Vaccination is the most effective way to prevent influenza infection and adverse outcomes; despite global recommendations to vaccinate pregnant persons, access to influenza vaccines remains low. We explored knowledge, attitudes, and practices of pregnant persons to inform actions to improve vaccine uptake. We pooled data from cross-sectional surveys assessing pregnant persons’ attitudes toward influenza vaccines in 8 low- and middle-income countries. Countries used standard methods to measure attitudes and intents toward influenza vaccination. We stratified by presence/absence of a national influenza vaccination program, income group, geographic region, and individual-level factors. Our analysis included 8556 pregnant persons from 8 countries. Most pregnant persons (6323, 74%) were willing to receive influenza vaccine if it was offered for free. Willingness differed by presence of an existing influenza vaccination program; acceptance was higher in countries without programs (2383, 89%) than in those with programs (3940, 67%, P < .001). Most pregnant persons in middle-income countries, regardless of influenza vaccination program status, were willing to be vaccinated against influenza if the vaccine was provided free of charge. National investments in influenza vaccination programs present an opportunity to avert illness both in pregnant persons themselves and in their newborn babies.

The Global Typhoid Genomics Consortium was established to bring together the typhoid research community to aggregate and analyse Salmonella enterica serovar Typhi (Typhi) genomic data to inform public health action. This analysis, which marks twenty-one years since the publication of the first Typhi genome, represents the largest Typhi genome sequence collection to date (n=13,000), and provides a detailed overview of global genotype and antimicrobial resistance (AMR) distribution and temporal trends, generated using open analysis platforms (GenoTyphi and Pathogenwatch). Compared with previous global snapshots, the data highlight that genotype 4.3.1 (H58) has not spread beyond Asia and Eastern/Southern Africa; in other regions, distinct genotypes dominate and have independently evolved AMR. Data gaps remain in many parts of the world, and we show potential of travel-associated data to provide informal “sentinel” surveillance for such locations. The data indicate ciprofloxacin non-susceptibility (>1 resistance determinant) is widespread across geographies and genotypes, with high-level resistance (≥3 determinants) reaching 20% prevalence in South Asia. Extensively drug-resistant (XDR) typhoid has become dominant in Pakistan (70% in 2020), but has not yet become established elsewhere. Ceftriaxone resistance has emerged in eight non-XDR genotypes, including a ciprofloxacin-resistant lineage (4.3.1.2.1) in India. Azithromycin resistance mutations were detected at low prevalence in South Asia, including in two common ciprofloxacin-resistant genotypes. The Consortium’s aim is to encourage continued data sharing and collaboration to monitor the emergence and global spread of AMR Typhi, and to inform decision-making around the introduction of typhoid conjugate vaccines (TCVs) and other prevention and control strategies.

Background/Objectives: The COVID-19 pandemic presented an urgent global need to quickly vaccinate health workers (HWs). We used this unique circumstance to assess whether mature influenza vaccination programs for HWs facilitated rapid deployment of COVID-19 vaccines in low- and middle-income countries (LMICs). Methods: We used publicly available population-level COVID-19 vaccination coverage data from the World Health Organization (WHO) COVID-19 PowerBI Dashboard for 60 LMICs to investigate general population coverage with the COVID-19 vaccine over the first year of vaccine rollout. We also evaluated country-level policy and program data reported to the WHO–United Nations Children’s Fund (UNICEF) electronic Joint Reporting Form (eJRF) in 2022 or earlier to determine if the presence of a mature (≥2 years of influenza vaccine introduction in HWs prior to 2019) HW influenza vaccination program was associated with more rapid COVID-19 vaccine deployment and/or pandemic preparedness. We used a mixed-effects beta regression model to investigate whether having a mature HW influenza vaccination program was associated with COVID-19 vaccination coverage levels and/or deployment timeliness. Finally, to provide a better understanding of the possible relationship between the presence of a mature HW influenza vaccination program and the COVID-19 vaccine rollout, we analyzed interview data collected during COVID-19 vaccine post-introduction evaluations (cPIEs). Results: Twenty-four of our study countries (40%) had mature HW influenza vaccination programs prior to the COVID-19 pandemic, and 16 (27%) participated in cPIEs. The overall adjusted mean general-population COVID-19 vaccination coverage at 12 months post-deployment in countries with mature HW influenza vaccination programs was 46% (95% CI: (35%, 56%)), compared with 25% (95% CI: (19%, 32%)) in countries without such programs. Vaccination coverage was 2.5 times higher in countries with mature programs (adjusted odds ratio 2.5, 95% CI: (1.5, 4.5); p = 0.001). Conclusions: Our analysis suggests that mature influenza vaccination programs for HWs were associated with timelier and more complete COVID-19 vaccination rollout.

Background/Objectives: Healthcare workers (HCW) in primary care settings play a significant role in recommending vaccines to patients. We aimed to describe COVID-19 vaccination knowledge, attitudes, perception, and practices (KAPP) of HCWs in Tunisia and identify associated factors. Methods: We conducted a national cross-sectional survey (29 January to 3 February 2024) among HCWs in primary public healthcare centers using purposive sampling. Factors associated with good knowledge, positive attitude, and good practice, measured through Likert scales using face-to-face questionnaires, were identified using binary logistic regression. Results: We included 906 HCWs (mean age = 41.87 ± 8.89 years). In total, 37.75% (342/906) of HCWs had good knowledge and perception, 4.30% (39/906) had a positive attitude, and 24.9% (226/906) had good practices related to COVID-19 vaccination. Working in urban compared to rural areas was associated with good knowledge (aOR = 1.57, 95%CI = 1.12–2.21) and positive attitude (aOR = 4.94, 95%CI = 1.19–20.44) to COVID-19 vaccination. Physicians had better KAPP scores than other medical professionals. HCWs working in departments with high-risk patients were more likely to have good knowledge (aOR = 1.28, 95%CI = 1.00–1.72). Positive attitude was also associated with being male (aOR = 2.97, 95%CI = 1.75–5.07) and having at least one non-communicable disease (aOR = 1.92, 95%CI = 1.14–3.23). Being male (aOR = 1.97, 95%CI = 1.35–2.88) and having more years of professional experience (aOR = 1.81, 95%CI = 1.29–2.52) were associated with good practice. Conclusions: Just over a third of HCWs in primary healthcare clinics had good knowledge of COVID-19 vaccination, while positive attitudes and good practices were low. Targeted interventions, particularly for HCWs with less professional experience working in rural settings, are needed to increase good practices and improve COVID-19 vaccination coverage in Tunisia.