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Improving vaccine coverage in adolescence and beyond.

ABSTRACT: High vaccine coverage is required to ensure population protection, including protection of those that cannot receive vaccines either due to contraindications or age. Despite this, some areas continue to report low vaccine coverage. Reasons for this may vary but can include factors such as difficulties accessing services, conflicting priorities and false contraindications or fear of potential side effects. Population groups with reported low vaccine coverage include pregnant women, adolescents and those aged 70-80 years and eligible to receive the shingles vaccine. The afternoon symposium included presentations from speakers each describing interventions for promoting vaccine uptake in these particular groups. Such interventions may include: • Ensuring effective leadership with clear aims for the delivery and on-going evaluation of the program • Providing health care workers with training and access to factually correct immunization resources • Offering a flexible service with vaccination in venues that are easy to access.

SUBMITTER: Falconer M

PROVIDER: S-EPMC5791556 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other

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Improving vaccine coverage in adolescence and beyond.

Falconer Michelle M

Human vaccines & immunotherapeutics 20171201 1

High vaccine coverage is required to ensure population protection, including protection of those that cannot receive vaccines either due to contraindications or age. Despite this, some areas continue to report low vaccine coverage. Reasons for this may vary but can include factors such as difficulties accessing services, conflicting priorities and false contraindications or fear of potential side effects. Population groups with reported low vaccine coverage include pregnant women, adolescents an ...[more]

PMID: 29072517

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Project description:BackgroundPrior to vaccine introduction in 2006, rotavirus was the leading cause of severe diarrhea in children under five years of age in the U.S. Vaccination of infants has led to major reductions in disease burden, a shift in the seasonal peak and the emergence of a biennial pattern of disease. However, rotavirus vaccine coverage has remained relatively low (70-75%) compared to other infant immunizations in the U.S. Part of the reason for this lower coverage is that children whose care is provided by family practitioners (FP) have considerably lower probability of being vaccinated compared to those seen be pediatricians (PE). We used a dynamic transmission model to assess the impact of improving rotavirus vaccine coverage by FP and/or PE on rotavirus gastroenteritis (RVGE) incidence and seasonal patterns.MethodsA deterministic age-structured dynamic model with susceptible, infectious, and recovered compartments (SIRS model) was used to simulate rotavirus transmission and vaccination. We estimated the reduction of RVGE cases by 2 doses of rotavirus vaccine with three vaccination scenarios: (Status Quo: 85% coverage by pediatricians and 45% coverage by family practitioners; Improved FP: 85% coverage by pediatricians and family practitioners; Improved FP+PE: 95% coverage by pediatricians and family practitioners). In addition, we tested the sensitivity of the model to the assumption of random mixing patterns between children visiting pediatricians and children visiting family practitioners.ResultsIn this model, higher vaccine coverage provided by family practitioners and pediatricians leads to lower incidence of severe RVGE cases (23% averted in Improved FP and 57% averted in Improved FP+PE compared to Status Quo) including indirect effects. One critical impact of higher total vaccine coverage is the effect on rotavirus epidemic patterns in the U.S.; the biennial rotavirus epidemic patterns shifted to reduced annual epidemic patterns. Additionally, assortative mixing patterns in children visiting pediatricians and family practitioners amplify the impact of increasing vaccine coverage.ConclusionOther high-income countries that introduced vaccine have not experienced biennial patterns, like the U.S. Our results suggest that increasing overall vaccine coverage to 85% among infants would lead to an overall reduction in incidence with annual epidemic patterns.

Project description:Vaccine-preventable diseases (VPD) are still a major cause of morbidity and mortality worldwide. In high and middle-income settings, immunization coverage is relatively high. However, in many countries coverage rates of routinely recommended vaccines are still below the targets established by international and national advisory committees. Progress in the field of communication technology might provide useful tools to enhance immunization strategies.To systematically collect and summarize the available evidence on the effectiveness of interventions that apply new media to promote vaccination uptake and increase vaccination coverage.We conducted a systematic literature review. Studies published from January 1999 to September 2013 were identified by searching electronic resources (Pubmed, Embase), manual searches of references and expert consultation. Study setting We focused on interventions that targeted recommended vaccinations for children, adolescents and adults and: (1) aimed at increasing community demand for immunizations, or (2) were provider-based interventions. We limited the study setting to countries that are members of the Organisation for Economic Co-operation and Development (OECD).The primary outcome was a measure of vaccination (vaccine uptake or vaccine coverage). Considered secondary outcomes included willingness to receive immunization, attitudes and perceptions toward vaccination, and perceived helpfulness of the intervention.Nineteen studies were included in the systematic review. The majority of the studies were conducted in the US (74%, n = 14); 68% (n = 13) of the studies were experimental, the rest having an observational study design. Eleven (58%) reported results on the primary outcome. Retrieved studies explored the role of: text messaging (n.7, 37%), smartphone applications (n.1, 5%), Youtube videos (n.1, 5%), Facebook (n.1, 5%), targeted websites and portals (n.4, 21%), software for physicians and health professionals (n.4, 21%), and email communication (n.1, 5%). There is some evidence that text messaging, accessing immunization campaign websites, using patient-held web-based portals and computerized reminders increase immunization coverage rates. Insufficient evidence is available on the use of social networks, email communication and smartphone applications.Although there is great potential for improving vaccine uptake and vaccine coverage by implementing programs and interventions that apply new media, scant data are available and further rigorous research - including cost-effectiveness assessments - is needed.

Dataset Information

Improving vaccine coverage in adolescence and beyond.

Publications

Improving vaccine coverage in adolescence and beyond.

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