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Objective: This study examines the impact of the COVID-19 pandemic on both routine and non-routine vaccinations in infants during their initial 18 months of life, concurrently exploring the complex influence of sociodemographic factors. Methods: A cohort study was conducted, involving 2007 children in two distinct periods: pre-pandemic (January–June 2018) and pandemic (March 2020–May 2021). Participants were classified into two cohorts: 962 children in the 2018 group and 1045 children in the 2020–21 group. Utilizing unconditional logistic regression, the association between vaccination (complete or non-routine) and socioeconomic factors was examined, with adjustments for potential confounding variables such as age, breastfeeding, gestational age, and twins. Results: The study's analysis reveals that in the post-pandemic period, mothers were three times more likely to opt for non-routine vaccines (95% CI 2.25–4.23). However, no significant alterations were observed in routine vaccination rates. Protective factors for complete vaccination included having an employed mother, higher education, and a medium-to-high income. Conversely, a higher income was associated with a reduced likelihood of complete vaccination (OR 0.34, 95% CI 0.20–0.59). Conclusion: Contrary to initial expectations, this study concludes that the COVID-19 pandemic did not have a substantial impact on childhood complete vaccination rates. Nevertheless, a noticeable increase in the choice of non-routine vaccination was observed. Sociodemographic factors, such as maternal education, income, and employment status, emerged as key influencers, particularly in the context of deciding on non-routine vaccinations.

Routine vaccine hesitancy is a major global health challenge observed in over 190 countries worldwide. This meta-analysis aims to determine the worldwide prevalence of routine vaccination hesitancy among parents of children aged 0–6. An extensive search was conducted in four scientific databases: PubMed, Scopus, Web of Science, and the Cochrane Library. Studies were included if they reported hesitancy related to WHO-recommended routine immunizations for children under 7 years of age. A single-arm meta-analysis was performed using the OpenMeta[Analyst] software. An initial search retrieved 5121 articles, of which only 23 publications, involving 29,131 parents, guardians, and caregivers from over 30 countries met the inclusion criteria and quality assessment. The cumulative prevalence of parental vaccine hesitancy was found to be 21.1% (95% CI = 17.5–24.7%, I2 = 98.86%, p < 0.001). When stratifying the prevalence of vaccine hesitancy per WHO region, significant variations were observed, ranging from 13.3% (95% CI = 6.7–19.9%, I2 = 97.72%, p < 0.001) in the Region of the Americas to 27.9% (95% CI = 24.3–31.4%) in the Eastern Mediterranean region. The study findings highlight the need for healthcare providers and governments to develop and improve comprehensive programs with communication strategies to reduce parental vaccine hesitancy.

The global vaccination rate against tuberculosis [bacillus Calmette-Guérin (BCG) vaccine] dropped from 88% in 2019 to 85% in 2020, coverage with three doses of diphtheria-tetanus-pertussis (DTP3)-containing vaccines or poliomyelitis vaccine (polio3) dropped from 86% in 2019 to 83% in 2020 for both vaccines, rates against hepatitis B third dose (HepB3) dropped from 85% in 2019 to 83% in 2020, and measles-containing vaccine first-dose (MCV1) dropped from 86% in 2019 to 84% in 2020 [4]. [...]the largest reduction in polio3 vaccination was recorded in the Democratic People's Republic of Korea (from 98% in 2019 to 70% in 2020) [5]. [...]in Oceania reductions in vaccine coverage were noted in some countries with the most notable in Samoa (30% for MCV1) and Kiribati (34% for MCV2) [5]. [...]there is need to enhance active surveillance of vaccine-preventable diseases such that real-time detection and transparent reporting can inform public health strategies.

This study aims to investigate the factors contributing to the underutilization of childhood and school-age immunizations among parents within the Jewish Ultra-Orthodox community in Israel. It identifies socio-demographic, attitudinal, and belief-related risk factors that affect vaccination decisions. A cross-sectional study was conducted involving 369 Jewish Orthodox parents in Israel, using structured questionnaires distributed through various community channels. Data on socio-demographic variables, vaccination status, and intentions were collected. Attitudinal assessments included the VAX Scale and the Multidimensional Health Locus of Control Scale. The proportion of fully vaccinated children was 46.3 % for childhood diseases and 64.2 % for school-age vaccinations. Flu vaccination rates were significantly lower, with only 19.2 % of parents and 15.2 % of children receiving flu shots. Key factors contributing to vaccine underutilization include large family size, lower socioeconomic and educational levels, reliance on the internet for health information, and the absence of media technology at home. Geographical disparities were notable, especially in the Jerusalem District, which demonstrated lower vaccination uptake, and among different Orthodox streams, with the Modern stream showing higher vaccination rates compared to the Lithuanian, Sephardic, and Hasidic streams. The VAX scale and Health-Related Locus of Control measures revealed that attitudinal factors significantly impacted vaccination decisions, such as mistrust in vaccine benefits, preference for natural immunity, and reliance on religious beliefs. To address vaccination disparities, targeted interventions should consider cultural and logistical barriers, engaging community leaders and offering culturally sensitive education to improve uptake within the Jewish ultra-Orthodox community.

The COVID-19 pandemic has disrupted the distribution of routine immunizations globally. Multi-country studies assessing a wide spectrum of vaccines and their coverage rates are needed to determine global performance in achieving vaccination goals. Global vaccine coverage data for 16 antigens were obtained from WHO/UNICEF Estimates of National Immunization Coverage. Tobit regression was performed for all country-antigen pairs for which data were continuously available between 2015–2020 or 2015–2021 to predict vaccine coverage in 2020/2021. Vaccines for which multi-dose data were available were assessed to determine whether vaccine coverage for subsequent doses were lower than that of first doses. Vaccine coverage was significantly lower-than-predicted for 13/16 antigens in 2020 and all assessed antigens in 2021. Lower-than-predicted vaccine coverage was typically observed in South America, Africa, Eastern Europe, and Southeast Asia. There was a statistically significant coverage drop for subsequent doses of the diphtheria-tetanus-pertussis, pneumococcus, and rotavirus vaccines compared to first doses in 2020 and 2021. The COVID-19 pandemic exerted larger disruptions to routine vaccination services in 2021 than in 2020. Global efforts will be needed to recoup vaccine coverage losses sustained during the pandemic and broaden vaccine access in areas where coverage was previously inadequate.

Despite increases in routine vaccination coverage during the past three decades, the percent of children completing the recommended vaccination schedule remains below expected targets in many low and middle income countries. In 2008, the World Health Organization Strategic Advisory Group of Experts on Immunization requested more information on the reasons that children were under-vaccinated (receiving at least one but not all recommended vaccinations) or not vaccinated in order to develop effective strategies and interventions to reach these children. A systematic review of the peer-reviewed literature published from 1999 to 2009 was conducted to aggregate information on reasons and factors related to the under-vaccination and non-vaccination of children. A standardized form was used to abstract information from relevant articles identified from eight different medical, behavioural and social science literature databases. Among 202 relevant articles, we abstracted 838 reasons associated with under-vaccination; 379 (45%) were related to immunization systems, 220 (26%) to family characteristics, 181 (22%) to parental attitudes and knowledge, and 58 (7%) to limitations in immunization-related communication and information. Of the 19 reasons abstracted from 11 identified articles describing the non-vaccinated child, 6 (32%) were related to immunization systems, 8 (42%) to parental attitudes and knowledge, 4 (21%) to family characteristics, and 1 (5%) to communication and information. Multiple reasons for under-vaccination and non-vaccination were identified, indicating that a multi-faceted approach is needed to reach under-vaccinated and unvaccinated children. Immunization system issues can be addressed through improving outreach services, vaccine supply, and health worker training; however, under-vaccination and non-vaccination linked to parental attitudes and knowledge are more difficult to address and likely require local interventions.

Background The COVID-19 pandemic caused disruptions to health services, including routine vaccination programs, affecting the uptake and timeliness of childhood vaccinations. This study explored the continued impact of the COVID-19 pandemic on routine vaccination coverage among children living in Armenia by examining full vaccination coverage a few years before and after the initial COVID-19 wave. Methods A quasi-experimental research design that included a single cohort interrupted time series analysis was used to assess full vaccination coverage among children ages one, two, and six years old based on monthly data from January 2019 through December 2023. ARIMA models were utilized to understand changes in routine vaccination coverage after the initial lockdown as well as the recovery levels among the different the age groups. Results An initial decrease in full vaccination coverage among one-year-olds (from 91.44% in January 2020 to 88.53% in January 2021) was observed. Similarly, coverage for two- and six-year-olds decreased from 91.55% to 89.04% and from 96.07% to 94.26%, respectively. Coverage rose to 92.04% for one-year-olds, 90.99% for two-year-olds, and 93.05% for six-year-olds by December 2023. The ARIMA models showed significant changes in vaccination coverage after the initial lockdown period, particularly among children two and six years old, with recovery levels differing among age groups. Conclusions Despite signs of recovery, routine vaccination coverage remained lower than before the pandemic for children two and six years old. The interventions by the Ministry of Health and National Centers for Disease Control and Prevention may have helped recover some lost vaccination levels. Yet, there remain ongoing challenges to routine vaccinations. This study highlights the importance of assessing coverage and timeliness of routine vaccinations and the need for targeted strategies to address lapses in vaccinations, particularly among older children, in Armenia.

Background Despite the effectiveness of the human papillomavirus (HPV) vaccine, uptake in the United States (US) remains suboptimal, with only about half of US adolescents completing the HPV vaccine series before the recommended age of 13. Adolescents are more likely to be vaccinated at annual well visits, making these visits key opportunities to promote HPV vaccination and improve overall completion rates of the HPV vaccination series. Further, it has been suggested that HPV vaccine initiation at age 9 may increase overall adolescent coverage of HPV vaccine. This study aimed to describe patterns in HPV vaccine administration during adolescent well visits and quantify potential HPV vaccination opportunities at age 9. Methods This retrospective descriptive analysis included adolescents aged 9–14 years with continuous enrollment from 2018 to 2022 in the MarketScan Commercial or the Multi-State Medicaid databases. We analyzed percentages of well visits and administered vaccines for each age cohort and calendar year. We assessed potential opportunities for HPV vaccination among adolescents at the 9-, 10-,11-, and 12-year well visits. Results Most age 9 well visits showed no vaccine claims (89.0–91.7%) while claims for two and three concurrent vaccines at age 11 occurred in 22.2–37.2% of well visits, most often for meningococcal and Tdap vaccines. Claims for HPV vaccine initiation at 11 and 12 years remained suboptimal (17.9–24.3%). We identified several potential opportunities for HPV vaccination. Among adolescents who did not receive the HPV vaccine at their 9- or 10-year well visits, 34.8–36.9% did not have a well visit at 11 or 12 years. Among adolescents with an 11- and 12-year well visit, 20.6–30.0% had claims for vaccination, but not the HPV vaccine. Among adolescents with a well visit at 11 or 12 years who received one or more other vaccinations, but not the HPV vaccine, 40.6–46.1% had a well visit at 9 or 10 years and did not initiate the HPV vaccine then. Conclusions Routine HPV vaccination beginning at age 9 well visits could optimize opportunities to improve vaccine coverage.

•Currently available typhoid vaccines have been used in field research and program settings.•Several disease control and vaccine delivery strategies are effective and feasible.•Selection of strategies depends on the epidemiological and operational contexts.•Operational studies with the typhoid conjugate vaccine are needed.•Typhoid vaccination should be complemented by improved water, sanitation and hygiene. Typhoid vaccination is an important component of typhoid fever prevention and control, and is recommended for public health programmatic use in both endemic and outbreak settings. We reviewed experiences with various vaccination strategies using the currently available typhoid vaccines (injectable Vi polysaccharide vaccine [ViPS], oral Ty21a vaccine, and injectable typhoid conjugate vaccine [TCV]). We assessed the rationale, acceptability, effectiveness, impact and implementation lessons of these strategies to inform effective typhoid vaccination strategies for the future. Vaccination strategies were categorized by vaccine disease control strategy (preemptive use for endemic disease or to prevent an outbreak, and reactive use for outbreak control) and vaccine delivery strategy (community-based routine, community-based campaign and school-based). Almost all public health typhoid vaccination programs used ViPS vaccine and have been in countries of Asia, with one example in the Pacific and one experience using the Ty21a vaccine in South America. All vaccination strategies were found to be acceptable, feasible and effective in the settings evaluated; evidence of impact, where available, was strongest in endemic settings and in the short- to medium-term. Vaccination was cost-effective in high-incidence but not low-incidence settings. Experience in disaster and outbreak settings remains limited. TCVs have recently become available and none are WHO-prequalified yet; no program experience with TCVs was found in published literature. Despite the demonstrated success of several typhoid vaccination strategies, typhoid vaccines remain underused. Implementation lessons should be applied to design optimal vaccination strategies using TCVs which have several anticipated advantages, such as potential for use in infant immunization programs and longer duration of protection, over the ViPS and Ty21a vaccines for typhoid prevention and control.