COVID-19 and flu vaccination in Romania, post pandemic lessons in healthcare workers and general population.

BACKGROUND: Influenza and corona viruses generate vaccine preventable diseases and have pandemic potential, frequently dramatic. A co-infection with these viruses, may be a new worldwide threat, researchers name it flurona. The aim of our study is to assess flu and COVID-19 Romanian vaccination for 2022-2023 season and the factor associated with higher odds to receive flu and COVID-19 vaccine. METHODS: An analytical cross-sectional observational survey was conducted in the general population; a self-administered questionnaire was used. RESULTS: 1056 responders were analyzed, mean age 32.08 ±13.36 years (limits:18-76), majority, 880 (83.33%), from urban areas, 608 (57.58%), high school graduated, 400 (37.88%) parents. More than half of the responders were healthcare workers, 582 (55.11%), also considered study population. In the study group, 796 (73.37%) responders consider flurona vaccination useful; and 872 (82.57%) responders consider that no sanctions are needed for not flurona vaccinating. In the 2022-2023 season, 162 (15.34%) responders vaccinated against the flu and 300 (28.41%) against COVID-19. The factor associated with higher odds to receive flu and COVID-19 vaccine was the habit of flu vaccination: for flu (OR = 58.43; 95% CI: (34.95-97.67)) and for COVID-19 (OR = 1.67; 95% CI: (1.21-2.31)). Other factors such as having university degree (OR = 1.46; 95% CI: (1.08-1.98)) and being a healthcare worker, (OR = 1.41; 95% CI: (1.07-1.87)) were influencing factors only for adult COVID-19 vaccination in the 2022-2023 season. In the parents' group, in 2022-2023 season, only 48 (12%) vaccinated their children against the flu and 68 (17%) against COVID-19, mostly parents that vaccinated themselves, p<0.001. In the 2022-2023 season, there were only 82 (7.65%) responders vaccinated against both diseases. Logistic regression analysis showed that no factor analyzed influenced the flurona vaccinated parent's decision to vaccinate their children for flu and for COVID-19. CONCLUSIONS: In the season 2022-2023, in Romania, the vaccination against flu and COVOD-19 is low, in adults and children as well. More efforts must be done to increase flurona vaccination, public health educational programs are strongly needed. Children, that are at greater risk when co-infecting with these viruses, must be vaccinated, school vaccination programs should be considered.

Barriers and Facilitators of Romanian HPV (Human Papillomavirus) Vaccination.

BACKGROUND: Many countries had initial success with HPV vaccination campaigns worldwide. The HPV vaccine coverage during the COVID-19 pandemic dropped consistently. The aim of our research is to assess the barriers and facilitators of the current Romanian HPV vaccination campaign. METHODS: An analytical cross-sectional observational survey was conducted in the Romanian general population; a self-administered questionnaire was used. RESULTS: 1122 responders were interviewed; 666 (59.36%) were parents, and 67 (5.97%) HPV vaccinated themselves. A multinominal logistic regression carried out in the parents' category showed that women with university studies and informed from medical sources have greater chances to HPV vaccinate. Reticence regarding vaccination comes from the high cost of the vaccine and a lack of information. Only 118 (10.51%) vaccinated against HPV. From the logistic regression analysis, gender (ORa 0.461 = 95% CI: (0.196; 1.083)), geographic area of residence (ORa = 0.517; 95% CI: (0.331; 0.807)), and the inclusion of the HPV vaccine in the National Vaccination Program (ORa = 2.4; 95% CI: (1.361; 4.235)) were the factors found most associated with HPV vaccination. CONCLUSIONS: In the general population, the inclusion of HPV vaccination in the National Vaccination Program would be the most important facilitator of HPV vaccination in Romania. In parents that did not vaccinate their children, one important barrier to HPV vaccination was the high cost of the HPV vaccine and the lack of proper information. The acceptability of HPV vaccination in Romania is low; therefore, public health educational programs are needed.

Aspects Regarding the Influence of Obesity on the Molecular Characteristics of Breast Tumors.

The influence of excess adipose tissue on the evolution and prognosis of breast cancer has been evaluated in numerous papers over the years. The ways in which obesity can influence the development, progression, and prognosis of this neoplasia are complex and requires the design of new studies, both clinical and preclinical. The aim of this study is to highlight a possible correlation between obesity-specific tumor microenvironment markers (adipokine or leptin) and the different histological subtypes and aggressive characteristics of breast tumors. We prospectively monitored the prognostic values of 39 patients diagnosed with breast cancer who received oncologic-specific treatment or are in follow-up regarding some obesity markers. Our analysis included parameters such as age, body mass index, immunohistochemical characteristics, and plasma concentration of leptin. The methodology was designed to reveal a possible correlation between obesity (quantified by measuring body mass index and waist circumference), the plasma level of leptin, and breast tumor immunohistochemical characteristics. The patients diagnosed with aggressive tumors subtypes (HER2-positive and triple-negative) had a significantly higher body mass index than patients diagnosed with luminal type tumors (32 kg/sqm versus 27 kg/sqm), the difference being 5 kg/sqm. In patients with non-luminal type breast tumors (HER2-positive and triple-negative), serum concentration of leptin is 55 pg/ml compared to 48 pg/ml in luminal type, statistically significant, p=0.0168. Leptin plays an important role in the connection of specific microenvironment tumors to breast cancer. An increased serum concentration of this adipokine was found in patients with HER2-positive and triple-negative breast tumors compared with luminal-type breast tumors, which could open new directions in the research of breast cancer prognosis in obese patients.

COVID-19 Parental Vaccine Hesitancy in Romania: Nationwide Cross-Sectional Study.

BACKGROUND: COVID-19 vaccination started in Romania in December 2020. Child vaccination started in 2021 with children aged 12-15 years in August. For children aged 5-11 years, vaccination started in January 2022. The aim of our study was to describe COVID-19 vaccination hesitancy in Romanian children and vaccine acceptability in the general population. As parental consent is required for child vaccination in Romania, these aspects have a significant association. METHODS: An analytical cross-sectional survey was conducted in October and November 2021 during the peak of the 4th COVID-19 wave. RESULTS: After validation, 1645 participants formed the main study group: median age 35 years, 72.83% women, and 35.44% from the medical domain. In total, 1311 (79.70%) participants were vaccinated against COVID-19 and 188 (11.42%) had vaccinated their 12-18-year-old children against COVID-19. Parents' level of education, geographic area of residence, and COVID-19 vaccination status were significantly associated with COVID-19 vaccination. The hesitancy factors of child vaccination included the novelty of COVID-19 vaccines (62, 47.32%), fear of adverse reactions (32, 24.42%), and anti-vaccinism in general (29, 22.13%). In the studied group, only 188 (11.42%) participants recommended vaccination of 5-11-year-old children. Vaccine acceptability was higher in the general population (1311, 79.70%) than in the medical domain (326 out of 583, 55.91%). General vaccine hesitancy was based mainly on beliefs regarding inefficiency (131, 39.22%) and fears about the side effects of the vaccine (76, 22.75%). CONCLUSIONS: Overall, the acceptability of COVD-19 vaccines in the Romanian population was influenced by the level of education, area of residence, and being a COVID-19-vaccinated parent. Public health intervention programs are essential.

Early COVID-19 Vaccination of Romanian Medical and Social Personnel.

BACKGROUND: In December 2020, the first doses of COVID-19 vaccines arrived in Romania and were made available to medical and social staff. Vaccine hesitancy appeared as a barrier to effectively ending the pandemic. The opinions of medical and social staff influence the opinion of the general population. This study assesess the attitudes, knowledge, and opinion of medical and social personnel toward COVID-19 vaccines and vaccination and the influencing factors. METHODS: 1025 persons participated in an online cross-sectional study from March until July 2021. RESULTS: Out of 1021 eligible responders, 719 (70.42%) had been vaccinated: 227 with one dose (22.23%) and 492 with two doses (48.18%). There were 302 responders who were not vaccinated at all. Out of them, 188 refused vaccinations. The participants showed a good understanding and knowledge of SARScoV-2 transmission and treatment. Geographic area, medical profession, and medical experience influenced COVID-19 vaccination (p < 0.001). There were no associations between willingness to vaccinate and vaccine/virus knowledge. Most of the responders who were vaccinated or wanted to be vaccinated indicated an mRNA vaccine as their first choice. The variables that were significantly associated with reporting COVID-19 vaccine acceptance after logistic regression were: living in an urban area (Ora = 1.58, 95% CI: 0.98-2.56), being female (Ora = 1.59; 95% CI:1.03-2.44), and being a medical doctor (Ora = 3.40; 95% CI: 1.84-6.26). CONCLUSIONS: These findings show that vaccine hesitancy persists in medical and social personnel in Romania, and, hence, it may be reflected in the hesitancy of the general population toward vaccination.