Monthly relative search query popularity of varicella keywords, 2015 to 2021, in 19 countries or regions without UVV.

Monthly relative search query popularity of varicella keywords, 2015 to 2021, in 19 countries or regions without UVV.</p

Percentage change in absolute search query volume from March 2020, the start of the COVID-19 pandemic, to April, May, and June 2020.

Bars represents the percent decline in search query volume from March to April 2020 (lightest bar), March to May 2020 (medium bar), and March to June 2020 (darkest bar).</p

Monthly relative search query popularity of varicella keywords in European countries without universal varicella vaccination, 2015–2021.

The Google Trends Index is calculated as the number of keyword searches divided by the total number of searches within a specific location and time period; it is standardized to range from 0 (no search activity) to 100 (peak search activity).</p

Cost-effectiveness of nonavalent HPV vaccination in the Netherlands

A bivalent human papillomavirus vaccine (2vHPV) is currently used in the Netherlands; a nonavalent vaccine (9vHPV) is also licensed. We compared the public health and economic benefits of 2vHPV- and 9vHPV-based vaccination strategies in the Netherlands over 100 years using a validated deterministic dynamic transmission metapopulation model. Compared to 2vHPV, the 9vHPV strategy averted an additional 3,245 cases of and 825 deaths from 9vHPV-strain-attributable cancers, 4,247 cases of and 190 deaths from recurrent respiratory papillomatosis (RRP), and 1,009,637 cases of anogenital warts (AGWs), with an incremental cost-effectiveness ratio (ICER) of €4,975 per quality-adjusted life year (QALY) gained. The ICER increased in a scenario with increased HPV vaccination coverage rates and was relatively robust to one-way deterministic sensitivity analyses, with variation in the disease utility parameter having the most impact. When catch-up vaccination for individuals ≤26 years of age was added to the model, vaccinating with 9vHPV averted additional cancers and AGWs compared to 2vHPV vaccination. Our analyses predict that transitioning from a 2vHPV- to a 9vHPV-based vaccination strategy would be cost-effective in the Netherlands.</p

Uniform resource locator information of search queries for varicella keywords in European countries, 2015 to 2021.

Uniform resource locator information of search queries for varicella keywords in European countries, 2015 to 2021.</p

Relative search query popularity of varicella keywords and varicella cases in Bulgaria, January 2015 to December 2021.

Monthly varicella case data are based on aggregated weekly case counts reported by the National Center of Infectious and Parasitic Diseases in Bulgaria [22]. The blue line shows these data converted to monthly averages, and the orange line is the Google Trends Index for internet searches performed in each month.</p

Monthly relative search query popularity of varicella keywords, 2015 to 2021, in countries where UVV was introduced before 2010: Germany, Greece, and Latvia.

Monthly relative search query popularity of varicella keywords, 2015 to 2021, in countries where UVV was introduced before 2010: Germany, Greece, and Latvia.</p

Varicella vaccination and varicella keyword search terms for the 28 European countries included in the study.

Varicella vaccination and varicella keyword search terms for the 28 European countries included in the study.</p

Fig 6 -

Percentage change in monthly absolute search volumes for varicella keywords, March 2020 through December 2021, compared with average search volumes during respective months in 2018 and 2019 in countries A) without UVV and B) with UVV. Percentage change was calculated by comparing the monthly search volumes recorded from March 2020 to December 2021, with the 2-year average of search volumes recorded during respective months in 2018 and 2019.</p

Assessment of the comprehensiveness of paediatric national immunisation programmes in Europe: expert validation and future perspectives

The breadth of protection of National Immunisation Programmes (NIPs) across Europe varies, however, this has not been assessed within published literature. Therefore, a framework was developed to assess the comprehensiveness of pediatric NIPs in Europe. This study aimed to validate and further develop criteria used to cluster countries into three tiers. Independent Europe-based experts (n = 23) in the field of pediatric vaccination were invited to participate in a double-blinded modified Delphi panel, with two online survey rounds and a virtual consensus meeting. Consensus was defined as ≥ 80% of experts rating their agreement/disagreement on a 9-point Likert scale. The number of preventable diseases covered by an NIP, simplification of the vaccination calendar, strengthened protection by increasing serotype, degree of funding and epidemiological factors were considered key concepts for consideration of the comprehensiveness of pediatric NIPs in Europe. Experts highlighted that the framework should be extended to include adolescent vaccines and populations up to 18 years of age. Consensus regarding further amendments to the framework was also reached. This Delphi panel validated a framework to assess the comprehensiveness of European NIPs. The framework can be used to facilitate discussions to help countries improve and expand the breadth of protection provided by their NIP.</p