Background
Despite recommendation by the World Health Organization (WHO), influenza vaccination coverage among high‐risk groups remains suboptimal in Afghanistan. This study aims to document the knowledge, attitudes, and practices of seasonal influenza vaccine uptake among two priority groups, pregnant women (PWs) and healthcare workers (HCWs).
Methods
This cross‐sectional study enrolled PWs and HCWs in Kabul, Afghanistan, from September to December 2021. Data on vaccine intention and uptake, knowledge, and attitudes towards vaccination were collected. Simple linear regression was used to predict the impact of sociodemographic characteristics on the KAP score.
Results
A total of 420 PWs were enrolled in Afghanistan. The majority (89%) of these women had never heard of the influenza vaccine but 76% intended to receive the vaccine. Of the 220 HCWs enrolled, 88% were unvaccinated. Accessibility and cost were factors which encouraged vaccination among HCWs. Fear of side effects and affordability were identified as key barriers. HCWs reported high level of vaccine intention (93%). PWs aged under 18 years (β: 6.5, P = 0.004), between 18 and 24 years (β: 2.9, P = 0.014), currently employed (β: 5.8, P = 0.004), and vaccinated against COVID‐19 (β: 2.8, P = 0.01) were likely to have a higher attitude score. Among HCWs, being female was a predictor for poor vaccination practice (β: −1.33, P < 0.001) whereas being vaccinated against COVID‐19 was a predictor for higher practice score (β: 2.4, P < 0.001).
Conclusion
To increase influenza vaccination coverage among priority groups, efforts should be made to address issues such as lack of knowledge, limited availability, and cost barriers.
Introduction
Sinopharm (BBIBP-CorV) inactivated virus vaccination for COVID-19 has been administered widely in Pakistan. We investigated the dynamics of BBIBP-CorV -induced antibody responses over a 24 week period in a region with a high seroprevalence.
Methods
Study subjects (n = 312) were followed up over a 24-week period between May and August 2021. Sera were tested for IgG antibodies to spike and the receptor binding domain (RBD).
Results
Study subjects were 62% female. Twenty-two percent had a prior history of COVID-19. At 4-, 8- 16- and 24-weeks post-vaccination, the rate of IgG antibodies positive to spike was 57%, 87%, 66% and 90% of individuals, compared with to RBD which was 48%, 62%, 68% and 85% of subjects, respectively,. IgG to spike and RBD showed a positive correlation at each interval (rho > 0.6, p < 0.0001). Seropositivity to both spike and RBD was reduced in those aged 50 years and over for up until 16 weeks post-vaccination (p < 0.05). Individuals with prior COVID-19 infection showed greater antibody responses for up to 16 weeks post-vaccination (p < 0.05). SARS-CoV-2 infections were observed with a mean interval of 16 weeks post-vaccination. Antibody responses did not wane for up to 6 months post-vaccination.
Conclusions
Sinopharm vaccination-induced antibody responses were negatively impacted by age and positively impacted by prior COVID-19 for 16 weeks after vaccination. Importantly, we did not find waning of IgG antibodies to RBD over the study period. Maintenance of antibodies may be the result of continued community exposure and boosting with COVID-19 vaccination.
The 10-valent pneumococcal vaccine was introduced in Pakistan’s Expanded Program on Immunization (EPI) in 2013 as a 3 + 0 schedule without catchup. We conducted three annual cross-sectional surveys from 2014–2016 to measure vaccine-type (VT) carriage in infants from a rural part of Pakistan. Nasopharyngeal specimens were collected by random sampling of infants from two union councils of Matiari. Samples were then transported to the Infectious Disease Research Laboratory (IDRL) at the Aga Khan University within 6–8 h of collection. Serotypes were established using sequential multiplex PCR. Of the 665 children enrolled across three surveys, 547 were culture-positive for pneumococcus. VT carriage decreased from 21.8% in 2014 to 12.7% in 2016 (p-value for trend <0.001). Those who were not vaccinated or partially vaccinated were found to be at higher risk of carrying a VT serotype ((aOR 2.53, 95% CI 1.39, 4.63 for non-vaccinated) and (aOR 3.35, 95% CI 1.82, 6.16 for partially vaccinated)). On the other hand, being enrolled in the most recent survey was negatively associated with VT carriage (aOR 0.51, 95% CI 0.28, 0.93). We found that PCV10 was effective in decreasing the carriage of vaccine-type serotypes in Pakistani infants.
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