Healthcare Workers' Acceptance of COVID-19 Vaccination in Russia.

During the COVID-19 pandemic, the problem of the population's adherence to vaccination has become significantly aggravated around the world. This study is aimed at evaluating healthcare workers' (HCWs) acceptance of COVID-19 vaccination in Russia. A cross-sectional multicenter study was carried out by interviewing HCWs in Russia using an electronic questionnaire and snowball sampling. The analysis included 85,216 questionnaires from 81 out of 85 regions of Russia. Statistical analysis was performed using SPSS v.22. The results indicated that 35.0% (CI 95%, 34.7-35.3) of HCWs were ready to get COVID-19 vaccination. The acceptance level was 42.4% (41.8-42.9) for all physicians and 31.3% (30.9-31.6) for nursing staff. A total of 29.4% (29.1-29.7) of HCWs were willing to recommend COVID-19 vaccination to patients: 38.5% (38.0-39.1) of physicians, and 24.7% (24.4-25.1) of nursing staff. Acceptance of COVID-19 vaccination is higher among HCWs dealing with infectious diseases and involved in vaccination. The low acceptance of HCWs toward vaccination against COVID-19 can be explained by the low level of awareness of HCWs in these issues. Additional educational programs are needed for HCWs, both for physicians and nurses, using all possible forms and methods of education.

Cost effectiveness and budget impact of universal varicella vaccination in Russia.

This economic evaluation assesses the cost-effectiveness and budget impact of introducing a two-dose varicella vaccine in the Russian national immunization program. A static Markov model followed a simulated 2019 Russian cohort over its lifetime and compared outcomes and costs of three varicella vaccination strategies: strategy I (doses given at 12 and 15 months of age), strategy II (doses given at 1 year and 6 years of age), and a no vaccination scenario. Inputs on age-dependent clinical pathways, associated costs, and related health outcomes were collected from national sources and published literature. Results are presented as incremental cost-effectiveness ratio (ICER) from the healthcare payer and societal perspective over the lifetime of the birth cohort and the budget impact over a 10 years' time horizon. Vaccination strategies I and II resulted in an ICER of approximately 1.7 million rubles per quality-adjusted life years gained from the healthcare payer perspective and were cost-saving from the societal perspective. From the healthcare payer perspective, the costs per varicella case averted were 5,989 and 7,140 rubles per case for strategies I and II, respectively. However, from the societal perspective, vaccination is a dominant strategy and the budget impact analysis shows significant healthcare savings over 10 years, with strategy I realizing savings of ~2 billion rubles more than strategy II. From a public health impact perspective, varicella vaccination of children at 12 and 15 months of age through the Russian NIP is expected to be cost-effective with an affordable budget impact compared to no vaccination.

A graphical version of the plain language summary can be found here: 10.6084/m9.figshare.19291463Focus on the patientWhat is the context? Varicella, or chickenpox, is a highly contagious infection. Though mild in children, complications can occur in older individuals, increasing the economic burden for society and public health institutions.In 2019, approximately 0.6% of the Russian population was impacted by varicella, a vaccine-preventable disease.In Russia, varicella vaccination is only implemented in some regions. These regions report a decreasing trend in infection rates in the groups covered by vaccination.What is new? This study assesses the public health and economic impact of implementing varicella vaccination in Russia through its National Immunization Program.We compared two vaccination strategies to a no vaccination scenario: º Strategy I: two doses at 12 and 15 months of ageº Strategy II: two doses at 1 and 6 years of age Over a 10-year period, we found that: º Strategy I prevented 607,682 cases, 2,388,659 general practitioner visits and 10,256 hospitalizations, and saved 6.2 million rublesº Strategy II prevented 491,084 cases, 1,805,668 general practitioner visits and 10,108 hospitalizations, and saved 4.2 million rubles Strategy I saves more direct (i.e., general practitioner visits, hospitalizations and treatment) and indirect (i.e., income loss, disability payments, and caregiving) costs to society than strategy II.What is the impact? Varicella vaccination, especially when introduced at 12 and 15 months (strategy I) in the National Immunization Program, provides public health and economic benefits.From the healthcare payer perspective: this is a cost-effective intervention. From the societal perspective: the budget impact analysis shows significant savings.

Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study.

BACKGROUND: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period. METHODS: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations. RESULTS: The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%. CONCLUSIONS: Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.

Sample study protocol for adapting and translating the 5C scale to assess the psychological antecedents of vaccination.

INTRODUCTION: Published in 2018, the 5C scale is psychometrically validated to assess five psychological antecedents of vaccination (confidence, complacency, constraints, calculation and collective responsibility). The original version offers a validated English and German scale to assess these determinants with a short 5-item scale (1 item per antecedent) and a long 15-item scale (3 items per antecedent). This sample study protocol provides a step-by-step guidance for the process of adapting the 5C scale to another country, language or cultural context. Data obtained from the 5C scale can support developing, implementing and evaluating an intervention and monitoring of general vaccine acceptance and demand. METHODS AND ANALYSIS: Phase 1 comprises the adaptation of the 5C scale including the translation and back translation of the antecedents, an expert evaluation of the antecedents and the identification of new antecedents as well as a pretest. Phase 2 involves the validation of the translated and potentially expanded scale including the assessment of reliability, construct and concurrent validity of all items of the scale. Code for data analysis is provided. ETHICS AND DISSEMINATION: The University of Erfurt's institutional review board provided ethical clearance (EV-201900416.2). The authors suggest and encourage publicly sharing all data obtained from the translated 5C scale (eg, on publication). The materials and the code for data analysis to support the process described in this protocol are available in https://osf.io/2agxe/. Sharing data on vaccine acceptance and demand is in the public and the scientific interest and will facilitate gaining a global overview of its current state and development over time. The authors of the original 5C scale are currently working on an online platform to facilitate publishing the data and to visualise the psychological antecedents across different countries.

Multicenter study of serotype distribution of Streptococcus pneumoniae nasopharyngeal isolates from healthy children in the Russian Federation after introduction of PCV13 into the National Vaccination Calendar.

Russia introduced PCV13 in 2014. We studied the serotype composition of S. pneumoniae isolated from the nasopharynx of healthy children younger than 6 years in St. Petersburg, Smolensk, Perm, Krasnoyarsk, Khanty-Mansiysk and Khabarovsk, between 2016 and 2018. 2.4% of children had completed a 3-dose course of PCV13, while 25.6% had received 1 or 2 doses. Pneumococcal DNA detection by PCR demonstrated S. pneumoniae in 37.2% of samples with regional variation between sites (27.3 to 56.9%). There was little difference between vaccinated, partially vaccinated and un-vaccinated children. Children who had received at least 1 dose of PCV13 had lower carriage rates of vaccine serotypes than their unvaccinated peers (49.9 vs. 61.4%; p < 0.001). Children who had received at least 1 dose of PCV13 showed increased carriage rates of non-vaccine serotypes (50 vs 38.6%; P < 0.001). Especially serogroup 15AF was more prevalent among fully immunized children than among their peers (12.5 vs 2.7%; P < 0.05).

Safety and immunogenicity of a single dose 23-valent pneumococcal polysaccharide vaccine in Russian subjects.

Pneumococcal infection is a major cause of pneumonia, bacteremia, and meningitis. Incidence of pneumococcal disease (PD) varies worldwide. The 23-valent pneumococcal polysaccharide vaccine (PPV23) displays an acceptable safety profile and has been demonstrated cost-effective in reducing burden of PD. METHODS: Approximately 100 subjects from the Russian Federation who were either 2 to 49 y of age with increased risk for PD or ≥50 years of age were enrolled into the study (NCT01734239) to receive a single dose of PPV23 administered intramuscularly. Each subject was followed for local and systemic adverse events (AEs) for 5 and 14 days, respectively. Serious AEs were collected for 28 d postvaccination. Blood samples were collected immediately prior to vaccination and 28 d postvaccination for the measurement of IgG to serotypes 1, 6B, 14, 19F, and 23F. RESULTS: High proportion of subjects had ≥2 -fold increase in IgG following receipt of PPV23. Rates were 92.0%, 83.0%, 89.0%, 81%, 84% for serotypes 1, 6B, 14, 19F, and 23F, respectively. Similar rates of responders and increases in the magnitude of immune responses were observed in both age groups (2-49, ≥50 ). PPV23 was generally safe and well tolerated. Injection site and systemic AEs were reported by 14.7% and 18.6% of study subjects, respectively. CONCLUSIONS: PPV23 is generally safe, well tolerated, and highly immunogenic when given as a single dose to Russian individuals 50 y of age and older, as well as Russian individuals 2 to 49 y of age who are at high risk for PD.