Vaccine: X最新文献

{"title":"Interdisciplinary symposium on challenges and opportunities for vaccines: A comprehensive approach of current and future vaccine strategies to improve vaccine effectiveness in complex chronic infectious contexts","authors":"Alex S. Siebner ,&nbsp;Marrium Habib ,&nbsp;Vanesa Osmani ,&nbsp;Ayola Akim Adegnika ,&nbsp;Christian Bogdan ,&nbsp;Minka Breloer ,&nbsp;Alison Elliott ,&nbsp;Anahita Fathi ,&nbsp;Greet Hendrickx ,&nbsp;Justin Komguep Nono ,&nbsp;Roland Lang ,&nbsp;Johannes U. Mayer ,&nbsp;Benjamin Mordmüller ,&nbsp;Esther Ndungo ,&nbsp;Ulrike Protzer ,&nbsp;Maria Yazdanbakhsh ,&nbsp;Stefanie J. Klug ,&nbsp;Clarissa Prazeres da Costa ,&nbsp;Meral Esen","doi":"10.1016/j.jvacx.2025.100615","DOIUrl":"10.1016/j.jvacx.2025.100615","url":null,"abstract":"<div><div>Vaccination is a key public health intervention, but vaccine immunogenicity, efficacy, and effectiveness vary geographically. These variations are not yet fully understood but are likely influenced by factors such as chronic infections, environmental and genetic differences, social and behavioral factors, and operational challenges, particularly in low- and middle-income countries (LMICs). To address these issues, the “International Symposium on Global Challenges and Opportunities for Vaccines” was held in Kloster Bernried, Germany, bringing together international scientists and stakeholders. Key discussions included: (1) Compromised vaccine immunogenicity due to helminth infections, (2) new vaccine approaches in vaccine development, (3) new frontiers in therapeutic vaccination, (4) challenges of vaccine trials, especially in low-resource settings, and (5) conceptualizing vaccine confidence in low and high resource contexts. The symposium highlighted the challenges of conducting vaccine trials in LMICs, such as participant follow-up, logistics, resources, and building trust. The main recommendation was to improve future vaccine trial designs through a comprehensive, interdisciplinary approach, including tools to evaluate vaccine immunogenicity, efficacy, and effectiveness.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"23 ","pages":"Article 100615"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination against tick-borne encephalitis virus in Denmark, Norway and Sweden","authors":"Mette F. Hansen ,&nbsp;John Shorter ,&nbsp;Martin T. Jepsen ,&nbsp;Anders Boman ,&nbsp;Pikka Jokelainen ,&nbsp;Solveig Jore ,&nbsp;Daniel Slunge ,&nbsp;Karen A. Krogfelt","doi":"10.1016/j.jvacx.2025.100625","DOIUrl":"10.1016/j.jvacx.2025.100625","url":null,"abstract":"<div><div>Tick-borne encephalitis (TBE) is one of the more severe and widespread arboviral infections in Europe, with an increase in incidence over the past decades in several countries. Prevention strategies against infection with the virus include vaccination and protection against tick bites. The virus is typically found in very localized endemic areas known as microfoci, possibly affecting differences in public knowledge and vaccination strategies between countries and regions. This study investigated how self-reported TBE vaccination status is associated with demographic variables, knowledge of TBE, and tick and TBE virus exposure in Denmark, Norway, and Sweden. An online questionnaire with 48 questions, including demographic prompts, knowledge questions about TBE, and TBE vaccination status was sent out to respondents in the three countries. The overall proportion of reportedly TBE-vaccinated people in the three countries (<em>N</em> = 2668) was 13 %, but with large differences between countries. The proportion was 28.5 % in Sweden (<em>N</em> = 1096), 2.3 % in Norway (<em>N</em> = 789) and 2.2 % in Denmark (<em>N</em> = 783), corresponding well with the higher TBE incidence in Sweden. The reported TBE-vaccination rates in Denmark and Norway were too low for further analyses. The results from Sweden were analysed by logistic regression, showing that respondents in Sweden who reportedly visited TBE virus risk areas were more likely to be vaccinated. The general knowledge of TBE appeared to be limited, especially in Denmark and Norway.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"24 ","pages":"Article 100625"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using nationwide data to examine the relative effectiveness of Covid-19 vaccination against omicron amongst a population with low prior rates of SARS-CoV-2 infection: A cohort study","authors":"J. Paynter ,&nbsp;P. McIntyre ,&nbsp;J. Wiki ,&nbsp;N. Nghiem ,&nbsp;B. Liu ,&nbsp;L. Marek ,&nbsp;M. Hobbs","doi":"10.1016/j.jvacx.2025.100624","DOIUrl":"10.1016/j.jvacx.2025.100624","url":null,"abstract":"<div><h3>Background</h3><div>We used nationwide data to examine relative vaccine effectiveness (rVE) of the Comirnaty mRNA vaccine (Pfizer–BioNTech (original), hereafter Comirnaty, against the Omicron variants (BA.1 and BA.2) during 2022 in Aotearoa New Zealand (NZ).</div></div><div><h3>Method</h3><div>We analysed a national cohort of 3.15 million adults (18+ years) who had received at least two doses of Comirnaty by March 2022. Data sources included national administrative records of vaccination, hospitalisation, ICU admission and death. Cox regression was used to estimate hazard ratios in recipients of three vaccine doses compared to recipients of two doses.</div></div><div><h3>Results</h3><div>Amongst adults, three vaccine doses provided significantly greater protection against hospitalisation attributable to Covid-19 than two doses, relative vaccine effectiveness (rVE) was 50 %, 95 % Confidence Interval (CI) 45–55 %) at peak virus circulation. The vaccine was effective for Māori, Pacific Peoples and those aged over 50 years however, the protection given by vaccination waned throughout the study period. The booster was also significantly more effective at preventing ICU admission or death with an rVE (3 vs 2 doses) of 53 %, 95 % CI 49–55 %. It was consistent for Māori, 49 %, 95 %CI 41–56 % and Pacific Peoples 52 %, 95 % CI 41–62 %, and those aged over 50 years, 54 %, 95 % CI 51–57 %.</div></div><div><h3>Conclusion</h3><div>The study provides important insights into relative vaccine effectiveness of the Comirnaty booster doses against Omicron variants in NZ in 2022 in an infection naive population. The findings highlight the importance of booster doses in combatting hospitalisation, ICU admission and death during the 2022 Omicron wave.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"24 ","pages":"Article 100624"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social networks, environmental, and individual factors associated with COVID-19 vaccination and booster uptake– The prospective PRIME cohort study","authors":"Céline J.A. van Bilsen ,&nbsp;Lisanne C.J. Steijvers ,&nbsp;Stephanie Wagner ,&nbsp;Demi M.E. Pagen ,&nbsp;Senne M.C.E. Wijnen ,&nbsp;Kevin Konings ,&nbsp;Christian J.P.A. Hoebe ,&nbsp;Annemarie Koster ,&nbsp;Nicole H.T.M. Dukers-Muijrers","doi":"10.1016/j.jvacx.2025.100626","DOIUrl":"10.1016/j.jvacx.2025.100626","url":null,"abstract":"<div><h3>Background</h3><div>Social networks (a person's social relationships) are important for health and in health behavior, including infection prevention behavior. This study aims to identify factors associated with coronavirus disease 2019 (COVID-19) vaccine and booster uptake, focusing on social networks and community participation factors, the physical environment, and individual level factors.</div></div><div><h3>Methods</h3><div>In the PRIME longitudinal cohort study, we used online questionnaires to collect baseline data at the end of 2021, including participants' COVID-19 vaccination status and various factors, i.e., structural and functional social network characteristics (interpersonal factors), societal (social and physical living environment) community (work and social participation), and individual (sociodemographics, health) factors. At follow-up (summer of 2022), we measured COVID-19 booster uptake. Associations between the factors and vaccine and booster uptake were analyzed using multivariable logistic regression analyses.</div></div><div><h3>Results</h3><div>At baseline (<em>N</em> = 9501), COVID-19 vaccine uptake was 94 %. In vaccinated participants at follow-up (<em>N</em> = 3620), booster uptake was 91 %. Community and societal factors associated with (booster) vaccine uptake included social participation, higher neighborhood livability and walkability scores, and a moderate level of urbanization. Interpersonal factors included a larger social network size, network diversity, network density, and not living alone. Associated individual factors included age ≥ 60 years, male sex, college/university education, being born in the Netherlands, having chronic conditions, being a never/former smoker, higher health literacy, and no loneliness.</div></div><div><h3>Conclusion</h3><div>The social and physical environment are key in COVID-19 vaccine and booster uptake. Health promotion and vaccination strategies should address the environmental context (community, societal and interpersonal factors) alongside individual-level factors to contribute to pandemic preparedness.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"23 ","pages":"Article 100626"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘It's a shot, not a vaccine like MMR’: A new type of vaccine-specific scepticism on Twitter/X during the COVID-19 pandemic","authors":"Elena Semino ,&nbsp;Tara Coltman-Patel ,&nbsp;William Dance ,&nbsp;Zsófia Demjén ,&nbsp;Richard Gleave ,&nbsp;Alison Mackey","doi":"10.1016/j.jvacx.2025.100620","DOIUrl":"10.1016/j.jvacx.2025.100620","url":null,"abstract":"<div><h3>Background</h3><div>While it is well-known that vaccine hesitancy can be vaccine-specific, little is known about how people spontaneously evaluate different vaccines in comparison with one another, or the implications of such comparisons for vaccine attitudes. This paper first investigates how people posting on Twitter/X in 2020–2022 discussed the MMR vaccine and the COVID-19 vaccines in relation to each other. Next it reveals a new manifestation of vaccine scepticism, namely the claim that some vaccines, notably those against COVID-19, are in fact not vaccines.</div></div><div><h3>Methods</h3><div>A 9-million-word ‘corpus’ was created, consisting of tweets containing references to the MMR vaccine posted in 2008–2022. First, tweets posted in 2020–2022 and also containing references to COVID-19 were coded for: (1) vaccine-specific evaluation, and (2) vaccine-related topic. Then, the whole corpus was analysed for tweets that contain expressions that challenge the status of a vaccine as a vaccine (e.g. ‘not a vaccine’, and the use of ‘shot’ in contrast with ‘vaccine’).</div></div><div><h3>Results</h3><div>In 2020–2022, tweets mentioning COVID-19 alongside MMR show an increasing tendency to compare the COVID-19 vaccines unfavourably with MMR, based on perceived low effectiveness against infection. A further analysis of the whole corpus reveals:<ul><li><span>•</span><span><div>A tendency in 2020–2022 to challenge the status of COVID-19 vaccines, as well as flu vaccines, as vaccines;</div></span></li><li><span>•</span><span><div>A perceived contrast in 2020–2022 between ‘shot’ and ‘vaccine’, with the former being described as an inferior medical intervention.</div></span></li><li><span>•</span><span><div>Very little evidence of similar arguments being made about any vaccines in 2008–2019.</div></span></li></ul></div></div><div><h3>Conclusion</h3><div>Data from Twitter/X suggests that perceptions about low effectiveness of the COVID-19 vaccines against infection have led to a belief that they are inferior to MMR and other vaccines, or are not vaccines at all. It is important to address this new form of scepticism about vaccines that primarily prevent serious illness.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"23 ","pages":"Article 100620"},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving hepatitis a vaccination rate by reducing missed follow up vaccine appointments","authors":"Mariana Block ,&nbsp;Alexander M. Sy","doi":"10.1016/j.jvacx.2025.100618","DOIUrl":"10.1016/j.jvacx.2025.100618","url":null,"abstract":"","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"23 ","pages":"Article 100618"},"PeriodicalIF":2.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPV vaccine uptake by Young adults in Hanoi, Vietnam: A qualitative investigation","authors":"Nguyen Thi My Hao ,&nbsp;Hoang Vo Ngoc Khanh ,&nbsp;Pranee Liamputtong ,&nbsp;Nguyen Khoi Quan ,&nbsp;Andrew W. Taylor-Robinson","doi":"10.1016/j.jvacx.2025.100619","DOIUrl":"10.1016/j.jvacx.2025.100619","url":null,"abstract":"<div><h3>Background</h3><div>Human papillomavirus (HPV) is recognized to cause not only cervical cancer but also several HPV-related sexually transmitted diseases in both sexes. Despite the effectiveness of HPV vaccines to prevent HPV-related sexually transmitted diseases, in 2021 only 12 % of Vietnamese females aged 15–29 were recorded as vaccinated, while information on males was underreported. This paper aimed to identify barriers and enabling conditions of the HPV vaccine as perceived by young adults residing in Hanoi, providing insights to improve future health promotion strategies in Vietnam.</div></div><div><h3>Methods</h3><div>Framed within the Theory of Reasoned Action (TRA), we conducted a descriptive qualitative study to examine the influencing factors. Semi-structured interviews were conducted with 24 participants (10 males and 14 females) aged 18–25, in Hanoi, Vietnam.</div></div><div><h3>Results</h3><div>Participants' main concerns regarding HPV vaccination were: (i) literacy towards HPV infection and vaccination; (ii) financial capacity; (iii) local availability of the vaccine; (iv) flexibility of the vaccination program. Motivating factors included perceived: (i) sexual activity-related risks; (ii) gender-related health risks and biological risks; (iii) fear of death. Moreover, social pressure from the government, family, and friends also influenced young people's intention to vaccinate.</div></div><div><h3>Conclusions</h3><div>This study enhances our understanding of young adults' acceptance of HPV vaccination in Hanoi, Vietnam. Identifying significant perceptions that affect health decision-making in this age group is crucial to developing prospective intervention programs that address financial barriers, increase accessibility, expand the national vaccination program. Our findings also highlight the need to enhance HPV health literacy among not just women but also men, as well as healthcare providers. Consideration of the implications may help to increase vaccine uptake rates in both genders.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"23 ","pages":"Article 100619"},"PeriodicalIF":2.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costs estimation of three models of COVID-19 vaccination in Beijing, China","authors":"Hongzeng Wang ,&nbsp;Dan Zhao ,&nbsp;Xiaomei Li ,&nbsp;Luodan Suo ,&nbsp;Li Lu ,&nbsp;Zhujiazi Zhang","doi":"10.1016/j.jvacx.2025.100616","DOIUrl":"10.1016/j.jvacx.2025.100616","url":null,"abstract":"<div><div>Since the emergency use authorization for the COVID-19 vaccine in 2021, the Chinese government has used three vaccination models: vaccination clinic, mass vaccination center, and door-to-door service. This study compared these three different models, focusing on costs, and implementation in each vaccination strategy. A cross-sectional study, conducted during the COVID-19 vaccination campaign from January 1 to 20, 2021, utilized a questionnaire to collect data on vaccination sites and conducted a random sample costs analysis of three models. Data on costs, including construction, materials, labor, and operations, were gathered through interviews and field surveys to understand resource utilization and personnel involvement in vaccination activities. Beijing's COVID-19 vaccination campaign involved 580 locations administering 1,829,324 doses. The numbers of vaccination clinics, mass vaccination centers, and door-to-door service were 233, 137, and 210. The total doses administered at vaccination clinics, mass vaccination centers, and door-to-door service numbered 465,721 (25.5 %), 991,444 (54.2 %), and 372,159 (20.3 %), respectively. The median daily doses administered at vaccination clinics, mass vaccination centers, and door-to-door service were 124, 453, and 540, respectively. The daily costs of the vaccination clinic, mass vaccination center, and door-to-door service were $4644.1, $22,746.5, and $4109.6, respectively, and the costs per dose were $12.9, $10.5, and $7.4, respectively. We concluded that there are significant variations in costs and efficiency across the three vaccination models. We must comprehensively consider the available regional resources, the target population for vaccination, the expected vaccination effect, and other factors to choose an appropriate vaccination model.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"23 ","pages":"Article 100616"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic diversity and prevalence of group A rotavirus infection in children of Imphal, Manipur, India: A hospital-based surveillance study conducted during December 2015 to March 2019","authors":"Damayanti Yengkhom Devi ,&nbsp;Chongtham Shyamsunder Singh ,&nbsp;C. Durga Rao ,&nbsp;Nima D. Namsa","doi":"10.1016/j.jvacx.2025.100614","DOIUrl":"10.1016/j.jvacx.2025.100614","url":null,"abstract":"<div><div>Rotavirus is the most common cause of acute gastroenteritis in infants and children worldwide. The study is hospital-based surveillance of rotavirus diarrhea in children from Imphal, Manipur, India conducted from December 2015 to March 2019. The positivity rate was found to be high ∼69.25% (358/517) and proportion of diarrhea cases and rotavirus diarrhea was peak in winter months and mostly in children from 6 to 24 months. G3 (43%) was the most widely circulating genotype in Imphal followed by G1 (16%), G2 (8%), G9 (5%), G8 (3%), G10 (1%), and G4 (1%), while G12 (0.26%) was rarely detected. Among P-types, P[6] (22%) accounted for the highest prevalence followed by P[8] (11%) and P[4] (4%), P[11] (4%), P[10] (3%), P-type mixed infection 3%, while 53% were untypeable. In G/P combinations, we detected 22 different rotavirus strains at varying frequencies. Globally distributed G3P[8] and G1P[8] strains were observed in the study. G3P[6] emerged as the most predominant rotavirus strain followed by G3P[8], G1P[6], G1P[8], and G9P[6]. The common rotavirus strains distributed across the region namely G3P[8], G1P[8], G2P[4], G9P[4], G1P[4], G1P[6], and G9P[6] were also observed. Interestingly, our study has observed a high percentage of unusual strains namely G9P[4], G1P[11], G2P[11], G3P[10], G3P[11], G4P[11], G9P[10], G9P[11],G10P[6], and G10P[8]. Of note, the high frequency of non-typeable rotavirus P-types (56%) are suggestive of point mutations that might have accumulated in the primer-binding region of VP4 gene. The findings of the present study revealed the hospital-based prevalence of rotavirus disease and the circulating genotypes during the pre-vaccination period and highlights the need for continuous surveillance of rotavirus infection post-rotavac vaccine introduction in the state of Manipur, India.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"23 ","pages":"Article 100614"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing vaccine drop-outs: Geographic and system-level barriers to full immunization coverage among children in Uttar Pradesh, India","authors":"Ravi Prakash ,&nbsp;Pradeep Kumar ,&nbsp;Bidyadhar Dehury ,&nbsp;Deep Thacker ,&nbsp;Esther Shoemaker ,&nbsp;Ramesh Banadakoppa Manjappa ,&nbsp;Shajy Isac ,&nbsp;John Anthony ,&nbsp;Vasanthakumar Namasivayam ,&nbsp;James Blanchard ,&nbsp;Marissa Becker ,&nbsp;Ties Boerma","doi":"10.1016/j.jvacx.2025.100613","DOIUrl":"10.1016/j.jvacx.2025.100613","url":null,"abstract":"<div><h3>Objective</h3><div>Global interventions on routine immunization aim to achieve at least 90 % immunization coverage of all vaccines as per national immunization schedules, aligning with the Immunization Agenda 2030. Despite significant global progress, regions like Uttar Pradesh (UP), India's most populous state, require more efforts to meet this target.</div></div><div><h3>Methods</h3><div>In 2021, a quantitative survey was conducted with 10,591 mothers/caregivers of children aged 0–15 months and 479 linked community health workers (Accredited Social Health Activists, ASHAs) responsible for connecting these families with vaccine services across 444 rural villages in UP. We developed a coverage cascade to assess the coverage of all basic vaccines (1 dose of each BCG and MR, and 3 doses each of DPT/Penta and Polio), immunization dropouts, and their drivers.</div></div><div><h3>Findings</h3><div>While 96.4 % of service platforms had the required vaccines available and 94.7 % of children aged 12–15 months had received the first dose of Pentavalent vaccine, only 67.8 % of children received all basic vaccines, with 53.5 % completing these vaccines in the first year of life. More than half (53 %) of dropouts were concentrated in 30 % of ASHA areas. Among these areas, 13 % had no dropouts, and 29 % had more than 60 % of children aged 12–15 months with incomplete immunization. Areas with high dropout rates had higher rates of home deliveries, lower possession of parent-held vaccination records (MCP cards), and poor community-level factors such as incomplete record keeping by ASHAs, less supportive supervision by their supervisors, and relatively lower work motivation compared to areas with no dropouts.</div></div><div><h3>Conclusion</h3><div>The wide heterogeneity in immunization coverage and dropouts emphasize the need to identify area-specific patterns and reasons for low immunization coverage and to develop interventions to address them. Robust support systems for community health workers and comprehensive record-keeping are pivotal to improve immunization coverage and to reduce the burden of vaccine-preventable diseases.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"23 ","pages":"Article 100613"},"PeriodicalIF":2.7,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}