Figure 1 - uploaded by Amado III Tandoc
Content may be subject to copyright.
Source publication
Objective: Vaccination is the most effective way to prevent seasonal influenza and its severe outcomes. The objective of our study was to synthesize information on seasonal influenza vaccination policies, recommendations and practices in place in 2011 for all countries and areas in the Western Pacific Region of the World Health Organization (WHO)....
Similar publications
With one third of the global human population suffering from tuberculosis (TB) in 2001, the disease was officially declared a worldwide emergency by the World Health Organization. Since then this disease has grown to epidemic proportions and the recent emergence of drug resistance, the rising incidence of HIV/TB co-infection, and the inability of t...
Influenza has long been a global public health priority because of the threat of another global pandemic. Although data are available for the annual burden of seasonal influenza in many developed countries, fewer disease burden data are available for low-income and tropical countries. In recent years, however, the surveillance systems created as pa...
We study the global spatio-temporal patterns of influenza dynamics. This is
achieved by analysing and modelling weekly laboratory confirmed cases of
influenza A and B from 138 countries between January 2006 and May 2014. The
data were obtained from FluNet, the surveillance network compiled by the the
World Health Organization. We report a pattern o...
Background
Influenza-associated illness results in increased morbidity and mortality in the Americas. These effects can be mitigated with an appropriately chosen and timed influenza vaccination campaign. To provide guidance in choosing the most suitable vaccine formulation and timing of administration, it is necessary to understand the timing of in...
Health authorities find thresholds useful to gauge the start and severity of influenza seasons. We explored a method for deriving thresholds proposed in an influenza surveillance manual published by the World Health Organization (WHO).
For 2002-2011, we analysed two routine influenza-like-illness (ILI) datasets, general practice sentinel surveillan...
Citations
... To reduce transmission across all age groups and decrease population-level disease burden, the World Health Organization (WHO) recommends that children aged between 6 and 59 months are vaccinated against influenza annually [6]. Over 40% of countries list seasonal influenza vaccination in their National Immunization Schedule, including most countries across North and South America, Europe, and some countries in African, South-East Asia, and the West Pacific Region [7][8][9][10][11][12][13]. Meanwhile, influenza vaccination is not included in the National Immunization Program (NIP) in many countries. ...
Childhood influenza vaccination coverage remains low in lower/middle-income countries. This systematic review aims to identify influencing factors around childhood influenza vaccination. A systematic literature review was conducted and included empirical studies with original data that investigated factors influencing childhood influenza vaccination. We searched MEDLINE, Web of Science, EMBASE, CINAHL Plus, Global Health, PsycINFO, and two Chinese databases, China Knowledge Resource Integrated Database and Chongqing VIP, using a combination of the key terms ‘childhood’, ‘influenza’, ‘vaccination’, and related syntax for all peer-reviewed publications published before December 2019. Thirty studies were included in the analysis. Childhood influenza vaccination was positively associated with caregivers’ knowledge of influenza vaccine, positive vaccine attitudes, self-efficacy, perceived susceptibility and severity of influenza, believing in the efficacy of influenza vaccine, the worry of getting sick, healthcare workers’ recommendations, and previous influenza vaccination experiences. Barriers included the fear of safety and side effects of the vaccine, as well as poor access to vaccination service. To improve childhood influenza vaccine uptake, health education is necessary to address caregivers’ lack of confidence on vaccine safety. Future studies are needed to investigate influencing factors around healthcare workers’ vaccination recommendation behaviors and the impact of contextual factors on public vaccination behaviors.
... Recommended by the World Health Organization (WHO), vaccination uptake among high-risk groups, is an effective strategy for decreasing influenza burden and therefore allowing for better preparedness for anticipated COVID-19 waves. In China, however, influenza vaccine remains excluded from national Expanded Program of Immunization (EPI) and needs to be paid out of pocket (5), although many countries have included it in their National Immunization Program (6)(7)(8)(9)(10). ...
Introduction
Influenza vaccination uptake among young children has been poor in China, but it is unclear how it changed during the COVID-19. This study aimed to investigate the uptake status and reasons of childhood influenza vaccination during the pandemic in China.
Methods
A mixed-methods study combining a questionnaire survey and semi-structured interviews was conducted in Anhui, Shaanxi, and Guangdong provinces between September and November 2021. 2081 caregivers completed the valid questionnaire. 38 caregivers participated in interviews, and data were analyzed thematically, using deductive and inductive coding.
Results
A total of 2081 caregivers completed the valid questionnaire, and 38 caregivers participated in interviews. Among the caregivers, a total of 1796 were in the age group for high-risk groups in the 2019–2020 flu season, and 46.10% reported that their children received influenza vaccination in the 2019–2020 flu season; 43.63% said that they vaccinated their children against influenza in the 2020–2021 flu season. Many caregivers indicated that the adoption of nonpharmacologic interventions (NPIs) during COVID-19 reduced the risk of influenza infection for children. Most caregivers consider the severity of influenza to be low, and some confused the common cold with influenza. Meanwhile, some caregivers lack confidence in the vaccine’s effectiveness and importance. They thought that vaccines are not effective in preventing the constantly mutating virus. Despite clear perceptions about the severity of influenza and the effectiveness of the vaccine, we found that most caregivers did not receive any relevant medical information, and the communication about vaccines between caregivers and professional information sources, such as healthcare workers, is inadequate. Hence, caregivers have no scientific evidence to back up their perceptions. In terms of access to vaccination service, caregivers reported conflicts between time of vaccination service and their schedule, and the need for vaccine prices to be reduced.
Discussion
Targeted interventions are needed to address caregivers’ lack of risk perception on influenza during COVID-19 and promote communication between caregivers and professional information sources. Extending vaccination service hours and increasing the number of vaccine clinics close to residential areas and expansion of financing sources for self-paid vaccination could facilitate the access to influenza vaccination service.
... The World Health Organization (WHO) recommends that children be a priority group for vaccination [6]. Over 40% of countries offer free seasonal influenza vaccination in their National Immunization Schedules, including most countries in North and South America, Europe, and some countries in Africa, South-East Asia, and the West Pacific Region [7][8][9][10][11]. In China, the national influenza vaccination coverage for all ages is only 2.2%, recorded in 2014 [12], and data collected between 2009 and 2012 indicate that influenza vaccination uptake among children <5 years living in five provinces in mainland China was about 26.4% [13]. ...
Young children aged 6–59 months are recommended as one of the priority groups for seasonal influenza vaccination in China. This study assessed influenza vaccination coverage and the factors associated with vaccination uptake among children in three Chinese provinces. In September 2021, 2081 caregivers with children <5 years completed self-administered questionnaires as part of a cross-sectional survey. Logistic regression was used to assess determinants of childhood influenza vaccination. A total of 43.63% of respondents reported vaccinating their children against influenza during the 2020–2021 flu season. Caregivers who lived in Anhui province, had a bachelor degree or above, and an annual household income <20,000 RMB were more likely to vaccinate their children against influenza. Confidence in the importance (OR: 2.50; 95%CI: 1.77–3.54), safety (OR: 1.60; 95%CI: 1.29–1.99), and effectiveness (OR: 1.54; 95%CI: 1.23–1.93) of influenza vaccine was significantly associated with childhood vaccine acceptance. Respondents who saw that other caregivers were vaccinating their children had significantly higher odds of vaccinating their own children. Caregivers’ receiving positive influence from healthcare workers (OR: 1.33; 95%CI: 1.00–1.77), family members, or friends (OR: 1.30; 95%CI: 1.14–1.49) were also significantly associated with childhood influenza vaccination. Poor access, including conflicts between caregivers’ availability and vaccination service schedules and inconvenient transportation to the vaccination site were negatively associated with childhood flu vaccination. To promote childhood influenza vaccination, public health information campaigns need to target wealthier and less educated caregivers to enhance caregivers’ confidence in influenza vaccination. Targeted interventions are also needed to optimize access to vaccination services, including extending vaccination service hours and increasing the number of vaccination sites close to residential areas. Interventions are also needed to encourage primary care providers to play a greater role in promoting vaccination. Finally, the dissemination of related information and the public response need to be monitored for the timely understanding of public perceptions.
... The discussion topic about influenza vaccination history and its relationship with COVID-19 vaccination acceptance in this systematic review is more applicable to countries that have a national policy to vaccinate pregnant women against influenza, such as Italy, India, Spain [47], the United Kingdom [38], Australia [48], the United States [39], Canada [49], Singapore and Thailand [50]. Although WHO has already recommended prioritizing seasonal influenza vaccination for pregnant women, many countries still do not have a national influenza vaccination policy, especially in low-middle-income countries [51]- [53]. In this case, Indonesia's national influenza vaccination policy only covers people who will go on pilgrimage [50], so the study of influenza vaccination history related to COVID-19 vaccination acceptance in pregnant women is less applicable in this country. ...
Pregnant women have a higher risk of serious illness during the coronavirus disease 2019 (COVID-19) pandemic. This raises concerns about COVID-19 infection in pregnant women. Other than COVID-19, pregnant women are also a high-risk group for influenza infection. Influenza vaccination is used to prevent coinfection with COVID-19. Thus, this study examined the acceptance of the COVID-19 vaccine in pregnant women based on factors of worry about COVID-19 infection and a history of influenza vaccination. This study was a systematic review that assessed cross-sectional articles of the year 2020-2021 from the Pubmed, Science Direct, and Medrxiv databases with narrative analysis. There were three articles that met the criteria. The three articles showed significant relationships between concerns of being infected with COVID-19 and receiving COVID-19 vaccine acceptance in pregnant women, while a significant relationships between a history of influenza vaccination and accepting COVID-19 vaccination in pregnant women were only found in two articles. Compared to the history of influenza vaccination, the concerns of being infected with COVID-19 in pregnant women were significantly more related to accepting COVID-19 vaccination, so it can be the focus of intervention to increase the acceptance of COVID-19 vaccination in pregnant women.
... As of 2014, more than 100 countries and regions around the world have formulated seasonal influenza vaccination policies that recommend vaccination of at least one of the risk groups [47]. More than 40% of countries and territories list seasonal influenza vaccination schedules in their National Vaccination Schedules, including North and South America, Europe, and most countries in Africa, Southeast Asia, and the Western Pacific [7,47]. ...
Common air pollutants, such as ozone (O3), sulfur dioxide (SO2) and nitrogen dioxide (NO2), can affect the spread of influenza. We propose a new non-autonomous impulsive differential equation model with the effects of ozone and vaccination in this paper. First, the basic reproduction number of the impulsive system is obtained, and the global asymptotic stability of the disease-free periodic solution is proved. Furthermore, the uniform persistence of the system is demonstrated. Second, the unknown parameters of the ozone dynamics model are obtained by fitting the ozone concentration data by the least square method and Bootstrap. The MCMC algorithm is used to fit influenza data in Gansu Province to identify the most suitable parameter values of the system. The basic reproduction number R0 is estimated to be 1.2486 (95%CI:(1.2470,1.2501)). Then, a sensitivity analysis is performed on the system parameters. We find that the average annual incidence of seasonal influenza in Gansu Province is 31.3374 per 100,000 people. Influenza cases started to surge in 2016, rising by a factor of one and a half between 2014 and 2016, further increasing in 2019 (54.6909 per 100,000 population). The average incidence rate during the post-upsurge period (2017-2019) is one and a half times more than in the pre-upsurge period (2014-2016). In particular, we find that the peak ozone concentration appears 5–8 months in Gansu Province. A moderate negative correlation is seen between influenza cases and monthly ozone concentration (Pearson correlation coefficient: r = -0.4427). Finally, our results show that increasing the vaccination rate and appropriately increasing the ozone concentration can effectively prevent and control the spread of influenza.
... The World Health Organization (WHO) recommends that countries give the highest priority to pregnant women if they are considering expansion of seasonal influenza programs, 6 but even then, many countries do not have national influenza vaccination policies or recommendations in place, particularly in low-and middle-income settings. [7][8][9] In Europe, where a goal of 75% influenza vaccination coverage of key risk groups including pregnant women has been established, no country achieved this target in the 2017/18 season and many countries did not report coverage. 10 In 2017, WHO updated tetanus toxoid (TT) recommendations to include tetanus-diphtheria (Td) vaccines for pregnant women, 11 and has a permissive recommendation for acellular pertussis-containing vaccines in pregnant women (e.g, national programs may consider 1 dose of tetanus, diphtheria, acellular pertusis (Tdap) in the 2 nd or 3 rd trimester in addition to vaccination of infants in high or increasing infant pertussis morbidity or mortality). ...
An important strategy for addressing maternal and newborn risks of disease is through vaccinating pregnant women. We conducted a mixed-methods study including a narrative literature review of drivers of maternal vaccination and key informant interviews in Spain, Italy, and India to characterize different approaches to national maternal immunization programs. Fifty-nine respondents participated in the study conducted between November 2018 and January 2019. Policies in Spain and Italy both reflect a life-course approach to vaccination, but recommendations and how they ensure uptake differs. Italy was focused on tracking of progress and mandates to ensure compliance in all regions, while Spain, an early adopter, relied more on advocacy and building provider acceptance. India includes Td in their national program, but the political will and advocacy for other vaccines are not seen. Needs for improving rates of maternal vaccination include education of health-care providers and pregnant women, use of central registries to track progress, stronger global guidance for use of vaccines, and engagement of champions, particularly obstetrician-gynecologists (ob-gyns). Health security concerns can also be leveraged to build political priority and needed platforms to detect disease and deliver vaccines in some countries. Understanding what drives a country’s maternal immunization program decisions and the success of implementation is useful in designing strategies to share best practices and guide support to strengthen platforms for maternal vaccination.
... Vaccination provides 40% to 60% protection during influenza seasons when the vaccine matches the season strains. 4 Influenza vaccines are produced at different times yearly; in the beginning of March in the southern hemisphere and of September in the northern hemisphere include influenza A (H 3 N 2 ) and influenza A (H 1 N 1 ), in addition to a strain of influenza B. 5 For influenza vaccines to be maximally effective, the vaccine viruses have to be antigenically matched to the influenza viruses circulating in humans. 6 The effectiveness of influenza vaccine is regularly assessed by the US, Centers for Disease Control and Prevention (CDC) during each season. ...
Background
Healthcare Workers (HCWs) constitute a major group exposed to influenza. Researchers herein try to determine the influenza vaccine effectiveness (VE). Influenza VE depends on the vaccinated personal characteristics and the closeness of matching between the vaccine and the prevalent strains of the virus. The aim of our research was to identify the 2018–2019 seasonal influenza VE in HCWs.
Methods
a record-based study was carried out using the test-negative design from October 2018 to September 2019 to calculate the influenza VE. HCWs with influenza like illness (ILI) were screened to detect the positive cases, and the vaccination status was determined based on vaccination database. VE was assessed from the ratio of the odds of vaccination among positive cases to the odds of vaccination among negative controls. Statistical analysis Multivariable logistic regression was used to estimate adjusted VE
Results
a total of 556 HCWs presented with ILI, 65.6% were females, and 54.1% were nurses, 152 HCWs (27.3%) had laboratory-confirmed influenza, shows two peaks in January and March 2019. VE for all types was 35.0% and rose to 42.0% after adjustment for HCWs age, gender, nationality, and job position, influenza A (H3N2) VE was 78.0%. H1N1 VE was 55.0% but no significant VE for type B was found.
Conclusion
Our VE estimates are in agreement with VE estimates published for that season. The use of quadrivalent vaccine with two stains of influenza B is recommended.
... 9 Where present there were mostly very low or unknown levels of vaccine coverage. 6,[47][48][49][50] According to previous evidence, a high influenza vaccine coverage (about 70%) can substantially reduce influenza-associated hospitalisations and deaths in children under 5 years of age. 51 A large proportion of influenza-virus-associated ALRI hospitalisations (44%) and in-hospital deaths (59%) occurred during infancy, with 23% of hospitalisations and 36% of the in-hospital deaths in infants under 6 months. ...
Background:
Seasonal influenza virus is a common cause of acute lower respiratory infection (ALRI) in young children. In 2008, we estimated that 20 million influenza-virus-associated ALRI and 1 million influenza-virus-associated severe ALRI occurred in children under 5 years globally. Despite this substantial burden, only a few low-income and middle-income countries have adopted routine influenza vaccination policies for children and, where present, these have achieved only low or unknown levels of vaccine uptake. Moreover, the influenza burden might have changed due to the emergence and circulation of influenza A/H1N1pdm09. We aimed to incorporate new data to update estimates of the global number of cases, hospital admissions, and mortality from influenza-virus-associated respiratory infections in children under 5 years in 2018.
Methods:
We estimated the regional and global burden of influenza-associated respiratory infections in children under 5 years from a systematic review of 100 studies published between Jan 1, 1995, and Dec 31, 2018, and a further 57 high-quality unpublished studies. We adapted the Newcastle-Ottawa Scale to assess the risk of bias. We estimated incidence and hospitalisation rates of influenza-virus-associated respiratory infections by severity, case ascertainment, region, and age. We estimated in-hospital deaths from influenza virus ALRI by combining hospital admissions and in-hospital case-fatality ratios of influenza virus ALRI. We estimated the upper bound of influenza virus-associated ALRI deaths based on the number of in-hospital deaths, US paediatric influenza-associated death data, and population-based childhood all-cause pneumonia mortality data in six sites in low-income and lower-middle-income countries.
Findings:
In 2018, among children under 5 years globally, there were an estimated 109·5 million influenza virus episodes (uncertainty range [UR] 63·1-190·6), 10·1 million influenza-virus-associated ALRI cases (6·8-15·1); 870 000 influenza-virus-associated ALRI hospital admissions (543 000-1 415 000), 15 300 in-hospital deaths (5800-43 800), and up to 34 800 (13 200-97 200) overall influenza-virus-associated ALRI deaths. Influenza virus accounted for 7% of ALRI cases, 5% of ALRI hospital admissions, and 4% of ALRI deaths in children under 5 years. About 23% of the hospital admissions and 36% of the in-hospital deaths were in infants under 6 months. About 82% of the in-hospital deaths occurred in low-income and lower-middle-income countries.
Interpretation:
A large proportion of the influenza-associated burden occurs among young infants and in low-income and lower middle-income countries. Our findings provide new and important evidence for maternal and paediatric influenza immunisation, and should inform future immunisation policy particularly in low-income and middle-income countries.
Funding:
WHO; Bill & Melinda Gates Foundation.
... Influenza vaccines are designed to protect against three or four different influenza viruses; two influenza A viruses (an A(H1N1)pdm09 subtype and A(H3N2) subtype) and either one or two influenza B viruses (covering one or both of the B/Yamagata and B/Victoria lineages). In 2013, 40% of countries worldwide recommended influenza vaccination in their national immunisation programmes, although vaccine uptake varies [5][6][7]. ...
Seasonal influenza poses serious problems for global public health, being a significant contributor to morbidity and mortality. In England, there has been a long-standing national vaccination programme, with vaccination of at-risk groups and children offering partial protection against infection. Transmission models have been a fundamental component of analysis, informing the efficient use of limited resources. However, these models generally treat each season and each strain circulating within that season in isolation. Here, we amalgamate multiple data sources to calibrate a susceptible-latent-infected-recovered type transmission model for seasonal influenza, incorporating the four main strains and mechanisms linking prior season epidemiological outcomes to immunity at the beginning of the following season. Data pertaining to nine influenza seasons, starting with the 2009/10 season, informed our estimates for epidemiological processes, virological sample positivity, vaccine uptake and efficacy attributes, and general practitioner influenza-like-illness consultations as reported by the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC). We performed parameter inference via approximate Bayesian computation to assess strain transmissibility, dependence of present season influenza immunity on prior protection, and variability in the influenza case ascertainment across seasons. This produced reasonable agreement between model and data on the annual strain composition. Parameter fits indicated that the propagation of immunity from one season to the next is weaker if vaccine derived, compared to natural immunity from infection. Projecting the dynamics forward in time suggests that while historic immunity plays an important role in determining annual strain composition, the variability in vaccine efficacy hampers our ability to make long-term predictions.
... 29 Moreover, none of the suspected ILI cases reported that they received an influenza vaccine because flu vaccination is not scheduled in the routine immunization program or is not prioritized in Cambodia. 30,31 The age group of 0-4 years showed the highest attack rate, and the ILI surveillance/CDC-MOH revealed that this age group had the highest proportion of ILI cases from January to June 2016 in the country. 18 To prevent deaths or outbreaks caused by an influenza virus, influenza vaccination should be considered for the high-risk group, especially children younger than 5 years old. ...
On June 4, 2016, the Prey Veng Provincial Health Department reported a total of 107 patients with influenza-like illness (ILI) from Chakhlanh village to the Cambodian Ministry of Health. To confirm the outbreak and evaluate its clinical and epidemiological characteristics, the investigation team visited the village and reviewed the case-based surveillance (CBS) data on severe respiratory infection (SRI) and patients' records in health facilities. The team interviewed all households in the village from May 1 to June 5, 2016 and obtained the following data: age, medical history, date of onset, treatment, symptoms, and history of contact with patients or dead poultry. Nasal swab samples were collected from suspected ILI cases to test for influenza virus by RT-PCR. The investigation detected 498 suspected ILI cases, including 288 females. Although the incidence of suspected ILI cases who visited health centers was 63.0 per 1,000 persons per month, the attack rate was 27.1 per 100 population. The major age group was 5-14 years followed by 0-4 years. Major symptoms were cough, fever, runny nose, and headache. Six of seven nasal swab samples were positive for influenza A/H1N1 pdm09 virus. Most children with flu symptoms had contact with previous cases. This study showed that the ILI outbreak might be caused by seasonal influenza A/H1N1 pdm09 spread from person to person. Poor living conditions and poor hygiene and sanitation practices were environmental factors that caused the outbreak. As the CBS system was unable to identify this epidemic, it needs to be improved.
