimal among college students, a key population for infectious disease transmission and a target group for public health interventions. The primary objective of this study was to examine the psychological and contextual determinants of influenza vaccination among college students in Israel, utilizing the Theory of Planned Behavior (TPB) as the guiding framework. A cross-sectional online survey was conducted among 591 students at Ashkelon Academic College between April and May 2023. The questionnaire included validated items assessing attitudes toward vaccination, subjective norms, perceived behavioral control, and vaccination history. Hierarchical logistic regression was used to assess the predictive power of these variables in explaining actual vaccination behavior. The results indicated that prior vaccination was the strongest predictor of current influenza vaccine uptake (OR = 38.7, p < 0.001). Positive attitudes (e.g., belief in vaccine protection), strong social influences (e.g., parental vaccination behavior and trust in healthcare professionals), and high perceived behavioral control (e.g., accessibility and convenience) were all significantly associated with increased vaccination likelihood. The final model explained 68% of the variance in vaccination behavior (Nagelkerke R² = 0.68, p < 0.001). These findings affirm the TPB as a robust framework for understanding vaccination behavior and underscore the importance of habitual vaccination, public trust, and systemic accessibility. The study contributes to the field by illustrating how national healthcare infrastructure interacts with individual-level beliefs to shape preventive health actions. Practical applications include the development of targeted interventions to promote first-time vaccination, address vaccine safety concerns, and leverage trusted social networks. Future research should investigate how digital communication, policy variation, and sociocultural context influence the components of the TPB across diverse populations. Full article

Background: Globally, pneumonia claims the lives of about 700,000 children under the age of 5 every year. Pneumococcal conjugate vaccine (PCV) was introduced in India phase-wise, beginning in high-burden states, and the rollout was completed nationwide by 2021—representing a major initiative by the Ministry of Health and Family Welfare (MoHFW). Despite the challenges posed by the COVID-19 pandemic, the campaign succeeded in maintaining progress and achieving nationwide coverage. This narrative review highlights the significant decisions, processes, and coordinated efforts of the various stakeholders involved that led to this successful PCV rollout. Methodology: A comprehensive desk review of both published and unpublished literature relevant to pneumonia burden and the efficacy and effectiveness of PCVs, along with documentation of PCV introduction and the scale-up was carried out. Results: The documentation of the PCV journey has been broken down into four sections: pre-introduction, PCV Phase-I introduction, pan-India rapid expansion, and the period post-introduction. Since the nationwide rollout in 2021, PCV coverage in India has steadily increased, reflecting successful immunization efforts. WUENIC, which is an annual WHO, and UNICEF estimates of national immunization coverage also show a positive trend in vaccination coverage (PCV booster coverage = 25% (2021), rising to 83% (2023), aligning with the goals of the WHO and UNICEF’s Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD). Conclusions: The phased rollout was an ambitious effort by the MoHFW, which was particularly challenging given the overlap with the COVID-19 pandemic. Despite these hurdles, the MoHFW, along with strong collaboration from development partners and stakeholders, successfully navigated the complex rollout. Future studies on the role of PCVs in reducing antibiotic resistance and the economic benefits of PCV introduction could help policymakers sustain funding and prioritize vaccine procurement decisions. Full article

African swine fever (ASF) has had a devastating impact on Vietnam’s swine industry since its introduction in Vietnam in 2019, leading to the culling of six million pigs. This paper aimed to review the epidemiological dynamics of ASF in Vietnam and measures applied to control the disease. ASF progressed through an initial epidemic phase (2019–2020) and has transitioned into a more endemic phase (2021–2024). The disease spread rapidly during the epidemic phase, driven by human-mediated transmission routes and inadequate biosecurity practices, particularly on smallholder farms. To control ASF, the Vietnamese government endorsed a national control plan that included biosecurity enhancements, disease surveillance, establishing ASF-free compartments, researching and evaluating ASF vaccines, and strengthening the capacity of veterinary services. While these measures have helped reduce the number of outbreaks, challenges persist, including the emergence of recombinant ASF strains, limited vaccine adoption, and gaps in the veterinary infrastructure. ASF has substantially changed Vietnam’s swine industry, shifting toward reducing small-scale household farming and increasing professional households and large-scale farms. As ASF has transitioned into an endemic phase, sustainable strategies focusing on continuous monitoring, improved vaccination coverage, and education programs are essential in order to mitigate its impacts and ensure the resilience of Vietnam’s swine industry. Full article

Introduction: In 2023, India’s National Technical Advisory Group on Immunization (NTAGI) recommended the inclusion of typhoid conjugate vaccine (TCV) in the Universal Immunization Programme (UIP). However, introducing TCV, an additional injectable vaccine (AIV), will potentially increase the number of injections administered in a single visit to a maximum of five (if given at the 9 to 12 months touchpoint) or four (if given in the second year of life). In this context, the present study aimed to explore the perspectives of program managers, service providers, and caregivers regarding introduction of an AIV in a single visit under the UIP. Methods: A mixed-method study was undertaken wherein quantitative data was collected by telephonic surveys, and qualitative data by key informant interviews (KIIs) and focus group discussions (FGDs). Purposive sampling encompassed eight states, eight districts, eight planning units, and 32 session sites. The qualitative data were thematically analyzed manually using Excel, while the quantitative data was analyzed using STATA 17. Results: A total of 1140 telephonic surveys, 96 KIIs, and 16 FGDs were conducted. The study revealed that program managers mentioned maternal emotional reactions as a significant concern and backed AIV introduction at the 9–12 months touchpoint. Vaccinators and community mobilizers favored the 16–24 months window with combined presentations and mentioned single-dose vials as the preferred approach for vaccine delivery. Caregivers acknowledged the benefits of vaccination but expressed discomfort and fear regarding multiple injections to the child in a single visit. Caregivers expressed a preference for a combination vaccine. No preference was reported among caregivers for the introduction of AIV to the 9–12 or 16–24 months touchpoints. Conclusion: Stakeholders’ perspectives on introducing an additional injectable vaccine in a single visit under the UIP are diverse. These will be helpful in developing an effective strategy for the future introduction of AIV under UIP. Full article

Background/Objectives: In 2022, the full-scale invasion in Ukraine forced over 6 million Ukrainians, primarily mothers and children, to seek safety outside of the country. This massive influx has posed a significant challenge to the Polish healthcare system, particularly regarding routine vaccination for children. This study aims to examine the vaccination intentions of displaced Ukrainian mothers, their compliance with the Polish National Immunisation Programme (PNIP), and the factors that influence these intentions. Methods: A web-based survey (June–July 2023) was conducted among Ukrainian mothers in Poland. The questionnaire assessed the importance placed on vaccination, knowledge of PNIP, and concerns related to displacement and vaccination. Hierarchical logistic regression identified key determinants. Results: Among 2572 respondents, 64.5% reported that their children had received only some or none of the recommended vaccines. Key barriers included unfamiliarity with PNIP, limited knowledge of vaccines, and concerns about vaccine side effects. Of mothers whose children had not followed PNIP, 41.7% intended to vaccinate, 33.1% refused, and 25.2% were undecided. Regression analysis identified perception of vaccination importance as the strongest predictor. Partial adherence to PNIP doubled vaccination likelihood, while a firm plan to return to Ukraine reduced it 2.4 times. Mistrust in vaccines increased refusal risk tenfold. The final model confirmed mothers’ attitudes towards vaccination and future plans (return to Ukraine) as dominant factors. Conclusions: This study underscores the complex determinants shaping vaccination decisions in conflict-displaced communities. It provides insights for public health strategies to enhance vaccine uptake by reducing access barriers, restoring trust, and strengthening vaccine literacy. Full article

Background: Since 1974, Essential Programme on Immunisation managers from ten Central African countries meet yearly with partners to review progress made and share experiences and lessons learned from the implementation of immunization programmes. The 2024 meeting occurred in Kinshasa, Democratic Republic of Congo, in September 2024. This conference report summarizes the key takeaways from discussions on using immunization data for decision-making, the implementation of the Big Catch-Up (BCU) initiative to reduce the burden of zero-dose children, and progress and challenges in introducing selected new vaccines. Conference Takeaways: Inaccurate administrative data on routine immunization observed in most countries, compared to WHO/UNICEF Estimates of National Immunization Coverage and national survey estimates, affect timely decisions to improve the Expanded Programme on Immunization (EPI) performance. Five countries in Central Africa are among the priority countries of the BCU initiative but, as of the end of August 2024, are yet to formally start its implementation. Cameroon and Central African Republic introduced the malaria vaccine in January 2024 and August 2024, respectively, while the Democratic Republic of Congo, Chad, and Burundi have planned to do so by 2025. Conclusions and Recommendations: Meeting participants put forward several recommendations for countries and immunization partners, including but not limited to (i) investing more in routine immunization data quality assurance to better use data to inform decisions, (ii) accelerating the implementation of the BCU initiative to close the immunity gap resulting from routine immunization disruptions due to the COVID-19 pandemic, (iii) updating malaria vaccine introduction plans to invest more in demand generation and community engagement, and (iv) learning from Cameroon’s experience in tackling hesitancy to human papilloma virus vaccine. It is critical to set up an appropriate mechanism for monitoring the implementation of these recommendations. Full article

Background: This study aims to analyze the vaccination status and factors influencing delayed vaccination among toddlers born to hepatitis B surface antigen (HBsAg)-positive mothers. Methods: Data of HBsAg-positive mothers between 1 January 2021 and 31 December 2022 were provided by the Suzhou Maternal and Child Health Care and Family Planning Service Center. The vaccination records were obtained from the Jiangsu Province Immunization Service Management Information System. Logistic regression analysis was used to analyze influencing factors of delayed vaccination. Results: A total of 4250 toddlers born to HBsAg-positive mothers were documented. The data revealed that the first dose of the hepatitis B vaccine was administered to 100% of the toddlers. In addition, the coverage of the National Immunization Program (NIP) vaccines among these toddlers ranged from 92.9% to 99.4%. The proportion of delayed NIP vaccination varied between 0% and 12.2%. The proportion of delayed Bacillus Calmette–Guérin (BCG) vaccination was 11.3%, with the delay predominantly observed between 4 and 6 months. Notably, the proportion of delayed BCG vaccination among the toddlers born to HBsAg-positive mothers was significantly higher than that in the general population. Additionally, the proportion of the first dose of non-NIP vaccines was 3.3–36.4%, and the proportion of DTaP-IPV/Hib was 27.0%. Logistic regression analysis revealed that the regional level, the mother’s human papillomavirus (HPV) vaccination status, and the infant’s birth weight were significant factors influencing the timeliness of vaccination. Conclusions: Although the vaccination status of toddlers born to HBsAg-positive mothers in Suzhou city remains stable, the issue of delayed vaccination requires attention. It is essential to continue strengthening targeted vaccine education to reduce vaccine hesitancy and improve the rate of timely vaccination. Full article

Background/Objectives: The Italian National Plan for Vaccine Prevention 2017–2019 recommended tetanus, diphtheria, and acellular pertussis vaccines (Tdap) for pregnant women, irrespectively of their immunization history. This study aims to describe the coverage rate trends for Tdap vaccination in pregnancy and evaluate the differences by socioeconomic status. Methods: This is a retrospective analysis within a health equity audit of the Local Health Authority of Reggio Emilia on vaccination in pregnancy from 2018 (a local vaccination campaign) to 2023. All women residents in our area who gave birth during that period were included and linked to the electronic Registry of Immunization Service. The vaccination coverage in pregnant women was analyzed over time and stratified by pregnant women’s sociodemographic and obstetric characteristics. Results: The coverage of Tdap in pregnant women of the Province of Reggio Emilia increased from 15.9% in 2018 to 53.9% in 2023. The coverage was higher among Italians, women with higher educational levels (aPR 1.49 (CI95%1.41–1.57)), within 31–35 years of age (aPR 1.37 (CI95% 1.28–1.46)), occupied, nulliparous (aPR multiparous vs nulliparous: 0.76 (0.74; 0.78)), and followed in the private sector (aPR 1.07 (1.03–1.11)). Inequalities in coverage increased during the study period for women assisted in the private sector, while decreased or remained stable for women assisted in the context of public services. Conclusions: The vaccination promotion campaign in Reggio Emilia helped increase Tdap coverage in pregnancy from 16 to 53%. Nevertheless, the coverage rates of the most disadvantaged women are still several points lower than the average. Full article

In the context of the Italian National Herpes Zoster Vaccine program, an exploratory survey was conducted on a sample of fragile adult patients to investigate the representations of the disease and its prevention to build future local vaccination campaigns. An ad hoc questionnaire was administered to 271 fragile adult patients who had adjuvanted recombinant Herpes Zoster vaccination to detect the following: knowledge and perception of the disease and its risks; information sources and confidence in the information sources used; and perception of the Herpes Zoster vaccination. Fragile adult patients have the representation of Herpes Zoster as a serious disease (86.5%), and they consider themselves informed concerning symptoms and health effects. Women are more fearful of the impact of the disease (Chi-square = 10.03; DF = 3; p-value = 0.018), while those with a higher average age consider themselves less informed (R = −158; p-value = 0.039). The sources of information that contributed to the construction of illness representation are health personnel (73.5%), followed by the web and social web (14.7%), and media such as radio and TV (10.0%). Regarding the vaccine representation, fragile patients are confident about the vaccine and the science behind it and believe everyone should receive it. However, a high percentage (62.9%) fear side effects. Our analysis highlights that vaccination campaigns must be planned based on the target audience, individual and contextual needs, and representations of the disease, particularly when dealing with frail patients, to implement effective preventive interventions. Full article

Background/Objectives: Takeda’s tetravalent dengue vaccine TAK-003 has been approved by the Brazilian regulatory agency ANVISA for dengue disease prevention in individuals aged 4 to 60 years. Dourados, in the state of Mato Grosso do Sul, became the world’s first city to implement a mass vaccination campaign targeting approximately 120,000 individuals. An ongoing collaborative, observational, population-based study using national surveillance and vaccination data was planned to measure the impact of the vaccine on the reduction in dengue incidence. Methods: In this manuscript, the study’s methodology, including its programmatic steps and public health relevance, is described. A collaborative assessment with multidisciplinary researchers in Brazil was conducted to identify key programmatic areas for the successful implementation of the study. These areas included feasibility and site selection assessment, methodology selection, vaccination program implementation, and public health importance. Results/Conclusions: Identification of the public health problem and understanding the disease burden, local healthcare infrastructure, and strategic partnerships were critical for a robust feasibility assessment. One of the feasibility criteria identified was the ability of the Dourados Municipal Health Secretary and the principal investigator to conduct an active vaccination campaign, utilizing extramural activities and diverse communication channels to increase vaccine acceptance and coverage. The selection of analytical methods, such as time series analysis, was dependent on the national and local structures of the databases and data availability. Full article

Background: The success of vaccination programs depends on a complex interplay of logistical, social, and structural factors. The objective of this study was to analyze the different approaches to vaccine administration implemented by several Italian regions since the onset of the SARS-CoV-2 pandemic. Methods: After careful qualitative review of information gathered from scientific articles, official reports (grey literature), contact with regional health authorities, and local health departments, five vaccination strategies across several Italian regions focusing on alternative vaccine providers and/or settings were identified. The innovative practices implemented by different actors covered specific topics and were then examined and described in detail. Results: In Veneto, where prevention departments were the main actor, herpes zoster vaccination coverage for the 65-year-old cohort increased from 44.4% to 54.9%; in Tuscany, family pediatricians administered 64% of all childhood vaccines; in Liguria, pharmacies delivered 70.1% of COVID-19 vaccines, while vaccinating in schools in Taranto led to higher human papilloma virus vaccination rates compared to regional and national averages. Finally, in all the regions, hospitals focused on vaccinating healthcare workers and vulnerable populations. Conclusions: The positive outcomes of these five experiences may, in a context of limited resources, encourage other national and international entities to adopt innovative practices, which offer new perspectives beyond the traditional delivery methods (i.e., local health authority vaccination centers for childhood and adolescent immunizations, and family doctors for adults and the elderly). These strategies suggest the efficacy of specific local approaches favored by regional autonomy in optimizing vaccine distribution and coverage. Full article