A Texas A&M University survey of US parents finds that 41% already had or would vaccinate their children against COVID-19, 63% against influenza, and 71% against respiratory syncytial virus (RSV) this fall and winter. 

The study, published late last week in Vaccine, involved 5,035 parents of children younger than 18 years surveyed on September 27 and 28, 2023.

Illness worries, trust in medicine increased intent

In total, 40.9% of respondents said they had or would vaccinate their children against COVID-19, while 63.3% said they would do so against flu, and 71.1% said their children would receive the RSV vaccine.

Predictors of intent to vaccinate included concerns about diseases (average marginal effects [AME] for COVID-19, 0.064; AME for flu, 0.060; and AME for RSV 0.048), as well as trust in health institutions (AME for COVID-19, 0.023; AME for flu, 0.010; AME for RSV, 0.028). Parents who had previously vaccinated their children were also more likely to pursue vaccination (AME for COVID-19, 0.176; AME for flu, 0.438; and AME for COVID-19, 0.194).

Relative to men, women were less likely to say they would vaccinate their children against COVID-19 and flu (AME for COVID-19, −0.076; AME for flu, −0.047). Respondents who indicated that vaccines were important were more likely to pursue vaccination for COVID-19 and RSV (AME, 0.097 and 0.072, respectively).

Worries about a link between vaccination and autism—which studies have disproven—were statistically significant for only COVID-19 (AME, -0.030). Relative to political conservatives, liberals were more likely to vaccinate against COVID-19 (AME, 0.076).

The large number of unvaccinated children will likely lead to large numbers of excessive disease in children.

Compared with Democrats, Republications were less inclined to vaccinate their children against COVID-19 (AME, -0.060), and Democrats had higher odds of seeking RSV vaccination (AME, 0.151). The most common reasons for vaccine hesitancy were doubts about safety and the need for vaccination and a lack of information.

"The large number of unvaccinated children will likely lead to large numbers of excessive disease in children," the authors wrote.

A meta-analysis published yesterday in Scientific Reports involving 9,059 patients shows a 26% decreased risk of heart attacks in people who received a flu vaccine and a 33% reduction in cardiovascular deaths.

"These findings highlight the potential of influenza vaccination as an adjunctive strategy in cardiovascular disease prevention," the authors write.

The authors searched all English-language scientific literature databases for studies looking at cardiovascular disease and influenza vaccines. In the final analysis of five studies, 4,529 patients who received flu vaccine were compared with 4,530 patients who received a placebo.

The average age of study participants was 61.3 years, and study follow-up lasted on average 9 months.

May prevent heart-damaging inflammation

Participants who received the flu vaccine saw a notable reduction in the occurrence of major cardiovascular events, with 517 cases compared to 621 cases in the placebo group (risk ratio [RR], 0.70; 95% confidence interval [CI], 0.55 to 0.91).

There was a decreased risk of heart attacks in vaccinated patients (RR, 0.74; 95% CI, 0.56 to 0.97) and a significant reduction in cardiovascular death events (RR, 0.67; 95% CI, 0.45 to 0.98).

The authors of the study said there are several theories as to why vaccination protects heart health, including lowering inflammation caused by influenza, preventing secondary infections, and ensuring the stability of atherosclerotic plaque, which can become destabilized during the flu.

The US Department of Agriculture (USDA) last week published a strategy for addressing antimicrobial resistance (AMR), saying it hopes the document will serve as a guide for identifying priority areas in the food and agriculture sector that will accelerate its understanding of the risk posed by drug-resistant pathogens.

Based in part on feedback from a public meeting held by the USDA in August 2022, the strategy lays out three areas of focus and 10 priorities for collaborative action by the USDA and its public and private partners. The three areas of focus are reducing disease and pathogen transmission, improving the scientific knowledge base on AMR risk, and improving communication and collaboration within USDA and with national, regional, and global partners to address AMR risk.

The 10 priorities within those three areas of focus include improving animal and crop health, promoting biosecurity and food safety, improving understanding of the drivers of antimicrobial use in food-producing animals, and improving knowledge dissemination.

The USDA says the strategy is not an implementation plan but rather "provides guidance for agency-specific planning or contributions to related Federal plans and strategies."

"Through this Strategy, USDA will integrate and build upon the work its agencies and offices do every day and its collaborations with public and private partners to better understand and address AMR," the agency wrote. "USDA will also work with agricultural producers and other stakeholders who wish to voluntarily collaborate to help the Department find solutions."

A new survey of 158 hospital executives, conducted by the Sepsis Alliance, found that 90% see antimicrobial resistance (AMR) as a threat, and 88% think the problem is getting worse. The survey, conducted by Sage Growth Partners on behalf of the Sepsis Alliance, also dug into executives' views on other related AMR issues. An 11-page report on the findings was published on the Sepsis Alliance website on November 17.

Another top concern is the public's lack of knowledge about AMR, with 59% of executives saying that public education of clinicians as well as patients is the largest barrier to antibiotic stewardship. Respondents recommend public service announcements covering the need for early treatment, the importance of completing treatment, and storing the drugs properly.

The survey also revealed some knowledge gaps about key legislative efforts to curb AMR, with 72% of executives unfamiliar with the provisions of the PASTEUR (Pioneering Antimicrobial Subscriptions to End Upsurging Resistance) Act, a proposal to create a subscription-style payment model in which the federal government would pay up front for access to Food and Drug Administration–approved antibiotics that target drug-resistant pathogens and meet critical, unmet health needs.

Barriers to stewardship

Also, the survey gauged the state of antibiotic stewardship programs at hospitals. Nearly all the executives (98%) said their organization has one, but only 26% would give their facility an A for stewardship efforts, with only 17% saying they were extremely confident in their organization's strategies for managing AMR. Barriers included underuse of infectious disease physicians and pharmacists, cost justification for new antibiotics, pushback on stewardship recommendations, and staffing shortages.

When asked what would help hospitals improve their AMR efforts, 54% responded that better availability of rapid tests and 54% said improved quality of rapid diagnostics would help.

The survey was funded through a grant from PhRMA, a trade group that represents the pharmaceutical industry. It was released as part of World Antimicrobial Awareness Week.