Vaccine最新文献

{"title":"Estimating the potential number of cases prevented by infant/ toddler immunisation with a MenACWY vaccine","authors":"","doi":"10.1016/j.vaccine.2024.126240","DOIUrl":"10.1016/j.vaccine.2024.126240","url":null,"abstract":"<div><p><u>Introduction:</u> Meningococcal disease control in the UK relies on various vaccines, with the discontinuation of the Hib/MenC combination vaccine Menitorix® in 2018 necessitating reassessment of the immunisation strategy. The quadrivalent MenACWY vaccine emerges as a promising long-term solution, already integrated into the teenage immunisation regimen. While indirect control of group W and C cases is anticipated through existing programs, the high incidence of meningococcal disease in infancy underscores the potential benefits of infant/toddler vaccination.</p><p><u>Methods:</u> Utilizing data from two UK studies, we recalibrated age-specific carriage prevalence curves and estimated the proportion of meningococcal carriage attributed to ACWY and non-ACWY strains. Employing a dynamic transmission model, we evaluated the combined indirect effects of the teenage MenACWY vaccination initiative and the direct impact of administering MenACWY vaccine at either 3 or 12 months, alongside ongoing 4CMenB vaccination efforts. Given the pandemic-induced decline in cases and alterations in social contact patterns reported in prior research, we also simulated the transmission model to reflect periods of COVID-19 lockdown.</p><p><u>Results:</u> Our projections indicate effective control of carriage and disease associated with groups A, C, W, and Y through the teenage vaccination campaign. Assuming sustained high uptake of teenage vaccines amid pandemic scenario, we forecast MenACWY carriage prevalence to be below 1% by 2025. Across all scenarios, the impact of an infant/toddler MenACWY program on case reduction remains modest. Notably, administering the MenACWY dose at 3 months yields a greater number of prevented cases compared to administration at 12 months. With sustained uptake of teenage vaccination, our estimates suggest that between 3 and 22 cases could be averted in a 2025 birth cohort through a 3-month MenACWY dose.</p><p><u>Conclusions:</u> Provided teenage uptake remains high and the infant 4CMenB programme is maintained, we suggest that few cases will be prevented from an infant/ toddler MenACWY dose.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24009228/pdfft?md5=1a63d33464f1267d06f7aa56fea3d4a5&pid=1-s2.0-S0264410X24009228-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142041328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operationalizing the Behaviour Change Wheel and APEASE criteria to co-develop recommendations with stakeholders to address barriers to school-based immunization programs","authors":"","doi":"10.1016/j.vaccine.2024.126226","DOIUrl":"10.1016/j.vaccine.2024.126226","url":null,"abstract":"<div><p><strong>Introduction:</strong> School-based immunization programs offer an accessible route to routine vaccines for students. During the COVID-19 pandemic, school closures to comply with public health measures had a drastic effect on school-based immunization program delivery and associated vaccine uptake. We sought to integrate findings from a mixed methods study to co-develop evidence-based and theory-informed recommendations with a diverse group of stakeholders (i.e., decision makers, healthcare providers, school staff, parents and adolescent students) to address barriers to new and existing school-based immunization programs. <strong>Methods:</strong> Findings from a mixed methods study were integrated using a joint display and narrative summary. These findings were mapped through the Behaviour Change Wheel, a series of tools designed to facilitate the development of behaviour change interventions. Draft recommendations were provided to previous mixed methods study participants who consented to participating in future phases of the research study (<em>n</em> = 26). Feedback was captured using a Likert-scale survey of acceptability, practicality, effectiveness, affordability, safety and equity (APEASE) criteria, with feedback and additional insights captured using open-ended textboxes. Data was used to revise and finalize recommendations. <strong>Results:</strong> Applying the Behaviour Change Wheel, we drafted 26 evidence-based, theory-informed recommendations to address barriers to school-based immunization programs. Participants (<em>n</em> = 16) provided feedback, with half of the recommendations scoring 80% or higher across all six APEASE criteria. The remaining 13 recommendations received a moderate score across one or more criteria. Stakeholders identified a high level of interest in expanding the use of e-consent forms, expanding programming to offer a meningitis B vaccine, and recommendations to ease student anxiety. <strong>Conclusion:</strong> We co-developed a range of recommendations to improve school-based immunization programs with stakeholders using data generated from a mixed methods study. Implementation of any single or combination of recommendations will need to be tailored to local clinic procedures, school system and health system resources.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24009083/pdfft?md5=883c2aca76b5ad404b2a96a3228fd5ec&pid=1-s2.0-S0264410X24009083-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Why did nobody ask us?’: A mixed-methods co-produced study in the United Kingdom exploring why some children are unvaccinated or vaccinated late","authors":"","doi":"10.1016/j.vaccine.2024.126172","DOIUrl":"10.1016/j.vaccine.2024.126172","url":null,"abstract":"<div><h3>Objective</h3><p>Childhood vaccine uptake in the United Kingdom (UK) is sub-optimal leading to outbreaks of preventable diseases. We aimed to explore UK parents' perspectives on why some children are unvaccinated or vaccinated late.</p></div><div><h3>Methods</h3><p>We undertook a mixed-methods, co-production study involving a survey using a questionnaire followed by focus groups. We partnered with The Mosaic Community Trust (Mosaic) who are based in a more deprived, ethnically diverse, low vaccine uptake area of London. Targeted recruitment to complete the questionnaire (either on paper or online) was done through Mosaic, community networks and social media promotion. We collected demographic data alongside parents' views on routine childhood vaccination, their vaccine decisions, and experiences of accessing childhood vaccine appointments We report descriptive findings from the questionnaire and thematic analysis of free-text questionnaire answers and focus groups guided by the COM-B model of Capability, Opportunity, and Motivation.</p></div><div><h3>Results</h3><p>Between June–October 2022, 518 parents were surveyed of whom 25% (<em>n</em> = 130), were from ethnic minorities (13%, <em>n</em> = 68-unknown ethnicity). In 2023 we held four focus groups with 22 parents (10 from ethnic minorities). Only 15% (<em>n</em> = 78) parents had delayed or refused a vaccine for their child. A quarter of parents felt they had not been given enough information nor an opportunity to ask questions before their children's vaccinations. Inconsistent reminders and difficulties booking or attending appointments impacted vaccine uptake with negative experiences influencing future vaccine decisions. Parents had mixed views on vaccinations being given in different locations and wanted trusted health professionals to vaccinate their children.</p></div><div><h3>Conclusion</h3><p>To reverse declining vaccine uptake and prevent future outbreaks it needs to be easier for UK parents to speak to health professionals to answer their childhood vaccine questions, alongside simplified booking systems and easier access to routine childhood vaccine appointments.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24008351/pdfft?md5=7cb7e4cba7935d316fca081ea2be3315&pid=1-s2.0-S0264410X24008351-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumococcal carriage and changes in serotype distribution post- PCV13 introduction in children in Matiari, Pakistan","authors":"","doi":"10.1016/j.vaccine.2024.126238","DOIUrl":"10.1016/j.vaccine.2024.126238","url":null,"abstract":"<div><h3>Background</h3><p>In early 2021, the 10-valent Pneumococcal conjugate vaccine (PCV10) was replaced with 13-valent (PCV13) by the federal directorate of immunization (FDI), Pakistan. We assessed the impact of a higher valent vaccine, PCV13, on the serotype distribution of nasopharyngeal carriage in rural Pakistan.</p></div><div><h3>Methods</h3><p>Children &lt;2 years were randomly selected from two rural union councils of Matiari, Sindh in Pakistan between September–October,2022. Clinical, sociodemographic and vaccination histories were recorded. Nasopharyngeal swabs were collected and processed at Infectious Disease Research Laboratory, Aga Khan University, Karachi. Whole genome sequencing was performed on the culture positive isolates.</p></div><div><h3>Results</h3><p>Of the 200 children enrolled, pneumococcus was detected in 140(70 %) isolates. Majority of age-eligible children (60.1 %,110/183) received 3 PCV13 doses. PCV10 carriage declined from 13.2 %(78/590) in 2017/18 to 7.2 % (10/140) in 2022, additional PCV13 serotypes (3, 6A/6C and 19A) decreased from 18.5 %(109/590) to 11.4 %(16/140) while non-PCV13 serotypes increased from 68.3 %(403/590) to 81.4 %(114/140). There were 88.5 %(<em>n</em> = 124), 80.7 %(<em>n</em> = 113), 55.0 %(<em>n</em> = 77), and 46.0 %(<em>n</em> = 65) isolates predicted to be resistant to cotrimoxazole, penicillin(meningitis cut-off), tetracycline, and erythromycin respectively.</p></div><div><h3>Conclusion</h3><p>Replacing PCV10 with PCV13 rapidly decreased prevalence of PCV13 carriage among vaccinated children in Matiari, Pakistan. Vaccine-driven selection pressure may have been responsible for the increase of non-PCV13 serotypes.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142012129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measles immunity status in Iranian infants and children and outbreak concerns: Time for reconsidering the vaccination schedule?","authors":"","doi":"10.1016/j.vaccine.2024.126243","DOIUrl":"10.1016/j.vaccine.2024.126243","url":null,"abstract":"<div><p><strong>Introduction:</strong> Measles vaccination has greatly reduced the disease burden worldwide, but challenges remain due to variations in vaccine effectiveness across age groups. This study aimed to assess the serological profile of measles antibodies across different age groups, evaluate the impact of maternal immunity on antibody levels in infants under 12 months, and assess measles immunity in vaccinated individuals. <strong>Material and methods:</strong> This cross-sectional study was conducted from June 2022 to January 2023 at the Children’s Medical Center, a referral hospital in Iran. Serum samples were tested for measles-specific IgG and IgM antibodies using a commercial enzyme-linked immunosorbent assay (ELSA). An avidity assay was performed to assess measles virus-specific IgG antibodies on the samples that were positive and borderline for the measles IgG ELISA. <strong>Results:</strong> The study included 969 participants across various age groups. Among them, 23% (221 out of 953) tested positive for measles IgM ELISA, and 52% (504 out of 969) for measles IgG ELISA. Regarding the avidity assay for measles virus-specific IgG, the majority (418 out of 573, 73%) showed high-avidity antibodies. Measles-specific IgG levels varied significantly across different age groups, with infants below 6 months old showing a mean IgG level of 477 mIU/mL, declining to 230 mIU/mL between 6 and 12 months, and increasing significantly to 683 mIU/mL in the 12 to 18 month age group, reaching a peak at 938 mIU/mL among children aged 18–72 months. <strong>Conclusion:</strong> The increasing IgM positivity among young Iranians suggests a rising risk of measles outbreaks, possibly due to vaccination gaps. Inadequate antibody levels in infants raise concerns about vaccination effectiveness. Considering declining maternal antibodies, vaccinating infants at 6–9 months could be beneficial. Boosters for adolescents and women may further mitigate outbreak risks.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination with a trivalent Klebsiella pneumoniae vaccine confers protection in a murine model of pneumonia","authors":"","doi":"10.1016/j.vaccine.2024.126217","DOIUrl":"10.1016/j.vaccine.2024.126217","url":null,"abstract":"<div><p><em>Klebsiella pneumoniae</em> (<em>K. pneumoniae</em>) is an opportunistic pathogen and the major cause of healthcare-associated infections, which are increasingly complicated by the prevalence of highly invasive and hyper-virulent <em>K. pneumoniae</em> strains, necessitating the development of alternative strategies for combatting infections caused by this bacterium. In this study, we successfully constructed a fusion antigen called KP-Ag1, comprising three antigens (GlnH, FimA, and KPN_00466) that were previously identified through reverse vaccinology. Immunization with KP-Ag1 formulated with Al(OH)₃ adjuvant elicited robust humoral and cellular immune response in mice, and conferred protective immunity in a murine model of <em>K. pneumoniae</em> lung infection. Further analysis of serum IgG subtypes from mice immunized with KP-Ag1 revealed a predominant IgG1 response, indicating that KP-Ag1 predominantly induces a Th2-biased immune response. Additionally, opsonophagocytic killing assay suggested that humoral immune responses play a pivotal role in mediating protection conferred by KP-Ag1. Moreover, KP-Ag1 was found to promote the activation and maturation of BMDCs <em>in vitro</em>, which is essential for subsequent efficient antigen presentation. More importantly, vaccination with KP-Ag1 demonstrated cross-protective efficacy against clinical isolates of <em>K. pneumoniae</em> varying in serotypes, antibiotic resistance, and virulence profiles. Therefore, KP-Ag1 holds promise as a candidate for <em>K. pneumoniae</em> vaccine development.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“REAl LIfe” observational study on the effectiveness of Evusheld prophylaxis against SARS-CoV-2 omicron variants in vaccine non-responder immunocompromised patients (REALISE)","authors":"","doi":"10.1016/j.vaccine.2024.126208","DOIUrl":"10.1016/j.vaccine.2024.126208","url":null,"abstract":"<div><p><strong>Background</strong>: Infection by SARS-CoV2 has become a challenge, especially for immunocompromised patients who show a weaker humoral response to COVID-19 vaccine. Tixagevimab+cilgavimab (Evusheld) is a combination of human monoclonal antibodies that can be used for pre-exposure prophylaxis to prevent infection or disease by SARS-CoV2. <strong>Objectives</strong>: Our study aimed to investigate the effectiveness of Evusheld by comparing an Exposed and an Unexposed group. <strong>Study design</strong>: Immunocompromised patients were enrolled in the Evusheld Group between March and September 2022. All patients had anti-spike IgG antibody levels &lt;260 BAU/ml before administration of Evusheld. Blood samples for serological evaluations were collected, and anti-Spike antibodies were tested. For the Unexposed Group, a serologic test was performed at enrollment and a questionnaire was performed after 6 months. <strong>Results</strong>: 43 patients received Evusheld pre-exposure prophylaxis and 45 patients not receiving Evusheld were enrolled in the Unexposed group. The median age was 59.0 years in the Evusheld group, and 63.0 in the unexposed group. In the Evusheld group, during the Omicron wave in Italy, 23.3% of subjects developed symptomatic infection compared to 42.2% in the unexposed group. A majority of infections was seen in male respect to female patients. No difference in length of infection between the groups was seen. Antibody level remained higher than the basal threshold at 180 days from enrollment. <strong>Conclusions</strong>: Evusheld seems to reduce the rate of symptomatic infection in immunocompromised patients. Further data are required to determine whether this prophylaxis may have a longer-lasting effect over time.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24008909/pdfft?md5=52fc41b4531e9e89fe6025953762abc7&pid=1-s2.0-S0264410X24008909-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the potential impact and cost-effectiveness of respiratory syncytial virus (RSV) prevention strategies for infants in Argentina","authors":"","doi":"10.1016/j.vaccine.2024.126234","DOIUrl":"10.1016/j.vaccine.2024.126234","url":null,"abstract":"<div><p><strong>Background.</strong> New interventions are available for the prevention of respiratory syncytial virus (RSV) disease in young infants. We aimed to assess the potential impact and cost-effectiveness of using a long-acting monoclonal antibody (RSV mAb) or maternal RSV vaccine in the Argentine context. <strong>Methods.</strong> We used a static proportionate outcomes model to calculate the costs and consequences of using RSV mAb or maternal RSV vaccine over a ten-year period (2025–2034) in Argentina, assuming both year-round and seasonal administration. We compared each intervention to no pharmaceutical RSV intervention. The primary outcome was the discounted cost per disability-adjusted life year (DALY) averted from a societal perspective. We assumed willingness-to-pay of US$ 12,285 per DALY averted (0.9 times the national gross domestic product per capita). We used population study data on costs and disease burden and the efficacy of clinical trials of both interventions as inputs. We ran deterministic and probabilistic uncertainty analyses. <strong>Findings.</strong> Either strategy (RSV mAb or maternal RSV vaccine) could prevent &gt;25% of RSV deaths aged &lt;5 years and ∼30% aged &lt;6 months (the age group where most intervention impact occurs). With a dose price of $US 50, both products have a 100% probability of being cost-effective compared to no intervention (US$ 5283 [95%CI $5203–$5363] and US$ 5522 [95%CI $5427 – $5617] per DALY averted for year-round use of RSV mAb and maternal RSV vaccine, respectively). Similar health impact could be achieved by a six-month seasonal strategy, which could improve cost-effectiveness by around 45% (assuming the dose price is unchanged). <strong>Interpretation.</strong> Either RSV mAb or maternal RSV vaccine are worth consideration in Argentina when priced at ≤US$ 50 per dose. A seasonal strategy could improve cost-effectiveness.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24009162/pdfft?md5=52defc90a2b9a173a77d6c28e7686d98&pid=1-s2.0-S0264410X24009162-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141998164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of mental health with vaccination readiness in informal caregivers and the vaccination status of their care recipients during the Covid-19 pandemic – A cross sectional analysis","authors":"","doi":"10.1016/j.vaccine.2024.126218","DOIUrl":"10.1016/j.vaccine.2024.126218","url":null,"abstract":"<div><h3>Introduction</h3><p>Vaccinations are important for informal caregivers and their care recipients. Mental health problems are common among care givers. The aim of this study was to investigate vaccination readiness in informal caregivers and associations with mental health issues. Associations between vaccination readiness in informal caregivers and the vaccination status of their aged care recipients were examined.</p></div><div><h3>Methods</h3><p>Within the multicenter prospective registry study ‘Bavarian ambulatory Covid-19 Monitor (BaCoM) ‘, informal caregivers were asked for symptoms of depression (PHQ-9), burden of caretaking (BSFC-s), psychological antecedents of vaccination readiness (5C model) and previous Covid-19 infections of their care recipients. The vaccination status against Covid-19, seasonal influenza and pneumococcal disease was determined via vaccination certificates. Data analysis was performed using ordinal regressions and Mann-Whitney-<em>U</em> tests.</p></div><div><h3>Results</h3><p>Data of <em>n</em> = 91 informal caregivers, associated with <em>n</em> = 84 care recipients were collected. Symptoms of depression were associated with reduced vaccination readiness (Calculation: <em>p</em> = 0.026, OR = 1.18), as well as the perceived burden of caretaking (Confidence: <em>p</em> = 0.006, OR = 0.88). A previous Covid-19 infection of the care recipients was associated with decreased vaccination readiness of informal caregivers (Median (Q1–Q3) Confidence: 5.0 (4.5–6.0) vs. 4.0 (3.0–5.0); Calculation: 5.0 (3.0–6.0) vs. 4.0 (1.0–5.0)). The vaccination status of the care recipients interrelated significantly with vaccination readiness of their informal caregivers (Confidence: <em>p</em> &lt; 0.001; Complacency: <em>p</em> &lt; 0.01; Constraints <em>p</em> &lt; 0.05). No significant interrelations between vaccination readiness and the vaccination status against seasonal influenza or pneumococcal disease occurred.</p></div><div><h3>Conclusion</h3><p>Mental health issues of informal caregivers seem to be associated with the actual vaccination status against Covid-19 in their care recipients. Target group specific counselling as well as an active involvement of informal caregivers in shared decision-making processes can be of relevance, but even more attention should be paid to the protection of mental health for informal caregivers.</p><p><strong>Trial registration number:</strong> German Register of Clinical Studies DRKS 26039.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24009009/pdfft?md5=90571dc07e665407136a62cddda17dee&pid=1-s2.0-S0264410X24009009-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term impact of rotavirus vaccination on all-cause and rotavirus-specific gastroenteritis and strain distribution in Central Kenya: An 11-year interrupted time-series analysis","authors":"","doi":"10.1016/j.vaccine.2024.126210","DOIUrl":"10.1016/j.vaccine.2024.126210","url":null,"abstract":"<div><p><strong>Background:</strong> Kenya introduced a monovalent rotavirus vaccine administered orally at 6 and 10 weeks of age into her National Immunization Program in July 2014. The study evaluated the long-term impact of the vaccine on hospitalization for all-cause and rotavirus-specific acute gastroenteritis (AGE) and strain epidemiology in Kenya. <strong>Methods:</strong> Data on all-cause and rotavirus-specific AGE and strain distribution were derived from an eleven-year hospital-based surveillance of AGE among children aged &lt;5 years at Kiambu County Teaching and Referral Hospital (KCTRH) in Central Kenya between 2009 and 2020. Fecal samples were screened for group A rotavirus using ELISA and genotyped using multiplex semi-nested RT-PCR. Trends in all-cause and rotavirus-related AGE and strain distribution were compared between the pre-vaccine (July 2009–June 2014), early post-vaccine (July 2014–June 2016) and late post-vaccine (February 2019–October 2020) periods. <strong>Results:</strong> Rotavirus-specific AGE was detected at 27.5% (429/1546, 95% CI: 25.5–30.1%) in the pre-vaccine period; 13.8% (91/658, 95% CI: 11.3–16.6%) in the early post-vaccine period (July 2014–June 2016); and 12.0% (229/1916, 95% CI: 10.6–13.5%) in the late post-vaccine period (February 2019–October 2020). This amounted to a decline of 49.8% (95% CI: 34.6%–63.7%) in rotavirus-specific AGE in the early post-vaccine period and 53.4% (95% CI: 41.5–70.3%) in the late post-vaccine period when compared to the pre-vaccine period. All-cause AGE hospitalizations declined by 40.2% (95% CI: 30.8%–50.2%) and 75.3% (95% CI: 65.9–83.1%) in the early post-vaccine and late post-vaccine periods, respectively, when compared to the pre-vaccine period. G3P [8] was the predominant strain in the late post-vaccine period, replacing G1P[8] which had predominated in the pre-vaccine and early post-vaccine periods. Additionally, we detected considerable proportions of uncommon strains G3P[6] (4.8%) and G12P[6] (3.5%) in the post-vaccine era. <strong>Conclusion:</strong> Rotavirus vaccination has resulted in a significant decline in all-cause and rotavirus-specific AGE, and thus, provides strong evidence for public health policy makers in Kenya to support the sustained use of the rotavirus vaccine in routine immunization. However, the shift in strain dominance and age distribution of rotavirus AGE in the post-vaccine era underscores the need for continued surveillance to assess any possible vaccine-induced selective pressure that could diminish the vaccine effectiveness over time.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141991385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}