Conclusion: Transforming evaluation practice for "business unusual"

The response to the COVID-19 epidemic has been varied, approached in different ways, and essentially at a national level. The World Health Organization (WHO) has been constantly calling for global coordination of both the management of the virus and of the vaccination program. We need to look beyond national responses. Awareness of our individual, social, and political responsibility in managing how to respond to the natural and societal challenges we are facing now and in the future is insufficient. The 2030 Agenda for Sustainable Development already holds some of the answers for what collective actions are needed. The authors are to be thanked for their thought-provoking contributions: They have also provided some very useful and practical suggestions for how evaluation can play its part in supporting transformation. The articles have stressed the worthwhile contribution that evaluation can make by applying its unique skill set to support a transformative socio-political end economic agenda. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Effect of vaccination against Covid-19 one year after its introduction in Brazil.

BACKGROUND: Worldwide, several efforts have been made to develop, distribute and administer safe and effective vaccines to reduce morbidity and mortality and control the Covid-19 pandemic. This study aimed to analyze the effect of vaccination against Covid-19, one year after its introduction in Brazil. METHODS: An ecological study that analyzed the general effect of vaccination against Covid-19 on disease morbidity and mortality indicators among the Brazilian population aged 18 years or older per epidemiological week (EW), comparing the pre and postvaccination period. Morbidity and mortality indicators were calculated from secondary databases (hospitalization rate, severity, case fatality rate and mortality) and vaccination coverage by age groups (18 to 59 years and 60 years or older). Morbimortality trends were estimated using the JoinPoint model and their association with vaccine coverage using the Poisson model. RESULTS: The average weekly percentage change (AWPC) of morbidity and mortality indicators reduced after the introduction of Covid-19 vaccination: hospitalization rate (from 15.3% to -6.0%), severity (from 0.4% to -0.2%), case fatality rate (from 0.3% to -0.2%) and mortality (from 20.5% to -4.3%). The following indicators were inversely associated with the increase in vaccine coverage against Covid-19: hospitalization (IRR: 0.974), mortality (IRR: 0.975) and lethality for people aged 60 years or older (IRR: 0.997). CONCLUSIONS: In spite of the three epidemic waves and the circulation of variants of concern, the general effect of vaccination against Covid-19 in reducing the trend of morbidity and mortality from the disease in Brazil was demonstrated. These findings contribute to a better understanding of the mass vaccination program against Covid-19 and may inform future public health policies.

COVID-19 Vaccine Hesitancy in Denmark and Russia: A qualitative typology at the nexus of agency and health capital.

Vaccination of the world population is being embraced by 184 countries as the main strategy to end the COVID-19 pandemic; vaccination rates are stalling even in countries with high vaccine availability, though. This article investigates the phenomenon of vaccine hesitancy in two such countries, the Kingdom of Denmark and the Russian Federation, through a qualitative study of the different types of hesitancy to COVID-19 vaccination programs and their underlying mechanisms. The analysis reveals a typology along the dimensions of agency and health capital: resisting hesitancy based on mistrust of authority, paralyzed hesitancy based on personal fear, informed hesitancy based on informed choice, and empowered hesitancy based on empowered choice. While the mechanisms underlying vaccine hesitancy are to a great extent comparable between the two countries, differences in population size, societal cohesion, and political culture seem to impact the prevalence and severity of types and, thereby, the outcomes of national COVID-19 vaccination programs and national campaigns for mitigating COVID-19 vaccine hesitancy. The implications of these findings extend beyond the particular context of COVID-19 and the countries studied, supporting and nuancing existing models for vaccine hesitancy, as well as providing a starting point for tailored campaigns for mitigating vaccine hesitancy.

Resumption of active recommendation of the human papillomavirus vaccine in Japan and future challenges for the National Immunization Program.

Japan's immunization program resumed proactively recommending the use of the human papillomavirus (HPV) vaccine nationwide in April 2022, after suspending this recommendation in June 2013. The promotion of catch-up vaccinations is an urgent issue to reduce the increase in cervical cancer and other cancers caused by low vaccination rates. In addition, the National Immunization Program still has issues to be considered, such as the adoption of the 9-valent vaccine, establishment of an appropriate number of vaccinations according to age, and routine immunization of males. There is a history of eliminating the use of the measles, mumps, and rubella vaccine and the mouse brain-derived, purified inactivated Japanese encephalitis vaccine, as well as suspending the HPV vaccine recommendation in Japan. These decisions have led to the current preventable infectious disease burden. In order to make the right policy decisions based on science-based assessments, it is necessary to establish a safety assessment platform to evaluate the causal relationship between vaccines and adverse events following immunization. Information technology, which has been promoted with the coronavirus disease 2019 vaccine in the current pandemic, may assist in providing more detailed vaccine safety evaluations for other vaccines.

Adolescent girls' recommendations for the design of a human papillomavirus vaccination program in Sindh, Pakistan: a qualitative study.

PURPOSE: Vaccination of adolescent girls against human papillomavirus (HPV) significantly reduces the incidence of cervical cancer. HPV vaccines are available in Pakistan but plans to develop HPV vaccination program are at a nascent stage. We conducted a formative study to explore adolescent girls' knowledge and perspectives on HPV and cervical cancer and collect their recommendations for implementing an HPV vaccination program in their community. METHODS: Using qualitative exploratory study design, we conducted four focus group discussions (FGDs) with 12 adolescent girls per group in District West, Karachi. We recruited unmarried girls aged 16-19 years from schools and community settings between May-December 2020. Data analysis was done using NVivo. RESULTS: Overall, participants displayed a positive attitude toward HPV vaccine. However, they were unfamiliar with basic concepts related to female reproductive health. Female relatives were indicated as girls' preferred point of contact for discussions on HPV and cervical cancer, but fathers were portrayed as decision-making authority on vaccination. Participants indicated vaccine hesitancy among parents may affect HPV vaccination uptake. Girls suggested individual household visits and community-based camps as strategies for successful implementation of HPV vaccination program. A solid foundation of trust between girls' families, program managers, and other stakeholders emerged as a key asset for the program's success. CONCLUSION: Adolescent girls' suggestions of informing key decision-makers in the family (particularly fathers) of the benefits of HPV vaccination, establishing trust with vaccine providers, and increasing accessibility of vaccinations should be explored for successful implementation of an HPV vaccination program in Pakistan.

Beyond Influenza Vaccination: Expanding Infrastructure for Hospital-based Pediatric COVID-19 Vaccine Delivery.

Controlling the spread of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), will rely on vaccination at increasing rates and in an equitable manner. The main reasons for under-vaccination are varied among different segments of the population and include vaccine hesitancy and lack of access. While vaccine hesitancy is complicated and requires long-term solutions, access can be enhanced through evidence-based delivery strategies that augment conventional approaches. Hospital-based COVID-19 vaccination programs hold particular promise in reaching populations with decreased vaccine access and those at higher risk for adverse outcomes from SARS-CoV-2 infection. Hospitals have the necessary equipment and storage capabilities to maintain cold chain requirements-a common challenge in the primary care setting-and can serve as a central distribution point for delivering vaccines to patients in diverse hospital locations, including inpatient units, emergency departments, urgent care centers, perioperative areas, and subspecialty clinics. They also have the capacity for mass-vaccination programs and other targeted outreach efforts. Hospital-based programs that have been successful in implementing influenza and other routine vaccinations can leverage existing infrastructure, such as electronic health record-related tools. With the possibility of COVID-19 becoming endemic, much like seasonal influenza, these programs will require flexibility as well as planning for long-term sustainability. This commentary highlights existing vaccine delivery to children in hospital-based settings, including key advantages and important challenges, and outlines how these systems could be expanded to include the COVID-19 vaccine delivery.

Estimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European Region, December 2020 to November 2021.

Since December 2019, over 1.5 million SARS-CoV-2-related fatalities have been recorded in the World Health Organization European Region - 90.2% in people ≥ 60 years. We calculated lives saved in this age group by COVID-19 vaccination in 33 countries from December 2020 to November 2021, using weekly reported deaths and vaccination coverage. We estimated that vaccination averted 469,186 deaths (51% of 911,302 expected deaths; sensitivity range: 129,851-733,744; 23-62%). Impact by country ranged 6-93%, largest when implementation was early.

Effects of the COVID-19 pandemic on routine pediatric vaccination in Brazil.

BACKGROUND: COVID-19 pandemic has disrupted health services, including vaccination demand. We describe the impact of the COVID-19 pandemic on routine pediatric vaccination in Brazil. METHODS: We conducted a retrospective analysis of all vaccine doses provided to children aged 0-6 years from January 2019 to December 2020. We obtained data stratified by age group (0 to 2 years and >2 to 6 years) and Brazilian region. Difference-in-difference (DiD) analyses were performed to compare vaccine uptake in the pre-pandemic (January-February), stay-at-home (March-June), and reopening (July-December) periods. RESULTS: The number of vaccine doses administered declined in the stay-at-home period. For children aged 0 to 2 years, the highest reductions were recorded in the North (-25.3%), Northeast (-16.8%) and Central-West (-10.2%) regions. For children aged >2 to 6 years, the highest decline was observed in the North (DiD = -27.2%) and South (DiD = -14.0%) regions. The number of vaccine doses administered in the reopening period has slightly increased in all regions. CONCLUSIONS: Vaccination decreased during the COVID-19 pandemic. Although the number of doses recovered in part during the reopening phase, additional strategies, such as increased public awareness and vaccination booster campaigns are required.

Attitudes and Knowledge of European Medical Students and Early Graduates about Vaccination and Self-Reported Vaccination Coverage-Multinational Cross-Sectional Survey.

Vaccination is one of the most useful preventive interventions in healthcare. The purpose of our study was to gain overview of the opinions, knowledge, and engagement in vaccination practices among medical students (MS) and junior doctors (JD) in Europe. The survey was distributed from March 2016 until August 2016 via the e-mail and social media of the European Medical Students' Association. In total, 1821 responses from MS and JD from 34 countries in the European region were analysed. The majority of respondents agreed that vaccines are useful (98.7%) and effective (97.2%). Although the necessity of revaccination was supported by 99.2%, only 68.0% of the respondents went through with it. Even though the potential benefit of the flu vaccination seems to be acknowledged by our participants, only 22.1% of MS and JD declared getting the flu shot every or every other season. MS and JD were in favour of specific mandatory vaccination for medical staff (86.0%) and medical students (82.7%). Furthermore, we analysed the self-reported vaccination coverage of our participants regarding 19 vaccines. Of the respondents, 89.5% claimed to provide advice about vaccination to their friends and family. In conclusion, European MS and JD have a very positive attitude towards vaccination. However, their behaviour and knowledge demonstrate certain gaps which should be further addressed in medical education.

The Global Interest in Vaccines and Its Prediction and Perspectives in the Era of COVID-19. Real-Time Surveillance Using Google Trends.

BACKGROUND: The COVID-19 pandemic has globally overwhelmed all sectors of life. The fast development of vaccines against COVID-19 has had a significant impact on the course of the pandemic. METHODS: Global data from Google Trends was analyzed for vaccines against flu, BCG, HPV, pneumococcal disease, polio, and COVID-19. The time frame includes the last five-year period starting from 17 April 2016. Multiple training of time series models with back testing, including Holt-Winters forecasting, Exponential Smoothing State Space, Linear model with trend and seasonal components (tlsm), and ARIMA was conducted. Forecasting according to the best fitting model was performed. RESULTS: Correlation analysis did not reveal a decrease in interest in vaccines during the analyzed period. The prediction models provided a short-term forecast of the dynamics of interest for flu, HPV, pneumococcal and polio vaccines with 5-10% growth in interest for the first quarter of 2022 when compared to the same quarter of 2021. CONCLUSIONS: Despite the huge interest in the COVID-19 vaccine, there has not been a detectable decline in the overall interest in the five analyzed vaccines.

Considerations for Establishing Successful Coronavirus Disease Vaccination Programs in Africa.

The accelerated development of coronavirus disease (COVID-19) candidate vaccines is intended to achieve worldwide immunity. Ensuring COVID-19 vaccination is crucial to stemming the pandemic, reclaiming everyday life, and helping restore economies. However, challenges exist to deploying these vaccines, especially in resource-limited sub-Saharan Africa. In this article, we highlight lessons learned from previous efforts to scale up vaccine distribution and offer considerations for policymakers and key stakeholders to use for successful COVID-19 vaccination rollout in Africa. These considerations range from improving weak infrastructure for managing data and identifying adverse events after immunization to considering financing options for overcoming the logistical challenges of vaccination campaigns and generating demand for vaccine uptake. In addition, providing COVID-19 vaccination can be used to promote the adoption of universal healthcare, especially in sub-Saharan Africa countries.

Latin American forum on immunization services during the COVID-19 pandemic.

Introduction: The Latin American Society of Pediatric Infectology (SLIPE for its acronym in Spanish) is working hard to contribute with strategic actions to prevent the recurrence of Vaccine-Preventable Diseases and to prevent the reduction of vaccine coverage in the region of the Americas.Areas covered: On Friday, September 25th, a Latin American forum of experts on immunization services during the COVID-19 pandemic was held through Webex platform. Issues such as: the imminent risk of occurrence and outbreaks of vaccine-preventable diseases, the importance of epidemiological surveillance and the vaccination campaign challenges, in the context of a pandemic were discussed.Expert opinion: Vaccination campaigns should no longer be postponed or delayed; instead, they must be reactivated; governments, scientific societies, and physicians must promote vaccination programs to avoid outbreaks of vaccine-preventable diseases. On the eve of a SARS-CoV-2 vaccine, it is necessary to insist on the availability of sufficient doses to avoid dose shortages in disadvantaged areas of the region.