Questions and answers about human papillomavirus, second edition

This document provides evidence-based answers to frequently asked questions related to human papillomavirus (HPV), HPV vaccines, and prevention of cervical cancer and other HPV-related diseases. This second edition of the document includes updated information on the impact of HPV vaccination since its introduction in 2006 and on inclusion of the vaccine in national immunization programmes of the WHO European Region.

Eliminating measles and rubella in the WHO European Region: integrated guidance for surveillance, outbreak response and verification of elimination

Member States of the WHO European Region share the goal of eliminating endemic transmission of measles and rubella viruses, which will also result in the elimination of congenital rubella syndrome. Significant progress has been made in the Region in recent years towards achieving and documenting interruption of endemic transmission of measles and rubella viruses. However, as evidenced by the occurrence of outbreaks, primarily of measles, the achievement of these goals at the Regional level has been delayed. It is essential that all Member States maximize efforts to achieve and maintain high vaccination coverage. In addition, the implementation of the WHO recommendations for elimination-standard surveillance for the rapid detection of outbreaks must be given the highest priority. Adherence to these surveillance standards for enhanced outbreak detection will provide the opportunity to deploy a timely and effective response to cases and outbreaks. This document provides guidance on conducting elimination-standard surveillance and how to implement a rapid and appropriate response to outbreaks of measles and rubella. The reader will gain an understanding of the necessary epidemiological and laboratory evidence that is critical for documenting the interruption of transmission and eventual elimination of these viruses through the established regional verification process.

Eastern Mediterranean Health Journal [2023; Vol.29, Issue 5]

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region

المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه

La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région

Vaccine hesitancy in the Gulf Cooperation Council countries

Background: Vaccination has a tremendous impact on health at the regional and global levels, however, the tendency for people to hesitate on vaccination has been increasing in the past few decades. Aims: We assessed vaccine hesitancy and its determinants in the Gulf Cooperation Council countries. Methods: We conducted a literature review to assess peer-reviewed articles published up to March 2021 on vaccine hesitancy in the Gulf Cooperation Council countries using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A search was conducted via PubMed and 29 articles were identified. After the removal of duplicates and irrelevant articles, 14 studies remained relevant and were used for the review. Results: Vaccine hesitancy in the Gulf Cooperation Council countries ranged from 11% to 71%. Differences in rates were noted for vaccine type, with COVID-19 vaccine having the highest reported hesitancy (70.6%). The likelihood of accepting vaccination was associated with previous individual acceptance of vaccine, specifically the seasonal influenza vaccine. The most common determinants of vaccine hesitancy were distrust in vaccine safety and concerns about side-effects. Healthcare workers were among the main sources of information and recommendations about vaccination, but 17–68% of them were vaccine-hesitant. The majority of the healthcare workers had never received any training on addressing vaccine hesitancy among patients. Conclusions: Vaccine hesitancy is prevalent among the publics and healthcare workers in the Gulf Cooperation Council countries. There is a need to continually monitor perceptions and knowledge about vaccines and vaccination in these countries to better inform interventions to improve vaccine uptake in the sub-region.

Barriers to childhood vaccination in urban slums of Pakistan

Background: The urban slums of Pakistan continue to record low childhood vaccination coverage. It is therefore vital to understand the demand-side barriers to childhood vaccination in the slums to determine the required demand-generation interventions. Aims: To document the demand-side barriers related to childhood vaccination in urban slums of Pakistan and recommend appropriate demand-generation interventions. Methods: We investigated the demand-side barriers to childhood vaccination in 4 urban slums of Karachi, Pakistan, and disseminated the findings to the Expanded Program on Immunization and their partners. Using the findings, we made recommendations for collaborations with the various partners and for the design of demand-generation interventions to address the barriers. We then expanded the scope of the original research through a mapping exercise that gathered information on the vaccination-related research and interventions of the partners and used the information gathered to create a portfolio of activities. We present the demand-side barriers from the original research and the portfolio of demand-generation interventions. Results: The original research showed that 412 (49.0%) children aged 12–23 months, from 840 households, were fully vaccinated. Reasons given for not receiving the recommended vaccinations were mainly related to the fear of side effects, social and religious influences, lack of awareness, and misconceptions about vaccine administration. The mapping of activities revealed 47 initiatives that aimed to generate demand for childhood vaccination in the urban slums of Pakistan. Conclusion: Several stakeholders involved in childhood vaccination in the urban slums of Pakistan act independently, operating programmes that are disconnected. There is a need for better coordination and integration of the childhood vaccination interventions by these partners to achieve the goal of universal vaccination coverage.

Acceptability of COVID-19 vaccination among healthcare workers in Sudan

Introduction: Several studies have investigated COVID-19 vaccine acceptability and hesitancy, especially among healthcare workers (HCWs). However, acceptability of the vaccine by HCWs in Sudan remains unclear. Aims: We investigated acceptability of the COVID-19 vaccine and its determinants among HCWs in Sudan. Methods: Using a semi-structured questionnaire, we conducted a web-based cross-sectional study of COVID-19 vaccine hesitancy and its associated determinants among healthcare workers in Sudan during March–April 2021. Results: A total of 576 HCWs responded to the survey. Mean age was 35 years. Females (53.3%), medical doctors (55.4%) and being located in Khartoum State (76.0%) each accounted for more than half of the participants. Absolute refusal of the COVID-19 vaccine was expressed by 16.0% of the respondents. Males were more than twice as likely to accept the vaccine as females. Lower acceptability was statistically significantly associated with the nurses (OR = 0.35, 95% CI: 0.15–0.82, P < 0.001), increased perceived harm from the vaccine (OR = 0.11, 95% CI: 0.05–0.23, P < 0.001), lack of confidence in the source of the vaccine (OR = 0.16, 95% CI: 0.08–0.31, P < 0.001) and lack of confidence in organizations or government sectors supervising the vaccination process (OR = 0.31, 95% CI: 0.17–0.58, P < 0.001). Conclusion: This study highlights a moderate level of COVID-19 vaccine acceptability among HCWs in Sudan. Special consideration should be given to addressing vaccine hesitancy among female HCWs and nurses.

Reasons for parental hesitancy or refusal of childhood vaccination in Türkiye

Background: Although vaccines play a critical role in the control of infectious diseases and disease outbreaks, vaccination rates have been declining in recent years because of vaccine hesitancy or refusal. Aims: We aimed to determine the rates and reasons for parental hesitancy or refusal of vaccination for their children in Türkiye. Method: A total of 1100 participants selected from 26 regions of Türkiye were involved in this cross-sectional study conducted between July 2020 and April 2021. Using a questionnaire, we collected data on the sociodemographic characteristics of parents, the status of vaccine hesitancy or refusal for their children, and reasons for the hesitancy or refusal. Using Excel and SPSS version 22.0, we analysed the data with chi-square test, Fisher’s exact test and binomial logistic regression. Results: Only 9.4% of the participants were male and 29.5% were aged 33–37 years. Just over 11% said they were worried about childhood vaccination, mainly because of the chemicals used in manufacturing the vaccines. The level of concern was greater among those who got information about vaccines from the internet, family members, friends, TV, radio, and newspapers. Those who used complementary health services were considerably more hesitant about vaccination than those who used mainstream services. Conclusions: Parents in Türkiye have several reasons for hesitating or refusing to vaccinate their children, key among which are concerns about the chemical composition of the vaccines and their ability to trigger negative health conditions such as autism. This study used a large sample size across Türkiye, although there were differences by region, the findings would be useful in designing interventions to counter vaccine hesitancy or refusal in the country.

Eastern Mediterranean Health Journal [2023; Vol.29, Issue 4]

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region

المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه

La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région

Assessment of concerns about vaccination among recovered COVID-19 patients in Saudi Arabia

Background: Vaccine hesitancy re-emerged as a critical public health issue during the COVID-19 pandemic. Aims: This study assessed the concerns of recovered COVID-19 patients about vaccination and the predictors of vaccine hesitancy. Methods: This was a cross-sectional study of 319 adult patients who recovered from COVID-19 in Saudi Arabia. It was conducted during 1 May to 1 October 2020 at King Abdulaziz Medical City, Riyadh. Each participant was interviewed 6–12 months post-recovery using the vaccination attitude examination scale. Data were collected on COVID-19 illness severity, sociodemographic characteristics, history of chronic disease, and post-COVID-19 vaccination. Level of vaccination concern was assessed based on the percentage mean score (PMS). Results: Most (85.3%) of the patients who recovered from COVID-19 expressed moderate overall concern (PMS = 68.96%) about vaccination. Concern was highest for mistrust in vaccine benefits (PMS = 90.28%), followed by natural immunity preference (PMS = 81.33%) and worries about the vaccine side-effects (PMS = 60.29%). Concern over commercial profiteering was low (PMS = 43.92%). The overall PMS for concern about vaccination was significantly higher among patients aged 45+ years (t = 3.12, P = 0.002) and among those who had experienced severe COVID-19 illness (t = 1.96, P = 0.05). Conclusion: Overall concern about vaccination was high, and specific concerns were prevalent. Patient education on how the vaccine protects against reinfection should be targeted at COVID-19 patients before being discharged from hospital.