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Perceptions of vaccine preventable diseases in Australian healthcare: focus on pertussis.

ABSTRACT: Adult vaccination in Australia is suboptimal. For instance, as few as one in nine people have received a pertussis vaccine in adolescence or adulthood, despite increasing disease burden and evidence of a positive correlation between older age and hospitalization rates. The objectives of this study were to describe general practitioners' (GPs) and adult consumers' knowledge and attitudes toward adult vaccination, with an emphasis on pertussis. Australian GPs and consumers were recruited in two nationally representative online surveys repeated annually between 2014 and 2018. Vaccination discussions occurred in a minority of adult/GP encounters. Pertussis was among the five most frequently identified vaccine preventable diseases but was unlikely to be proactively discussed with adults not in contact with young children. Among consumers, only one in three recalled ever receiving a pertussis vaccination. GPs are a strong predictor of adults receiving a pertussis vaccine. Possible factors contributing to low uptake are misconceptions around pertussis disease, vaccination requirements and lack of GP recommendation for adult vaccination. GPs have a key role to play in increasing adult vaccination coverage with their recommendation.

SUBMITTER: Bayliss J

PROVIDER: S-EPMC7899657 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Perceptions of vaccine preventable diseases in Australian healthcare: focus on pertussis.

Bayliss Julianne J Randhawa Roshnee R Oh Kyu-Bin KB Kandeil Walid W Jenkins Victoria A VA Turriani Elisa E Nissen Michael M

Human vaccines & immunotherapeutics 20200722 2

Adult vaccination in Australia is suboptimal. For instance, as few as one in nine people have received a pertussis vaccine in adolescence or adulthood, despite increasing disease burden and evidence of a positive correlation between older age and hospitalization rates. The objectives of this study were to describe general practitioners' (GPs) and adult consumers' knowledge and attitudes toward adult vaccination, with an emphasis on pertussis. Australian GPs and consumers were recruited in two na ...[more]

PMID: 32698657

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Project description:ImportanceParents hesitant to vaccinate their children may delay routine immunizations or seek exemptions from state vaccine mandates. Recent outbreaks of vaccine-preventable diseases in the United States have drawn attention to this phenomenon. Improved understanding of the association between vaccine refusal and the epidemiology of these diseases is needed.ObjectiveTo review the published literature to evaluate the association between vaccine delay, refusal, or exemption and the epidemiology of measles and pertussis, 2 vaccine-preventable diseases with recent US outbreaks.Evidence reviewSearch of PubMed through November 30, 2015, for reports of US measles outbreaks that have occurred since measles was declared eliminated in the United States (after January 1, 2000), endemic and epidemic pertussis since the lowest point in US pertussis incidence (after January 1, 1977), and for studies that assessed disease risk in the context of vaccine delay or exemption.FindingsWe identified 18 published measles studies (9 annual summaries and 9 outbreak reports), which described 1416 measles cases (individual age range, 2 weeks-84 years; 178 cases younger than 12 months) and more than half (56.8%) had no history of measles vaccination. Of the 970 measles cases with detailed vaccination data, 574 cases were unvaccinated despite being vaccine eligible and 405 (70.6%) of these had nonmedical exemptions (eg, exemptions for religious or philosophical reasons, as opposed to medical contraindications; 41.8% of total). Among 32 reports of pertussis outbreaks, which included 10,609 individuals for whom vaccination status was reported (age range, 10 days-87 years), the 5 largest statewide epidemics had substantial proportions (range, 24%-45%) of unvaccinated or undervaccinated individuals. However, several pertussis outbreaks also occurred in highly vaccinated populations, indicating waning immunity. Nine reports (describing 12 outbreaks) provided detailed vaccination data on unimmunized cases; among 8 of these outbreaks from 59% through 93% of unvaccinated individuals were intentionally unvaccinated.Conclusions and relevanceA substantial proportion of the US measles cases in the era after elimination were intentionally unvaccinated. The phenomenon of vaccine refusal was associated with an increased risk for measles among people who refuse vaccines and among fully vaccinated individuals. Although pertussis resurgence has been attributed to waning immunity and other factors, vaccine refusal was still associated with an increased risk for pertussis in some populations.

Project description:UnlabelledVaccine manufacturing costs prevent a significant portion of the world's population from accessing protection from vaccine-preventable diseases. To enhance vaccine production at reduced costs, a genome-wide RNA interference (RNAi) screen was performed to identify gene knockdown events that enhanced poliovirus replication. Primary screen hits were validated in a Vero vaccine manufacturing cell line using attenuated and wild-type poliovirus strains. Multiple single and dual gene silencing events increased poliovirus titers >20-fold and >50-fold, respectively. Host gene knockdown events did not affect virus antigenicity, and clustered regularly interspaced short palindromic repeat (CRISPR)-Cas9-mediated knockout of the top candidates dramatically improved viral vaccine strain production. Interestingly, silencing of several genes that enhanced poliovirus replication also enhanced replication of enterovirus 71, a clinically relevant virus to which vaccines are being targeted. The discovery that host gene modulation can markedly increase virus vaccine production dramatically alters mammalian cell-based vaccine manufacturing possibilities and should facilitate polio eradication using the inactivated poliovirus vaccine.ImportanceUsing a genome-wide RNAi screen, a collection of host virus resistance genes was identified that, upon silencing, increased poliovirus and enterovirus 71 production by from 10-fold to >50-fold in a Vero vaccine manufacturing cell line. This report provides novel insights into enterovirus-host interactions and describes an approach to developing the next generation of vaccine manufacturing through engineered vaccine cell lines. The results show that specific gene silencing and knockout events can enhance viral titers of both attenuated (Sabin strain) and wild-type polioviruses, a finding that should greatly facilitate global implementation of inactivated polio vaccine as well as further reduce costs for live-attenuated oral polio vaccines. This work describes a platform-enabling technology applicable to most vaccine-preventable diseases.

Project description:Potentially Preventable Hospitalisations (PPH) is a widely used indicator of the effectiveness of non-hospital care. Specified using the International Classification of Diseases (ICD) coding, PPH comprises a suite of health conditions that could have potentially been prevented with appropriate care. The most recent edition of the National Guide to a Preventative Health Assessment for First Nations People documents the health conditions of interest to providers of primary care, many of which are not represented in PPH. Given the National Guide has been developed specifically with First Nations in mind, the aim of this research is twofold. The first aim is to formally posit the question of whether a summative measure of hospitalisations aligned diagnostically to the National Guide has value either as an alternative or complement to PPH in the context of First Nations primary health information. The second aim is to develop and present a prototype ICD-10 data specification for such a measure, referred to as the First Nations primary healthcare (FNPHC) data specification, and examine the age-standardised hospitalisation rates for FNPHC and PPH for correlations and/or differences. Age-standardised hospitalisation rates from 2016-17 to 2019-20 using both classifications were examined to assess the usefulness and relevance of summative measures of hospitalisations for informing primary care. Rates of FNPHC for principal diagnoses were between 1.5 and 2.5 times higher than those of PPH and approximately between 6 and 12 times higher for additional diagnoses. There was a strong correlation with PPH when rates were compared across all observations: jurisdictions with higher rates of PPH tended to have higher rates of hospitalisations according to the custom specification. Findings support its application as a summary measure for First Nations primary care providers. Given the policy landscape in Australia that aims to close the gap, it is imperative that measures of primary health take advantage of the concepts and application of First Nations data sovereignty and governance. The validity and cultural appropriateness of the First Nations primary health data specification needs to be further researched.

Dataset Information

Perceptions of vaccine preventable diseases in Australian healthcare: focus on pertussis.

Publications

Perceptions of vaccine preventable diseases in Australian healthcare: focus on pertussis.

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