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1.
Multimedia | Multimedia Resources | ID: multimedia-9975

ABSTRACT

El encuentro con pediatras y médicos generalistas en vista de la campaña de seguimiento de sarampión y rubeola


Subject(s)
Immunization Programs/organization & administration , Epidemiology/organization & administration , Infectious Disease Medicine/organization & administration
2.
Multimedia | Multimedia Resources | ID: multimedia-9976
3.
Multimedia | Multimedia Resources | ID: multimedia-9971

ABSTRACT

El encuentro de hoy presenta la micro programación de un municipio con todas las dificultades y problemas que se van presentando frente a una Campaña de vacunacion a nivel municipal


Subject(s)
Immunization Programs/organization & administration , Measles-Mumps-Rubella Vaccine/supply & distribution
4.
BMJ Open ; 12(9): e061742, 2022 09 26.
Article in English | MEDLINE | ID: mdl-36167397

ABSTRACT

OBJECTIVE: To assess the contribution of partners in the introduction of two new vaccines concurrently: pneumococcal 10-valent conjugate vaccine (PCV-10) and inactivated polio vaccine (IPV) into the routine Expanded Programme on Immunization (EPI) in Bangladesh. DESIGN: We conducted a prospective process evaluation that included the theory of change development, root cause analysis and in-depth investigation. As part of process tracking, we reviewed relevant documents, observed trainers' and vaccinators' training and key stakeholder meetings. We analysed the data thematically. SETTING: We purposively selected eight Upazila (subdistrict) and one city corporation covering nine districts and seven administrative divisions of Bangladesh. PARTICIPANTS: Nineteen national key informants were interviewed and 16 frontline health workers were invited to the group discussions considering their involvement in the vaccine introduction process. RESULTS: The EPI experienced several challenges during the joint introduction of PCV-10 and IPV, such as frequent changes in the vaccine introduction schedule, delays in budget allocation, vaccine supply shortage and higher wastage rates of IPV. EPI addressed these challenges in collaboration with its partners, that is, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), who provided technical assistance to develop a training curriculum and communication materials and enhanced demand generation at the community level. In addition, the WHO conducted a country readiness assessment for PCV-10, and UNICEF supported vaccine shipment. Other government ministries, City Corporations and municipalities also supported the EPI. CONCLUSIONS: The partnership among the EPI stakeholders effectively addressed various operational challenges during the joint introduction of PCV-10 and IPV helped strengthen Bangladesh's immunisation systems. These accomplishments are attributed to several factors that should be supported and strengthened for future vaccine introductions in Bangladesh and other low and-middle countries.


Subject(s)
Immunization Programs , Pneumococcal Vaccines , Poliovirus Vaccine, Inactivated , Bangladesh , Child , Humans , Immunization Programs/organization & administration , Pneumococcal Vaccines/administration & dosage , Poliovirus Vaccine, Inactivated/administration & dosage , Program Evaluation , Prospective Studies , Vaccines, Conjugate
5.
Eur J Public Health ; 32(4): 648-654, 2022 08 01.
Article in English | MEDLINE | ID: mdl-35394507

ABSTRACT

BACKGROUND: Several countries paused their rollouts of the Oxford-AstraZeneca coronavirus disease-19 (COVID-19) vaccine in mid-March 2021 due to concerns about vaccine-induced thrombosis and thrombocytopenia. Many warned that this risked damaging public confidence during a critical period of pandemic response. This study investigated whether the pause in the use of the Oxford-AstraZeneca vaccine had an impact on subsequent vaccine uptake in European countries. METHODS: We used a difference-in-differences approach capitalizing on the fact that some countries halted their rollouts whilst others did not. A longitudinal panel was constructed for European Economic Area countries spanning 15 weeks in early 2021. Media reports were used to identify countries that paused the Oxford-AstraZeneca vaccine and the timing of this. Data on vaccine uptake were available through the European Centre for Disease Control and Prevention COVID-19 Vaccine Tracker. Difference-in-differences linear regression models controlled for key confounders that could influence vaccine uptake, and country and week fixed effects. Further models and robustness checks were performed. RESULTS: The panel included 28 countries, with 19 in the intervention group and 9 in the control group. Pausing the Oxford-AstraZeneca vaccine was associated with a 0.52% decrease in uptake for the first dose of a COVID-19 vaccine and a 1.49% decrease in the uptake for both doses, comparing countries that paused to those that did not. These estimates are not statistically significant (P = 0.86 and 0.39, respectively). For the Oxford-AstraZeneca vaccine only, the pause was associated with a 0.56% increase in uptake for the first dose and a 0.07% decrease in uptake for both doses. These estimates are also not statistically significant (P = 0.56 and 0.51, respectively). All our findings are robust to sensitivity analyses. CONCLUSIONS: As new COVID-19 vaccines emerge, regulators should be cautious to deviate from usual protocols if further investigation on clinical or epidemiological grounds is warranted.


Subject(s)
COVID-19 , ChAdOx1 nCoV-19 , Immunization Programs , Vaccination , COVID-19/epidemiology , COVID-19/prevention & control , ChAdOx1 nCoV-19/administration & dosage , ChAdOx1 nCoV-19/adverse effects , Europe/epidemiology , Humans , Immunization Programs/organization & administration , Pandemics , Vaccination/statistics & numerical data
9.
Am J Public Health ; 112(3): 393-396, 2022 03.
Article in English | MEDLINE | ID: mdl-35196045

ABSTRACT

Refugee and immigrant populations are extremely vulnerable to the consequences of the COVID-19 pandemic. COVID-19 vaccination is a critical tool in mitigating these consequences, but these same communities often lack access to COVID-19 vaccines. We describe the efforts of a community-based primary care clinic in Clarkston, Georgia to provide access to COVID-19 vaccines in a culturally sensitive manner to address this health disparity and vaccine hesitancy.


Subject(s)
COVID-19 Vaccines/supply & distribution , COVID-19/prevention & control , Emigrants and Immigrants , Immunization Programs/organization & administration , Refugees , COVID-19/ethnology , Cultural Competency , Georgia/epidemiology , Humans , Pandemics , SARS-CoV-2 , Trust
10.
Am J Emerg Med ; 52: 179-183, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34942427

ABSTRACT

INTRODUCTION: Influenza vaccination is a recommended tool in preventing influenza-related illnesses, medical visits, and hospitalizations. With many patients remaining unvaccinated each year, the Emergency Department (ED) represents a unique opportunity to provide vaccinations to patient not yet vaccinated. However, busy urban safety-net EDs maybe challenged to safely execute such a vaccination program. The aim of this quality improvement project was to assess influenza vaccination feasibility in the ED and improve influenza vaccination rates in our community. METHODS: The quality improvement work-group, comprised of ED physicians, nurses, and pharmacists, designed and implemented an influenza vaccination protocol that aligned with the ED workflow. The outcome measure was the total number of patients vaccinated per month and per influenza season. Process measures included the type of influenza vaccine administered and type of care area within ED. Balancing measures were also included. RESULTS: Following the initiative, a total of 337 patients received influenza vaccinations in the ED between September 1, 2018 and December 31, 2020 compared to none during the previous influenza season. With each influenza season, the number of vaccinated patients increased from 61 to 134 and 142, respectively. The average age of the patients was 48.23 ± 15.29, 52.89 ± 15.91, and 44.92 ± 18.97 years old. Most patients received the vaccination while roomed in the high acuity section of the adult ED. No adverse effects or automated dispensing cabinet stockouts were observed. CONCLUSION: Our structured program indicates that influenza vaccine administration to eligible patients is feasible in a busy urban safety-net ED. Piloting new and further developing existing ED-based influenza vaccination programs have the potential to significantly benefit public health.


Subject(s)
Immunization Programs/organization & administration , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Vaccination/statistics & numerical data , Adult , Emergency Service, Hospital/statistics & numerical data , Feasibility Studies , Humans , Influenza Vaccines/adverse effects , Middle Aged , Quality Improvement , Safety-net Providers/organization & administration
11.
Neumol. pediátr. (En línea) ; 17(1): 20-25, 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1379410

ABSTRACT

La pandemia por Covid-19 ha provocado millones de hospitalizaciones y muertes en el mundo, principalmente en la población adulta. A pesar de que la población pediátrica se ha visto afectada con una menor frecuencia y severidad que los adultos, no están exentos de casos prolongados, graves y letalidad, destacando la aparición de un nuevo cuadro clínico, como el síndrome inflamatorio multisistémico asociado a Covid-19. Constantes esfuerzos científicos han permitido avanzar de manera efectiva en la implementación de estrategias de vacunación pediátrica masiva contra el Covid-19. Actualmente, en Chile esta estrategia está demostrando ser segura, efectiva y puede colaborar con la reapertura de escuelas y el regreso a clases presenciales, de manera de disminuir las interrupciones y brechas escolares, otorgando otros beneficios indirectos, tales como el mejoramiento de la salud mental y emocional, el incremento de la actividad física y estabilidad familiar, aportando en el mejoramiento del bienestar y calidad de vida de los niños y sus familias.


The Covid-19 pandemic has caused millions of hospitalizations and deaths in the world, mainly in the adult population. Although the pediatric population has been affected less frequently and less severely than adults, they are not exempt from prolonged, severe cases and lethality by SARS-CoV-2, highlighting the appearance of a new clinical picture, such as multisystem inflammatory syndrome associated with Covid-19. Constant scientific efforts have made it possible to effectively advance in the implementation of mass pediatric vaccination strategies against Covid-19. Currently, in Chile this strategy is proving to be safe, effective and can collaborate with the school openings and returning to presential classes, to reduce interruptions and school-gaps, granting other indirect benefits, such as the improvement of mental and emotional health, the increase of physical activity and family stability, contributing to the improvement of the well-being and quality of life of children and their families.


Subject(s)
Humans , Child , Immunization Programs/organization & administration , COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Chile/epidemiology , Immunization Programs/statistics & numerical data , Pandemics , COVID-19 Vaccines/adverse effects , SARS-CoV-2 , COVID-19/epidemiology
13.
PLoS One ; 16(12): e0261470, 2021.
Article in English | MEDLINE | ID: mdl-34928996

ABSTRACT

BACKGROUND: Hepatitis B infection is a major health concern in Myanmar. Hepatitis B birth dose vaccination to prevent mother-to-child transmission is not universal, especially in births outside of health care facilities. Little is documented about delivery of immunization programs in rural Myanmar or in conflict-affected regions. To address this gap, this study describes the implementation of a novel community delivered neonatal hepatitis B immunization program in rural Karenni State, Myanmar. METHODS: A mixed-methods study assessed the effectiveness and feasibility of hepatitis B birth dose immunization program. 1000 pregnant women were screened for hepatitis B virus (HBV) infection using point of care testing. Neonates of HBV positive mothers were immunized with a three dose HBV vaccine schedule at birth, 1, and 6 months of age. HBV testing was completed for children at 9 months to assess for infection. Descriptive statistics were collected including demographic data of mothers, neonatal vaccination schedule completion, and child HBV positivity at 9 months. Qualitative data examining barriers to implementation were collected through semi-structured interviews, participant-observation, and analysis of program documents. Themes were codified and mapped onto the Consolidated Framework for Implementation Research. RESULTS: 46 pregnant women tested HBV positive leading to 40 live births. 39 women-child dyads were followed until the 9-month age mark. With the exception of two neonates who received their birth dose past 24 hours, all children received their vaccines on time. None of the 39 children tested positive for HBV at nine months. Themes regarding barriers included adaptability of the program to the rural setting, friction with other stakeholders and not meeting all needs of the community. Identified strengths included good communication and leadership within the implementing ethnic health organization. CONCLUSION: A community delivered neonatal HBV vaccination program by ethnic health organizations is feasible and effective in rural Myanmar.


Subject(s)
Hepatitis B Vaccines/therapeutic use , Hepatitis B/prevention & control , Immunization Programs/organization & administration , Infant, Newborn, Diseases/prevention & control , Infectious Disease Transmission, Vertical/prevention & control , Adolescent , Adult , Female , Hepatitis B Vaccines/administration & dosage , Humans , Immunization Programs/methods , Immunization Schedule , Infant, Newborn , Middle Aged , Myanmar/epidemiology , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/virology , Program Development , Young Adult
14.
Multimedia | Multimedia Resources | ID: multimedia-9425

ABSTRACT

O Ministério da Saúde (MS) promoveu, nesta quinta-feira (8), uma coletiva trazendo as principais informações sobre as vacinas em desenvolvimento contra a COVID-19, bem como os avanços no planejamento da logística e distribuição de doses. Presente no evento, que foi transmitido on-line para todo o país, o diretor do Departamento de Informática do SUS (DATASUS), Jacson de Barros, destacou a modernização do Sistema de Informação do Programa Nacional de Imunização (SI-PNI). A grande novidade será a adoção de uma estratégia para identificar o cidadão por meio do CPF – o que vai permitir o monitoramento de comportamento adversos – e o registro na carteira de vacinação digital, iniciativa já prevista no programa Conecte SUS Rastreabilidade A apresentação do diretor do DATASUS detalhou as ações inéditas com foco na rastreabilidade. Diferentemente das outras campanhas de vacinação, a da COVID-19 terá como objetivo que cada dose distribuída seja identificada na carteira de vacinação do paciente, o que vai gerar mais controle, evitando que uma mesma pessoa tome vacinas diferentes; além de conseguir monitorar reações adversas na população. Com o advento da carteira de vacinação digital, o DATASUS estuda a criação de um certificado de vacinação em formato de PDF e com QRCode de validação, com a garantia de segurança do documento emitido. O cidadão poderá acessar a carteira de vacinação por meio do aplicativo do ConecteSUS ou qualquer ponto de computador com acesso à internet. Além dele, também o profissional de saúde poderá visualizar o certificado. Conecte SUS - Campanha de Vacinação Covid-19.


Subject(s)
COVID-19/prevention & control , Immunization Programs/organization & administration , COVID-19 Vaccines/supply & distribution , Public Health Informatics
15.
Infect Dis Poverty ; 10(1): 124, 2021 Oct 15.
Article in English | MEDLINE | ID: mdl-34654478

ABSTRACT

BACKGROUND: China is facing substantial risks of imported coronavirus disease 2019 (COVID-19) cases and a domestic resurgence in the long run, and COVID-19 vaccination is expected to be the long-lasting solution to end the pandemic. We aim to estimate the size of the target population for COVID-19 vaccination at the provincial level in the mainland of China, and summarize the current progress of vaccination programs, which could support local governments in the timely determination and adjustment of vaccination policies and promotional measures. METHODS: We conducted a descriptive study of the entire population in the mainland of China, between December 2020 and August 2021. By extracting provincial-stratified data from publicly available sources, we estimated the size of priority target groups for vaccination programs, and further characterized the ongoing vaccination program at the provincial level, including the total doses administered, the coverage rate, and the vaccination capacity needed to achieve the target coverage of 80% by the end of 2021. We used R (version 4.1.0) to complete the descriptive statistics. RESULTS: The size of the target population shows large differences among provinces, ranging from 3.4 million to 108.4 million. As of 31 August, 2021, the speed of vaccine roll-out differs considerably as well, with the highest coverage occurring in Beijing and Shanghai, where 88.5% and 79.1% of the population has been fully vaccinated, respectively. In 22 of 31 provincial-level administrative divisions (PLADs), more than 70% of the population was administered at least one dose by August. With the current vaccination capacity, the target of 80% coverage could be achieved by 2021 in 28 PLADs. CONCLUSIONS: Disparities exist in the target population size and vaccination progress across provinces in the mainland of China. China has made great strides in the vaccination speed since roll-out, and could basically achieve the targeted vaccine coverage.


Subject(s)
COVID-19 Vaccines , COVID-19 , Immunization Programs , Vaccination , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Child , Child, Preschool , China/epidemiology , Female , Healthcare Disparities , Humans , Immunization Programs/organization & administration , Infant , Infant, Newborn , Male , Middle Aged , Pregnancy , Program Evaluation , Vaccination/statistics & numerical data , Young Adult
16.
J Infect Dis ; 224(12 Suppl 2): S754-S758, 2021 12 20.
Article in English | MEDLINE | ID: mdl-34668559

ABSTRACT

Cholera remains a major contributor of diarrheal diseases and leads to substantial morbidity and mortality, particularly in low socioeconomic settings. Nonavailability of a national cholera control plan in India, compounded by underreporting of cholera cases and deficient accurate cholera hotspot estimates, has made cholera control a challenge. Obstacles in the programmatic introduction of oral cholera vaccine (OCV) lie within the infrastructure-stockpile, costing, distribution system, cold-chain mechanism, vaccine logistics, and lack of strengthened surveillance systems for adverse events following immunization. Sustained political commitment along with collaboration of people working in the media will also determine the policy outcome of OCV introduction in India.


Subject(s)
Cholera Vaccines/administration & dosage , Cholera/prevention & control , Immunization Programs/organization & administration , Administration, Oral , Cholera/epidemiology , Communicable Disease Control , Humans , India/epidemiology , Vaccination
17.
JAMA Netw Open ; 4(10): e2130800, 2021 10 01.
Article in English | MEDLINE | ID: mdl-34714342

ABSTRACT

Importance: Although there are reports of COVID-19 vaccine implementation in real-world populations, these come from high-income countries or from experience with messenger RNA technology vaccines. Data on outcomes of vaccine deployment in low- or middle-income countries are lacking. Objective: To assess whether the pragmatic application of the 3 COVID-19 vaccines available in Argentina, 2 of which have no reports of evaluation in real-world settings to date, were associated with a reduction in morbidity, all-cause mortality, and mortality due to COVID-19. Design, Setting, and Participants: This cohort study used individual and ecological data to explore outcomes following vaccination with rAd26-rAd5, ChAdOx1, and BBIBP-CorV. To correct for differences in exposure times, results are shown using incidence density per 100 000 person-days from the start of the vaccination campaign (December 29, 2020) to the occurrence of an event or the end of follow-up (May 15, 2021). Participants included 663 602 people aged at least 60 years residing in the city of Buenos Aires, Argentina. Statistical analysis was performed from June 1 to June 15, 2021. Main Outcomes and Measures: Diagnosis of COVID-19 confirmed by reverse transcription-polymerase chain reaction, death from all causes, and death within 30 days of a diagnosis of COVID-19. Poisson regression models were fitted to estimate associations with all 3 outcomes. Results: Among 663 602 residents of the city of Buenos Aires included in the study, 540 792 (81.4%) were vaccinated with at least 1 dose, with 457 066 receiving 1 dose (mean [SD] age, 74.5 (8.9) years; 61.5% were female [n = 281 284]; 68.0% [n = 310 987] received the rAd26-rAd5 vaccine; 29.5% [n = 135 036] received ChAdOx1; 2.4% [n = 11 043] received BBIBP-CorV) and 83 726 receiving 2 doses (mean [SD] age, 73.4 [6.8] years; 63.5% were female [n = 53 204]). The incidence density of confirmed COVID-19 was 36.25 cases/100 000 person-days (95% CI, 35.80-36.70 cases/100 000 person-days) among those who did not receive a vaccine, 19.13 cases/100 000 person-days (95% CI, 18.63-19.62 cases/100 000 person-days) among those who received 1 dose, and 4.33 cases/100 000 person-days (95% CI, 3.85-4.81 cases/100 000 person-days) among those who received 2 doses. All-cause mortality was 11.74 cases/100 000 person-days (95% CI, 11.51-11.96 cases/100 000 person-days), 4.01 cases/100 000 person-days (95% CI, 3.78-4.24 cases/100 000 person-days) and 0.40 cases/100 000 person-days (95% CI, 0.26-0.55 cases/100 000 person-days). COVID-19-related-death rate was 2.31 cases/100 000 person-days (95% CI, 2.19-2.42 cases/100 000 person-days), 0.59 cases/100 000 person-days (95% CI, 0.50-0.67 cases/100 000 person-days), and 0.04 cases/100 000 person-days (95% CI, 0.0-0.09 cases/100 000 person-days) among the same groups. A 2-dose vaccination schedule was associated with an 88.1% (95% CI, 86.8%-89.2%) reduction in documented infection, 96.6% (95% CI, 95.3%-97.5%) reduction in all-cause death, and 98.3% (95% CI, 95.3%-99.4%) reduction in COVID-19-related death. A single dose was associated with a 47.2% (95% CI, 44.2%-50.1%) reduction in documented infection, 65.8% (95% CI, 61.7%-69.5%) reduction in all-cause death, and 74.5% (95% CI, 66%-80.8%) reduction in COVID-19-related death. Conclusions and Relevance: This study found that within the first 5 months after the start of the vaccination campaign, vaccination was associated with a significant reduction in COVID-19 infection as well as a reduction in mortality.


Subject(s)
COVID-19 Vaccines , COVID-19 , Immunization Programs , Vaccination Coverage/statistics & numerical data , Aged , Argentina/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/mortality , COVID-19/prevention & control , COVID-19 Nucleic Acid Testing/methods , COVID-19 Vaccines/classification , COVID-19 Vaccines/therapeutic use , Cohort Studies , Ecological Parameter Monitoring/methods , Ecological Parameter Monitoring/statistics & numerical data , Female , Humans , Immunization Programs/methods , Immunization Programs/organization & administration , Immunization Programs/statistics & numerical data , Incidence , Male , Middle Aged , Mortality , SARS-CoV-2/immunology , Vaccine Potency
18.
Environ Health Prev Med ; 26(1): 99, 2021 Sep 30.
Article in English | MEDLINE | ID: mdl-34592930

ABSTRACT

OBJECTIVES: In this article, we aim to share our experience in the hospital reorganization made to conduct the SARS-CoV-2 vaccination campaign, based on the principles of flexibility and adaptability. STUDY DESIGN: A descriptive study. METHODS: The data concerning the organization of the vaccination campaign were taken from the operative protocol developed by the hospital dedicated task force, composed by experts in hygiene, public health, occupational medicine, pharmacists, nurses, hospital quality, and disaster managers. Data about the numbers of vaccine administered daily were collected by the Innovation and Development Operative Unit database. RESULTS: Vaccinations against COVID-19 started across the EU on the 27th of December 2020. The first phase of the vaccination campaign carried out in our hospital was directed to healthcare workers immunization including medical residents, social care operators, administrative staff and technicians, students of medicine, and health professions trainees. The second phase was enlarged to the coverage of extremely fragile subjects. Thanks to the massive employment of healthcare workers and the establishment of dynamic pathways, it was possible to achieve short turnaround times and a large number of doses administered daily, with peaks of 870 vaccines per day. From the 27th of December up to the 14th of March a total of 26,341 doses of Pfizer have been administered. 13,584 were first doses and 12,757 were second doses. From the 4th to the 14th of March, 296 first doses of Moderna were dispensed. It was necessary to implement adequate spaces and areas adopting anti-contagion safety measures: waiting area for subjects to be vaccinated, working rooms for the dilution of the vaccine and the storage of the material, vaccination rooms, post-vaccination observation areas, room for observation, and treatment of any adverse reactions, with an emergency cart available in each working area. CONCLUSIONS: The teaching hospital of Pisa faced the beginning of the immunization campaign readjusting its spaces, planning an adequate hospital vaccination area and providing an organization plan to ensure the achievement of the targets of the campaign. This represented a challenge due to limited vaccine doses supplied and the multisectoral teams of professionals to coordinate in the shortest time and the safest way possible. The organizational model adopted proved to be adequate and therefore exploited also for the second phase aimed to extremely fragile subjects.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Immunization Programs/organization & administration , SARS-CoV-2/immunology , Hospitals, Teaching/organization & administration , Humans , Italy/epidemiology
19.
PLoS One ; 16(9): e0257277, 2021.
Article in English | MEDLINE | ID: mdl-34529714

ABSTRACT

Vaccination is a cost-effective public health intervention, yet evidence abounds that vaccination uptake is still poor in many low- and middle-income countries. Traditional and Religious Leaders play a substantial role in improving the uptake of health services such as immunization. However, there is paucity of evidence on the cost-effectiveness of using such strategies. This study aimed to assess the cost-effectiveness of using a multi-faceted intervention that included traditional and religious leaders for community engagement to improve uptake of routine immunisation services in communities in Cross River State, Southern Nigeria. The target population for the intervention was traditional and religious leaders in randomly selected communities in Cross River State. The impact of the intervention on the uptake of routine vaccination among children 0 to 23 months was assessed using a cluster randomized trials. Outcome assessments were performed at the end of the project (36 months).The cost of the intervention was obtained from the accounting records for expenditures incurred in the course of implementing the intervention. Costs were assessed from the health provider perspective. The cost-effectiveness analysis showed that the incremental cost of the initial implementation of the intervention was US$19,357and that the incremental effect was 323 measles cases averted, resulting in an incremental cost-effectiveness ratio (ICER) of US$60/measles case averted. However, for subsequent scale-up of the interventions to new areas not requiring a repeat expenditure of some of the initial capital expenditure the ICER was estimated to be US$34 per measles case averted. Involving the traditional and religious leaders in vaccination is a cost-effective strategy for improving the uptake of childhood routine vaccinations.


Subject(s)
Community Health Services/organization & administration , Health Education/organization & administration , Immunization Programs/economics , Immunization Programs/organization & administration , Measles Vaccine/economics , Measles/economics , Measles/prevention & control , Religious Personnel , Child , Cluster Analysis , Cost-Benefit Analysis , Humans , Immunization , Infant , Infant, Newborn , Leadership , Nigeria/epidemiology , Public Health , Religion , Vaccination
20.
J Infect Dis ; 224(12 Suppl 2): S443-S451, 2021 09 30.
Article in English | MEDLINE | ID: mdl-34590134

ABSTRACT

This manuscript describes the history, background, and current structure of the United States Immunization Program, founded upon public- and private-sector partnerships that include federal agencies, state and local health departments, tribal nations and organizations, healthcare providers, vaccine manufacturers, pharmacies, and a multitude of additional stakeholders. The Centers for Disease Control and Prevention sets the U.S. adult and childhood immunization schedules based on recommendations from the Advisory Committee on Immunization Practices. We review the current immunization schedules; describe the set of surveillance and other systems used to monitor the health impact, coverage levels, and safety of recommended vaccines; and note significant challenges. Vaccines have reduced the incidence of many diseases to historic lows in the US, and have potential to further reduce the burden of respiratory and other infectious diseases in the United States. Though the United States vaccination program has had notable successes in reducing morbidity and mortality from infectious disease, challenges-including disparities in access and vaccine hesitancy-remain. Supporting access to and confidence in vaccines as an essential public health intervention will not only protect individuals from vaccine-preventable diseases; it will also ensure the country is prepared for the next pandemic.


Subject(s)
Immunization Programs , Immunization/statistics & numerical data , Vaccination Coverage/statistics & numerical data , Vaccine-Preventable Diseases , Vaccines/administration & dosage , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Health Promotion , Humans , Immunization Programs/organization & administration , Immunization Programs/trends , Immunization Schedule , Infant , Male , Middle Aged , Population Surveillance , United States/epidemiology , Vaccination , Vaccine-Preventable Diseases/epidemiology , Vaccine-Preventable Diseases/prevention & control , Young Adult
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