Changes in vaccine administration trends across the life-course during the COVID-19 pandemic in the United States: a claims database study.

BACKGROUND: This study provides an updated and expanded analysis of the impact of the COVID-19 pandemic on routine vaccinations across the life-course in the United States. RESEARCH DESIGN AND METHODS: Routine wellness visits and vaccination rates were calculated using structured claims data for each month during the impact period (January 2020 to August 2022) and compared to the respective baseline period (January 2018 to December 2019). Monthly rates were aggregated as annual accumulated and cumulative percent changes. RESULTS: The complete monthly rate interactive dataset can be viewed at https://vaccinationtrends.com. The greatest decrease in annual accumulated administration rates in the 0-2 and 4-6 years age groups was for the measles, mumps, and rubella vaccine; for adolescents and older adults, it was for human papillomavirus and pneumococcal vaccines, respectively. Routine in-person wellness visit rates recovered faster and more completely than vaccination rates in all age groups, indicating potential missed opportunities to administer vaccines during visits. CONCLUSIONS: This updated analysis reveals that the negative impact of the COVID-19 pandemic on routine vaccination continued through 2021 and into 2022. Proactive efforts to reverse this decline are needed to increase individual- and population-level vaccination coverage and avoid the associated preventable morbidity, mortality, and health care costs.

The Role of Faith-Based Organizations in Improving Vaccination Confidence & Addressing Vaccination Disparities to Help Improve Vaccine Uptake: A Systematic Review.

The COVID-19 pandemic underscored the importance of vaccination to support individual health across the life-course, with vaccination playing a central strategy role in mitigating transmission and disease. This required unprecedented mobilization and coordination across all sectors to meet people where they are, enable equitable access, and build vaccination confidence. A literature search was conducted with combinations of the keywords and variations of vaccination and faith-based organizations (FBOs). Search inclusion criteria were: (1) FBO programs that supported public health emergency efforts, including vaccination efforts as the primary outcome; and (2) articles written in English language. A total of 37 articles met inclusion criteria (n = 26 focused on general public health campaigns, n = 11 focused on vaccination efforts). The findings related to public health campaigns fell into four themes: FBO's ability to (1) tailor public health campaigns; (2) mitigate barriers; (3) establish trust; and (4) disseminate and sustain efforts. The findings related to vaccine uptake efforts fell into three themes: (1) pre-pandemic influenza and HPV vaccination efforts, (2) addressing vaccine disparities in minority communities, and (3) enabling COVID-19 vaccination. This review demonstrated that FBOs have a vital role in both public health campaigns and vaccination initiatives to support high vaccine uptake and confidence.

Higher Prevalence of Food Insecurity and Psychological Distress among International University Students during the COVID-19 Pandemic: An Australian Perspective.

The COVID-19 pandemic and related disruptions have not only affected university students' learning and academic outcomes, but also other issues, such as food security status, mental health and employment. In Australia, international students faced additional pressures due to sudden border closures and lack of eligibility for government-provided financial support. This study explored the experiences of domestic and international university students residing in Australia during the early stages of the COVID-19 pandemic across a range of outcomes. A cross-sectional online survey was conducted between July and September 2020 at Macquarie University in Sydney, Australia. The online survey included food insecurity status, mental health (psychological distress), disruptions to study, employment and sleep. A total of 105 students (n = 66 domestic and n = 39 international) completed the survey. Respondents reported having food insecurity (41.9%) and psychological distress (52.2%, with high and very high levels), with international students reporting significantly higher food insecurity (OR = 9.86 (95% CI 3.9-24.8), p < 0.001) and psychological distress scores (t(90) = 2.68, 95% CI: 1.30 to 8.81, p = 0.009) than domestic students. About one quarter of all respondents reported disruptions to study and employment status around the time of the survey. When asked what government support should be provided for international students, 'financial aid' was the most frequently suggested form of support. This research may help governments and educational institutions design appropriate support, particularly financial and psychological, for both international and domestic university students.

Attitudes and Beliefs around the Value of Vaccination in the United States.

Despite the benefits of immunization, differences in attitudes persist toward vaccines. We captured individuals' perceptions of vaccines and vaccination across the United States (US) to inform vaccine-related policy development. A survey was completed by 5000 respondents from 10 states. Respondents were screened for inclusion, which included individuals ≥ 18 years of age that had received a vaccine or were unvaccinated but indicated a favorable or neutral attitude towards vaccinations. Participants were excluded if they indicated they did not support the idea of vaccinations. Questions explored perceptions of vaccines for all age groups. Among unvaccinated individuals, the most common concerns were about safety (38%). Most respondents (95%) highlighted the importance of state immunization programs for disease prevention. Access to health and immunization records and immunization information systems were important to 96% and 88% of respondents, respectively, for future health planning. Doctors and healthcare professionals (HCPs) were considered trusted sources for vaccine information (95%). Overall, respondents recognized the importance of vaccination, but documented concerns among the unvaccinated indicated a need for greater promotion regarding vaccine safety. Doctors and HCPs, as trusted information sources, should continue to and increasingly advocate for the importance of immunization to increase vaccine uptake.

Overcoming Silos: A Sustainable and Innovative Approach to Curriculum Development

The COVID-19 pandemic has highlighted the importance of being adaptable and flexible in our teaching practices in higher education. Traditionally, a siloed approach to curriculum development has dominated in higher education institutions. These silos are known to create inefficiencies and, in the context of developing teaching resources, often result in the duplication of curricula, resulting in wasted effort and time, and inconsistent teaching practices. In this short communication, we put forward a sustainable and innovative approach to cross-disciplinary curriculum development, known as the Connected Curriculum for Professionals in Health initiative. This ongoing initiative was launched in 2018 and brought together teaching academics and students to co-design a centralized online repository of high-quality, evidence-based online educational modules that support student learning across disciplines. A mixed-methods evaluation of this initiative found that this is a well-utilized repository of engaging modules (n = 46) that have enhanced learning outcomes for both undergraduate and postgraduate health professional students. The Connected Curriculum for Professionals in Health initiative has wide-ranging applicability, beyond disciplines, and is a sustainable, efficient, and strategic approach to enhance pedagogy and the student experience.

A Comprehensive Assessment Of Child Care Vaccination Laws Across The US.

All fifty US states and Washington, D.C., require children from birth through age five to be vaccinated against certain communicable diseases as a condition of attending child care settings such as day care, Head Start, preschools, pre-kindergarten, and other early childhood programs. However, the nuances and implementation of these laws vary greatly across jurisdictions. To date, a comprehensive analysis of all child care vaccination laws in the US has not been performed. We have developed the first compilation of child care vaccination laws across the US. This compilation is the culmination of an exhaustive examination of multiple components of the laws, such as which vaccines are required, provisions that enable unvaccinated children to temporarily attend child care until they are fully vaccinated, attendance provisions for unvaccinated students during an outbreak, methods of enforcement of vaccination policy, and child care personnel vaccination requirements. This comprehensive analysis provides a critical and foundational framework to inform policy makers and public health professionals involved in policy planning and implementation and policy research. It provides a benchmark for further evaluation of existing and future vaccination laws and their impact on vaccine coverage rates.

Addressing an urgent global public health need: Strategies to recover routine vaccination during the COVID-19 pandemic.

Routine vaccination has been severely impacted by the COVID-19 pandemic, with 37% of countries reporting continuing disruptions to vaccination services into 2021. These programs have been faced with the challenges of achieving high vaccination coverage rates (VCRs), as well as identifying and vaccinating those who missed recommended doses since the pandemic began. Declines in VCRs, even for short periods, can lead to an increase in disease outbreaks, place additional pressure on health systems, and leave communities across the world at risk of death and disease from vaccine-preventable diseases.In the face of these disruptions, select governments are implementing promising approaches to address low VCRs, some of which represent innovative solutions to advance short-term, as well as longer-term program improvement. However, expanded action is urgently required to fully recover vaccination programs and strengthen vaccine system infrastructure. The COVID-19 pandemic provides a unique opportunity to modernize routine programs and corresponding infrastructure to meet today's and tomorrow's health challenges more effectively and efficiently. This can be achieved by prioritizing routine vaccination as an essential health service, improving access to vaccination across the life-course, strengthening data systems, ensuring sustainable immunization financing, and building confidence in vaccination.

Impact of the COVID-19 pandemic on adolescent vaccinations: projected time to reverse deficits in routine adolescent vaccination in the United States.

OBJECTIVE: The COVID-19 pandemic has led to significant reductions in the administration of routinely recommended vaccines among adolescents in the US including tetanus, diphtheria, and acellular pertussis (Tdap); meningococcal (ACWY); and human papillomavirus (HPV) vaccines. The extent to which these deficits could persist in 2021 and beyond is unclear. To address this knowledge gap, this study estimated the cumulative deficits of routine vaccine doses among US adolescents during the COVID-19 pandemic and estimated the time and effort needed to recover from those deficits. METHODS: Monthly reductions in Tdap, meningococcal, and HPV doses administered to US adolescents during the COVID-19 pandemic were quantified using MarketScan Commercial Claims and Encounters data. The time and effort required to reverse the vaccination deficit under various catch-up scenarios were estimated. RESULTS: Annual doses administered of Tdap, meningococcus, and HPV vaccines decreased by 21.2%, 20.8%, and 24.0%, respectively, in 2020 compared to 2019. For 2021, the reduction in doses administered is projected to be 6%-21% compared to 2019 under different scenarios. The projected deficit of missed doses is expected to be cleared between winter 2023 and fall 2031. CONCLUSIONS: Administration rates of routine vaccines decreased significantly among US adolescents during COVID-19. Reversing these deficits to mitigate long-term health and economic consequences will require a sustained increase in vaccination rates over multiple years.

Silent Consequences of COVID-19: Why It's Critical to Recover Routine Vaccination Rates Through Equitable Vaccine Policies and Practices.

In the United States, routine vaccination rates have plummeted across all age groups due to the COVID-19 pandemic, with our most vulnerable and under-served populations suffering the greatest declines. Returning to a "new normal" and recovering our nation's health and economy is of the utmost importance; however, there is a critical need to recover and protect communities against the spread of other vaccine-preventable diseases and outbreaks. While routine vaccination rates are slowly recovering for certain age groups, the introduction of COVID-19 vaccines adds complexities and challenges to recovery efforts. If not addressed, hard-won gains in routine vaccination may be lost, which could result in communities missing out on the social, economic, and health benefits offered by vaccinations.There is an urgent need to utilize evidence-based and innovative strategies to support both immediate and long-term efforts to recover, maintain, and sustain routine vaccination. Key short-term strategies include leveraging digital and mainstream media to drive awareness, coordinating across health and education sectors, utilizing centralized reminder recall, expanding access points to vaccination services, and elevating trusted voices for vaccination. In order to build back stronger, long-term strategies include enhancing immunization information systems, mitigating financial barriers to vaccination, investing in building vaccine confidence, and ensuring sustainable funding for immunization infrastructure.Annals "Online First" article.

Adapting to Teaching During a Pandemic: Pedagogical Adjustments for the Next Semester of Teaching During COVID-19 and Future Online Learning

COVID-19 has altered public health higher education and its impact on pedagogy will be felt long into the future. In response to social distancing measures, teaching academics implemented a number of changes to curricula. It is important to better understand and begin to evaluate these changes, as well as set a course for future changes to public health curricula both during and after the pandemic to best enable transformative learning. Teaching academics have an understanding of academic hierarchies and student perceptions and are well placed to provide insights into current and future changes to pedagogy in response to the pandemic. A survey was developed to examine changes that academics had made to their teaching in response to COVID-19. Responses were received from 63 public health teaching academics from five universities in Australia, the United States, and Canada. Public health teaching academics rapidly implemented a number of changes to their teaching, including alterations that enabled online teaching. The great majority of changes to teaching were related to tools or techniques, such as synchronous tutorials delivered in a video meeting room. There remains further work for the public health pedagogy community in reevaluating teaching aims and teaching philosophies in light of the COVID-19 pandemic. This could include examination of the weighting of different topics, including communicable diseases, in curricula. A series of questions to assist academics reformulating their curricula is provided. Public health teaching evolved rapidly to meet the challenges of COVID-19;however, ongoing adaptation is necessary to further enhance pedagogy.