Norovirus (NoV) is a major cause of sporadic cases and outbreaks of acute gastroenteritis (AGE), thereby imposing threat to health globally. It is unclear how quantitation of wastewater NoV reflects the incidence of human AGE infections; therefore, we conducted this systematic review and meta-analysis of published NoV wastewater surveillance studies. A literature search was performed, and all studies on NoV wastewater surveillance were identified. Quantitative results were evaluated. The results showed that the overall detection rate of NoV in wastewater was 82.10% (95% confidence interval [CI]: 74.22–89.92%); NoV concentration was statistically significant in terms of season ( P < 0.001), with higher concentration in spring and winter. There were positive correlations between NoV GII concentration in wastewater and GII AGE cases ( r s = 0.51, 95% CI: 0.18–0.74, I 2 = 0%), total AGE cases ( r s = 0.40, 95% CI: 0.15–0.61, I 2 = 23%) and NoV outbreaks ( r s = 0.47, 95% CI: 0.30–0.62, I 2 = 0%). Results of cross-correlation analysis of partial data indicated that variations in GII concentration were consistent with or ahead of those in the number of AGE cases. The diversity of NoV genotypes in wastewater was elucidated, and the dominant strains in wastewater showed a consistent temporal distribution with those responsible for human AGE. Our study demonstrated the potential association of NoV detected in wastewater with AGE infections, and further studies are needed to confirm this conclusion. Supplementary Information The online version contains supplementary material available at 10.1007/s11356-021-18202-x.

Background It was reported that one in four parents were hesitant about vaccinating their children in China. Previous studies have revealed a declining trend in the vaccine willingness rate in China. There is a need to monitor the level of parental vaccine hesitancy toward routine childhood vaccination and hesitancy toward the COVID-19 vaccine during the ongoing COVID-19 pandemic. Objective This study aims to assess changes in trends of parental attitudes toward routine childhood vaccines and COVID-19 vaccinations across different time periods in China. Methods Three waves of cross-sectional surveys were conducted on parents residing in Wuxi City in Jiangsu Province, China from September to October 2020, February to March 2021, and May to June 2021. Participants were recruited from immunization clinics. Chi-square tests were used to compare the results of the three surveys, controlling for sociodemographic factors. Binary and multivariable logistic regression analysis was used to examine factors related to parental vaccine hesitancy and COVID-19 vaccine willingness. Results Overall, 2881, 1038, and 1183 participants were included in the survey’s three waves. Using the Vaccine Hesitancy Scale, 7.8% (225/2881), 15.1% (157/1038), and 5.5% (65/1183) of parents showed hesitancy to childhood vaccination (P<.001), and 59.3% (1709/2881), 64.6% (671/1038), and 92% (1088/1183) of parents agreed to receive a COVID-19 vaccine themselves in the first, second, and third surveys, respectively (P<.001). In all three surveys, “concerns about vaccine safety and side effects” was the most common reason for refusal. Conclusions There has been an increasing acceptance of COVID-19 vaccination in Wuxi City, China. Effective interventions are needed to mitigate public concerns about vaccine safety.

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HPV vaccine uptake remains low in China, especially among girls. Recently, China has initiated a pilot program on HPV immunization for girls 9–14. From November to December 2021, a cross-sectional study was conducted among parents of girls 9–14 in China through a web-based anonymous online questionnaire survey. Descriptive epidemiological analysis was used to analyze parental acceptability. Hierarchical regression analysis and structural equation modeling were to determine associated factors. A total of 5623 participants were included in the analysis. 21.2% girls had received HPV vaccine, and 94.3% parents intended to receive vaccination for their daughters, the Kappa values between them was −0.016. 31.9% of vaccinated mothers had received HPV vaccine for their daughters, vaccination history had a positive impact on behavior ( β = 0.048). Attitude ( β = 0.186), subjective norms ( β = 0.148) and perceived behavioral control ( β = 0.648) had a positive impact on intention. Vaccination intention mediated the relationships between attitude ( β = 0.044), subjective norms ( β = 0.035), and perceived behavioral control ( β = 0.154) with behavior. There is a gap between vaccination intention and behavior in parents of girls 9–14. Perceived behavior control had a strong association on HPV vaccination behavior.

BACKGROUND It was reported that one in four parents were hesitant about vaccinating their children in China. Previous studies have revealed a declining trend in the vaccine willingness rate in China. There is a need to monitor the level of parental vaccine hesitancy toward routine childhood vaccination and hesitancy toward the COVID-19 vaccine during the ongoing COVID-19 pandemic. OBJECTIVE This study aims to assess changes in trends of parental attitudes toward routine childhood vaccines and COVID-19 vaccinations across different time periods in China. METHODS Three waves of cross-sectional surveys were conducted on parents residing in Wuxi City in Jiangsu Province, China from September to October 2020, February to March 2021, and May to June 2021. Participants were recruited from immunization clinics. Chi-square tests were used to compare the results of the three surveys, controlling for sociodemographic factors. Binary and multivariable logistic regression analysis was used to examine factors related to parental vaccine hesitancy and COVID-19 vaccine willingness. RESULTS Overall, 2881, 1038, and 1183 participants were included in the survey’s three waves. Using the Vaccine Hesitancy Scale, 7.8% (225/2881), 15.1% (157/1038), and 5.5% (65/1183) of parents showed hesitancy to childhood vaccination (<i>P</i>&lt;.001), and 59.3% (1709/2881), 64.6% (671/1038), and 92% (1088/1183) of parents agreed to receive a COVID-19 vaccine themselves in the first, second, and third surveys, respectively (<i>P</i>&lt;.001). In all three surveys, “concerns about vaccine safety and side effects” was the most common reason for refusal. CONCLUSIONS There has been an increasing acceptance of COVID-19 vaccination in Wuxi City, China. Effective interventions are needed to mitigate public concerns about vaccine safety.