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1.
Bull World Health Organ ; 99(9): 627-639, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34475600

RESUMO

Objective: To analyse subnational inequality in diphtheria-tetanus-pertussis (DTP) immunization dropout in 24 African countries using administrative data on receipt of the first and third vaccine doses (DTP1 and DTP3, respectively) collected by the Joint Reporting Process of the World Health Organization and the United Nations Children's Fund. Methods: Districts in each country were grouped into quintiles according to the proportion of children who dropped out between DTP1 and DTP3 (i.e. the dropout rate). We used six summary measures to quantify inequalities in dropout rates between districts and compared rates with national dropout rates and DTP1 and DTP3 immunization coverage. Findings: The median dropout rate across countries was 2.4% in quintiles with the lowest rate and 14.6% in quintiles with the highest rate. In eight countries, the difference between the highest and lowest quintiles was 14.9 percentage points or more. In most countries, underperforming districts in the quintile with the highest rate tended to lag disproportionately behind the others. This divergence was not evident from looking only at national dropout rates. Countries with the largest inequalities in absolute subnational dropout rate tended to have lower estimated national DTP1 and DTP3 immunization coverage. Conclusion: There were marked inequalities in DTP immunization dropout rates between districts in most countries studied. Monitoring dropout at the subnational level could help guide immunization interventions that address inequalities in underserved areas, thereby improving overall DTP3 coverage. The quality of administrative data should be improved to ensure accurate and timely assessment of geographical inequalities in immunization.


Assuntos
Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Difteria/prevenção & controle , Programas de Imunização/estatística & dados numéricos , Tétano/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Coqueluche/prevenção & controle , África , Criança , Feminino , Disparidades em Assistência à Saúde , Humanos , Imunização , Lactente , Masculino , Pobreza , Fatores Socioeconômicos
2.
PLoS One ; 16(8): e0256394, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34415928

RESUMO

BACKGROUND: The COVID-19 vaccination campaign in the US has been immensely successful in vaccinating those who are receptive, further increases in vaccination rates however will require more innovative approaches to reach those who remain hesitant. Developing vaccination strategies that are modelled on what people want could further increase uptake. METHODS AND FINDINGS: To inform COVID-19 vaccine distribution strategies that are aligned with public preferences we conducted a discrete choice experiment among the US public (N = 2,895) between March 15 to March 22, 2021. We applied sampling weights, evaluated mean preferences using mixed logit models, and identified latent class preference subgroups. On average, the public prioritized ease, preferring single to two dose vaccinations (mean preference: -0.29; 95%CI: -0.37 to -0.20), vaccinating once rather than annually (mean preference: -0.79; 95%CI: -0.89 to -0.70) and reducing waiting times at vaccination sites. Vaccine enforcement reduced overall vaccine acceptance (mean preference -0.20; 95%CI: -0.30 to -0.10), with a trend of increasing resistance to enforcement with increasing vaccine hesitancy. Latent class analysis identified four distinct preference phenotypes: the first prioritized inherent "vaccine features" (46.1%), the second were concerned about vaccine "service delivery" (8.8%), a third group desired "social proof" of vaccine safety and were susceptible to enforcement (13.2%), and the fourth group were "indifferent" to vaccine and service delivery features and resisted enforcement (31.9%). CONCLUSIONS: This study identifies several critical insights for the COVID-19 public health response. First, identifying preference segments is essential to ensure that vaccination services meet the needs of diverse population subgroups. Second, making vaccination easy and promoting autonomy by simplifying services and offering the public choices (where feasible) may increase uptake in those who remain deliberative. And, third vaccine mandates have the potential to increase vaccination rates in susceptible groups but may simultaneously promote control aversion and resistance in those who are most hesitant.


Assuntos
Vacinas contra COVID-19 , Programas de Imunização/organização & administração , Adulto , Afro-Americanos , Comportamento do Consumidor , Feminino , Humanos , Programas de Imunização/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Política , Inquéritos e Questionários , Estados Unidos , Cobertura Vacinal , Recusa de Vacinação
3.
Epidemiol Infect ; 149: e187, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34340722

RESUMO

We update our previous insights into COVID-19 vaccine acceptance and hesitancy in Finland. Vaccine acceptance increased from 64% (November/December 2020) to 74% (April 2021). However, there was a group of participants that were preferring to wait to get vaccinated ranging from 6% of over-64-years-olds to 29% of under-30-years-olds. The previously identified enablers convenience (below-50-years-olds), worry about severe disease and protection for oneself (above-50-years-olds) were no longer significantly associated with increased vaccine acceptance. Understanding barriers and enablers behind vaccine acceptance is decisive in ensuring a successful implementation of COVID-19 vaccination programs, which will be key to ending the pandemic.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Vacinação/psicologia , Adulto , Fatores Etários , Idoso , Feminino , Finlândia , Humanos , Programas de Imunização/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Healthc Q ; 24(2): 7-11, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34297657

RESUMO

The COVID-19 pandemic has highlighted the need for a robust and nimble public health data infrastructure. ICES - a government-sponsored, independent, non-profit research institute in Ontario, Canada - functions as a key component of a resilient information infrastructure and an enabler of data co-production, contributing to Ontario's response to the COVID-19 pandemic as part of a learning health system. Linked data on the cumulative incidence of infection and vaccination at the neighbourhood level revealed disparate uptake between areas with low versus high risk of COVID-19. These data were leveraged by the government, service providers, media and the public to inform a more efficient and equitable vaccination strategy.


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Sistema de Aprendizagem em Saúde/organização & administração , Administração em Saúde Pública , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Vacinas contra COVID-19/provisão & distribuição , Equidade em Saúde/organização & administração , Humanos , Programas de Imunização/organização & administração , Programas de Imunização/estatística & dados numéricos , Sistema de Aprendizagem em Saúde/métodos , Pessoa de Meia-Idade , Ontário/epidemiologia , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Adulto Jovem
8.
Appl Health Econ Health Policy ; 19(4): 463-472, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34235643

RESUMO

With vaccines for coronavirus disease 2019 (COVID-19) being introduced in countries across the world, policy makers are facing many practical considerations about how best to implement a vaccination programme. The supply of vaccines is insufficient for the global population, so decisions must be made as to which groups are prioritised for any vaccination and when. Furthermore, the aims of vaccination programmes will differ between countries, with some prioritising economic benefits that could stem from the relaxation of non-pharmaceutical interventions and others seeking simply to reduce the number of COVID-19 cases or deaths. This paper aims to share the experiences and lessons learned from conducting economic evaluations in Singapore and Thailand on hypothetical COVID-19 vaccines to provide a basis for other countries to develop their own contextualised economic evaluations, with particular focus on the key uncertainties, technical challenges, and characteristics that modellers should consider in partnership with key stakeholders. Which vaccines, vaccination strategies, and policy responses are most economically beneficial remains uncertain. It is therefore important for all governments to conduct their own analyses to inform local policy responses to COVID-19, including the implementation of COVID-19 vaccines in both the short and the long run. It is essential that such studies are designed, and ideally conducted, before vaccines are introduced so that policy decisions and implementation procedures are not delayed.


Assuntos
Vacinas contra COVID-19/economia , COVID-19/prevenção & controle , Política de Saúde/economia , Programas de Imunização/economia , Programas de Imunização/estatística & dados numéricos , Vacinação/economia , Vacinação/estatística & dados numéricos , Análise Custo-Benefício , Humanos , SARS-CoV-2 , Singapura , Tailândia
11.
Elife ; 102021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34165077

RESUMO

Background: Childhood immunisation services have been disrupted by the COVID-19 pandemic. WHO recommends considering outbreak risk using epidemiological criteria when deciding whether to conduct preventive vaccination campaigns during the pandemic. Methods: We used two to three models per infection to estimate the health impact of 50% reduced routine vaccination coverage in 2020 and delay of campaign vaccination from 2020 to 2021 for measles vaccination in Bangladesh, Chad, Ethiopia, Kenya, Nigeria, and South Sudan, for meningococcal A vaccination in Burkina Faso, Chad, Niger, and Nigeria, and for yellow fever vaccination in the Democratic Republic of Congo, Ghana, and Nigeria. Our counterfactual comparative scenario was sustaining immunisation services at coverage projections made prior to COVID-19 (i.e. without any disruption). Results: Reduced routine vaccination coverage in 2020 without catch-up vaccination may lead to an increase in measles and yellow fever disease burden in the modelled countries. Delaying planned campaigns in Ethiopia and Nigeria by a year may significantly increase the risk of measles outbreaks (both countries did complete their supplementary immunisation activities (SIAs) planned for 2020). For yellow fever vaccination, delay in campaigns leads to a potential disease burden rise of >1 death per 100,000 people per year until the campaigns are implemented. For meningococcal A vaccination, short-term disruptions in 2020 are unlikely to have a significant impact due to the persistence of direct and indirect benefits from past introductory campaigns of the 1- to 29-year-old population, bolstered by inclusion of the vaccine into the routine immunisation schedule accompanied by further catch-up campaigns. Conclusions: The impact of COVID-19-related disruption to vaccination programs varies between infections and countries. Planning and implementation of campaigns should consider country and infection-specific epidemiological factors and local immunity gaps worsened by the COVID-19 pandemic when prioritising vaccines and strategies for catch-up vaccination. Funding: Bill and Melinda Gates Foundation and Gavi, the Vaccine Alliance.


Assuntos
COVID-19/epidemiologia , Programas de Imunização/estatística & dados numéricos , Sarampo/prevenção & controle , Infecções Meningocócicas/prevenção & controle , Febre Amarela/prevenção & controle , Adolescente , Adulto , África/epidemiologia , Bangladesh/epidemiologia , Criança , Pré-Escolar , Surtos de Doenças , Humanos , Programas de Imunização/métodos , Lactente , Sarampo/epidemiologia , Vacina contra Sarampo/uso terapêutico , Infecções Meningocócicas/epidemiologia , Vacinas Meningocócicas/uso terapêutico , Pandemias , Medição de Risco , SARS-CoV-2 , Vacinação/estatística & dados numéricos , Febre Amarela/epidemiologia , Vacina contra Febre Amarela/uso terapêutico , Adulto Jovem
12.
Nurs Adm Q ; 45(3): 219-225, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34060505

RESUMO

The COVID-19 pandemic has overwhelmed communities. Physical, emotional, and financial struggles have heightened, especially with our vulnerable populations. People have been afraid to return to their provider's office. For children, there has been an interruption of well-visits and immunizations. As the nation saw a decline in immunization uptake, a pilot nurse-led program was designed to increase vaccinations and address the social determinant needs during a global pandemic. The purpose of this article is to describe the planning and implementation of a curbside immunization event. The Logic model was used as a framework to ensure an efficient and replicable process. Initial observations showed an overall increase in immunization uptake and 97% of participants current with recommended vaccinations. Most parents (93%) would attend again and recommend it to others. They also felt that infection control precautions helped make the care delivered safe and efficient. Social determinants of health were assessed and addressed. This method of vaccine delivery is a viable model going into the future. Others may replicate this model, and it may also serve as a platform regarding flu or COVID-19 vaccine distribution.


Assuntos
Imunização/enfermagem , Modelos de Enfermagem , Determinantes Sociais da Saúde/estatística & dados numéricos , Humanos , Imunização/estatística & dados numéricos , Programas de Imunização/métodos , Programas de Imunização/normas , Programas de Imunização/estatística & dados numéricos , Michigan , Projetos Piloto
14.
Malar J ; 20(1): 210, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933088

RESUMO

The Global Polio Eradication Initiative (GPEI) was launched in 1988 with the aim of completely clearing wild polio viruses by 2000. More than three decades later, the goal has not been achieved, although spectacular advances have been made, with wild polio virus reported in only 2 countries in 2019. In spite of such progress, novel challenges have been added to the equation, most importantly outbreaks of vaccine-derived polio cases resulting from reversion to neurovirulence of attenuated vaccine virus, and insufficient coverage of vaccination. In the context of the latest discussions on malaria eradication, the GPEI experience provides more than a few lessons to the malaria field when considering a coordinated eradication campaign. The WHO Strategic Advisory Committee on Malaria Eradication (SAGme) stated in 2020 that in the context of more than 200 million malaria cases reported, eradication was far from reach in the near future and, therefore, efforts should remain focused on getting back on track to achieve the objectives set by the Global Technical Strategy against Malaria (2016-2030). Acknowledging the deep differences between both diseases and the stages they are in their path towards eradication, this paper draws from the history of GPEI and highlights relevant insights into what it takes to eradicate a pathogen in fields as varied as priority setting, global governance, strategy, community engagement, surveillance systems, and research. Above all, it shows the critical need for openness to change and adaptation as the biological, social and political contexts vary throughout the time an eradication campaign is ongoing.


Assuntos
Erradicação de Doenças/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Malária/prevenção & controle , Poliomielite/prevenção & controle , Humanos , Programas de Imunização/estatística & dados numéricos
15.
Pan Afr Med J ; 38: 194, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995800

RESUMO

Introduction: the World Health Organisation (WHO) recommends that countries conduct comprehensive national immunisation program reviews regularly to help them identify systems wide-barriers or gaps and monitor performance against the set targets. Methods: we reviewed reports from the latest national immunisation program reviews conducted in the 20 countries in the sub-region in the course of 2012-2018. We generated descriptive analysis of the findings across the sub-region. Results: the 20 program reviews included field observations to the subnational levels as well as interviews with program staff and stakeholders. At the time of the reviews, only 11 countries had functional National Immunisation Technical Advisory Groups. Operational funding was inadequate in half of the countries. The reviews documented the cancellation of outreach services, supportive supervision visits and maintenance of cold chain equipment due to the lack of fuel or operational funding. Immunisation programs in 10 countries had major human resource gaps. Vaccine stock management tools were not effectively used in 10 countries, and stock out of vaccines and supplies was documented in 9 countries during the review. The full components of the RED strategy were implemented in only 3 of the 20 countries. Twelve countries reported challenges with the availability and accuracy of target populations. Four countries had documented the presence of vaccine hesitant groups at the time of the reviews. Conclusion: the reviews demonstrated challenges in various aspects of the programs in different countries. The implementation of the review recommendations should be built into the annual program plans, as well as into coasted multi-year plans, in order to address the gaps and helps the program to attain the set targets. With the rapid evolution of the scope and complexity of the immunisation programs in recent years, countries should invest their efforts in building the capacity of their human resources as well as updating their logistics and data systems.


Assuntos
Programas de Imunização/organização & administração , Vacinas/provisão & distribuição , Recursos Humanos/estatística & dados numéricos , África Oriental , África Austral , Fortalecimento Institucional , Humanos , Programas de Imunização/estatística & dados numéricos , Refrigeração , Recusa de Vacinação/estatística & dados numéricos
17.
Anaesth Crit Care Pain Med ; 40(3): 100874, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33946037

RESUMO

We report data regarding three countries with similar healthcare systems which had three different vaccinal strategies between 1st of January and 10th of April 2021: rapid full vaccination (Israel), rapid first-dose vaccination (United Kingdom) and a delayed vaccination strategy (France).


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Hospitalização/estatística & dados numéricos , Programas de Imunização/estatística & dados numéricos , Brasil , COVID-19/virologia , França , Humanos , Programas de Imunização/métodos , Esquemas de Imunização , Israel , SARS-CoV-2/imunologia , África do Sul , Reino Unido
20.
Pharm. pract. (Granada, Internet) ; 19(1): 0-0, ene.-mar. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-201720

RESUMO

BACKGROUND: COVID-19 vaccine development is proceeding at an unprecedented pace. Once COVID-19 vaccines become widely available, it will be necessary to maximize public vaccine acceptance and coverage. OBJECTIVE: This research aimed to analyze the predictors of COVID-19 vaccine acceptance in Russia. METHODS: A cross-sectional online survey was conducted among Russian adults from September 26th to November 9th, 2020. Predictors of the intent to take up COVID-19 vaccination were explored using logistic regression. RESULTS: Out of 876 participants, 365 (41.7%) would be willing to receive the vaccine if it became available. Acceptance increased for a vaccine with verified safety and effectiveness (63.2%). Intention to receive the COVID-19 vaccine was relatively higher among males (aOR=2.37, 95% CI 1.41-4.00), people with lower monthly income (aOR=2.94, 95%CI 1.32-6.57), and with positive trust in the healthcare system (aOR=2.73, 95% CI 1.76-4.24). The Russian people were more likely to accept the COVID-19 vaccine if they believed that the vaccine reduces the risk of virus infection (aOR=8.80, 95%CI 5.21-14.87) or relieves the complications of the disease (aOR=10.46, 95%CI 6.09-17.96). Other barriers such as being unconcerned about side-effects (aOR=1.65, 95%CI 1.03-2.65) and the effectiveness and safety of the vaccination (aOR=2.55, 95%CI 1.60-4.08), also affected acceptance. CONCLUSIONS: The study showed the usefulness of the health belief model constructs in understanding the COVID-19 vaccination acceptance rate in the Russian population. This rate was influenced by sociodemographic and health-related characteristics, and health beliefs. These findings might help guide future efforts for policymakers and stakeholders to improve vaccination rates by enhancing trust in the healthcare system


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Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Programas de Imunização/estatística & dados numéricos , Vacinação em Massa/estatística & dados numéricos , Federação Russa/epidemiologia , Vírus da SARS/patogenicidade , Vacinas/administração & dosagem , Programas de Imunização/organização & administração , Pandemias/prevenção & controle , Estudos Transversais , Inquéritos e Questionários/estatística & dados numéricos
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