New immunization strategies: adapting to global challenges

Mantel, Carsten; Cherian, Thomas

doi:10.1007/s00103-019-03066-x

Cited by 30 publications

(29 citation statements)

References 28 publications

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“…Regularly scheduled outreach events have the potential to greatly facilitate access to immunisation services in distant communities, especially when communities are involved in planning them 33. The WHO and UNICEF have endorsed the RED/REC strategy since 2002,33 34 but our findings suggest that there has been inadequate resource allocation to implement RED/REC in the study communities.…”

Section: Discussionmentioning

confidence: 62%

Determinants of immunisation dropout among children under the age of 2 in Zambézia province, Mozambique: a community-based participatory research study using Photovoice

Powelson

Magadzire²,

Draiva³

et al. 2022

BMJ Open

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ObjectiveImmunisations are highly impactful, cost-effective public health interventions. However, substantial gaps in complete vaccination coverage persist. We aimed to describe caregivers’ immunisation experiences and identify determinants of vaccine dropout.DesignWe used a community-based participatory research approach employing Photovoice, SMS (short messaging service) exchanges and in-depth interviews. A team-based approach was used for thematic analysis. The Increasing Vaccination Model guided the analysis and identification of vaccination facilitators and barriers.SettingThis study was conducted in Zambézia province, Mozambique, in Namarroi and Gilé districts, where roughly 19% of children under 2 start but do not complete the recommended vaccination schedule.ParticipantsParticipants were identified through health facility vaccination records and included caregivers of children aged 25–34 months who were fully vaccinated (n=10) and partially vaccinated (n=22). We also collected data from 12 health workers responsible for delivering immunisations at the selected health facilities.ResultsFour main patterns of barriers leading to dropout emerged: (1) social norms and limited family support place the immunisation burden on mothers; (2) perceived poor quality of health services reduces caregivers’ trust in vaccination services; (3) concern about side effects causes vaccine hesitancy; and (4) caregivers hesitate to seek and advocate for vaccination due to power imbalances with health workers. COVID-19 created additional barriers related to social distancing, mask requirements, supply chain challenges and disrupted outreach services. For most caregivers, dropout becomes increasingly likely with compounding barriers. Caregivers of fully-vaccinated children noted facilitators, including accompaniment to health facilities or assistance caring for other children, which enabled them to complete vaccination.ConclusionsOvercoming immunisation barriers requires strengthening health systems, including improving logistics to avert vaccine stockouts and building health worker capacity, including empathic communication with caregivers. Consistent and reliable immunisation outreach services could address access challenges and improve immunisation uptake, particularly in distant communities.

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Section: Discussionmentioning

confidence: 62%

Determinants of immunisation dropout among children under the age of 2 in Zambézia province, Mozambique: a community-based participatory research study using Photovoice

Powelson

Magadzire²,

Draiva³

et al. 2022

BMJ Open

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“…Beyond access to the vaccine, there are questions that are common to vaccines for global health 10 . The purchase, supply management, transport through the cold chain, in-country distribution and vaccine administration are accomplished daily for childhood vaccines with roughly 80% coverage worldwide, which is a testament to the success of national vaccination programs, complemented by the efforts of Gavi and other public and private entities 25,26 . Several factors complicate the use of COVID-19 vaccines: programmatic scale, in particular the need for vaccination of all age groups rather than simply children; logistics-a global supply chain that will be complex and might result in bottlenecks and delays; the potential use of multiple different vaccines and a lack of evidence on substitution of one for the other; and unique and demanding cold-chain requirements, especially for messenger RNA vaccines, which require −20 °C storage for the Moderna candidate and −70 °C storage for the Pfizer candidate (although higher temperatures are being explored), and which is an especially challenging issue for use in LMICs.…”

Section: Vaccination Access and Equitymentioning

confidence: 99%

Looking beyond COVID-19 vaccine phase 3 trials

Kim

Marks

Clemens

2021

Nat Med

540

435

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After the recent announcement of COVID-19 vaccine efficacy in clinical trials by several manufacturers for protection against severe disease, a comprehensive post-efficacy strategy for the next steps to ensure vaccination of the global population is now required. These considerations should include how to manufacture billions of doses of high-quality vaccines, support for vaccine purchase, coordination of supply, the equitable distribution of vaccines and the logistics of global vaccine delivery, all of which are a prelude to a massive vaccination campaign targeting people of all ages. Furthermore, additional scientific questions about the vaccines remain that should be answered to improve vaccine efficacy, including questions regarding the optimization of vaccination regimens, booster doses, the correlates of protection, vaccine effectiveness, safety and enhanced surveillance. The timely and coordinated execution of these post-efficacy tasks will bring the pandemic to an effective, and efficient, close.

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“…Vaccination is still one of the most cost-effective me thods in reducing morbidity and mortality associated with infectious diseases; however, challenges remain and persisting inequities in vaccine uptake contribute to the continued occurrence and outbreaks of vaccine-preventable diseases [9].…”

Section: Discussionmentioning

confidence: 99%

Awareness of diabetic adult patients about immunization

Оncu¹,

Atayoğlu

Sari³

et al. 2021

Mìžnarodnij endokrinologìčnij žurnal

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Background. Diabetes mellitus (DM) is associated with an increased rate of infection, which was partly explained by a decreased T cell-mediated response, and although being controversial, impaired function of neutrophil associated with diabetes is also documented. The purpose was to determine awareness of type 2 Diabetic patients about immunization against hepatitis-B, influenza, tetanus and zona, to find out the source of current vaccine information. Materials and methods. The study was planned as a single centred, prospective, cross-sectional, descriptive and analytical trial. The questionnaire form was applied to patients diagnosed with type 2 DM, who applied to Diabetics Outpatient Clinic by face-to-face interview technique. Results. A total of 439 patients was evaluated; the diagnosis time of 38.5, 19, 24 and 18 % of the patients was determined as 0–5 years, 6–10 years, 11–15 years and more than 16 years, respectively. Organ damage was detected in 76 of the patients, and as the most common complication, retinopathy was found to be in 57 (13.01 %) patients. Among the patients, 175 (39.86 %) of them had coexisting hypertension, and 164 (37.36 %) of them had coexisting hyperlipidaemia. Whereas 153 (35.75 %) were aware of pneumococcal vaccine, the number of patients who got vaccinated was 55 (12.53 %). Whereas 336 (76.54 %) were aware of influenza vaccine, 108 (24.60 %) of them got vaccinated. Among the patients, 179 (40.77 %) heard of hepatitis B vaccine, but 34 (7.74 %) got vaccinated. It was determined that, 279 people heard od tetanus vaccine, 183 people were administered at least one dose of vaccine, however the last vaccine of 101 (55.49 %) of those who had tetanus vaccine, was more than 11 years ago. Only 3 out of 33 (7.52 %), who knew about the zona vaccine, got vaccinated. In that study, 243 (55.35 %) people got vaccinated in adulthood for any reason. There was no significant relationship between education level and duration of disease and vaccination. Conclusions. Adult immunization rates of diabetic patients were found to be in low levels. The primary care professionals play an essential role in the immunization of diabetic patients.

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New immunization strategies: adapting to global challenges

Cited by 30 publications

References 28 publications

Determinants of immunisation dropout among children under the age of 2 in Zambézia province, Mozambique: a community-based participatory research study using Photovoice

Determinants of immunisation dropout among children under the age of 2 in Zambézia province, Mozambique: a community-based participatory research study using Photovoice

Looking beyond COVID-19 vaccine phase 3 trials

Awareness of diabetic adult patients about immunization

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