OBJECTIVE

Given that rabies remains endemic in the Philippines despite government interventions and the pandemicrelated restrictions have hampered its surveillance, this study aimed to estimate the effect of human population, anti-rabies vaccination efforts, and COVID-19 situation on the spread of rabies cases in the districts of Davao City, Philippines.

A retrospective study of the canine records at Davao City Veterinarians’ Office was done from January 2018 to June 2021. Monthly rabies cases were ascertained, and the effect of the human population, COVID-19 season, and vaccination ratio on rabies cases was estimated using panel regression models adjusting for confounding factors.

The reporting of rabies cases was lower during COVID-19 than during the non-COVID-19 season, with an IRR of 0.52 [95% confidence interval (CI): 0.33–0.82]. Furthermore, rabies cases increased by 2.23% (95% CI: 0.60–3.89) per 1% increase in vaccination ratio. Additionally, high-population districts recorded more rabies cases than low-population districts.

Consistency in monitoring rabies cases during the pandemic is suggested as a roadmap for future program initiatives. Vaccination efforts should be reinforced to increase rabies awareness and ensure early response to emerging diseases. Moreover, highpopulated districts should be prioritized in implementing rabies control interventions to gain optimal development.

BACKGROUND

Cervical cancer remains to be the second leading cancer and cause of cancer-related deaths among Filipino women despite the use of the Papanicolaou screening. Latest research has shown that the human papillomavirus (HPV) is a necessary cause of cervical cancer. With major morbidity and high mortality rates associated with HPV infection and cervical cancer, several modes of primary and secondary forms of prevention have to be implemented. Among the primary modes of prevention is the administration of the preventive vaccine, which has consistently shown to decrease substantially HPV disease and cervical cancer rates in developed countries. In our country, before a successful vaccination, program is implemented, several sociocultural issues have to be addressed. Knowledge, attitude, and motivational factors are vital in determining acceptance of the vaccine. One relevant setting is exploring the willingness of mothers to get their female children vaccinated even before they become sexually active.

The aim of the study was to determine the association of the knowledge, attitude, and motivational factors of mothers on their willingness for their female children aged 9–13 years to undergo HPV vaccination at a tertiary government hospital.

This was a cross-sectional study that was carried out at a government institution.

The population consisted of 352 mothers with female children aged 9–13 years consulting the outpatient clinics at the department of obstetrics and gynecology at a tertiary government hospital.

A pretested and validated survey was given to 352 respondents. They were asked to answer a self-administered questionnaire that included sociodemographic, reproductive, sexual history variables, knowledge, and attitude, and motivational factors toward the disease and the associated vaccine.

Using the survey proportion estimation methods, the prevalence of women who were willing to enroll their daughters for HPV vaccination was 97.18% (n = 42, 95% confidence interval [CI]: 94.91 to 98.46%). It can be noted that only a third of the sample had high knowledge on the vaccine and its use 34.93% (n = 124, 95% CI: 30.25 to 39.92%). More women who reached college level (χ2: 5.67) and also those whose youngest child was between 11 and 13 years old (χ2: 8.82)-had higher knowledge scores than otherwise. Those who have an annual income of greater than or equal to P 60,000 (χ2: 16.55) and are non-Catholic (χ2: 18.77) – also appeared to have higher knowledge ratings on the questionnaire. Women who never to a few times a year attend church-related activities had higher knowledge scores compared to women who were more frequent goers (χ2: 16.33). For the attitude toward the vaccine, more mothers believed that getting the vaccine would not have an effect on a girl’s sexual activity and most agreed that they would not be viewed as bad parents. Most women also did not believe that religion would affect their willingness to vaccinate their children. There was an association in the degree of agreement between negative and positive attitudes from the Chi-square test performed (χ2: 7.44, P: 0.01). There were more agreeing responses from factors determining positive attitude and more disagreeing responses in the factors determining negative attitude. With regard to motivational factors, more women agreed that the cost was prohibitive and that they were more willing if only two doses would be required for their daughters. They were also not concerned about what other parents may think about getting the vaccine. Most answered that they were willing to follow their doctors’ recommendations and they have trust in vaccine manufacturers. Most women were also concerned that their daughters may get cervical cancer in the future. There was no difference in the proportion of agreeing responses between positive and negative motivating factors among the study participants (Z: 0.30, P: 0.79). This suggested that these factors could be important predictors of willingness to use vaccination on their children. Based on the crude odds ratios from the logistic regression, the likelihood of being willing to administer HPV vaccine to their children was almost twice as the knowledge score and scores on the positive attitude items increased, and was found to be statistically significant. At the same time, the odds of willingness increased by more than twice as the score on the negative attitude items decreased, and was also significant. There was no noted association for the other predictors of the association.

The role of knowledge and attitudes on the negative perceptions on the vaccine were important predictors of the willingness of mothers to have their female children vaccinated against HPV infection.

BACKGROUND

Vaccine hesitancy among senior citizens remains common in many countries. This was significantly observed during the COVID-19 pandemic in Dauis, Bohol, Philippines. However, there is limited research on the factors influencing this hesitancy.

This study aimed to identify the determinants associated with COVID-19 vaccine hesitancy among senior citizens in the municipality of Dauis, Bohol.

This case-control study employed a modified survey questionnaire adapted from relevant literatures. A total of 497 registered senior citizens participated, of whom 331 were vaccinated against COVID-19 and 166 were unvaccinated. The study determined the socio-demographic factors, health status, and perceptions of COVID-19 vaccine safety. Bivariate and multivariable logistic regression analyses were used to identify factors associated with vaccine hesitancy.

The study found that respondents aged 84 and older were significantly more likely to exhibit vaccine hesitancy (p = 0.018, OR = 7.817). In contrast, factors associated with a reduced likelihood of hesitancy included having tertiary education (p = 0.012, OR = 0.239), a low income (p = 0.042, OR = 0.138), receiving an annual flu vaccine (p = 0.020, OR = 0.328), and perceiving the COVID-19 vaccine as safe (p = 0.000, OR = 0.032).

Age is a significant determinant of COVID-19 vaccine hesitancy. Educational attainment, monthly income, receipt of annual influenza vaccine and perception on vaccine safety were found to be influential determinants. These findings offer valuable insights for evidence-based interventions to enhance vaccine acceptance to this vulnerable population.

BACKGROUND

The COVID-19 pandemic significantly impacted global health, especially among older adults at higher risk for severe illness. Despite the benefits of vaccination, booster vaccine hesitancy posed a barrier to optimal protection in the elderly population.

This study aimed to identify factors associated with COVID-19 booster vaccine hesitancy among geriatric patients at the Family Medicine Outpatient Clinic of Region 1 Medical Center.

An analytic, cross-sectional study was conducted with 183 geriatric patients aged 60 and above who had received the primary COVID-19 vaccine series. Data were collected using a 25-item questionnaire addressing sociodemographic information, medical history, COVID-19 knowledge, and vaccine attitudes. Statistical analyses, including chi-square tests and logistic regression, identified factors influencing booster vaccine hesitancy.

The majority of participants were between the ages of 60-69 (66.7%, n=122) and predominantly female (69.4%, n=127). High hesitancy rates were notably observed among elderly females (75.6%), individuals with lower educational attainment (79.7%), and single individuals (93.3%). Other significant factors included hypertension (76.5%) and the absence of prior influenza (81.5%) or pneumococcal (75.9%) vaccinations.

These findings highlight the critical need for targeted educational efforts to mitigate COVID-19 vaccine hesitancy within specific subgroups, particularly elderly females, those with lower education levels, and individuals with certain health conditions. By implementing personalized outreach and emphasizing the advantages of vaccination, stakeholders can enhance vaccine uptake and improve health outcomes for this vulnerable segment of the population.

Objective: This study aims to report the incidence and characteristics of breakthrough infections among medical students in the first Philippine private medical school that resumed limited face-to-face classes and clinical rotations from July to December 2021. Methods: This is a descriptive study using secondary worksheet from multiple-source records review of breakthrough infections among medical students from July to December 2021. Results: Among the 837 vaccinated medical students, 23 (2.7%) experienced COVID-19 breakthrough infections. Of these, 9 were male and 14 were female. Four were asymptomatic and 19 were symptomatic. Of the 19 symptomatic, 18 had mild and 1 had severe disease. Mild infections presented with upper respiratory tract symptoms. Duration of symptoms ranged from 4 to 27 days with an average of 10 days. Timing of breakthrough infections ranged from 35 to 212 days after the second dose of COVID-19 vaccine with a mean of 86 days. Contact with confirmed cases was reported in 14 of 23 cases, 13 were from household members and none within the SLICE and CLARO programs. Conclusion Our study showed that even in the midst of the Delta surge, low breakthrough infection rate with mostly mildly symptomatic cases and no case transmissions within the SLICE and CLARO programs are possible with vaccination, regular health surveillance, and strict adherence to minimum health protocols.
Breakthrough Infections ; COVID-19 ; Philippines ; Students, Medical ; Vaccination

Humans ; Aluminum/adverse effects* ; Pruritus/etiology* ; Skin Neoplasms ; Vaccination ; Hypersensitivity

BACKGROUND

The study will help give a more objective look at the effects of vaccines versus COVID-19 by comparing imaging findings of unvaccinated versus vaccinated patients. It may demonstrate the use of CT imaging in the screening for COVID-19 pneumonia in the different sub-groups of patients, as well as to help determine severity patterns of pneumonia in vaccinated and unvaccinated patients which may guide future assessment of the disease.

A retrospective study on COVID-19 positive adult in patients from a tertiary hospital who underwent chest CT from 2020 to 2021 was conducted. Multiple variables were collected (demographics, vaccination status, etc). Continuous data was presented using means and standard deviations, while categorical variables were presented using frequencies and percentages. For categorical variables, statistical differences between groups were determined using Pearson's chi-square test or Fisher's exact test; and for continuous variables, student's t test and analysis of variance.

All 174 subjects were included in this study (68 females and 106 males) have pneumonia (77 mild, 75 moderate, and 22 severe). 113 were fully vaccinated, 4 were partially vaccinated, and 57 were unvaccinated. Based on the study, vaccinated group had mean scores of 8.637, while the other group had a mean score of 11.934. The difference was statistically significant, which implies that the vaccinated group had lower pneumonia severity scores.

100% of the patients reviewed had pneumonia and patients with complete vaccination status had less severe cases of pneumonia on Chest CT.

OBJECTIVE: Vaccine hesitancy has been a public health issue for some time now, but gained more attention during COVID-19 pandemic. This systematic review aimed to estimate the prevalence of COVID-19 vaccination hesitancy and identify factors affecting it among adolescents. MATERIALS AND METHODS: The preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P 2020) was used. A search was performed in PubMed/ MEDLINE, EMBASE, Google Scholar, Herdin, and Cochrane databases on September 2023 using the key words: (COVID-19 OR SARS-COV OR corona virus) AND (Vaccination OR immunization) AND (adolescence OR teenagers OR youth) AND (hesitancy OR acceptance). Observational studies which determined the prevalence or risk factors for COVID-19 vaccine hesitancy among adolescents aged 10-19 years old were included. RESULTS: There were 5 good quality cross-sectional studies included. The prevalence of adolescents who did not want to be vaccinated ranged between 8.4% and 61.0%; while the prevalence of being unsure if they want to be vaccinated was between 31.6% and 88.0%. Factors associated with vaccine hesitancy included being economically disadvantaged, not having influenza vaccination, worrying about its effectiveness and safety, and low perceived necessity. CONCLUSION There is good quality evidence that COVID-19 vaccine hesitancy exists among adolescents. It is recommended that health workers should conduct information and education campaigns to iterate the effectiveness, safety, and misconceptions about of COVID-19 vaccination. Vaccination programs should also reach out to economically disadvantaged adolescents, and tapping parents and social media may be an effective strategy to improve vaccination acceptance among adolescents.
COVID-19 ; SARS-COV ; Severe acute respiratory syndrome-related coronavirus ; Vaccination ; Immunization ; Adolescent ; Adolescence ; Teenagers ; Youth

BACKGROUND

A community survey on the immunization status of residents in Barangay Pinag-Isang Palad, Old Balara, Quezon City, reflected a low immunization rate of 8% for influenza and 6% for pneumococcal vaccines. Exploring ways to increase awareness on vaccination is important to improve the delivery of primary prevention.

This study aimed to compare the effectiveness of infomercials versus infographics in promoting influenza and pneumococcal vaccination among residents of Barangay Pinag-Isang Palad.

A quasi-experimental study design using systematic sampling where one group of respondents was assigned to the infomercial intervention, and the other group to the infographics intervention. Each participant completed a self-administered 25-item questionnaire assessing perceived barriers to influenza and pneumococcal vaccination. Wilcoxon signed rank test was used to compare within group changes in scores pre- and post-intervention. Mann-Whitney test was used to determine between group differences in post-intervention scores.

A total of 70 respondents representing 70 households in the barangay participated in the study. Respondents were mostly from the 26-35 age group, females with high school education in the service industry, with < P23,381 average monthly income, and good self-reported health status. Comparison of the pre- and post-intervention mean scores of both groups (infomercial and infographics), showed statistically significant change in post-intervention mean scores from baseline. However, comparison of the post-intervention mean scores between groups was not statistically significant. Identified barriers in both groups were challenges in affordability and accessibility of influenza and pneumococcal vaccines.

This study showed that the InfoVax Strategy, using infomercials and infographics, can be effective tools in improving perceptions on influenza and pneumococcal vaccination among residents of Barangay Pinag-Isang Palad. The findings of this study can be applied to communities having similar characteristics. Healthcare providers may improve perceptions on vaccination and subsequent uptake by distributing infographics or playing infomercials aside from public health lectures. Vaccination will help prevent loss of earnings and incrased medication consumption. The local health unit needs to evaluate and address the identified barriers of affordability and accessibility.

Introduction: Coronavirus disease 2019 (COVID-19) has severely influenced all aspects of life since its emergence and one of the strategies to end this pandemic rests on the vaccination to achieve herd immunity. While vaccinations are usually a safe and effective tool, the abbreviated development process of the available COVID-19 vaccines has increased uncertainties about the safety among the general population especially among patients with rheumatic and musculoskeletal diseases (RMD). Methods: A cross-sectional analysis was performed on rheumatic disease (RMD) patients from the rheumatology clinic at Hospital Tuanku Ja’afar Seremban (HTJS), investigating adverse events occurring within one month of receiving COVID-19 vaccines administered from 1st May 2021 to 30th September 2021. Results: 549 RMD patients were recruited in this study. Pfizer/BioNTech was the predominant vaccine (n = 257, 64.3%), followed by Sinovac (n = 60, 47.2%), Oxford/AstraZeneca (n = 7, 1.3%) and Moderna (n = 1, 0.2%). 330 (60.1%) patients experienced at least one adverse event, none of which required hospitalisation. Common side effects included pain at the site of injection (n = 169, 30.8%), generalised muscle pain (n = 91, 16.4%), fever (n = 90, 16.4%), arthralgia (n = 55, 10.0%), and lethargy (n = 43, 7.7%). Female patients (OR = 0.88, CI 0.79-0.97, p = 0.012), Sinovac recipients (OR = 0.51, CI 0.34-0.76, p = 0.001) and age >50 years (OR = 0.62, CI 0.44-0.89, p = 0.009) had significantly lower risks of experiencing adverse events. Among patients with autoimmune rheumatic disease (AIRD), 28 (6.4%) experienced disease flare. Patients with spondyloarthropathy (SpA) and overlap syndrome were more likely to experience disease flare following COVID-19 vaccination compared to rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (OR = 2.87, CI 1.23 – 6.69, p = 0.014). The use of combination conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was associated with a tendency toward increased risk of disease flare (OR = 2.34, CI: 0.97–5.64, p = 0.056). However, the use of glucocorticoids (OR = 2.02, CI 0.72–5.61, p = 0.17) and an active disease state (OR = 1.94, CI 0.75–5.02, p = 0.171) did not show a statistically significant impact on the frequency of disease flares. Conclusions The study affirms the overall safety of COVID-19 vaccines in rheumatic musculoskeletal disease patients, supporting efforts to address vaccine hesitancy in this population.
COVID-19 ; SARS-CoV-2 ; Vaccination