Vaccine, volume 42, pages 125541

The 2020 immunization programme landscape: Piloting an assessment metric to evaluate the maturity of national immunization programmes across the life course

Publication type: Journal Article
Publication date: 2024-10-01
Journal: Vaccine
scimago Q1
wos Q2
SJR: 1.342
CiteScore: 8.7
Impact factor: 4.5
ISSN: 0264410X, 18732518, 13588745
Molecular Medicine
Infectious Diseases
General Immunology and Microbiology
Public Health, Environmental and Occupational Health
General Veterinary
Abstract
The World Health Organization (WHO) encourages countries to provide appropriate vaccinations for children, adolescents, and relevant adult populations. Childhood programme have been the focus of global investments, but recent pandemics have increasingly demonstrated the value of life course vaccination. Our objective is to compare national life course immunization programmatic maturity prior to mass COVID-19 vaccine introduction, the largest adult vaccination programme, globally. As coverage estimates (typically used to assess childhood programmes) are not available for adult vaccinations, this analysis pilots a standardized quantitative metric of programmatic maturity. Through consultation with vaccination experts, we developed a standardized approach to assess national immunization programme maturity across the life course. In accordance with expert input, five vaccines were selected to represent delivery across the life course: diphtheria tetanus toxoid and pertussis (DTP); measles (MCV) second dose; human papillomavirus (HPV) final dose; pneumococcal conjugate (PCV) final dose; and seasonal influenza annual dose. Experts recommended inclusion of the following indicators for each vaccine: a legal mandate (national policy), experience delivering the vaccine (programme duration), and vaccine use (uptake for relevant populations). We developed a metric accordingly that provides up to 5 points per vaccine (“vaccine specific maturity score”) which when summed forms the “life course maturity score”, with a maximum score of 25. We analysed the prevalence of national policies, experience, and use by region and World Bank income group. More than 55% of the 194 WHO Member States had childhood vaccine policies for all three of the vaccines considered (DTP, MCV, and PCV) compared to 60% for HPV (proxy for adolescent vaccination programme) and 52% for seasonal influenza (proxy for adult vaccination programme). Childhood vaccination programmes (e.g., MCV and DTP) had the highest vaccine specific maturity scores, while seasonal influenza and HPV vaccination programmes had much lower scores. The national life course maturity scores ranged from 1 to 23, with a global median of 12 (IQR: 8; 16). The piloted metric provides an overview of the maturity of life course immunization programmes. The metric is structured to be a flexible, rapid resource that can be used to assess other combinations of vaccines across the life course. The findings from this paper provide a baseline of immunization programme maturity for childhood, adolescent, and adult vaccination programmes immediately prior to the COVID-19 vaccine introduction. This maturity score, or adaptations of this approach, could be used to monitor the trajectory of national immunization programme maturity across the life course in the years ahead.
Found 9
By date By citations
Wiley
COVID‐19 disease and vaccination in pregnant and lactating women
Safadi M.A., Spinardi J., Swerdlow D., Srivastava A.
American Journal of Reproductive Immunology scimago Q1 wos Q3 , 
2022-05-09,  citations by CoLab: 19 ,  Abstract  
More than 325,000 cases of coronavirus disease 2019 (COVID-19) have been reported among pregnant women in the Americas. Multiple studies indicate that pregnant women are more susceptible to adverse COVID-19 outcomes, including hospitalization, intensive care unit admission, and invasive ventilation than non-pregnant women with COVID-19. Furthermore, COVID-19 in pregnancy is associated with adverse maternal and neonatal outcomes. Adverse COVID-19 outcomes appear to disproportionately affect pregnant women from low- and middle-income countries, likely reflecting inequities in access to quality healthcare. Despite the absence of safety and efficacy data from randomized clinical trials in this subpopulation, observational studies and data from pregnancy registries thus far have demonstrated that vaccination of pregnant or lactating women against COVID-19 is safe, effective, and results in robust immune responses including transfer of antibodies to the newborn via the placenta and breast milk, respectively. These data support vaccination recommendations intending to help protect these vulnerable individuals against COVID-19 and its sequelae. Randomized clinical studies will further evaluate the safety and immunogenicity of COVID-19 vaccines in these populations. This review examines the impact of COVID-19 in pregnant women and describes available evidence on the safety, effectiveness, and immune response(s) to vaccination among pregnant and lactating women. This article is protected by copyright. All rights reserved
Elsevier
Impact of the SARS-CoV-2 pandemic on routine immunisation services: evidence of disruption and recovery from 170 countries and territories
Shet A., Carr K., Danovaro-Holliday M.C., Sodha S.V., Prosperi C., Wunderlich J., Wonodi C., Reynolds H.W., Mirza I., Gacic-Dobo M., O'Brien K.L., Lindstrand A.
The Lancet Global Health scimago Q1 wos Q1 Open Access , 
2022-02-01,  citations by CoLab: 202 ,  Abstract  
SummaryBackgroundThe SARS-CoV-2 pandemic has revealed the vulnerability of immunisation systems worldwide, although the scale of these disruptions has not been described at a global level. This study aims to assess the impact of COVID-19 on routine immunisation using triangulated data from global, country-based, and individual-reported sources obtained during the pandemic period.MethodsThis report synthesised data from 170 countries and territories. Data sources included administered vaccine-dose data from January to December, 2019, and January to December, 2020, WHO regional office reports, and a WHO-led pulse survey administered in April, 2020, and June, 2020. Results were expressed as frequencies and proportions of respondents or reporting countries. Data on vaccine doses administered were weighted by the population of surviving infants per country.FindingsA decline in the number of administered doses of diphtheria–pertussis–tetanus-containing vaccine (DTP3) and first dose of measles-containing vaccine (MCV1) in the first half of 2020 was noted. The lowest number of vaccine doses administered was observed in April, 2020, when 33% fewer DTP3 doses were administered globally, ranging from 9% in the WHO African region to 57% in the South-East Asia region. Recovery of vaccinations began by June, 2020, and continued into late 2020. WHO regional offices reported substantial disruption to routine vaccination sessions in April, 2020, related to interrupted vaccination demand and supply, including reduced availability of the health workforce. Pulse survey analysis revealed that 45 (69%) of 65 countries showed disruption in outreach services compared with 27 (44%) of 62 countries with disrupted fixed-post immunisation services.InterpretationThe marked magnitude and global scale of immunisation disruption evokes the dangers of vaccine-preventable disease outbreaks in the future. Trends indicating partial resumption of services highlight the urgent need for ongoing assessment of recovery, catch-up vaccination strategy implementation for vulnerable populations, and ensuring vaccine coverage equity and health system resilience.FundingUS Agency for International Development.
Elsevier
Seasonal influenza vaccination policies in the 194 WHO Member States: The evolution of global influenza pandemic preparedness and the challenge of sustaining equitable vaccine access
Morales K.F., Brown D.W., Dumolard L., Steulet C., Vilajeliu A., Ropero Alvarez A.M., Moen A., Friede M., Lambach P.
Vaccine: X scimago Q1 wos Q3 Open Access , 
2021-08-01,  citations by CoLab: 34 ,  Abstract  
As of 2018, 118 of 194 WHO Member States reported the presence of an influenza vaccination policy. Although influenza vaccination policies do not guarantee equitable access or ensure vaccination coverage, they are critical to establishing a coordinated influenza vaccination program, which can reduce morbidity and mortality associated with yearly influenza, especially in high-risk groups. Established programs can also provide a good foundation for pandemic preparedness and response.We utilized EXCEL and STATA to evaluate changes to national seasonal influenza vaccination policies reported on the WHO/UNICEF Joint Reporting Forms on Immunization (JRF) in 2014 and 2018. To characterize countries with or without policies, we incorporated external data on World Bank income groupings, WHO regions, and immunization system strength (using 3 proxy indicators).From 2014 to 2018 there was a small net increase in national seasonal influenza vaccination policies from 114 (59%) to 118 (61%). There was an increase in policies targeting high-risk groups from 34 in 2014 (34 /114 policies, 29%) to 56 (56/118 policies, 47%) in 2018. Policies were consistently more frequent in high-income countries, in WHO Regions of the Americas (89% of countries) and Europe (89%), and in countries satisfying all three immunization system strength indicators. Low and low-middle income countries, representing 40% of the worlds' population, accounted for 52/61 (85%) of countries with no evidence of a policy in either year.Our results demonstrate that national influenza vaccination policies vary significantly by region, income, and immunization system strength, and are less common in lower-income countries. Barriers to establishing and maintaining policies should be further examined as part of international efforts to expand influenza vaccination policies globally. Next generation influenza vaccine development should work to address barriers to influenza vaccination policy adoption, such as cost, logistics for adult vaccination, country priorities, need for yearly vaccination, and variations in seasonality.
Elsevier
COVID-19 vaccine challenges: What have we learned so far and what remains to be done?
Forman R., Shah S., Jeurissen P., Jit M., Mossialos E.
Health Policy scimago Q1 wos Q1 , 
2021-05-01,  citations by CoLab: 212 ,  Abstract  
Developing and distributing a safe and effective SARS-CoV-2 (COVID-19) vaccine has garnered immense global interest. Less than a year after COVID-19 was declared a pandemic, several vaccine candidates had received emergency use authorization across a range of countries. Despite this scientific breakthrough, the journey from vaccine discovery to global herd immunity against COVID-19 continues to present significant policy challenges that require a collaborative, global response. We offer a framework for understanding remaining and new policy challenges for successful global vaccine campaigns against COVID-19 as well as potential solutions to address them. Decision-makers must be aware of these challenges and strategize solutions that can be implemented at scale. These include challenges around maintaining R&D incentives, running clinical trials, authorizations, post-market surveillance, manufacturing and supply, global dissemination, allocation, uptake, and clinical system adaption. Alongside these challenges, financial and ethical concerns must also be addressed.
Public Library of Science (PLoS)
Incidence, risk factors and impact of seasonal influenza in pregnancy: A national cohort study
Vousden N., Bunch K., Knight M.
PLoS ONE scimago Q1 wos Q1 Open Access , 
2021-01-15,  citations by CoLab: 29 ,  PDF,  Abstract  
Background Pregnant women are particularly vulnerable to severe infection from influenza resulting in poor neonatal outcomes. The majority of evidence relates to pandemic 2009 A/H1N1 influenza. The objective of this study was to describe the characteristics and outcomes of pregnant women hospitalised with seasonal influenza. Methods This national, prospective, observational cohort study used the UK Obstetric Surveillance System (UKOSS) to identify all pregnant women admitted to hospital between 01/11/2016 and 31/10/2018 with laboratory confirmed influenza at any gestation and up to two days after giving birth. These were compared to women admitted to give birth that did not have influenza. Baseline characteristics, immunization status, maternal and perinatal outcomes were compared. Results There were 405 women admitted to hospital with laboratory confirmed influenza in pregnancy: 2.7 per 10,000 maternities. Compared to 694 comparison women, women with influenza were less likely to be professionally employed (aOR 0.59, 95%CI 0.39–0.89) or immunised in the relevant season (aOR 0·59, 0·39–0·89) and more likely to have asthma (aOR 2.42, 1.30–4.49) or have had a previous pregnancy complication (aOR 2·47, 1·33–4·61). They were more likely to be admitted to intensive care (aOR 21.3, 2.78–163.1) and to have a cesarean birth (aOR 1·42, 1·02–1.98). Their babies were more likely to be admitted to neonatal intensive care (aOR 1.86, 1·01–3·42). Conclusions Immunization reduces the risk of hospitalisation with influenza in pregnancy which is associated with increased risk of morbidity for both the mother and baby. There is a continued need to increase awareness of safety and effectiveness of immunization in pregnancy and provision within antenatal care settings, especially for high-risk groups.
JMIR Publications
The Association Between Chronic Disease and Serious COVID-19 Outcomes and Its Influence on Risk Perception: Survey Study and Database Analysis
Laires P.A., Dias S., Gama A., Moniz M., Pedro A.R., Soares P., Aguiar P., Nunes C.
JMIR Public Health and Surveillance scimago Q1 wos Q1 Open Access , 
2020-12-15,  citations by CoLab: 65 ,  Abstract  
Background COVID-19, a viral respiratory disease first reported in December 2019, quickly became a threat to global public health. Further understanding of the epidemiology of the SARS-CoV-2 virus and the risk perception of the community may better inform targeted interventions to reduce the impact and spread of COVID-19. Objective In this study, we aimed to examine the association between chronic diseases and serious outcomes following COVID-19 infection, and to explore its influence on people’s self-perception of risk for worse COVID-19 outcomes. Methods This study draws data from two databases: (1) the nationwide database of all confirmed COVID-19 cases in Portugal, extracted on April 28, 2020 (n=20,293); and (2) the community-based COVID-19 Barometer survey, which contains data on health status, perceptions, and behaviors during the first wave of COVID-19 (n=171,087). We assessed the association between relevant chronic diseases (ie, respiratory, cardiovascular, and renal diseases; diabetes; and cancer) and death and intensive care unit (ICU) admission following COVID-19 infection. We identified determinants of self-perception of risk for severe COVID-19 outcomes using logistic regression models. Results Respiratory, cardiovascular, and renal diseases were associated with mortality and ICU admission among patients hospitalized due to COVID-19 infection (odds ratio [OR] 1.48, 95% CI 1.11-1.98; OR 3.39, 95% CI 1.80-6.40; and OR 2.25, 95% CI 1.66-3.06, respectively). Diabetes and cancer were associated with serious outcomes only when considering the full sample of COVID-19–infected cases in the country (OR 1.30, 95% CI 1.03-1.64; and OR 1.40, 95% CI 1.03-1.89, respectively). Older age and male sex were both associated with mortality and ICU admission. The perception of risk for severe COVID-19 disease in the study population was 23.9% (n=40,890). This was markedly higher for older adults (n=5235, 46.4%), those with at least one chronic disease (n=17,647, 51.6%), or those in both of these categories (n=3212, 67.7%). All included diseases were associated with self-perceptions of high risk in this population. Conclusions Our results demonstrate the association between some prevalent chronic diseases and increased risk of worse COVID-19 outcomes. It also brings forth a greater understanding of the community’s risk perceptions of serious COVID-19 disease. Hence, this study may aid health authorities to better adapt measures to the real needs of the population and to identify vulnerable individuals requiring further education and awareness of preventive measures.
Public Library of Science (PLoS)
Risk Factors for Severe Outcomes following 2009 Influenza A (H1N1) Infection: A Global Pooled Analysis
Van Kerkhove M.D., Vandemaele K.A., Shinde V., Jaramillo-Gutierrez G., Koukounari A., Donnelly C.A., Carlino L.O., Owen R., Paterson B., Pelletier L., Vachon J., Gonzalez C., Hongjie Y., Zijian F., Chuang S.K., et. al.
PLoS Medicine scimago Q1 wos Q1 Open Access , 
2011-07-05,  citations by CoLab: 543 ,  PDF,  Abstract  
This study analyzes data from 19 countries (from April 2009 to Jan 2010), comprising some 70,000 hospitalized patients with severe H1N1 infection, to reveal risk factors for severe pandemic influenza, which include chronic illness, cardiac disease, chronic respiratory disease, and diabetes.
Centers for Disease Control and Prevention (CDC)
Pandemic Influenza and Pregnant Women
Rasmussen S.A., Jamieson D.J., Bresee J.S.
Emerging Infectious Diseases scimago Q1 wos Q1 Open Access , 
2008-10-09,  citations by CoLab: 254 ,  Abstract  
Planning for a future influenza pandemic should include considerations specific to pregnant women. First, pregnant women are at increased risk for influenza-associated illness and death. The effects on the fetus of maternal influenza infection, associated fever, and agents used for prophylaxis and treatment should be taken into account. Pregnant women might be reluctant to comply with public health recommendations during a pandemic because of concerns regarding effects of vaccines or medications on the fetus. Guidelines regarding nonpharmaceutical interventions (e.g., voluntary quarantine) also might present special challenges because of conflicting recommendations about routine prenatal care and delivery. Finally, healthcare facilities need to develop plans to minimize exposure of pregnant women to ill persons, while ensuring that women receive necessary care.
Elsevier
Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults11The names and affiliations of the Task Force members are listed on page v of this supplement and at http://www.thecommunityguide.org22Some of this material was published previously in: Shefer A, Briss P, Rodewald L, et al. Improving immunization coverage rates: an evidence-based review of the literature. Epidemiol Rev 1999;20:96–142.
Briss P.A., Rodewald L.E., Hinman A.R., Shefer A.M., Strikas R.A., Bernier R.R., Carande-Kulis V.G., Yusuf H.R., Ndiaye S.M., Williams S.M.
American Journal of Preventive Medicine scimago Q1 wos Q1 , 
2000-01-01,  citations by CoLab: 397 ,  Abstract  
This paper presents the results of systematic reviews of the effectiveness, applicability, other effects, economic impact, and barriers to use of selected population-based interventions intended to improve vaccination coverage. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis for recommendations by the Task Force on Community Preventive Services (the Task Force) regarding the use of these selected interventions. The Task Force recommendations are presented on pp. 92-96 of this issue.
Found 3
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Taylor & Francis
Readiness assessment for cervical cancer elimination and prevention of human papillomavirus (hpv)-related cancers in Europe – are we winning the RACE?
Karamousouli E., Sabale U., Valente S., Morosan F., Heuser M., Dodd O., Riley D., Heron L., Calabrò G.E., Agorastos T., Sevelda P., Krasznai Z.T., Nahum S., Horby R.
Expert Review of Vaccines scimago Q1 wos Q1 Open Access , 
2024-12-15,  citations by CoLab: 0 ,  PDF, 
Oxford University Press
Caregiver Adverse Childhood Experiences and Pediatric Infection-Related Outcomes
Day M.E., Duan Q., Burkhardt M.C., Klein M., Schlaudecker E.P., Beck A.F.
Journal of the Pediatric Infectious Diseases Society scimago Q1 wos Q1 , 
2024-09-19,  citations by CoLab: 0 ,  Abstract  
Abstract Background Higher caregiver-adverse childhood experiences (ACEs) have been associated with multiple adverse pediatric outcomes. However, no studies have examined links between caregiver ACEs and infectious outcomes like antibiotic prescriptions or infection-related clinical encounters. Methods We conducted a retrospective cohort study including patients from 2 pediatric primary care sites, serving predominantly non-Hispanic Black, publicly insured populations. Our outcomes were antibiotic prescriptions and infection-related ambulatory clinical encounters for children 0-3 years old. We captured these outcomes and additional covariates (demographics, health-related social risk screen results, and Socioeconomic Deprivation Index scores linked to geocoded street addresses) from the electronic health record. High (≥4) or low (≤3) caregiver ACEs, and individual ACE question answers, were our exposures. Multivariable logistic regression was used to determine associations with any antibiotic use. Cox proportional hazards regression was used to assess the time to first antibiotic exposure and first infection-related visit. Results A total of 1465 children 0-3 years were included (50.0% female, 75.0% Black, and 2.6% Hispanic). High caregiver ACEs were not associated with pediatric antibiotic exposure. The presence of caregiver-witnessed parental abuse was associated with a higher likelihood of any antibiotic exposure (odds ratio [OR 1.90]; 95% confidence interval [CI] 1.2, 3.2) and time to first antibiotic exposure (hazard ratio [HR] 1.77; 95% CI 1.23, 2.56). Sexual abuse of the caregiver was associated with time to first infection-related clinical visit (HR 1.27; 95% CI 1.05, 1.53). Conclusions Certain caregiver ACEs were associated with pediatric antibiotic use and infection-related visits. Future studies need to evaluate underlying mechanisms and test effective clinical responses.
Taylor & Francis
Assessment of the comprehensiveness of paediatric national immunisation programmes in Europe: expert validation and future perspectives
Sabale U., Murtagh J., Cochrane J., Riley D., Perry R., Heron L., Bonanni P., Navarro Alonso J., Eskola J., Laigle V.
Expert Review of Vaccines scimago Q1 wos Q1 Open Access , 
2024-03-01,  citations by CoLab: 0 ,  PDF, 

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