Pediatric Immunization

Pharmacists have a key role to play to advance public health through immunization. Pharmacists are well trained and play a huge role in vaccine production, research and development, safety, pharmacovigilance, storage, logistics and distribution. There is a need for a revised national policy and strategy in Nigeria on vaccination and immunization programs with the involvement of community pharmacies and/or pharmacists. This will help accelerate getting a wider vaccination access coverage, establishing a greater healthcare delivery workforce for societal benefits and demonstrate the full potential of the community pharmacies and the pharmacists' role in immunization programs.

Background: Ever since the return of some form of governance and administration (interim/ provisional, state, or federal), Somalia has been struggling to streamline administrative structures capable of handling effective service delivery to the public. The health sector, supposedly one of the priority areas under the public service delivery umbrella, has been ailing and continues to be facing serious encounters which the health authority is grappling with, though yet unable to tackle them independently. Child immunization, the focus of this study, remains a sub-sector the country has been massively underperforming. Objective: The current study aims to review the efforts engaged and challenges needed to be addressed in order to improve the overall approach of the country's immunization policy. Method: The researchers utilized secondary data to review available literature on immunization selected from various sources to determine the efforts made and challenges faced or being faced in the course of child immunization. Results: The study found that in addition to issues such as security, low education, low coverage, and inaccessibility, factors including resources, language barrier, and trust contribute to the challenges. Conclusion: The health authority and its partners made remarkable efforts and achievements but still need to consider approaches that are friendly to the target groups in the course of enhancing the country's child immunization programs. Trust, which is built on a smooth flow of communication between the beneficiaries and service providers, needs to be gained through mutual linguistic intelligibility in order to maximize the endeavor toward improving the health sector, particularly immunization of vaccine-preventable diseases and the challenges it is facing towards the realization of national and global health goals.

Background: Contemporary research on immunization has suggested a redefinition or at least acknowledgement of the impact of pertussis beyond the traditional belief of defining it as an isolated infant and child disease. A section of scholars is seeking a more expansive understanding and relevant redefinition that reflects its prevalence among adolescents and adults. A variety of case-oriented, labbased definitions were produced to respond to national, regional or global descriptions of the disease within a unified goal to eradicate or substantially minimize its recurrence and therefore contain its impact on the victims. Objective: This study sought to explore the prevalence of pertussis in Baidoa, a small city which is the provisional capital of the administration of the Southwest State of Somalia. Method: The study used desk research by examining secondary sources that discussed pertussis in general as well as others that provide insights specific only to the context of Baidoa city. Results: Although recent research has indicated tremendous success in the prevention and containment of immunizable diseases through robust vaccination schemes, the menace of the pertussis disease is present among the residents of Baidoa, both hosts and internally displaced persons (IDPs), but without much detail on the estimates of the victims. Conclusion: Insufficient awareness and lack of emphasis to single out the pertussis threat and its impact on children, are very likely among the possible contributors to the prevalence of the disease in the city. It is in view of the significance to eradicate or at least mitigate its effect on children that a more thorough focus on awareness is needed to increase the rate of immunization as an important preventive measure against pertussis.

In the world today, there are roughly 25 million cancer survivors. Progress in treatments have greatly improved cure rates, with 5-year survival now approaching 80%, but are associated with numerous negative physical and psychological side-effects and a deterioration in the quality of future life. Cancer survivors are at increased risk for second cancers, other forms of comorbidity (e.g., cardiovascular disease, diabetes, osteoporosis), and functional decline. Lifestyle factors, such as a healthy diet, regular exercise, and smoking cessation may prevent these conditions and improve survivors' quality of life. Observational research has shown that the physical activity levels of survivors of hematological cancer are low, with deleterious health consequences. The aim of this systematic review was to understand and evaluate if and how much a program of physical activity improves the quality of life in children survivors of acute lymphoblastic leukemia (ALL). A systematic literature search was carried out in the MEDLINE/PubMed database and has been analyzed 40 studies. Completing the analysis it seems that no one exercise-related risks in children was identified in these studies. Though more trials are needed, a growing literature supports the notion that regular physical activity has potential benefits for pediatric hematological cancer survivors.

There is a need to revise/review recommendations regarding existing vaccines in view of current developments in vaccinology. Process: Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics (IAP) reviewed the new evidence, had two meetings, and representatives of few vaccine manufacturers also presented their data. The recommendations were finalized unanimously. Objectives: To revise and review the IAP recommendations for 2018-19 and issue recommendations on existing and certain new vaccines. Recommendations. The major changes in the IAP 2018-19 Immunization Timetable include administration of hepatitis B vaccine within 24 hours of age, acceptance of four doses of hepatitis B vaccine if a combination pentavalent or hexavalent vaccine is used, administration of DTwP or DTaP in the primary series, and complete replacement of oral polio vaccine (OPV) by injectable polio vaccine (IPV) as early as possible. In case IPV is not available or feasible, the child should be offered three doses of bivalent OPV. In such cases, the child should be advised to receive two fractional doses of IPV at a Government facility at 6 and 14 weeks or at least one dose of intramuscular IPV, either standalone or as a combination, at 14 weeks. The first dose of monovalent Rotavirus vaccine (RV1) can be administered at 6 weeks and the second at 10 weeks of age in a two-dose schedule. Any of the available rotavirus vaccine may be administered. Inactivated influenza vaccine (either trivalent or quadrivalent) is recommended annually to all children between 6 months to 5 years of age. Measles-containing vaccine (MMR/MR) should be administered after 9 months of age. Additional dose of MR vaccine may be administered during MR campaign for children 9 months to 15 years, irrespective of previous vaccination status. Single dose of Typhoid conjugate vaccine (TCV) is recommended from the age of 6 months and beyond, and can be administered with MMR vaccine if administered at 9 months. Four-dose schedule of anti-rabies vaccine for Post Exposure Prophylaxis as recommended by World Health Organization in 2018, is endorsed, and monoclonal rabies antibody can be administered as an alternative to Rabies immunoglobulin for post-exposure prophylaxis.

To determine the spectrum of vaccine preventable diseases amongst children in pediatric medical unit of tertiary care hospitals and also determine its relationship with the vaccination status. Methodology: It was a cross sectional study held at isolation ward of pediatric therapeutic division of

Vaccination enrollment requirements are an important tool used to improve vaccination coverage among school-aged children. However, all states permit varying exemptions that allow students to stay enrolled without receiving some (or all) vaccinations. In Arizona, schools are required to report vaccination data on their kindergarten and 6th grade students annually to the Arizona Department of Health Services (ADHS). We analyzed trends in herd immunity and personal belief exemptions in Arizona schools from 2015 to 2018. We also identified multiple correlates of herd immunity at the school level. Our results demonstrate decreased herd immunity statewide and by school type and an increased rate of personal belief exemptions during this period. These findings contribute to the body of literature suggesting that vaccine hesitancy is growing, resulting in suboptimal vaccination coverage for children. Moreover, this research has several policy implications, especially for states permitting multiple exemption types and lax exemption criteria.

Vaccination enrollment requirements are an important tool used to improve vaccination coverage among school-aged children. However, all states permit varying exemptions that allow students to stay enrolled without receiving some (or all) vaccinations. In Arizona, schools are required to report vaccination data on their kindergarten and 6th grade students annually to the Arizona Department of Health Services (ADHS). We analyzed trends in herd immunity and personal belief exemptions in Arizona schools from 2015 to 2018. We also identified multiple correlates of herd immunity at the school level. Our results demonstrate decreased herd immunity statewide and by school type and an increased rate of personal belief exemptions during this period. These findings contribute to the body of literature suggesting that vaccine hesitancy is growing, resulting in suboptimal vaccination coverage for children. Moreover, this research has several policy implications, especially for states permitting multiple exemption types and lax exemption criteria.

Poliomyelitis, a dreaded disease of the last century that had already crippled millions of people across the globe, is now on the verge of eradication thanks mainly to two polio vaccines, inactivated polio vaccine (IPV) and oral polio vaccine (OPV). Ever since their development in late 1950s and early 1960s, the journey of their early development process, clinical trials, licensure and ultimately widespread clinical use in different countries provide a fascinating tale of events. Oral polio vaccine has been the mainstay of global polio eradication initiative (GPEI) in most of the countries. With the advent of 'polio endgame', the focus has now shifted back to IPV. However, there are certain issues associated with global cessation of OPV use and universal implementation of IPV in routine immunization schedules across the globe that need to be dealt with some urgency, before proclaiming the global victory over polio.

The COVID 19 pandemic has prompted the world to implement drastic prevention methods based on limiting population movements that have an impact on public health policies such as vaccination. The objective of this work was to evaluate the impact of these prevention measures on routine vaccination in hospitals since the advent of the pandemic in Senegal. Methodology: This is a retrospective cross-sectional study carried out in August 2020 in the vaccination unit of the Abass NDAO hospital centre. We compared data from the vaccination unit during the period from March to August of the last three years (2018, 2019 and 2020). The parameter studied was the number of vaccine doses administered for the different periods according to the expanded programme of immunization. Results: For the vaccines administered in the sixth week in April, the number of doses was 36 in 2018, 29 in 2019 and 15 in 2020, i.e. a 50% drop compared to March. In July the number of doses administered was 40 in 2018, ...

Childhood immunization remains a critical public health strategy to reduce morbidity and mortality associated with vaccine-preventable diseases. This study assesses the enablers and barriers to childhood immunization in Wau County of Western Bahrel Ghazel State, South Sudan. Using a qualitative research approach. Data were collected through Key Informant Interviews (KII) and Focus Group Discussions (FGD) with parents', healthcare workers, and community leaders. Key enablers identified include community awareness campaigns, support from local leaders, accessible healthcare infrastructure, trust in healthcare professionals, and government and NGOsupported initiatives. Conversely, barriers to immunization encompass cultural beliefs, misinformation about vaccines, logistical challenges such as vaccine stockouts and inconvenient scheduling, limited engagement by healthcare workers, and financial constraints faced by parents'. The findings show the importance of targeted strategies to strengthen community engagement, improve healthcare accessibility, and address sociocultural and economic barriers.

Objective: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. Methods: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. Results: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capit...

This letter is a response to Jyotiprasad Chatterjee and Suprio Basu (“Politics of Regionalism and Welfare: The Twin Aces That Helped the Trinamool Defeat the BJP,” EPW, 21 September 2024), who claimed that regional populism combined with strategic welfarism entrenched in the spirit of political clientelism could possibly have been electorally productive for the Trinamool Congress (TMC) in the Lok Sabha elections of 2024 in West Bengal (WB). While I acknowledge the importance of welfarism and regional populism, I also identify two other factors that had a bearing on voters’ behaviour in WB. First, one-way polarisation of minority votes; and second, the pattern of political foundation in WB.

India's recent health surveys have highlighted a worrying trend of incomplete child immunization rates across several district clusters in India. Conventional training methods for community healthcare workers (CHWs) in India are inadequate for improving their skills and knowledge. Smartphone games could be a viable and cost-effective method of refresher training specifically targeting immunization practices. A refresher training game was designed both as a physical card-based and digital app-based game, focusing on enhancing CHWs' knowledge and practices related to child immunization. A quasi-experimental study was conducted with 368 participants. Quantitative gameplay analytics and qualitative feedback from players were collected through interviews. The findings show that game-based refresher training significantly improves CHWs' knowledge gain and retention in the area of child immunization. The discussion highlights the study's implications and insights while developing effective digital tools for training CHWs. The research contributes to the growing body of work on digital tools for training CHWs in resource-constrained settings. The study underscores the potential of smartphone games as a scalable and effective method of refresher training for improving child immunization rates. CCS Concepts • Human-centered computing → Field studies.

Objective. We examined childhood vaccinations coverage and its associated factors in sub-Saharan Africa (SSA) countries. Methods. We used demographic and health surveys (DHSs) data collected between 2008 and 2022 from 35 SSA countries. A sample of 358 949 under-5 children was analyzed. Percentage and multivariable binary logistic regression analyses were conducted. A 5% significance level was set. Results. Rwanda (7461/8092; 92.2%), Burundi (10 792/13 192; 81.8%), Gambia (6548/8362; 78.3%), Kenya (14 570/19 530; 74.6%), and Burkina Faso (8739/12 343; 70.8%) had the leading coverage of under-5 children who received all basic vaccinations in the first year of life. For every unit increase in the age of a child, there was 72% increase in the odds of vaccination. Children from older mothers had higher odds of vaccination, when compared with children with mothers aged 15 to 19 years. There was a 6% reduction in the odds of vaccination among children from rural residence, when compared with their urban counterparts. Children with educated mothers had over two times higher odds of vaccination, when compared with those from mothers with no formal education. Children from rich households had higher odds of vaccination, when compared with children from poorest household. There was a 13% increase in the odds of vaccination among children covered by health insurance, when compared with those not covered by health insurance. Conclusion. Vaccination uptake for children under-5 in SSA was found to be sub-optimal and associated with several factors. A health educational intervention for pregnant women could potentially increase the uptake of vaccines among children.

Objective  To analyze factors associated with full vaccination coverage with valid doses, in children from four state capitals and three other cities in Southeast Brazil.

Method  Analysis of a population survey conducted in 2020-2021, with a sample stratified according to socioeconomic levels of children born in 2017-2018, with data collected through photographic records of their vaccination cards. Odds ratios (OR) and 95% confidence intervals (95%CI) for full vaccination coverage were estimated based on the characteristics of the family, mother and child.

Results  Among 8703 children, lowest coverage occurred in strata A and B (OR=0.39; 95%CI 0.23;0.67 and OR=0.38; 95%CI 0.25;0.58); in consumption level A/B (OR=0.38; 95CI% 0.28;0.52); among those with income >BRL8000/month (OR=0.23; 95%CI 0.12;0.42); in children of mothers with higher education (OR=0.47; 95%CI 0.32;0.71); in children not vaccinated exclusively in the public service (OR=0.37; 95%CI 0.26;0.51) and in children with a vaccination delay of up to 6 months (OR=0.28; 95%CI 0.22;0.37).

Conclusion  Coverage did not reach the targets for controlling vaccine-preventable diseases and was negatively associated with higher socioeconomic status.

Keywords Vaccination Coverage; Child Health; Socioeconomic Factors; Health Surveys

Objetivo  Analisar fatores associados à cobertura vacinal completa com doses válidas, em crianças das capitais e em três outras cidades da região sudeste.

Métodos  Trata-se de análise de inquérito populacional conduzido em 2020-2021, em amostra estratificada segundo níveis socioeconômicos de crianças nascidas em 2017-2018, com dados coletados por registro fotográfico da caderneta de vacinação. Foram estimadas razões de chances (odds ratio, OR) e intervalo de confiança de 95% (IC95%) da cobertura vacinal completa pelas características da família, mãe e criança.

Resultados  Em 8.703 crianças, menor cobertura ocorreu nos estratos A e B (OR=0,39; IC95% 0,23;0,67 e OR=0,38; IC95% 0,25;0,58); nível de consumo A/B (OR=0,38; IC95% 0,28;0,52); renda mensal inferior a R$ 8.000,00 (OR=0,23; IC95% 0,12;0,42); em filhos de mães com ensino superior (OR=0,47; IC95% 0,32;0,71); em crianças não vacinadas exclusivamente no serviço público (OR=0,37; IC95% 0,26;0,51) e com atraso vacinal até 6 meses (OR=0,28; IC95% 0,22;0,37).

Conclusão  As coberturas não atingiram metas para controlar doenças imunopreveníveis e associaram-se negativamente ao maior nível socioeconômico.

Palavras-chave Coberturas Vacinais; Saúde da Criança; Fatores Socioeconômicos; Inquéritos Epidemiológicos

Objective  To analyze measles, mumps, and rubella vaccination coverage among children up to 24 months old and factors associated with non-vaccination in a 2017−2018 live birth cohort, in state capitals and large interior region cities in Northeast Brazil.

Methods  Population-based survey analyzing vaccination coverage and sociodemographic factors through logistic regression.

Results  For 12,137 children, vaccination coverage was 79.3% (95%CI 76.5;81.8), and the dropout rate was 10.6%. Association with non-vaccination: socioeconomic stratum A (OR-a 1.29; 95%CI 1.10;1.50), living in the interior region (OR-a 1.22; 95%CI 1.07;1.39), no access to the Bolsa Família Program (OR-a 1.19, 95%CI 1.05;1.34), family income ≤BRL 1,000 (OR-a 1.17, 95%CI 1.03;1.31), mother not working (OR-a 1.28, 95%CI 1.15;1.42), >1 child per mother (OR-a 1.12, 95%CI 1.08;1.17), and no vaccination card (OR-a 10.69, 95%CI 6.27;18.20).

Conclusion  Low vaccination coverage and a high dropout rate in state capitals and municipalities in the interior region of Northeast Brazil.

Keywords Vaccination Coverage; Measles; Measles-Mumps-Rubella Vaccine; MMR Vaccine; Health Surveys

Objetivo  Analisar a cobertura vacinal contra sarampo, caxumba e rubéola em crianças até 24 meses de idade e os fatores associados à não vacinação em coorte de nascidos-vivos em 2017-2018, em capitais e municípios de grande porte populacional do interior do Nordeste brasileiro.

Métodos  Inquérito domiciliar populacional com análise de cobertura vacinal e fatores sociodemográficos por regressão logística.

Resultados  Em 12.137 crianças, cobertura vacinal de 79,3% (IC95% 76,5;81,8) e taxa de abandono de 10,6%. Associação à não vacinação: estrato socioeconômico A (OR-a 1,29; IC95% 1,10;1,50), residir no interior (OR-a 1,22; IC95% 1,07;1,39), não acesso ao Programa Bolsa Família (OR-a 1,19; IC95% 1,05;1,34), renda familiar ≤ R$ 1.000,00 (OR-a 1,17; IC95% 1,03;1,31), mãe sem trabalho remunerado (OR-a 1,28; IC95% 1,15;1,42), > 1 filho por mãe (OR-a 1,12; IC95% 1,08;1,17), sem caderneta de vacinação (OR-a 10,69; IC95% 6,27;18,20).

Conclusão  Baixa cobertura e alta taxa de abandono vacinal em capitais e municípios do interior do Nordeste.

Palavras-chave Cobertura Vacinal; Sarampo; Vacina contra Sarampo-Caxumba-Rubéola; Inquéritos Epidemiológicos

Objetivo

Analisar a cobertura vacinal até os 24 meses de vida, segundo raça/cor da pele, na coorte de nascidos vivos em 2017-2018 em Natal, Rio Grande do Norte.
Métodos

Inquérito de base populacional realizado em 2020 e 2021. Estimaram-se as coberturas vacinais até os 24 meses de idade, segundo doses aplicadas, válidas e oportunas. A associação bruta da raça/cor da pele foi estimada pelo cálculo da razão de prevalência bruta e respectivos intervalos de confiança de 95% (IC95%), utilizando-se regressão de Poisson.
Resultados

Das 688 crianças da coorte selecionadas, houve maior cobertura entre as crianças negras para as doses aplicadas (brancas 30,5%; negras 47,8%; IC95%) e válidas (brancas 25,8%; negras 40,1%; IC95%), sem significância estatística, e menor cobertura para as doses oportunas, no esquema completo sem febre amarela (RP = 0,21; IC95% 0,04;0,90).
Conclusão

Evidenciou-se menor cobertura oportuna entre crianças negras, comparadas com crianças brancas.

Palavras-chave
Cobertura Vacinal; Disparidades Socioeconômicas em Saúde; Acesso aos Serviços de Saúde; Saúde das Minorias Étnicas; Determinantes Sociais da Saúde; Inquéritos Epidemiológicos

Childhood routine immunization (RI) is a highly effective public health intervention for the prevention of infectious diseases. Despite high immunization rates, a 2018 Knowledge, Attitudes, and Practices (KAP) study by the United Nations Children’s Fund (UNICEF) noted a growing practice of vaccine refusal among parents and primary caregivers as well as clusters of significantly lower immunization coverage in some provinces. Moreover, a 2018 Joint Appraisal report by GAVI (Global Vaccine Alliance) has highlighted a decrease in immunization rates among children under 1 year of age from 96.1% to 92% for some vaccines. As a result, UNICEF is spearheading a national communication initiative to increase the rates of RI in Kyrgyzstan. This initiative includes strengthening interpersonal communication skills of local healthcare workers, improving the quality and accuracy of media coverage via a tailored outreach to the Kyrgyz media, as well as fostering community engagement to give voice to...

Vaccine wastage may occur due to physical damage including breakage or because fewer vaccine doses are administered during an immunization session than included in multi-dose vials. Methods: We analyzed reported data from 2,553 vaccination centers distributed in 600 municipalities for 4 vaccines: measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis-Hib (DTP-Hib), Bacille Camille Guerin (BCG) and oral rotavirus vaccine. Vaccine costs were provided by the immunization program. Results: Mean vaccine wastage was 65.7% for MMR (range, 46.1% to 72.4%), 23.9% for DTP-Hib (range, 10.3% to 32.6%), 74% for BCG (range, 64.4% to 79.9%), and 3.2% for rotavirus (range, 1.3% to 4.8%). The ratio of doses in opened vials to doses administered was almost 3:1 for MMR, 1.3:1 for DTP-Hib, 3.8:1 for BCG and nearly 1:1 for rotavirus. Conclusion: Multi-dose vials are often preferred by immunization programs for requiring less space for transport and vaccine storage but may result in higher cost per do...

Objective: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. Methods: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. Results: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. Conclusion: There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage.

Objetivo

Analisar a cobertura vacinal completa em nascidos vivos em 2017 e 2018, nas capitais da região Centro-Oeste do Brasil, segundo estratos sociais.
Métodos

Inquérito domiciliar de base populacional com amostragem por conglomerados. Analisou-se a cobertura vacinal completa em crianças aos 12 e 24 meses de idade e os fatores sociodemográficos.
Resultados

Foram analisadas 5.715 crianças. A cobertura completa aos 12 meses de idade foi 67,9% (IC95% 65,4;70,4) e aos 24 meses de idade foi 48,2% (IC95% 45,3;51,1). A maior cobertura foi da vacina pneumococo (91,3%) e a pior da segunda dose da vacina rotavírus (74,2%). Em Campo Grande, nenhuma vacina alcançou cobertura acima de 90%, destacando-se as vacinas BCG (82,9%) e hepatite B (82,1%). Campo Grande e Brasília tiveram piores coberturas vacinais no estrato social alto (24 meses de idade).
Conclusão

A cobertura vacinal na região Centro-Oeste foi inferior a 80%, abaixo da meta preconizada e associada com fatores socioeconômicos.

Palavras-chave
Programas de Imunização; Cobertura Vacinal; Fatores Socioeconômicos; Desigualdades Sociais em Saúde; Inquéritos Populacionais

Objective

To analyze full vaccination coverage in live births in 2017 and 2018 in the capitals of the Midwest region of Brazil, according to social strata.
Methods

Population-based household survey with cluster sampling. Full coverage in children at 12 and 24 months of age and sociodemographic factors were analyzed.
Results

5,715 children were analyzed. Full coverage at 12 months of age was 67.9% (95%CI 65.4;70.4), while at 24 months it was 48.2% (95%CI 45.3;51.1). Pneumococcal vaccine had the highest vaccination coverage (91.3%), while the second dose of rotavirus vaccine had the lowest (74.2%). In Campo Grande, no vaccine reached coverage above 90%, with BCG (82.9%) and hepatitis B (82.1%) standing out. Campo Grande and Brasília had the worst vaccination coverage in the high social stratum (24 months of age).
Conclusion

Vaccination coverage in the Midwest was below 80%, falling short of the recommended target and associated with socioeconomic factors.

Keywords
Immunization Programs; Vaccination Coverage; Socioeconomic Factors; Socioeconomic Disparities in Health; Population Surveys

Objective

To estimate vaccination coverage and analyze sociodemographic factors associated with non-vaccination in children born in 2017 and 2018 in the state capitals of Northeast Brazil.
Methods

A household survey using cluster sampling was conducted from 2020-2022 to estimate vaccination coverage and hesitancy. Factors associated with non-vaccination were analyzed using logistic regression to calculate Odds Ratios (OR) and their Confidence Intervals (95%CI).
Results

Natal was the capital with the lowest vaccination coverage, below 75.0% for most immunizers. Teresina had rates equal to or greater than 90.0% for all vaccines. Among those interviewed, 99.1% (95%CI 98.9;99.3) believe that vaccines are important for health; 95.4% (95%CI 95.0;95.8) trust immunobiologicals and 79.6% (95%CI% 78.8;80.3) are not afraid of reactions. Belonging to the highest socioeconomic stratum (adjusted OR: 1.34 – 95%CI 1.20;1.50) was as a factor associated with non-vaccination.
Conclusion

Low coverage highlights the need for a better understanding of regional specificities and social inequalities.

Objetivo

Estimar a cobertura vacinal e analisar fatores sociodemográficos associados à não vacinação em crianças nascidas vivas em 2017 e 2018 nas capitais do Nordeste brasileiro.
Métodos

Realizou-se inquérito domiciliar com amostragem por conglomerados, entre 2020 e 2022, para estimar cobertura e hesitação vacinal. Fatores associados à não vacinação foram analisados usando-se regressão logística para calcular odds ratio (OR) e seus intervalos de confiança (IC95%).
Resultados

A capital com menores coberturas vacinais foi Natal, com < 75,0% para a maioria dos imunizantes; Teresina apresentou coberturas ≥ 90,0% em todos os imunizantes. Dos entrevistados, 99,1% (IC95% 98,9;99,3) acreditavam que vacinas são importantes para a saúde; 95,4% (IC95% 95,0;95,8) confiavam nos imunobiológicos distribuídos pelo governo; e 79,6% (IC95% 78,8;80,3) não tinham medo de reações adversas. Residir em estrato socioeconômico mais alto (OR ajustado: 1,34 – IC95% 1,20;1,50) foi fator associado à não vacinação.
Conclusão

As baixas coberturas destacam a necessidade de entender melhor as especificidades regionais e as desigualdades sociais.

Palavras-chave
Cobertura Vacinal; Hesitação Vacinal; Vacinação em Massa; Programas de Imunização; Inquéritos Epidemiológicos

Objetivo: Estimar a cobertura vacinal em crianças nascidas entre 2017-2018, residentes nas áreas urbanas das capitais, do Distrito Federal e em 12 municípios do interior do Brasil, e identificar fatores associados. Métodos: Inquérito domiciliar realizado entre 2020-2022, em crianças até 24 meses. Estimou-se a cobertura vacinal segundo características da família, da mãe e da criança. Resultados: Nas 37.801 crianças da amostra, a cobertura completa (doses aplicadas) foi de 60,1% (IC 95% 58,6;61,6), e 6,1% (IC 95% 5,4;7,0) não receberam qualquer vacina. A cobertura foi menor em crianças de mães com menor instrução (OR = 0,70; IC 95% 0,54;0,90) e nas que tinham atraso em qualquer vacina até os 6 meses de vida (OR = 0,28; IC 95% 0,24;0,32). Conclusão: As coberturas vacinais estão aquém do esperado. É necessário adotar estratégias de comunicação efetivas para reforçar a importância da vacinação de rotina, prevenindo atrasos e abandono do esquema vacinal, para retomar os altos níveis alcançados em décadas passadas.

Objetivo

Caracterizar a utilização dos serviços privados na vacinação de lactentes e avaliar as coberturas vacinais segundo serviço utilizado.
Métodos

Inquérito nacional de vacinação realizado em 2020 que estimou a utilização de serviços privados de vacinação e as coberturas vacinais de lactentes residentes nas capitais dos estados, no Distrito Federal e em 12 municípios do interior.
Resultados

Dos 37.801 participantes, 25,1% (IC95% 23,2;27,2) utilizaram alguma vez serviços privados, com maiores proporções em capitais, cidades de maior porte e regiões Sul e Sudeste. Identificaram-se diferenças socioeconômicas e demográficas nas famílias, segundo o serviço utilizado. A cobertura para o conjunto de vacinas aplicadas até 24 meses foi de 60,3% (IC95% 58,6;62,0) no serviço público e de 59,5% (IC95% 55,9;63,0) no privado, e das vacinas em dia, de 10,3% (IC95% 9,1;11,6) e 9,4% (IC95% 7,4;11,8), respectivamente.
Conclusão

A utilização dos serviços privados foi frequente, com baixas coberturas para o conjunto de vacinas, independentemente do tipo de serviço utilizado, especialmente para vacinas em dia.

Palavras-chave
Cobertura de Serviços Privados de Saúde; Cobertura Vacinal; Vacinas; Inquérito Epidemiológico

Objective

To characterize the use of private services in infant vaccination and assess vaccination coverage according to the service used.
Methods

: This was a national vaccination survey conducted in 2020 that estimated the use of private vaccination services and vaccination coverage among infants residing in state capitals and 12 inland municipalities.
Results

: Of the 37,801 participants, 25.1% (95%CI 23.2;27.2) used private services at least once, with higher proportions in capitals, larger cities and in the South and Southeast regions. Socioeconomic and demographic differences were identified among families, based on the service used. The coverage for the set of vaccines administered up to 24 months was 60.3% (95%CI 58.6;62.0) in the public service and 59.5% (95%CI 55.9;63.0) in private services, and up-to-date vaccines, 10.3% (95%CI 9.1;11.6) and 9.4% (95%CI 7.4;11.8), respectively.
Conclusion

The use of private services was frequent, with low coverage for the set of vaccines, regardless of the type of service used, especially for up-to-date vaccines.

Keywords
Private Health Service Coverage; Vaccination Coverage; Vaccines; Epidemiological Survey

Objective

To estimate vaccination coverage, identify barriers and hesitancy to vaccinating children up to 24 months, born between 2017-2018, living in the urban area of Rio Branco, Acre, Brazil.
Methods

Population survey carried out from 2020 to 2021, which assessed sociodemographic characteristics and vaccination status among children.
Results

Among 451 included children, vaccination coverage was below 80%. Meningococcal C vaccine had the lowest coverage for administered doses (76.3%; 95%CI 70.5;81.3) and doses on time (27.4%; 95%CI 23.1;32.1). The statements “vaccines cause serious adverse reactions” (26.4%; 95%CI 18.1;36.8) and “you don’t need vaccination for diseases that no longer exist” (22%; 95%CI 15.7;29.8) were the most frequent regarding vaccination hesitancy. Lack of vaccines was the main barrier to care (86.6%; 95%CI 71.8;94.3).
Conclusion

Vaccination coverage in children born in 2017-2018 was below the target recommended for the full schedule of administered doses, both valid and timely administered.

Keywords
Immunization Programs; Vaccination Coverage; Vaccination Hesitation; Vaccines; Health Surveys

Objetivo

Estimar a cobertura vacinal, identificar barreiras e hesitação à vacinação em crianças com até 24 meses, nascidas em 2017 e 2018, residentes na área urbana de Rio Branco-AC.
Métodos

Inquérito populacional realizado de 2020 a 2021, que avaliou as características sociodemográficas e a situação vacinal em crianças nascidas entre 2017 e 2018.
Resultados

Entre as 451 crianças estudadas, as coberturas vacinais foram inferiores a 80%. A menor cobertura para doses aplicadas (76,3%; IC95% 70,5;81,3) e oportunas (27,4%; IC95% 23,1;32,1) foi para o reforço da meningocócica C. As afirmações “vacinas causam reações adversas graves” (26,4%; IC95% 18,1;36,8) e “não precisa da vacina para doenças que não existem mais” (22%; IC95% 15,7;29,8) foram as mais frequentes quanto à hesitação vacinal. A falta da vacina foi a principal barreira assistencial (86,6%; IC95% 71,8;94,3).
Conclusão

As coberturas vacinais em crianças nascidas em 2017 e 2018 ficaram abaixo da meta preconizada nos esquemas completos de doses aplicadas, válidas e oportunas.

Palavras-chave
Programas de Imunização; Cobertura Vacinal; Hesitação Vacinal; Vacinas; Inquéritos Epidemiológicos

Objetivo

Avaliar as coberturas vacinais e o atraso nas doses de vacinas em lactentes em seis municípios da região Sul do Brasil.
Metodologia

Inquérito Nacional de Cobertura Vacinal 2020, com lactentes nascidos vivos em 2017 e 2018, realizado entre setembro de 2020 e março de 2022. Foram avaliadas as coberturas de doses aplicadas, doses em dia e o tempo de atraso da aplicação.
Resultados

Para 4.681 lactentes analisados, as coberturas para vacinas indicadas até os 24 meses foram de 68,0% (IC95% 63,9;71,8) para doses aplicadas e 3,9% (IC95% 2,7;5,7) para doses em dia. A maioria das aplicações em atraso foi ≤ 3 meses. Para alguns reforços, 25% das aplicações atrasaram ≥ 6 meses.
Conclusão

Além da busca de faltosos às vacinas, são necessárias estratégias para estímulo ao cumprimento do esquema de vacinação nas idades preconizadas.

Palavras-chave
Cobertura Vacinal; Vacinas; Inquéritos Epidemiológicos; Hesitação Vacinal; Atraso Vacinal

Objective: To estimate hepatitis A vaccination coverage in 24-month-old children and identify factors associated with non-vaccination. Methods: This was a survey involving a sample stratified by socioeconomic strata in capital cities (2020-2022), with coverage estimates and 95% confidence intervals (95%CI), the factor analysis was performed using the prevalence ratio (PR) by means of Poisson regression. Results: Among 31,001 children, hepatitis A coverage was 88.1% (95%CI  6.8;89.2). Regarding socioeconomic strata (A/B), the variable immigrant parents/guardians was associated with non-vaccination (PR = 1.91; 95%CI 1.09;3.37); in strata C/D, children of Asian race/skin color (PR = 4.69; 95%CI 2.30;9.57), fourth-born child or later (PR = 1.68; 95%CI 1.06;2 .66), not attending daycare/ nursery (PR = 1.67; 95%CI 1.24;2.24) and mother with paid work (PR = 1.42; 95%CI 1.16;1.74) were
associated with non-vaccination. Conclusion: Hepatitis A coverage was below the target (95%), suggesting that specificities of social strata should be taken into consideration.

Keywords: Vaccination Coverage; Immunization Programs; Hepatitis A Vaccines; Child; Socioeconomic Factors; Epidemiological Surveys.

Objetivo

Estimar a cobertura vacinal da hepatite A em crianças de 24 meses e identificar fatores associados à ausência de vacinação.
Métodos

Inquérito em amostra estratificada por estratos socioeconômicos em capitais (2020-2022), com estimativa de cobertura e intervalos de confiança de 95% (IC95%) e análise de fatores pela razão de prevalência (RP) via regressão de Poisson.
Resultados

Nas 31.001 crianças, a cobertura da hepatite A foi de 88,1% (IC95% 86,8;89,2). Nos estratos socioeconômicos (A/B), a variável pais/responsáveis imigrantes foi associada à ausência de vacinação (RP = 1,91; IC95% 1,09;3,37); nos estratos C/D, crianças de cor amarela (RP = 4,69; IC95% 2,30;9,57), 4ª ordem de nascimento ou mais (RP = 1,68; IC95% 1,06;2,66), não frequentar creche/berçário (RP = 1,67; IC95% 1,24;2,24) e mãe com trabalho remunerado (RP = 1,42; IC95% 1,16;1,74) foram associadas à ausência de vacinação.
Conclusão

Cobertura da hepatite A abaixo da meta (95%), sugerindo-se considerar especificidades dos estratos sociais.

Palavras-chave
Cobertura Vacinal; Programas de Imunização; Vacinas contra Hepatite A; Criança; Fatores Socioeconômicos; Inquéritos Epidemiológicos

BACKGROUND: Data on analgesic effects of breast/formula milk sucking while receiving routine childhood immunizations are available only in early infancy, have rarely been compared in the same study, and are not accompanied by information on mothers' satisfaction/acceptance. Here we aimed to compare the analgesic effect of both methods vs. held-only controls up to 1 year of age, and verify mothers' satisfaction. METHODS: Two to 12 months children subjected to vaccine were allocated into three groups: breastfed, formula-fed, and held-only controls. A video recording was performed to analyze pain parameters: crying latency/duration and specific scales [FLACC (Face, Legs, Activity, Cry, and Consolability), NIPS (Neonatal Infant Pain Scale)]. After the procedure, mothers filled in a satisfaction questionnaire. RESULTS: One-hundred and sixty-two children were recruited: 54 breastfed, 35 formula fed, and 73 controls. Breastfed showed the longest crying latency, and together with formula fed, had the shortest duration and lowest pain scores. Most mothers appreciated not only the respective feeding-mediated pain mitigation method used, but also the simply-holding procedure. In all cases, they felt reassured, with an unexpected frequent underestimation of their child's pain during the shot. CONCLUSIONS: The analgesic effect of breastfeeding during vaccination extends also to children >6 months old, and is obtained by formula too. Embracing the child may help to reassure mothers.

The contribution of vaccination to global health, especially in low-middle-income countries is one of the achievements in global governance of modern medicine, averting 2-3 million child deaths annually. However, in Nigeria, vaccine-preventable-diseases still account for one-in-eight child deaths before their fifth-year birthday. Nigeria is one of the ten countries where 4.3 million children under five are without complete immunization. Therefore, the goal of this contribution is to shed light on the reasons to set a foundation for future interventions. To conduct focus groups, a simplified quota sampling approach was used to select mothers of children 0-12 months old in four geographical clusters of Nigeria. An interview guide developed from the 5C psychological antecedence model was used (assessing confidence, complacency, calculation, constraints, collective responsibility); two concepts were added that had proved meaningful in previous work (religion and masculinity). The data were analyzed using a metaaggregation approach. The sample was relatively positive toward vaccination. Still, mothers reported low trust in vaccine safety and the healthcare system (confidence). Yet, they had great interest in seeking additional information (calculation), difficulties in prioritizing vaccination over other equally competing priorities (constraints) and were aware that vaccination translates into overall community wellbeing (collective responsibility). They had a bias toward God as ultimate giver of good health (religion) and their husbands played a dominant role in vaccination decision-making (masculinity). Mothers perceived their children vulnerable to disease outbreaks, hence, motivated vaccination (complacency). The study provided a useful qualitative tool for understanding mothers' vaccination decision-making in low resources settings.

As strong pillars are needed for the better foundation of building, so are healthy children needed for the development of country. Therefore, various child welfare services are started by the government for comprehensive development of children. MidDay Meal Scheme and Integrated Child Development Services are important services started by government for child welfare. Awareness among parents regarding child welfare is very important for better utilization. The present study is titled as "A descriptive study to assess the awareness and utilization of selected child welfare services among parents in selected areas of Pune city". Objectives: a) To assess the knowledge regarding Breast Complications. b) To associate the findings with the selected demographic variables. Material and Method: A non-experimental descriptive study was conducted enrolling 100 postnatal mothers available at the time of data collection. Non probability purposive sampling technique was adopted. Analysis was done using descriptive statistics, frequency percentage distribution and fisher exact test. Findings  Majority 49% were in the age group of 26 to 30 with the education 57 % (57) secondary education.  Postnatal mothers are distributed as Occupation wise 93% are house wife.  Mothers are belong to Religion 95% Hindu, 62% are multi gravida.  63% belong to extended family, 56% are from normal delivery,  57% Mothers are doing breast feeding on demand child.  87% mothers were having good knowledge with the mean of 16.77 and SD of 2.25  There is no any association between knowledge and demographic variables except occupation. At the 0.05 level of significance Conclusion: The purpose of the study was to assess the knowledge regarding breast complications during Puerperium among post natal mothers. The post natal mothers were having good knowledge regarding breast complications during puerperium with the mean of 16.77 and SD of 2.25. But it is observed that knowledge regarding breast complications during puerperium is not been practiced by mothers. The demographic variable and knowledge regarding breast complications during Puerperium among post natal mothers are not significantly associated.

Objetivo

Descrever a completude vacinal em tempo oportuno nos primeiros 24 meses de vida no Brasil e os obstáculos para vacinação, testando-se associações com raça/cor da pele materna.
Métodos

Fez-se coleta de informações sobre os nascidos em 2017 e 2018, constantes no Inquérito Nacional de Cobertura Vacinal. Foram calculados prevalência e intervalos de confiança de 95% de obstáculos à vacinação e completude vacinal em tempo oportuno aos 5 meses, primeiro e segundo ano, segundo raça/cor da pele materna. Empregou-se regressão logística para análise de associações.
Resultados

Analisaram-se dados de 37.801 crianças. Do total, 7,2% (IC95% 6,3;8,2) dos responsáveis enfrentaram dificuldades para levar seus filhos para vacinação e 23,4% (IC95% 21,7;25,1) das crianças não foram vacinadas, mesmo sendo levadas. Essas proporções foram 75% (IC95% 1,25;2,45) e 97% (IC95% 1,57;2,48) mais elevadas, respectivamente, entre pretas; e 49,9% (IC95% 47,8;51,9) e 61,1% (IC95% 59,2;63,0) das crianças tiveram atraso em alguma vacina até os 5 meses e o primeiro ano, respectivamente. Tais valores foram maiores entre pardas/pretas.
Conclusão

Há desigualdades raciais nos obstáculos enfrentados e na vacinação no Brasil.

Objective

To describe timely vaccination completion and obstacles in the first 24 months of life in Brazil, examining associations with maternal race/skin color.
Methods

Study participants were 37,801 children born in 2017 and 2018 included in the National Immunization Coverage Survey. We calculated prevalence and 95% confidence intervals for timely vaccine completeness and obstacles at 5, 12 and 24 months of life, according to maternal race/skin color. Associations were analyzed using logistic regression.
Results

7.2% (95%CI 6.3;8.2) of mothers faced difficulties in taking their children to be vaccinated, and 23.4% (95%CI 21.7;25.1) were not vaccinated when taken. These proportions were 75% (95%CI 1.25;2.45) and 97% (95%CI 1.57;2.48) higher, respectively, among Black mothers. At least one vaccination was delayed among 49.9% (95%CI 47.8;51.9) and 61.1% (95%CI 59.2;63.0) of children by 5 and 12 months, respectively. These rates were higher among Black/mixed race mothers.
Conclusion

There are racial inequalities in both the obstacles faced and in vaccination rates in Brazil.

The major problem of the study was: What is the Level of Compliance to the Expanded Program for Immunization in Barangay Anolid, Mangaldan, Pangasinan?&lt;br&gt; This study aimed to answer the following sub-problems: 1. What is the profile of immunization of Children (0-5 years old) in Barangay Anolid, Mangaldan, Pangasinan in terms of the following vaccines:&lt;br&gt; A. BACILLUS CALMETTE-GUÉRIN (BCG) VACCINE&lt;br&gt; B. ORAL POLIO VACCINE (OPV) VACCINE&lt;br&gt; C. DIPTHERIA, PERTUSSIS AND TETANUS (DPT) VACCINE&lt;br&gt; D. MEASLES VACCINE&lt;br&gt; E. HEPATITIS B VACCINE&lt;br&gt; 2. What is the Level of Knowledge of Mothers regarding the vaccines included in the EPI?&lt;br&gt; 3. What are the reasons for compliance and/or non-compliance to the EPI?

Immunization remains the most important and cost effective public health strategy for disease prevention. However, routine immunization coverage in Nigeria has continued to fall below average. Missed opportunities are one of the obstacles to raising immunization coverage among children, leading to resurgence of vaccine preventable diseases. This study was to determine the prevalence of missed opportunities for immunization against the eight diseases listed in the national programme on immunization (NPI) schedule and the associated factors

1b. Luc Montagnier et al. are AIDS denialists;.Activation and PHA; Mycoplasma removal agent; Continuous infection no lymphocyte pathology. c. Dr. Flossie Wong-Staal and Dr. Robert Gallo and DIADS are AIDS denialists; Kaposi’s sarcoma; Activation and PHA. d. DIADS are AIDS denialists. e. Nobelists, Howard Temin, and former NIH head Harold Varmus advocated AIDS denialism-Reverse transcriptase (RT) not specific for &quot;HIV.&quot; f. AIDS denialists are always talking about the fact that there aren’t good animal models of AIDS. Dogs, caprines, primates, chimp models versus SIV models and others. g. Extreme AIDS denialism in Minnesota. h. AIDS denialists forget about “HIV’s ” ability to genetically mutate. Part 2a. AIDS denialists among &quot;HIV &quot; test kit makers-Fraudulent kits claim 100 % accuracy. b. Package inserts deny they can detect “HIV ”in every person. c. AIDS denialism at the Red Cross-statistics on low incidence with PCR and protein tests-Statistics on high incidence ...

Vaccination prevents an estimated 2.5 million deaths worldwide each year (European Commision and World Health Organization, 2019). Nowadays in countries with high vaccination levels, parents ponder about vaccinating their children (Domínguez et al., 2018; Moran, Lucas, Everhart, Morgan, & Prickett, 2016). This is a global problem that risks 90% national minimum vaccination coverage (95% for measles) (WHO Library Cataloguing-in-Publication, 2013). It involves a hazard for children and adults&#39; life who cannot be vaccinated as well as for those people who reject vaccination. Non-vaccination advocacy people strive to persuade hesitant parents through online videos, a communication source whose consumption is increasing. This research aims to unveil persuasive traits in provaccination and anti-vaccination Youtube videos to provide some hints for future online campaigns to counteract vaccine hesitancy. We will go through nine analysis layers of the content of the videos with pro-vacci...