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The COVID-19 pandemic represents a global health problem, which has been mitigated by the opportune introduction of vaccination programs. Although we already know the benefit that vaccines provide, these are not exempt from adverse events which can be mild to deadly, such as idiopathic inflammatory myopathies, in which a temporal association has not been defined. It is for this reason that we carried out a systematic review of all reported cases of vaccination against COVID-19 and myositis. To identify previously reported cases of idiopathic inflammatory myopathies associated with vaccination against SARS-CoV-2 we registered this protocol on the website of PROSPERO with identification number CRD42022355551. Of the 63 publications identified in MEDLINE and 117 in Scopus, 21 studies were included, reporting 31 cases of patients with vaccination-associated myositis. Most of these cases were women (61.3%); mean age was 52.3 years (range 19-76 years) and mean time of symptom onset post-vaccination was 6.8 days. More than half of the cases were associated with Comirnaty, 11 cases (35.5%) were classified as dermatomyositis, and 9 (29%) as amyopathic dermatomyositis. In 6 (19.3%) patients another probable trigger was identified. Case reports of inflammatory myopathies associated with vaccination have heterogeneous presentations without any specific characteristics: as a consequence, it is not possible to ensure a temporal association between vaccination and the development of inflammatory myopathies. Large epidemiological studies are required to determine the existence of a causal association.
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COVID-19 , Miositis , Humanos , Femenino , Recién Nacido , Lactante , Masculino , SARS-CoV-2 , Pandemias , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/etiología , Miositis/inducido químicamente , Miositis/epidemiología , Vacunación/efectos adversosRESUMEN
Background: The coronavirus disease 2019 pandemic has prompted the exploration of new response strategies for such health contingencies in the near future. Over the last 15 years, several pharmacy-based immunization (PBI) strategies have emerged seeking to exploit the potential of pharmacies as immunization, medication sale, and rapid test centers. However, the participation of pharmacies during the last pandemic was very uneven from one country to another, suggesting a lack of consensus on the definition of their roles and gaps between the literature and practice. Purpose: This study aimed to consolidate the current state of the literature on PBI, document its progress over time, and identify the gaps not yet addressed. Moreover, this study seeks to (i) provide new researchers with an overview of the studies on PBI and (ii) to inform both public health and private organization managers on the range of possible immunization models and strategies. Methodology: A systematic review of scientific qualitative and quantitative studies on the most important scientific databases was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-analyzes guidelines were followed. Finally, this study discusses the trends, challenges, and limitations on the existing literature on PBI. Findings: Must studies concluded that PBI is a beneficial strategy for the population, particularly in terms of accessibility and territorial equity. However, the effectiveness of PBI is affected by the economic, political, and/or social context of the region. The collaboration between the public (government and health departments) and private (various pharmacy chains) sectors contributes to PBI's success. Originality: Unlike previous literature reviews on PBI that compiled qualitative and statistical studies, this study reviewed studies proposing mathematical optimization methods to approach PBI.
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COVID-19 , Farmacias , Farmacia , Humanos , COVID-19/prevención & control , Inmunización , VacunaciónRESUMEN
BackgroundMeta-analyses and single-site studies have established that children are less infectious than adults within a household when positive for ancestral SARS-CoV-2. In addition, children appear less susceptible to infection when exposed to ancestral SARS-CoV-2 within a household. The emergence of SARS-CoV-2 variants of concern (VOC) has been associated with an increased number of paediatric infections worldwide. However, the role of children in the household transmission of VOC, relative to the ancestral virus, remains unclear.AimWe aimed to evaluate children's role in household transmission of SARS-CoV-2 VOC.MethodsWe perform a meta-analysis of the role of children in household transmission of both ancestral SARS-CoV-2 and SARS-CoV-2 VOC.ResultsUnlike with the ancestral virus, children infected with VOC spread SARS-CoV-2 to an equivalent number of household contacts as infected adults and were equally as likely to acquire SARS-CoV-2 VOC from an infected family member. Interestingly, the same was observed when unvaccinated children exposed to VOC were compared with unvaccinated adults exposed to VOC.ConclusionsThese data suggest that the emergence of VOC was associated with a fundamental shift in the epidemiology of SARS-CoV-2. It is unlikely that this is solely the result of age-dependent differences in vaccination during the VOC period and may instead reflect virus evolution over the course of the pandemic.
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COVID-19 , SARS-CoV-2 , Adulto , Niño , Humanos , COVID-19/epidemiología , COVID-19/transmisión , Pandemias , SARS-CoV-2/genética , Vacunación , Composición FamiliarRESUMEN
OBJECTIVE: Although mass vaccination is critical for curbing the spread of COVID-19 and saving lives, vaccine rates remain suboptimal in most countries, calling for effective behavioral interventions to promote vaccinations. Nonfinancial behavioral interventions and monetary incentives are commonly used to promote COVID-19 vaccination but their effects are mixed. METHOD: Articles were searched in the Web of Science, PubMed, and PsycINFO databases. Previous review papers, Google Scholar search, references from the included articles, and unpublished databases were also searched for any other relevant articles. RESULTS: Drawing on 71 studies comprising 1,132,533 participants and 233 effect sizes, we found that the overall behavioral interventions (including nonfinancial interventions and monetary incentives) have a small but statistically significant effect size of Cohen's d = 0.20, 95% confidence interval [0.08, 0.31]. Different types of single interventions and combined strategies produce similar effects. Effect sizes were not moderated by early/late implementation time points, except that collective benefit-oriented interventions showed a marginally significant downward trend as COVID-19 evolves. The effect size of nonfinancial interventions did not significantly differ from monetary incentives. CONCLUSIONS: Our findings affirm the value of nonfinancial strategies and may help forecast the effectiveness of future interventions for ever-evolving pandemics. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Vacunas contra la COVID-19 , COVID-19 , Humanos , Motivación , COVID-19/prevención & control , Vacunación , PandemiasRESUMEN
Debate regarding vaccinating high-risk infants with penta- and hexavalent vaccines persists, despite their good immunogenicity and acceptable safety profile in healthy full-term infants. We report the findings of a systematic literature search that aimed to present data on the immunogenicity, efficacy, effectiveness, safety, impact, compliance and completion of penta- and hexavalent vaccination in high-risk infants, including premature newborns. Data from the 14 studies included in the review showed that the immunogenicity and the safety profile of penta- and hexavalent vaccines in preterm infants was generally similar to those seen in full-term infants, with the exception of an increase in cardiorespiratory adverse events such as apnea, bradycardia and desaturation following vaccination in preterm infants. Despite recommendations of vaccinating preterm infants according to their actual age, and the relatively high completion rate of the primary immunization schedule, vaccination was often delayed, increasing the vulnerability of this high-risk population to vaccine-preventable diseases.
Combined vaccines such as penta- and hexavalent vaccines against multiple childhood diseases are widely used in healthy babies born at term. However, it is still debated whether these vaccines act the same way in babies considered to be high-risk: babies born prematurely at <34 weeks of pregnancy, those with a birthweight of <1500 g or babies with chronic diseases. We did a systematic literature search to find studies on such high-risk babies vaccinated with penta- or hexavalent vaccines; we focused on their antibody levels following vaccination, side effects, and protection from the diseases against which they were vaccinated. We also analyzed whether they were vaccinated on time and with all the doses recommended for healthy full-term babies. We found 14 studies that included premature babies. The results of these studies suggest that premature babies' immune systems respond to penta- and hexavalent vaccines in largely the same way as those of full-term babies; side effects of penta- and hexavalent vaccines are also mostly similar to those seen in full-term babies. However, side effects like pauses in breathing, slow heart rate or low blood oxygen levels seem to be more common in preterm babies; for safety, these babies should be monitored closely after vaccination. Preterm babies are often vaccinated with a delay compared to the recommended schedule. No studies reported data on protection from the diseases covered by penta- and hexavalent vaccinations in preterm babies. More research is needed on penta- and hexavalent vaccination of other high-risk babies besides those born prematurely.
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Enfermedades del Recién Nacido , Rubiaceae , Lactante , Recién Nacido , Humanos , Recien Nacido Prematuro , Vacunas Combinadas/efectos adversos , Vacunación/efectos adversos , Esquemas de InmunizaciónRESUMEN
BACKGROUND: After introducing Covid-19 vaccines, a few side effects were reported, pityriasis rosea being one of them. Therefore, this study will systematically review its manifestation afteradministration. METHODS: Databases were searched, covering a timeline from December 1, 2019 to February 28, 2022. Data were independently extracted and accessed for bias. SPSS statistical software version 25 was used for appropriate inferential statistics. RESULTS: Thirty-one studies were included for data extraction after screening following the eligibility criteria. A total of 111 people were identified to have developed pityriasis rosea or pityriasis rosea-like eruptions after vaccination, out of which 36 (55.38%) were female. The average age of incidence was calculated to be 44.92 years, and 63 (62.37%) people presented after administration of the first dose. It was found popularly in the trunk area, either asymptomatically or with mild symptoms. Meantime the onset, was 8.58 days, and meantime it took to recover, was 6.44 weeks. CONCLUSION: The association between pityriasis rosea and pityriasis rosea-like eruptions after Covid-19 vaccines was established, but given the scarcity of studies, there is a need to conduct different clinical trials to confirm this association further and study the etiology and mechanism of the disease.
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COVID-19 , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Pitiriasis Rosada , Humanos , Femenino , Adulto , Persona de Mediana Edad , Masculino , Pitiriasis Rosada/epidemiología , Pitiriasis Rosada/etiología , Pitiriasis Rosada/diagnóstico , Vacunas contra la COVID-19/efectos adversos , COVID-19/epidemiología , VacunaciónRESUMEN
AIMS: In order to better define the need for influenza vaccination in people with diabetes (DM), we collected all available evidence on the effect of DM as a risk factor for complications of both seasonal and pandemic influenza, and on the specific effectiveness of vaccines in patients with DM. DATA SYNTHESIS: Two distinct systematic searches on MEDLINE, Cochrane, ClinicalTrials.gov and Embase databases were performed, one for each metanalysis, collecting all observational studies and randomized clinical trials performed on humans up to May 31st, 2022. We retrieved 34 observational studies comparing risk for influenza complications in people with or without diabetes, and 13 observational studies assessing vaccine effectiveness on preventing such complications. Mortality for influenza and hospitalization for influenza and pneumonia resulted significantly higher in individuals with versus without DM, both when unadjusted and adjusted data are analyzed. In diabetic individuals vaccinated for influenza overall hospitalization, hospitalization for influenza or pneumonia and overall mortality are significantly lower in comparison with not vaccinated DM subjects, both when unadjusted and adjusted data were analyzed. CONCLUSION: This systematic review and meta-analysis shows that: 1) influenza is associated with more severe complications in diabetic versus not diabetic individuals and 2) influenza vaccination is effective in preventing clinically relevant outcomes in adults with DM with a NNT (number needed to treat) of 60, 319, and 250 for all-cause hospitalization, specific hospitalization, and all-cause mortality, respectively. The identification of diabetic patients as the target of vaccination campaigns for influenza appears to be justified by available clinical evidence.
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Diabetes Mellitus , Vacunas contra la Influenza , Gripe Humana , Adulto , Humanos , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Vacunas contra la Influenza/efectos adversos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Diabetes Mellitus/tratamiento farmacológico , Factores de Riesgo , VacunaciónRESUMEN
Background: Mastitis is the most important disease in dairy cattle with impact in welfare of animals and the economy of the dairy farming activity. Attempts have been made to produce vaccines to prevent the disease, however, results have been dubious. Aim: The aim of this study was to evaluate the efficacy of the mastitis vaccination in dairy cattle by merging several trials to allow evidence synthesis. Methods: A list of publications with common methodological grounds was selected to allow a quantitative comparison in a meta-analysis with moderators. Results: A mixed methods model (p < 0.001), with four significant moderators was successfully fitted: "year of publication" (p < 0.001), "vaccination timing" (p < 0.01), "type of animal" (p < 0.001), and "vaccine fabrication" (p < 0.001). The model is homogeneous (p > 0.05), with the moderators explaining the variability. Efficacy decreases over time. Vaccines applied after calving show inefficacy [log risk ratio (RR) 1.72 (1.34, 2.21)], and applied before calving show reduced efficacy [log RR 0.86 (0.72, 1.03)]. Commercial vaccines don't show efficacy [log RR 1.07 (0.94, 1.22)]. Self-fabricated vaccines show efficacy [log RR (0.51, 0.94)]. Conclusion: Full clarification of efficacy is not shown; however, if vaccination is used, must follow a pre-calving protocol. While not showing efficacy, the vaccination has demonstrated a reduction of the severity in clinical cases, rate of culling, and has increased the production of milk and milk solids. Vaccination may improve health and welfare but does not prevent the disease effectively; it must be seen as an additional tool to the traditional preventive measures.
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Enfermedades de los Bovinos , Mastitis Bovina , Femenino , Bovinos , Animales , Mastitis Bovina/prevención & control , Leche , Vacunación/veterinaria , AgriculturaRESUMEN
Patients received kidney transplantation (KTR) have a low seroconversion rate after vaccination. Our objective was to compare the seroconversion rates and adverse effects of additional different vaccinations in KTR patients in existing studies. Databases such as PubMed, Cochrane Library, Web of Science, Embase, ClinicalTrials.gov and others. Three high-quality RCT were included and showed no statistical difference in seroconversion rates between the two vaccines (RR = 0.93[0.76,1.13]). There was no statistical difference in seroconversion rates between the sexes, for men (RR = 0.93[0.69,1.25]) and women (RR = 0.91[0.62,1.33]). Among the adverse effects there was no statistically significant difference in fever (RR = 1.06[0.44,2.57]), while for injection site pain there was a statistically significant difference (RR = 1.14[1.18,1.84]). There was no significant difference in seroconversion rates in patients with KTR who received the two additional vaccines. Patients injected with the viral vector vaccine were less painful than those injected with the mRNA vaccine.
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Vacunas contra la COVID-19 , COVID-19 , Trasplante de Riñón , Femenino , Humanos , Masculino , Anticuerpos Antivirales , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Seroconversión , Vacunación/efectos adversosRESUMEN
CONTEXT: Provider-based human papillomavirus (HPV) vaccine promotion interventions have been widely implemented; however, the effectiveness of these approaches is unclear. OBJECTIVES: This systematic review assessed the effects and costs of provider-based interventions designed to increase HPV vaccination coverage. A meta-analysis was conducted to estimate pooled effect sizes of the interventions. DATA SOURCES: We searched PubMed, Medline, Embase, and the Cochrane Library. STUDY SELECTION: We identified articles on provider-based HPV vaccine promotion interventions published in English between 2007 and 2021. DATA EXTRACTION: Information about the interventions' effects and costs was extracted from the studies. A meta-analysis was performed to estimate the pooled intervention effects, including changes in the HPV vaccine initiation rate, HPV vaccine completion rate, and the percentage of patients receiving the next needed dose. RESULTS: We identified 32 studies of provider-based interventions to improve the HPV vaccination rate. The reported intervention strategies included provider training, provider reminders, and provider assessment and feedback. In the meta-analysis, we found significant improvements in the HPV vaccine initiation rate (3.7%) and the percentage of patients receiving the next needed dose (9.4%). LIMITATIONS: Because of the limited number of studies, we were unable to compare the same outcomes between different provider-based approaches. We found the high heterogeneity across studies. The random effects method was applied to adjust for study heterogeneity, the heterogeneity remined high for certain outcomes. CONCLUSIONS: Provider-based interventions were effective in improving HPV vaccination rates. Sustainability and continuous implementation are the central factors that contributed to intervention success.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Humanos , Infecciones por Papillomavirus/prevención & control , Vacunación , Cognición , Costos y Análisis de CostoRESUMEN
BACKGROUND: Healthcare workers (HCWs) and healthcare students display high levels of vaccine hesitancy with impact on healthcare provision, patient safety, and health promotion. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, this evidence needs to be synthesised, as interventions to reduce vaccination hesitancy in this population are needed. METHODS: This Umbrella Review aimed to explore the barriers and facilitators of vaccine hesitancy toward the COVID-19 vaccine for HCWs and healthcare students. The review was performed and reported in accordance with Joanna Briggs Institutes guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A protocol was preregistered on PROSPERO (CRD42022327354). Eight databases were searched from November 2019 to 23rd May 2022 to identify any systematic reviews that explored factors associated with hesitancy towards the COVID-19 vaccine for HCWs or healthcare students. RESULTS: A total of 31 studies were included in the review. The majority of studies (71%) were appraised as strong or moderate quality and there was a slight degree of overlap (<5%) of primary studies between the reviews. Vaccine hesitancy was more common among HCWs and healthcare students in specific occupational roles (e.g. nurses) than others (e.g. physicians). Frequent reasons for hesitancy were related to sociodemographic factors (gender, age, ethnicity), occupational factors (COVID-19 exposure, perceived risk, mandatory vaccination), health factors (vaccination history), vaccine-related factors (concerns about safety, efficacy, side-effects, rapid development, testing, approval and distribution of the vaccine), social factors (social pressure, altruism and collective responsibility), distrust factors (key social actors, pandemic management), information factors (inadequate information and sources, exposure to misinformation). CONCLUSION: The results from this Umbrella Review have wide-reaching implications for the research area, healthcare systems and institutions and governments worldwide. Designing tailored strategies for specific occupational groups is pivotal to increasing vaccine uptake and securing a safe healthcare provision worldwide.
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Vacunas contra la COVID-19 , COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Instituciones de Salud , Personal de Salud , Vacunación , Vacilación a la VacunaciónRESUMEN
BACKGROUND: This study aimed to evaluate the safety and effectiveness of the BNT162b2 vaccine in immunocompromised adolescents and young adults. RESEARCH DESIGN AND METHODS: The study conducted a meta-analysis of post-marketing studies examining BNT162b2 vaccination efficacy and safety among immunocompromised adolescents and young adults worldwide. The review included nine studies and 513 individuals aged between 12 and 24.3 years. The study used a random effect model to estimate pooled proportions, log relative risk, and mean difference, and assessed heterogeneity using the I2 test. The study also examined publication bias using Egger's regression and Begg's rank correlation and assessed bias risk using ROBINS-I. RESULTS: The pooled proportions of combined local and systemic reactions after the first and second doses were 30% and 32%, respectively. Adverse events following immunization (AEFI) were most frequent in rheumatic diseases (40%) and least frequent in cystic fibrosis (27%), although hospitalizations for AEFIs were rare. The pooled estimations did not show a statistically significant difference between immunocompromised individuals and healthy controls for neutralizing antibodies, measured IgG, or vaccine effectiveness after the primary dose. However, the evidence quality is low to moderate due to a high risk of bias, and no study could rule out the risk of selection bias, ascertainment bias, or selective outcome reporting. CONCLUSIONS: This study provides preliminary evidence that the BNT162b2 vaccine is safe and effective in immunocompromised adolescents and young adults, but with low to moderate evidence quality due to bias risk. The study calls for improved methodological quality in studies involving specific populations.
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Vacuna BNT162 , COVID-19 , Huésped Inmunocomprometido , Inmunogenicidad Vacunal , Adolescente , Adulto , Niño , Humanos , Adulto Joven , Vacuna BNT162/inmunología , COVID-19/prevención & control , VacunaciónRESUMEN
INTRODUCTION: Here, we systematically assessed the safety and immunogenicity of the heterologous ChAd/BNT vaccination regimens. MATERIALS AND METHODS: We evaluated the immunogenicity by the geometric mean titers ratio (GMTR) of the neutralizing antibody and anti-spike IgG. The safety of heterologous ChAd/BNT vaccination was evaluated using the pooled risk ratios (RRs) calculated by the random-effects model about the adverse events. Our study was registered with PROSPERO, CRD42021265165. RESULTS: Eleven studies were included in the analyses. Compared to the homologous ChAd/ChAd vaccination, the heterologous ChAd/BNT vaccination showed significantly higher immunogenicity in terms of the neutralizing antibody and GMTR of anti-spike IgG, but at the same time displayed higher incidence of total adverse reactions, especially for the local adverse reactions. Moreover, heterologous ChAd/BNT vaccination showed similar immunogenicity to the homologous BNT/BNT vaccination (GMTR of neutralizing antibody and anti-spike IgG) and similar safety. DISCUSSION: Heterologous ChAd/BNT vaccination showed robust immunogenicity and tolerable safety.
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Vacuna BNT162 , COVID-19 , Humanos , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Vacunación/efectos adversos , Anticuerpos Neutralizantes , Inmunoglobulina G , Anticuerpos AntiviralesRESUMEN
BACKGROUND: Global COVID-19 vaccinations rates among youth and adolescent populations prove that there is an opportunity to influence the acceptance for those who are unvaccinated and who are hesitant to receive additional doses. This study aimed to discover the acceptance and hesitancy reasons for choosing or refusing to be vaccinated against COVID-19. METHODS: A scoping review was conducted, and articles from three online databases, PubMed, Wiley, and Cochrane Library, were extracted and screened based on exclusion and PICOs criteria. A total of 21 studies were included in this review. Data highlighting study attributes, characteristics, and decision-making dynamics were extracted from the 21 studies and put into table format. RESULTS: The results showed that the primary drivers for accepting the COVID-19 vaccine include protecting oneself and close family/friends, fear of infection, professional recommendations, and employer obligations. Primary hesitancy factors include concerns about safety and side effects, effectiveness and efficacy, lack of trust in pharmaceuticals and government, conspiracies, and perceiving natural immunity as an alternative. CONCLUSIONS: This scoping review recommends that further research should be conducted with adolescent and youth populations that focus on identifying health behaviors and how they relate to vaccine policies and programs.
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Vacunas contra la COVID-19 , COVID-19 , Adolescente , Humanos , COVID-19/prevención & control , Vacunación , Gobierno , Bases de Datos FactualesRESUMEN
OBJECTIVES: The purpose of this study was to examine the current literature on paediatric COVID-19 vaccine hesitancy among parents and identify key influencing factors, thus enabling targeted policy development and implementation. STUDY DESIGN: This was a systematic literature review and Decision-making Trial and Evaluation Laboratory (DEMATEL) analysis. METHODS: A review of the quantitative and qualitative literature focusing on factors influencing paediatric COVID-19 vaccine hesitancy was conducted. Searches were performed in PubMed, ScienceDirect, SpringerLink and Embase. Because of the immediacy of the topic, commentaries were included in addition to research and review articles. Influencing factors were categorised according to the Health Ecology Theory and screened using the DEMATEL method. RESULTS: A total of 44 articles were included in the study, and 44 factors influencing paediatric COVID-19 vaccine hesitancy were identified. Of these, 18 were categorised as key factors using the DEMATEL method, including a history of COVID-19 infection in parents and perceived safety of the paediatric COVID-19 vaccine. CONCLUSIONS: Policymakers and public health personnel should pay more attention to the key factors influencing paediatric COVID-19 vaccine hesitancy. The outcome of this research will benefit and motivate decision-makers to consider strategies to overcome various challenges of COVID-19 vaccine hesitancy.
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Vacunas contra la COVID-19 , COVID-19 , Humanos , Niño , Vacunas contra la COVID-19/uso terapéutico , COVID-19/prevención & control , Padres , Formulación de Políticas , VacunaciónRESUMEN
OBJECTIVES: Developing countries face the greatest cervical cancer disease burden and mortality with suboptimal immunisation uptake. This review explores the communication strategies adopted, successes, challenges and lessons learnt in sub-Saharan countries to enhance human papillomavirus (HPV) immunisation. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed, Hinari, Cochrane Library, Trip database, CINAHL, Web of Science, Scopus and seven grey resources were searched through May 2022. ELIGIBILITY CRITERIA: We included observational studies addressing communication strategies for HPV immunisation uptake. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search, screen and code included studies. Data extraction and assessment of risk of bias were done in duplicate to enhance validity of the results. Meta-analysis was conducted using the random-effects model. Findings were summarised and synthesised qualitatively. RESULTS: Communication intervention to facilitate decision-making achieved uptake rate of 100% (95% CI 0.99% to 1.00%), followed by intervention to enable communication, which achieved 92% (95% CI 0.92% to 0.92%). Communication intervention to inform and educate achieved 90% (95% CI 0.90% to 0.90%).Targeting both healthcare workers and community leaders with the communication intervention achieved 95% (95% CI 0.91% to 0.98%), while teachers and school boards achieved 92% (95% CI 0.84% to 1.01%). Targeting policymakers achieved 86% (95% CI 0.78% to 0.93%).Based on the method of communication intervention delivery, use of training achieved an uptake rate of 85% (95% CI 0.84% to 0.87%); similarly, drama and dance achieved 85% (95% CI 0.84% to 0.86%). However, use of information, education and communication materials achieved 82% (95% CI 0.78% to 0.87%). CONCLUSION: HPV vaccine communication is critical in ensuring that the community understands the importance of vaccination. The most effective communication strategies included those which educate the population about the HPV vaccine, facilitate decision-making on vaccine uptake and community ownership of the vaccination process immunisation. PROSPERO REGISTRATION NUMBER: CRD42021243683.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino , Femenino , Humanos , Adolescente , Virus del Papiloma Humano , Infecciones por Papillomavirus/prevención & control , Padres/educación , Educación en Salud/métodos , Vacunación , Inmunización , Comunicación , Neoplasias del Cuello Uterino/prevención & control , África del Sur del SaharaRESUMEN
INTRODUCTION: The World Health Organization's Global Strategy on Human Resources for Health: Workforce 2030 sets policy recommendations and targets for in-service and pre-service training programs to improve workforce competency. To date, comprehensive reviews on immunization training have mainly focused on in-service trainings. This systematic review aimed to synthesize current literature on pre-service immunization training, including primary immunization competencies covered, methods used, outcomes on improving competencies and behavior change for immunization service delivery, and student readiness for immunization practice, in both low-resource and high-income settings. METHODS: A systematic search of seven scholarly databases identified published literature on pre-service training on immunization published between January 2001 and November 2021. It included all geographic regions and languages, study designs, and individuals preparing to enter the immunization workforce. Additional search methods included reviewing references of retrieved articles, scanning journals, and engaging pre-service training experts for unpublished reports. RESULTS: Search results yielded 5,611 articles; 39 articles met the inclusion criteria. Five articles were identified through other search methods. Studies took place mostly in high-income countries (35/44), targeted professional (medical, nursing, and pharmacy) students and tutors at health training institutions. Eight of the ten recommended immunization competencies were included in the curricula and methods used to deliver pre-service training varied. Teaching techniques and applied learning strategies using realistic situations increased students' knowledge, attitudes, and awareness of vaccine benefits; built confidence to administer vaccines and communicate with hesitant patients; and increased the likelihood of recommending vaccines. CONCLUSION: This review was the first step to understanding pre-service training on immunization. Further research is needed to inform pre-service training programs in low- and middle-income countries, particularly for nurses, vaccinators with low-level educational backgrounds, and other healthcare professional students. Prioritizing essential audiences, designing and delivering practical training, and evaluating results will help prepare students for the immunization challenges of tomorrow.
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Inmunización , Vacunación , Humanos , Curriculum , Estudiantes , AprendizajeRESUMEN
BACKGROUND: To understand the currentâmeasles mortality burden, and to mitigate the future burden, it is crucial to have robust estimates of measles case fatalities. Estimates of measles case-fatality ratios (CFRs) that are specific to age, location, and time are essential to capture variations in underlying population-level factors, such as vaccination coverage and measles incidence, which contribute to increases or decreases in CFRs. In this study, we updated estimates of measles CFRs by expanding upon previous systematic reviews and implementing a meta-regression model. Our objective was to use all information available to estimate measles CFRs in low-income and middle-income countries (LMICs) by country, age, and year. METHODS: For this systematic review and meta-regression modelling study, we searched PubMed on Dec 31, 2020 for all available primary data published from Jan 1, 1980 to Dec 31, 2020, on measles cases and fatalities occurring up to Dec 31, 2019 in LMICs. We included studies that previous systematic reviews had included or which contained primary data on measles cases and deaths from hospital-based, community-based, or surveillance-based reports, including outbreak investigations. We excluded studies that were not in humans, or reported only data that were only non-primary, or on restricted populations (eg, people living with HIV), or on long-term measles mortality (eg, death from subacute sclerosing panencephalitis), and studies that did not include country-level data or relevant information on measles cases and deaths, or were for a high-income country. We extracted summary data on measles cases and measles deaths from studies that fitted our inclusion and exclusion criteria. Using these data and a suite of covariates related to measles CFRs, we implemented a Bayesian meta-regression model to produce estimates of measles CFRs from 1990 to 2019 by location and age group. This study was not registered with PROSPERO or otherwise. FINDINGS: We identified 2705 records, of which 208 sources contained information on both measles cases and measles deaths in LMICS and were included in the review. Between 1990 and 2019, CFRs substantially decreased in both community-based and hospital-based settings, with consistent patterns across age groups. For people aged 0-34 years, we estimated a mean CFR for 2019 of 1·32% (95% uncertainty interval [UI] 1·28-1·36) among community-based settings and 5·35% (5·08-5·64) among hospital-based settings. We estimated the 2019 CFR in community-based settings to be 3·03% (UI 2·89-3·16) for those younger than 1 year, 1·63% (1·58-1·68) for age 1-4 years, 0·84% (0·80-0·87) for age 5-9 years, and 0·67% (0·64-0·70) for age 10-14 years. INTERPRETATION: Although CFRs have declined between 1990 and 2019, there are still large heterogeneities across locations and ages. One limitation of this systematic review is that we were unable to assess measles CFR among particular populations, such as refugees and internally displaced people. Our updated methodological framework and estimates could be used to evaluate the effect of measles control and vaccination programmes on reducing the preventable measles mortality burden. FUNDING: Bill & Melinda Gates Foundation; Gavi, the Vaccine Alliance; and the US National Institutes of Health.
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Países en Desarrollo , Sarampión , Humanos , Teorema de Bayes , Sarampión/epidemiología , Sarampión/prevención & control , Vacunación , Renta , Salud GlobalRESUMEN
OBJECTIVES: To identify technologies used in vaccine safety communication and evaluate their impact on vaccination intention, uptake, knowledge, attitude, and perceptions of consumers. METHODS: We searched 6 electronic databases to identify randomised controlled trials assessing the impact of using technology in vaccine safety communication. The Cochrane Collaboration's tool for assessing risk of bias was used to evaluate each study. RESULTS: We included 22 studies involving 27,109 participants from 8 countries; 15 studies assessed the use of videos and 7 examined innovative technologies. Using videos significantly improved knowledge (n = 3) and participant engagement (n = 2) compared to printed material. Among the innovative technologies, the use of virtual reality, and smartphone applications incorporating social networking or gamification significantly increased vaccination knowledge, confidence, and engagement. The studies showed that narrative messaging increased perceived disease severity (n = 2) and vaccination intention (n = 2). CONCLUSIONS: While the use of innovative technologies is increasing, videos currently remain the most popular technology for vaccine safety communication. Communication technology, particularly with narrative messaging, improves patient engagement and comprehension. PRACTICE IMPLICATIONS: Health authorities should increase focus on using videos and smartphone applications for vaccine safety communication. Collaboration among stakeholders is essential to develop guidelines on effective message content to complement the technology.
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Aplicaciones Móviles , Vacunas , Humanos , Comunicación , Narración , Vacunación/efectos adversos , Vacunas/efectos adversosRESUMEN
BACKGROUND: A variety of intervention strategies to improve Human Papillomavirus (HPV) vaccination rates in adults exist; however, they have shown varying efficacy and inconsistent outcomes. PURPOSE: This meta-analysis tested the efficacy of HPV vaccination interventions for adults in increasing vaccine intentions, rates of initiation of the vaccine series, and completion rates. The study also tested potential moderators (intervention strategy, theory-based versus nontheory-based interventions, race/ethnicity, gender, study quality) of relationships between intervention receipt and vaccine intentions. METHOD: Electronic databases (PsychINFO, Web of Science, Scopus, EBSCO, JSTOR, PubMed) were searched for English-language articles published up to September 2021. Eligible studies included outcomes of vaccine intentions, receipt of the first dose, or vaccine series completion and included intervention and comparison conditions. RESULTS: The search yielded 38 eligible studies reporting 78 effect sizes. Random effects, multilevel, meta-analytic models revealed a significant, small effect of interventions on vaccine intentions (OR = 0.36, 95% CI [0.07, 0.65]); a nonsignificant effect on vaccine initiation rates (OR = 1.29; 95% CI [0.87, 1.91]); and significant effects on vaccine completion rates (OR = 1.58, 95% CI [1.18, 2.11]). Race/ethnicity, gender, intervention strategy, theory-based interventions, and study quality did not moderate the intervention effects on vaccine intentions. CONCLUSION: Evidence supports the efficacy of interventions to increase intentions to receive the HPV vaccine and completion of the HPV vaccine series in adults. However, evidence did not support the efficacy of interventions to increase HPV vaccine initiation. Findings highlight directions for developing more efficacious HPV vaccine interventions for adults.
