Are children on track with their routine immunisation schedule in a fragile and protracted conflict state of South Sudan?

Objectives The objective of this study was to assess if children aged 0–23 months in a conflict-affected state of South Sudan were on track with their immunisation schedule and to identify predisposing factors that affected this study population from being on track with their routine immunisation schedule. Design Community-based cross-sectional study using a semi-structured questionnaire. The binary outcome of interest was defined as being on or off track with routine vaccination schedule. Multivariable logistic regression was used to analyse for the association between the predisposing factors surveyed and being off track with one’s routine immunisation schedule. Setting Rural communities in four counties (Rumbek Centre, Rumbek North, Rumbek East and Wulu) of the Western Lakes state in South Sudan during January 10, 2020 to June 10, 2020. Participants We surveyed 428 children aged 0–23 months and their mothers/caregivers who lived in either of the four counties in the Western Lakes State. Participants were selected using random ballot sampling. Results More than three-quarters of the children surveyed (75.5%) were off track with their vaccination schedule. Children with an immunisation card had 71% reduced odds of being off track with their immunisation (AOR = 0.29; 95% CI 0.10–0.83, p-value = 0.021) compared to children without immunisation cards. Children who reside near health facilities and do not require transportation to facilities had 87% reduced odds of being off track with their immunisation compared to those who lived far and required transport to facilities. Giving an adequate immunisation notice before conducting immunisation outreach visits to communities was also associated with reduced odds (AOR = 0.27; 95% CI 0.09–0.78. p-value = 0.016) of children being off track with their immunisation. Conclusion This study revealed that most children were off track with their vaccination schedule in South Sudan, which is not only influenced by maternal characteristics but mainly by community- and state-level immunisation service delivery mechanisms. Interventions to improve child immunisation uptake should put these contextual characteristics into high health agenda consideration.

Awareness and acceptance of anticipated pediatric COVID-19 vaccination in rural South India

Background: The objective of this study was to assess the awareness and acceptance of anticipated COVID-19 pediatric vaccination among parents in rural south India.Methods: Objective questionnaire based online cross-sectional study in out-patient department, school WhatsApp groups and the community between 01 July 2021 to 15 July 2021. Sample size 873. Parents of children less than 18 years of age willing to participate in the study were included. Parents not willing to participate in the study were excluded.Results: 64.6% parents accepted pediatric COVID-19 vaccination; 96.4% felt it beneficial to vaccinate children prior to re-opening of school. 96.68% were positive that vaccination in children shall play a pivotal role in the projected third wave. 35.39% were hesitant and wanted to delay vaccinating their children and 14.14% do not believe in vaccine efficacy. 14.53% parents were weary of giving vaccine to their children due to personal experience of adverse effects they had suffered, and 22.45% parents refused vaccination due to hearsay adverse effects. 17.6% parents felt that post COVID-19 infection, children don’t need vaccination. 38.95% of parents were concerned about interaction of COVID-19 vaccine with other vaccines of immunisation schedule, 19.36% felt that children don’t need specific COVID-19 vaccine since the regular immunisation schedule prevents COVID-19 infection.Conclusions: Parents of rural India are aware of the pandemic and its lasting impact in our society but its effect on children is still beyond their comprehension. Most parents are willing and accept pediatric COVID-19 vaccination, however vaccine hesitancy and misconceptions are significant entities that can derail full coverage of children.

Are children on track with their routine immunisation schedule in a fragile and protracted conflict state of South Sudan?

Objectives The objective of this study was to assess if children aged 0-23 months in a conflict-affected state of South Sudan were on track with their immunisation schedule and to identify predisposing factors that affected this study population from being on track with their routine immunisation schedule. Design Community-based cross-sectional study using a semi-structured questionnaire. The binary outcome of interest was defined as being on or off track with routine vaccination schedule. Multivariable logistic regression was used to analyse for the association between the predisposing factors surveyed and being off track with one’s routine immunisation schedule. Setting Rural communities in four counties (Rumbek Centre, Rumbek North, Rumbek East and Wulu) of the Western Lakes state in South Sudan during January 10, 2020 to June 10, 2020.Participants We surveyed 428 children aged 0-23 months and their mothers/caregivers who lived in either of the four counties in the Western Lakes State. Participants were selected using random ballot sampling. Results More than three-quarters of the children surveyed (75.5%) were off track with their vaccination schedule. Children with an immunisation card had 71% reduced odds of being off track with their immunisation (AOR=0.29; 95% CI 0.10 – 0.83, p-value=0.021) compared to children without immunisation cards. Children who reside near health facilities and do not require transportation to facilities had 87% reduced odds of being off track with their immunisation compared to those who lived far and required transport to facilities. Giving an adequate immunisation notice before conducting immunisation outreach visits to communities was also associated with reduced odds (AOR=0.27; 95% CI 0.09 – 0.78. p-value=0.016) of children being off track with their immunisation.Conclusion This study revealed that most children were off track with their vaccination schedule in South Sudan, which is not only influenced by maternal characteristics but mainly by community- and state-level immunisation service delivery mechanisms. Interventions to improve child immunisation uptake should put these contextual characteristics into high health agenda consideration.

Pneumococcal disease and vaccination: recent changes to the schedule

Vaccination against pneumococcal disease has led to a significant drop in cases in the UK. Helen Sisson provides an overview of recent changes to the vaccination schedule Vaccination to protect against infectious diseases is a fundamental part of the practice nurse's role. The immunisation schedule in the UK frequently changes and this emphasises the need for nurses to remain familiar with what the changes are, and why they have occurred. The most recent change to the pneumococcal vaccination schedule at the start of this year provides an opportunity to reflect on the significance of infection with Streptococcus pneumoniae, which can cause non-invasive or invasive disease. The introduction of routine vaccination against pneumococcal disease for children has led to a significant drop in invasive disease in the population as a whole.

Bronchopulmonary Pathology Prevalence Among Premature infants and Estimation of Prophylactic Efficacy and Reactogenicity of 13-Valent Pneumococcal Conjugate Vaccine in Premature infants with Bronchopulmonary Dysplasia

Background. The most frequent chronic lung pathology among infants and especially in premature children with extremely low and very low body weight is bronchopulmonary dysplasia (BPD). The aim of the study is to study the prevalence of bronchopulmonary pathology among premature children and justify the need to vaccinate against pneumococcal disease premature children suffering from BPD. Methods. The official statistics (Form №32) and data from annual reports of the catamnesis department of “the Honourary order” Perm Regional Clinical Hospital were used in order to measure the number of premature children born alive in Perm region in 2015-2017 yy. The estimation of prophylactic efficacy and reactogenicity of 13-valent pneumococcal conjugate vaccine (PCV13) at immunization of premature children with BPD. Results. The study group included vaccinated premature children with BPD (n=29), the experimental group included non-vaccinated premature children with BPD (n=29) and 30 vaccinated term children. Administration of PCV13 in premature children suffering from BPD has revealed its high prophylactic efficacy (no cases of community-acquired pneumonia among vaccinated children during the prospective study for 3 years), high tolerability (no cases of broncho-obstructive syndrome or negative effects on respiratory system such as apnoea or desaturation among vaccinated children). Low reactogenicity (17.2 ± 0.57%) and similar vaccine tolerance with term children (16.5 ± 0.55%) has been revealed as well. The combination of PCV13 with other vaccines from immunisation schedule did not increase the number of vaccine-induced diseases in comparison with administration of PCV13 alone. Conclusion. The scientific necessity of vaccination of premature children with BPD against pneumococcal disease has been proved. The high prophylactic efficacy and low reactogenicity of PCV13 in this children group at tertiary neonatological care (catamnesis department of perinatal center) has been established within the national immunisation schedule.