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Background. Every life aspect and group of the community have changed during the COVID-19 pandemic, including the group of pregnant, childbirth, and postpartum woman. COVID-19 Pandemic occurred in 2020-2021. Maternal mortality in East Java Province was the highest in Indonesia during the pandemic. Objective. This study analyzed the effect of spatial determinants that consist of antenatal, childbirth, and post-partum care on maternal mortality in East Java Province during the Pandemic. Methods. This study used a crossectional method with the unit of analysis in this study was all pregnant, childbirth and postpartum women in 38 districts of East Java Province from 2020 until 2021. Data were analyzed with spatial regression by using Geographically Weighted Regression Software. Results. Maternal mortality in East Java had a spreading pat-tern and negative value of the diff criterion, so we concluded that there was a spatial influence. The variables of antenatal care, accessibility of healthcare service, third postpartum visit, and complication service had significant effects on maternal mortality in all regions (P<0,05). There were four groups of districts that showed a similarity of significant factors. This result showed that each region's diversity of the accessibility of health services affects maternal mortality during the COVID-19 era. Antenatal services, access to health facilities and complication services affected maternal mortality in regions with high maternal mortality rate. Conclusion. Every region has its spatial determinants of maternal mortality. The top government should give authority to local government to have programs to reduce maternal mortality according to the condition in their region. r.Copyright © the Author(s), 2023.
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Objectives: Pertussis, a highly contagious respiratory disease caused by Bordetella pertussis, is endemic in Brazil, but is underdiagnosed in adults due to atypical symptomatology and limited diagnosis time window. Brazil's Ministry of Health recommends decennial boosters in adults against diphtheria and tetanus, but not pertussis. After the COVID-19 pandemic, infectious diseases surged worldwide due to lack of natural exposure and reduced immunization coverage. Asthma and COPD populations are at increased risk of pertussis infection. This study assessed the cost-utility of decennial pertussis vaccination with Tdap vaccine versus no pertussis vaccination in Brazil's adult asthma and COPD populations in a high-incidence context. Method(s): A static cross-sectional population-based cost-utility model of decennial Tdap boosters in asthma patients >=50 years and COPD patients >=40 years was developed from the payer's perspective. Pertussis incidence from Sao Paulo's state surveillance system in the peak year 2014 was adjusted for underdiagnosis and relative risk of pertussis in asthma and COPD populations. Vaccine efficacy and coverage, and costs and outcomes discounted at 5%, were obtained from the literature and public databases. Deterministic and probabilistic sensitivity analyses, and scenario analyses were run, including alternative annual incidence. Result(s): In the asthma population, Tdap boosters would incur 7,065,788 Brazilian reais (BRL) direct costs and save 32.85 Life Years (LYs) and 262.13 Quality-Adjusted LYs (QALYs). In the COPD population, Tdap boosters would incur 41,102,844 BRL direct costs and save 157.47 LYs and 1,078.26 QALYs. Discounted incremental cost-utility ratios were 26,956 and 38,120 BRL/QALY in asthma and COPD populations, respectively. At a cost-effectiveness threshold of 1 Gross Domestic Product (GDP)/capita, 85.8% and 49.7% of simulations were cost-effective in asthma and COPD populations, respectively, while all simulations were cost-effective at a threshold of 3 GDP/capita. Conclusion(s): Implementing decennial Tdap boosters for adult asthma and COPD patients should be considered, given the favorable cost-utility profile in peak-incidence years.Copyright © 2023
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Objectives: To describe the use of economic evaluation to update the antigens dispensed by the Colombian Expanded Program on Immunization (EPI) from 2000 and 2021. Method(s): a review of economic evaluation of vaccines (EEV) studies conducted by the Expanded Program of Immunization in Colombia between 2000 and 2021. A literature search was carried out in different databases complemented with information obtained from different stakeholders who participated in the updating process. Result(s): In 2000, sponsored by the Pan-American Health Office of the World Health Organization (PAHO/WHO), was conducted the cost-effectiveness analysis of vaccination against Hemophilus influenzae type b was the first economic evaluation of vaccines (EEV) conducted ever in Colombia. Between 2005 and 2007, 4 EEV (Rotavirus, Heptavalent Pneumococcus, Influenza and Hepatitis A) were carried out in order to inform the decision process at local level in Bogota DC, the Colombian capital. Between 2007 and 2010, the Ministry of Health sponsored 8 EEV (Rotavirus, 7- and 10-valent pneumococcus, Influenza, Hepatitis A, chickenpox, tetanus in men, and HPV) which were used to decide about the introduction of new vaccines at national level. Subsequently, with the support of PAHO's PROVAC initiative, Colombia went from having 6 EPI vaccines in the 1990s, to 21 EPI vaccines that currently protect against 29 diseases, not including the vaccines used against COVID-19 which Colombia have been using since March 2021. Conclusion(s): Colombia has been one of the middle-income countries with the highest number of vaccines included in its EPI in the last 20 years and the use of the EEV has been essential for decision-making.Copyright © 2023
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Midwives are the front-line workers providing maternity care for women in many countries. The role of the midwife includes providing information about, and recommendations for, maternal vaccination in pregnancy and for the baby in the postnatal period. Vaccinations recommended in pregnancy include those to prevent influenza, pertussis, tetanus and now COVID-19. Vaccinations for the newborn baby include hepatitis B. Healthcare professionals play an important role in influencing decision-making around vaccination and midwives are key in supporting vaccination uptake. Midwives are strong influencer in women's decisions around vaccination for themselves and their babies. The COVID-19 vaccination programs have shone a light on vaccination in pregnancy especially as SARS-COV-2 infection has significant adverse effects in pregnancy. COVID-19 vaccination has been shown to be safe and effective in pregnancy. Despite this, there is vaccine hesitancy from pregnant women in many countries. Midwives play a unique role in the provision of care to women and families but they need specific support and information regarding vaccination in pregnancy. Targeted education, supportive mentoring and supervision and opportunities to lead innovative ways of ensuring vaccine access is logistically easy and possible are all needed. This Commentary outlines the key vaccinations recommended in pregnancy including COVID-19 vaccination and highlights some strategies to scale-up vaccination programs in pregnancy with a particular focus on the role of midwives.
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Organ transplant recipients are at a high risk of infection with high hospitalization rate, critical rate and fatality, due to low immune function caused by taking immunosuppressants for a period of long time after organ transplantation. Currently, vaccination is recognized as an effective approach to prevent infection. Organ transplant recipients may be vaccinated according to individual conditions. However, the sensitivity to vaccines may decline in organ transplant recipients. The types, methods and timing of vaccination have constantly been the hot spots of clinical trials. In this article, the general principles, specific vaccines and SARS-CoV-2 vaccines of vaccination in organ transplant recipients were briefly reviewed, aiming to provide reference for the vaccination of organ transplant recipients. Moreover, current status of SARS-CoV-2 vaccination for organ transplant recipients was illustrated under the global outbreak of novel coronavirus pneumonia pandemic.Copyright © 2022 Journal of Zhongshan University. All Rights Reserved.
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Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the benefits and adverse effects of vaccines for the prevention of infections in adults with haematological malignancies.Copyright © 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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This article discusses the worldwide routine vaccination coverage in 2021, as part of the Immunisation Agenda 2030, a global immunisation strategy to reduce morbidity and mortality from vaccine-preventable diseases. The report presents global, regional, and national estimates and trends in vaccination coverage through 2021, based on reviews of country-specific data, including administrative and survey-based coverage. Global estimates show that coverage with 3 doses of diphtheria, tetanus and pertussis-containing vaccine (DTPcv3) and the first dose of measles-containing vaccine (MCV1) decreased to their lowest levels since 2008. In 2021, 25.0 million infants were not vaccinated with DTPcv3, 2.1 million more than in 2020, and 5.9 million more than in 2019. The number of zero-dose children was 37% higher than in 2019, with 18.2 million infants not receiving any DTPcv dose by the age of 12 months. The report highlights that the full recovery from disruptions to immunisation programmes due to the COVID-19 pandemic will require context-specific strategies to find missed children, prioritise essential health services, and strengthen immunisation programmes to prevent outbreaks.
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Adult vaccination rates are low in the United States, despite clear benefits for reducing morbidity and mortality. Vaccine science is evolving rapidly, and family physicians must maintain familiarity with the most recent guidelines. The recommended adult immunization schedule is updated annually by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. All eligible patients should receive SARS-CoV-2 vaccines according to the current guidelines. Adults without contraindications should also receive an annual influenza vaccine. Hepatitis A vaccine is recommended for adults with specific risk factors. All pregnant patients, adults younger than 60 years, and those 60 years and older who have risk factors should receive a hepatitis B vaccine. A 15- or 20-valent pneumococcal conjugate vaccine is recommended for all patients who are 65 years and older. Patients who receive 15-valent pneumococcal conjugate vaccine should receive a dose of 23-valent pneumococcal polysaccharide vaccine one year later. Adults 19 to 64 years of age should receive a pneumococcal vaccination if they have medical risk factors. A single dose of measles, mumps, and rubella vaccine is recommended for adults without presumptive immunity, and additional doses are recommended for patients with HIV and postdelivery for pregnant patients who are not immune to rubella. A tetanus and diphtheria toxoids booster is recommended every 10 years. For pregnant patients and those in close contact with young infants, a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine should be administered. The human papillomavirus vaccine is recommended for all people through 26 years of age. Herpes zoster vaccine is indicated for all adults 50 years and older.Copyright © 2022 American Academy of Family Physicians.
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Vaccination is effective in preventing the increase of disease, especially emerging infectious diseases (EIDs), and it is particularly important for people in close contact with infected sources and susceptible populations who are at increased risk of getting infectious diseases due to behavior, occupation or health. Despite targeted vaccination guidelines, inadequate vaccination of the key populations fails to receive widespread attention, resulting in a high-risk transition of disease from key populations to general populations. Strengthening the vaccination of the susceptible groups can effectively block the spread of pathogens to general populations, and reduce the consumption of medical resources in universal vaccination, which has significant economic value. In this review, we describe the prevalence of EIDs, analyze the experience and lessons of infectious disease vaccination in key populations through several cases, and further explore the causes for the decline in vaccination rates of key populations. According to the trends of EIDs, a plan to strengthen the vaccination of key populations is proposed to effectively prevent the transition of EIDs from key populations to general populations.
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In the face of massive numbers of casualties returning to the UK in World War 1, health services were rapidly reorganized under the leadership of Sir Alfred Keogh. Hundreds of military hospitals were set up. Sir Alfred personally asked two women doctors, both militant suffragettes and members of the British Women's Social and Political Union, to set up and run a hospital in London. This remarkable hospital was to pioneer new antiseptic treatments for wounds. Endell Street Military Hospital was set up in 1915 by doctors Flora Murray and Louisa Garrett Anderson. The hospital was staffed and run solely by women, treating 26 000 patients in 520 beds over the course of the war. One of their most heroic contributions was to the care of wounds in injured soldiers returning from France. Throughout the war wound infections led to the deaths of thousands of soldiers and contributed to significant morbidity such as limb loss in countless others. In 1916 James Rutherford Morrison, Professor of Surgery in Durham, invented bismuth iodoform paste (BIPP) for the treatment of wound infections. The paste has significant antimicrobial properties. The Endell Street doctors contacted Morrison in June 1916 and started using his formulation on injured patients. By early 1917 they had treated > 400 patients with gunshot wounds, compound fractures, septic wounds, through-and-through wounds and foreign body wounds with BIPP, reporting their findings in The Lancet (Garrett Anderson L, Chambers H. The treatment of septic wounds with bismuth-iodoform-paraffin paste. Lancet 1917;189: 331-3). They reported no cases of tetanus or gas gangrene and were able to explain side-effects such as iodine and bismuth poisoning, why it occurred and how it could be avoided. BIPP has been in use constantly since 1916, and is still used today in ear, nose and throat departments, especially for packing nasal cavities. By changing from the traditional eusol (sodium hypochlorite solution) to BIPP Drs Murray and Anderson reduced dressing changes from daily to once every 7-14 days, saving staff time, costs and hugely improving outcomes. These women doctors saved hundreds of lives and pioneered wound treatments that are still used today. Both were awarded the CBE for their services, but sadly the hospital staff were sacked at the end of the war, when the hospital closed. This form of pioneering work, conducted under great strain with limited resources is still to be seen today in the COVID-19 pandemic.
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Satisfying the needs of the national immunization program requires maintaining diphtheria-tetanus-pertussis (DTP)-hepatitis B (HB)-Haemophilus influenza B (Hib) production. Therefore, new hepatitis B sources are needed. This study aimed to evaluate the immunogenicity of the DTP-HB-Hib vaccine (Bio Farma) that used a different source of hepatitis B. A prospective randomized, double-blind, bridging study was conducted. Subjects were divided into two groups with different batch numbers. Healthy infants 6-11 weeks of age at enrollment were immunized with three doses of the DTP-HB-Hib vaccine after a birth dose of hepatitis B vaccine. Blood samples were obtained prior to vaccination and 28 days after the third dose. Adverse events were recorded until 28 days after each dose. Of the 220 subjects, 205 (93.2%) completed the study protocol. The proportion of infants with anti-diphtheria and anti-tetanus titers ≥ 0.01 IU/mL was 100%, with anti-HBsAg titers ≥ 10 mIU/mL was 100%, and with Polyribosylribitol Phosphate-Tetanus Conjugate (PRP-TT) titers > 0.15 µg/mL was 96.1%. The pertussis response rate was 84.9%. No serious adverse events related to the study vaccine occurred. The three-dose DTP-HB-Hib vaccine (Bio Farma) is immunogenic, well tolerated, and suitable to replace licensed-equivalent vaccines.
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To assess how the COVID-19 pandemic affected catch-up HPV vaccination among age-eligible adults (ages 18–45). The current study leverages a national, cross-sectional sample of US adults ages 18–45 years to assess the prevalence and determinants of COVID-19 pandemic-related disruptions to catch-up HPV vaccination in 2021. The sample was restricted to adults intending to receive the HPV vaccine. Multinomial logistic regression analysis was conducted to assess the probability of 1) pandemic-related HPV vaccination disruption and 2) uncertainty about pandemic-related HPV vaccination disruption. Report of ‘no pandemic-related HPV vaccination disruption' served as the reference category. Among adults intending to get the HPV vaccine (n = 1,683), 8.6 % reported pandemic-related HPV vaccination disruption, 14.7 % reported uncertainty about vaccination disruption, and 76.7 % reported no disruption. Factors associated with higher odds of pandemic-related vaccination disruption included non-English language preference (OR: 3.20;95 % CI: 1.99–5.13), being a parent/guardian (OR: 1.77;95 % CI: 1.18–2.66), having at least one healthcare visit in the past year (OR: 1.97;95 % CI: 1.10–3.53), being up-to-date on the tetanus vaccine (OR: 1.81;95 % CI: 1.19–2.75), and being a cancer survivor (OR: 2.57;95 % CI: 1.52–4.34). Catch-up HPV vaccination for age-eligible adults is a critical public health strategy for reducing HPV-related cancers. While a small percentage of adults reported pandemic-related disruptions to HPV vaccination, certain adults (e.g., individuals with a non-English language preference and cancer survivors) were more likely to report a disruption. Interventions may be needed that increase accessibility of catch-up HPV vaccination among populations with reduced healthcare access during the pandemic. © 2022 The Authors
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Peptide vaccine is not effective due to its low immunogenicity. To improve the efficacy of peptide vaccine against COVID-19, a novel method was developed by mixing a COVID-19 peptide vaccine with a tetanus vaccine. In this study, intramuscular injection of a mixture of COVID-19 peptide vaccine and tetanus vaccine twice, i.e., first dose on day 0 and second dose on day 21, induced neutralizing antibodies against authentic virus of SARS-CoV-2 Delta variant in a horse. Horse serum of day 35, i.e., two weeks after the second dose, neutralized authentic virus of SARS-CoV-2 Delta variant, equal to half effectiveness of human serum from vaccinees of Moderna COVID-19 vaccine. However, neither horse serum nor human serum neutralized Omicron variant authentic virus. No side effects were observed after each dose. This study indicates intramuscular injection of a mixture of COVID-19 peptide vaccine and tetanus vaccine may work in humans to improve peptide vaccine efficacy against SARS-CoV-2.
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Introduction: Data on vaccination against preventable vaccine diseases are among the basic epidemiological indicators necessary to evaluate the success of vaccination campaigns and the effectiveness of the vaccination schedule in the prevention of infectious diseases. Without the existence of a national vaccination registry, this requirement cannot be successfully met. At present, we can monitor vaccination coverage in adults only in the national register of paid health services, based on reports from health insurance companies about vaccinations paid for by health insurance, which is still the minimum for adults. From 2022 onwards, we can expect vaccination data against tick-borne encephalitis in people over 50 and against the flu in healthcare professionals. Another way of determining adult vaccination coverage is based on vaccine sales, i.e. data from vaccine manufacturers that are inaccurate. The last option is to determine the vaccination coverage of adults on the basis of questionnaire surveys. But we still lack accurate robust data. At the same time, the World Health Organization has recommended to set up registers of vaccinated people long ago. Adult vaccination coverage: Insufficient interest in some vaccines, and consequently small volume of influenza vaccine imports, makes it impossible to increase vaccination coverage in the 2021/2022 season beyond vaccine imports. Given the planned import of 1,080,000 doses of influenza vaccine in 2021 for 10.7 million people, we can reach a maximum of 10.1% vaccination coverage this season. In 2020, there was a decrease in the vaccination coverage of people aged 65+ against pneumococcal diseases. The cause may be remote health care for the elderly, limited preventive care and fear of doctor visits during the COVID-19 pandemic. In 2020, 24.8% influenza vaccination coverage was achieved in institutionalized persons (persons in homes for the elderly, in long-term care facilities, in homes for the disabled, in homes with a special regime);24.5% influenza vaccination coverage in people aged 65 and over. Low influenza vaccination coverage was also achieved in 2020 in chronically ill patients (23.8% in patients with chronic obstructive pulmonary disease, 23% with kidney disease, 20.8% with diabetes mellitus, 17.0% with cardiovascular disease and 11.2% with bronchial asthma). Compared to the data for the period 2010–2020, there was a decrease in vaccination coverage of institutionalized persons (a decrease of 8 percentage points). A lower number of vaccine doses compared to the previous year was also administered against tetanus in 2020 (a decrease of 21%). On the contrary, in 2020 there was a slight increase in vaccination against tick-borne encephalitis, from 29 to 33%. Unfortunately, almost half of those vaccinated did not complete the basic vaccination schedule. Conclusion: Despite significant improvements, we still do not have sufficient data on adult vaccination coverage. The creation of a national register of vaccinees and an electronic vaccination card is a necessity. COVID-19 has contributed to the decline in vaccination coverage of seniors and institutionalized individuals. Unlike children, we achieve significantly lower adult vaccinations in comparasion with international recommendations and with developed countries. © 2021, EEZY Publishing, s.r.o.. All rights reserved.
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Objective: To identify and map strategies to increase vaccine uptake in pregnant and breastfeeding populations with the aim of informing practice and strategies to increase vaccination uptake in this group. Study Design: We conducted a scoping review of the literature wherein we used a comprehensive search algorithm to identify relevant publications indexed in six electronic databases. We included studies that reported on pregnant and breastfeeding individuals, examined an intervention to improve vaccine uptake, and reported outcomes related to change in vaccine attitude, perspective, intention, behaviour, or uptake. Interventions were mapped using a five-level social ecological framework (intrapersonal, interpersonal, institutional, community, and policy level) or as bundled interventions, when strategies targeted multiple levels. Result(s): The search yielded 5458 publications after deduplication, of which 63 were included in the final review. Included studies reported mostly on the uptake of influenza, pertussis, tetanus toxoid and COVID-19 vaccines in 17 high- and middle-income countries. Studies varied in terms of design, sample size, scope and study output (Table 1) and described interventions corresponding to all levels of the social ecological framework (Figure 1). Most studies (33.3%) described using bundled interventions, although intrapersonal (31.7%) and institutional (15.9%) strategies were also widely employed. While the reported uptake (5% to 93%) varied based on comparator group, vaccine type, country and intervention(s), most strategies were deemed effective when implemented in the context of experimental and observational studies. Conclusion(s): The published literature points to several successful strategies for increasing vaccine uptake among pregnant and breastfeeding individuals. Incorporating these strategies into guidelines and protocols could increase the uptake of routinely recommended and new (COVID-19) vaccines in this population. [Formula presented] [Formula presented] Copyright © 2022
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OBJECTIVE: To assess provider attitudes and practices regarding vaccination in pregnancy to discern strategies to increase vaccination rates in pregnancy, given that in the USA, various healthcare organizations recommend that pregnant individuals be vaccinated against influenza, pertussis, and SARS-CoV-2, but vaccination rates among gravidas remain suboptimal across these vaccines. METHODS: An Institutional Review Board-approved survey was disseminated to obstetric healthcare providers by email from June through October 2021. Questions assessed provider demographics, attitudes, and practices surrounding vaccination in pregnancy. A total of 192 providers consented, 179 initiated the survey, and 153 completed it entirely. Statistical software (SAS) was used to perform descriptive statistics. RESULTS: All providers strongly agreed/agreed that all pregnant individuals should receive vaccines in pregnancy. Following patient vaccination consent, 13% reported needing to refer patients to alternative sites for vaccine administration. Following patient vaccination decline, 13% did not determine reasons for refusal, 30% did not re-counsel at subsequent visits, and 92% did not ask another staff member to counsel the patient. CONCLUSION: Despite provider support for maternal immunization, uptake of vaccines in gravidas remains suboptimal, demonstrating a gap between provider recommendations and patient uptake. These data highlight opportunities for intervention regarding counseling and vaccine availability to increase vaccine uptake in pregnancy.
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Introduction: Vaccination control is performed by all European Union countries, but uniform standards for the collection of valid data are still lacking. The analysis of vaccination data is used to evaluate vaccination programs and their effectiveness in preventing the occurrence of infectious diseases at the national level. Vaccination information also helps to plan the required amount of vaccines in advance so that outages do not occur and deliveries are smooth. Various methods are used for the purpose of determining vaccination coverage, namely administrative methods, surveys, including seroprevalence or direct use of data from immunization programs. Methods based on the use of data from vaccination registers are another way of obtaining information about vaccinations. Thanks to the change in the payment of compulsory vaccination and the introduction of paid vaccination from health insurance, we have now had the opportunity in the Czech Republic to monitor and analyze data from health insurance companies on the vaccination of the population in selected preventable diseases. The data are managed by the Institute of Health Information and Statistics of the Czech Republic within the National Health Information System and national health registers. Data from health insurance companies on the number of reported vaccination doses, including used vaccines, are available in the National Register of Paid Health Services. The register contains data from health insurance companies in the inpatient and outpatient areas, including complete data on reported diagnoses, procedures and treatment. The national information system of the public administration enables the determination of the number of administered doses of the vaccine on the basis of the used registers, also in relation to the number of inhabitants of the given year of birth and their permanent residence. Vaccination in children: Full-term infants born from 1 January 2018 are vaccinated with a combined vaccine against diphtheria, tetanus, pertussis, viral hepatitis B, poliomyelitis and invasive infections caused by Haemophilus influenzae type b (hexavaccine) in scheme 2 + 1, unlike the original 3 + 1 dose, which remains valid for premature babies born before the 37th gestational week of pregnancy. The National Register of Paid Health Services data were used to monitor vaccination coverage. Vaccination in the case of hexavaccine in infants born in 2018 reached 94.8%, in children born in 2019 then 95.2% with the monitored parameter of administration of at least one dose of vaccine up to one year of age. A similar change of the scheme to 2 + 1 occurred in the case of optional vaccination against pneumococcal infections in infants, where we observe an increase in vaccination coverage from 66.9% in chlidren born in 2017 to 73% in children born in 2019 when monitoring the administration of at least one dose up to one year of age. In the case of the combined measles, mumps and rubella (MMR) vaccine, above 90% (90.3%) of two-year-olds born in 2018 receive a first dose vaccination. The revaccination against tetanus, diphtheria and pertussis (Tdap) in five-year-olds in 2019 reached 90%, in the previous year 2018 it was 91.2%. In the case of revaccination of children aged 10-11 years with the combined vaccine together with revaccination against poliomyelitis (Tdap-IPV), based on the data for 2020, the vaccination coverage reached 91.7%, while in the previous year of children it was 94.5%. In the case of vaccination against human papillomavirus (HPV) diseases, there is a slight increase in the number of vaccinated girls and boys, with a current vaccination prediction of 63.6% for girls in 2020 and 42.6% for boys. In addition, in 2020, thanks to the amendment to Act No. 48/1997 Coll. on public health insurance, we managed to launch optional paid vaccinations for infants and toddlers against meningococcal infections and thus extend the national immunization program to include additional vaccinations. Despite this spread, there has been no decrease in vaccination coverage in infa ts and toddlers with other vaccines. Conclusion(s): Despite the ongoing epidemic of covid-19, preventive child care was maintained in the Czech Republic in 2020 and there was no decrease in vaccination coverage for compulsory and optional (paid) vaccinations for infants and toddlers. On the contrary, we managed to implement additional optional vaccinations paid for from public health insurance funds, also thanks to the acceleration of the legislative process within the declared state of emergency. The epidemic shows the importance of adherence to preventive measures and the need for early prevention of the disease using vaccination programs. Unfortunately, the burden of the epidemics has been delayed by the possibility of repeated publication of updated data on vaccination coverage of children from the national registers of paid health care and are thus published at a delay. The lack of data obtained in this way still remains, the method is limited only for paid vaccinations from public health insurance funds, ie without records of vaccinations paid for by the parents of children. In the future, we will not do without registers of vaccinations based on information obtained from medical records of vaccinated individuals in the form of electronic vaccination records. Copyright © 2021, EEZY Publishing, s.r.o.. All rights reserved.