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Deng L, Macartney K, Gill D, Fathima P, Wood N, Gidding H. Status epilepticus outcomes among vaccinated and unvaccinated children: A population-based study. Epilepsy Behav 2022; 126:108482. [PMID: 34920348 DOI: 10.1016/j.yebeh.2021.108482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022]
Abstract
AIM To determine the proportion of first status epilepticus (SE) cases that are vaccine-proximate (VP-) and compare clinical outcomes to non-vaccine-proximate (NVP-) cases. METHODS Birth records for 1,440,807 Australian children born in 1998-2012, were probabilistically linked to hospitalizations, deaths, and vaccination history available to 2013. First SE coded hospitalizations were categorized as VP-SE or NVP-SE; clinical severity and post-SE vaccination coverage were compared. SE rates were calculated. RESULTS Of 867 first SE cases (7.9 per 100,000 person-years), 31 (3.6%) were VP-SE; 16 followed dose-1 measles vaccine (1.2 SE per 100,000 doses). Compared with NVP-SE, VP-SE cases were younger (1.0 vs 2.6 years, P < 0.0001) and had longer hospitalizations (4 vs 3 days, P = 0.005). There was no difference in the proportion of VP-SE cases with a coinfection diagnosis compared to NVP-SE (25.8% vs 19.9%, P = 0.42). Controlling for age and history of hospitalization for a neurological condition, intensive care unit (ICU) admission had a stronger association with coinfection (aOR 2.52 (95%CI 1.78-3.57)) than having VP-SE (aOR 1.41 (0.66-3.01)). Groups had similar SE recurrence rates at 12-months (12.9% VP vs 16.9% NVP, P = 0.56) and reduced vaccine uptake following initial SE (from 93.5% to 56.3%). CONCLUSION Proportionally few first SE cases were VP-SE, with higher ICU admission rates mostly explained by younger age and higher coinfection rates. Vaccination plans are needed to improve vaccine uptake following SE.
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Affiliation(s)
- Lucy Deng
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia; The University of Sydney Children's Hospital Westmead Clinical School, NSW, Australia.
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia; The University of Sydney Children's Hospital Westmead Clinical School, NSW, Australia
| | - Deepak Gill
- T.Y. Nelson Department of Neurology, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Parveen Fathima
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia; Epidemiology Branch, Western Australia Department of Health, Perth, WA, Australia
| | - Nicholas Wood
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia; The University of Sydney Children's Hospital Westmead Clinical School, NSW, Australia
| | - Heather Gidding
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia; Women and Babies Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia; The University of Sydney Northern Clinical School, NSW, Australia
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Arora G, Lehman D, Charlu S, Ross N, Ardy A, Gordon B, Pannaraj PS. Vaccine health beliefs and educational influences among pediatric residents. Vaccine 2019; 37:857-862. [PMID: 30611603 DOI: 10.1016/j.vaccine.2018.12.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/15/2018] [Accepted: 12/18/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE A pilot study of pediatric residents to describe perceived benefits and effects of vaccines and educational influences on vaccine practice among pediatric residents. STUDY DESIGN Eighty-seven residents, from two institutions in a region with relatively high vaccine hesitancy, responded to a survey conducted in 2014-2015. RESULTS Residents identified professional experiences with vaccine preventable diseases (VPDs) and observing pediatricians as most impactful to their vaccine beliefs. Residents who had observed pediatric faculty agreeing to alternative or delayed vaccinations were more likely to believe this to be acceptable vaccine practice (70.1% vs. 21.1%, χ2 = 17.778, p < 0.001). Most residents (68 [79.1%]) reported feeling confident in their ability to discuss vaccines. CONCLUSIONS Pediatricians must be equipped with accurate vaccine health beliefs to impact parental vaccine hesitancy. This study identifies important gaps in medical education, with pediatric residents reporting limitations in their professional experience with VPDs and high rates of observing alternative vaccination practice.
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Affiliation(s)
- Gitanjli Arora
- Department of Pediatrics, Children's Hospital Los Angeles, United States.
| | - Deborah Lehman
- Department of Pediatrics, University of California Los Angeles, United States
| | - Sandhya Charlu
- Department of Pediatrics, Children's Hospital Los Angeles, United States
| | - Nicole Ross
- Department of Pediatrics, Children's Hospital Los Angeles, United States
| | - Adriana Ardy
- Department of Pediatrics, Children's Hospital Los Angeles, United States
| | - Bahareh Gordon
- Department of Pediatrics, University of California Los Angeles, United States
| | - Pia S Pannaraj
- Department of Pediatrics, Children's Hospital Los Angeles, United States; Department of Molecular Microbiology and Immunology, University of Southern California, United States
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Al-lela OQB, Bahari MB, Salih MRM, Al-abbassi MG, Elkalmi RM, Jamshed SQ. Factors underlying inadequate parents' awareness regarding pediatrics immunization: findings of cross-sectional study in Mosul- Iraq. BMC Pediatr 2014; 14:29. [PMID: 24485194 PMCID: PMC3909509 DOI: 10.1186/1471-2431-14-29] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 01/30/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since last 100 years, immunization rate is one of the best public health outcome and service indicators. However, the immunization system is still imperfect; there are many countries that still have unvaccinated children. Parental decisions regarding immunization are very important to improve immunization rate. The aim of this study is to evaluate the association between parental knowledge-practice (KP) regarding immunization with family and immunization providers' factors. METHODS This is a prospective cross-sectional study design. Immunization knowledge and practices among 528 Iraqi parents were evaluated through validated questionnaire. Familial data and immunization provider's characteristics were collected from parents through interview. RESULTS More than half of respondents/study population (66.1%) have adequate knowledge- practice scores. Significant associations were noted for knowledge-practice groups with father's education level, mother's education level, mother's age at delivery, number of preschool children, parents gender, family income, provider types, and birth place (p < 0.05). CONCLUSION Immunization campaigns and awareness are required to improve parents' knowledge and practice regarding immunization. The study results reinforce recommendations for use of educational programmes to improve the immunization knowledge and practice.
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Affiliation(s)
| | | | | | | | - Ramadan M Elkalmi
- International Islamic University Malaysia, Kulliyyah of Pharmacy, Pahang, Malaysia
| | - Shazia Q Jamshed
- International Islamic University Malaysia, Kulliyyah of Pharmacy, Pahang, Malaysia
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Tillmann BU, Tillmann HC, Heininger U, Lütschg J, Weber P. Acceptance and timeliness of standard vaccination in children with chronic neurological deficits in north-western Switzerland. Eur J Pediatr 2005; 164:320-5. [PMID: 15731906 DOI: 10.1007/s00431-005-1627-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2004] [Revised: 12/15/2004] [Accepted: 12/23/2004] [Indexed: 10/25/2022]
Abstract
UNLABELLED There are no special recommendations for basic vaccinations in patients with chronic neurological deficits distinct from the nationwide advocated schedule in Switzerland. Reports describing adverse neurological events possibly related to vaccinations have attracted public attention. It is unclear if patients with chronic neurological deficits are more reluctantly vaccinated compared to healthy children. We therefore investigated the acceptance of vaccinations in such patients and healthy controls in a retrospective case-control study. At the University Children's Hospital, Basel, Switzerland we investigated 100 patients with chronic neurological deficits and 200 age-matched healthy controls regarding the issue of vaccination rates and ages. The total number of administered vaccinations against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib), mumps, measles, rubella and hepatitis B were significantly lower in patients compared to healthy controls ( P < 0.01 for each of the respective vaccines). Patients had an increased risk to receive the third pertussis, diphtheria, and tetanus vaccinations (relative risks (RR) for late vaccination 1.53, 1.53, and 1.54 respectively, P < 0.01 for all comparisons), the second (RR = 1.60, P < 0.05) and third Hib vaccinations (RR = 1.52, P < 0.05), and the third polio vaccination (RR = 1.43, P < 0.05) later than controls. CONCLUSION Children with chronic neurological deficits received fewer vaccinations than healthy controls. In addition, patients received vaccinations later than healthy children. Hence, it may be assumed that children with chronic neurological deficits are at an increased risk to acquire preventable infections. Therefore, vaccination should be promoted as part of the consultation during a routine appointment with the specialist.
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Affiliation(s)
- Bettina Ute Tillmann
- Department of Neuropaediatrics, University Children's Hospital, P.O. Box, 4005 Basel, Switzerland.
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Rogers MAM, McCoy RC. Rubella immunoglobulin G antibody titers in children with seizures. Epilepsy Res 2003; 54:35-40. [PMID: 12742594 DOI: 10.1016/s0920-1211(03)00040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The third National Health and Nutrition Examination Survey was utilized to assess serum rubella immunoglobulin G antibody titers in a representative sample of American children. Antibody titers were significantly lower in children with a history of seizures and in children treated for seizures compared to unaffected children, after adjustment for age, ethnicity, residence, and region (P=0.022 and 0.029, respectively). Children with the lowest antibody titers were non-Hispanic whites who had a history of seizures. The percentage of US adolescents and young adults with a history of seizures that may have insufficient immunity to rubella is estimated to be 14-50%.
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Affiliation(s)
- Mary A M Rogers
- Patient Safety Enhancement Program, University of Michigan, 300 North Ingalls, Suite 7E07, Ann Arbor, MI 48109-0429, USA.
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Prislin R, Sawyer MH, Nader PR, Goerlitz M, De Guire M, Ho S. Provider-staff discrepancies in reported immunization knowledge and practices. Prev Med 2002; 34:554-61. [PMID: 11969357 DOI: 10.1006/pmed.2002.1019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The purpose of the study was to compare immunization-relevant knowledge, certainty about knowledge, self-efficacy, vested interest, and reported practices of providers and clinical staff in the same clinics. METHODS A valid and reliable instrument measuring the aforementioned issues was developed and administered to a sample of 50 providers and 60 members of the clinical staff. RESULTS Providers were significantly more knowledgeable than staff (P < 0.001); however, they were not more certain about their knowledge (P = 0.52) nor were they more confident in their capability to properly immunize all children in their practice (P = 0.10). Providers reported lower vested interest in immunizations than clinical staff (P < 0.05). Both groups were equally likely to immunize a child with a cold. Providers were less likely to defer needed immunizations for a 15-month-old child, and they were more likely to administer multiple injections to an 18-month-old (both P < 0.05). Providers were more likely than staff to immunize during acute and chronic illness visits (both P < 0.001), and both groups were equally likely to immunize during preventive visits. CONCLUSIONS Discrepancies in reported immunization practices between providers and staff may be a barrier to full immunization.
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Affiliation(s)
- Radmila Prislin
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, California 92182-4611, USA.
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Kempe A, Lowery NE, Pearson KA, Renfrew BL, Jones JS, Steiner JF, Berman S. Immunization recall: effectiveness and barriers to success in an urban teaching clinic. J Pediatr 2001; 139:630-5. [PMID: 11713438 DOI: 10.1067/mpd.2001.117069] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine effectiveness of immunization recall in an urban pediatric teaching clinic and to identify barriers to recall effectiveness. DESIGN Randomized, controlled trial. Children aged 5 to 17 months who were not up to date (UTD) with recommended immunizations were identified and assigned to intervention (n = 294) or control groups (n = 309). The intervention consisted of a mailed postcard and up to 4 telephone calls. Two months after intervention, UTD status, visit, and probable missed opportunity rates were assessed. RESULTS Of the intervention group, 30% could not be reached. In 12-month-old children in the intervention group compared with those in the control group, there was a trend toward higher UTD rates (51% vs 39%, P =.07) and a higher proportion of UTD children receiving immunizations as opposed to getting more complete documentation (25% vs 10%, P =.005). Similar differences between intervention and control children were not seen in the 7-month and 19-month age categories. More children in the intervention group had a health maintenance visit (17% vs 11%, P =.03). Of children in the intervention group who were seen when not UTD, 17 of 24 (71%) of those seen for an illness visit and 5 of 24 (21%) of those seen for health maintenance probably had missed opportunities to be immunized. CONCLUSIONS Recall efforts were partially successful but were undermined by inability to reach the clinic population, poor documentation of immunizations, and missed opportunities.
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Affiliation(s)
- A Kempe
- The Children's Hospital, Denver, CO 80218, USA
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Tarrant M, Gregory D. Mothers' perceptions of childhood immunizations in First Nations communities of the Sioux Lookout Zone. Canadian Journal of Public Health 2001. [PMID: 11257989 DOI: 10.1007/bf03404842] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Low uptake of childhood immunizations is a problem in many First Nations communities. This article describes the results of a study that examined mothers' perceptions of childhood immunizations and the factors that influence uptake. METHOD Person-centred interviews focussing on childhood immunizations and child health were conducted with 28 mothers of young children in two First Nations communities in the Sioux Lookout Zone. Content analysis was applied to the interview data and patterns and themes were developed. RESULTS Data analysis identified four key factors as negatively influencing immunization uptake: knowledge barriers, the influence of others, vaccine barriers, and missed opportunities. CONCLUSIONS Further research with Elders and community members along with culturally sensitive education initiatives are required to address low immunization uptake. Changes in health professionals' behaviours may serve to reduce missed opportunities.
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Affiliation(s)
- M Tarrant
- Department of Nursing Studies, University of Hong Kong, G/F, Block B, Queen Mary Hospital, 102 Pokfulam Rd., Hong Kong.
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Clayton MF, Boegel E. Missed immunization opportunities: a comparison of nurse practitioners and physicians. JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS 1999; 11:423-9. [PMID: 10690092 DOI: 10.1111/j.1745-7599.1999.tb01236.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Prislin R, Nader PR, De Guire M, Hoy PL, Pung MA, Ross S, Goerlitz MJ, Sawyer MH. Physicians' immunization knowledge, attitudes, and practices: a valid and internally consistent measurement tool. Am J Prev Med 1999; 17:151-2. [PMID: 10490060 DOI: 10.1016/s0749-3797(99)00054-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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England L, Shelton R, Schubert CJ. Immunizing preschool children: beliefs and practices of pediatric residents. Clin Pediatr (Phila) 1997; 36:129-34. [PMID: 9078413 DOI: 10.1177/000992289703600302] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Immunization practices and knowledge of vaccine contraindications among pediatric residents were assessed at five pediatric training facilities by surveying 227 pediatric residents. Residents administer vaccines even in the presence of an afebrile minor illness. They are less likely to vaccinate if a fever (< 102 degrees F) is present. Only 57% of residents report administering vaccines at the 15-month well-child checks. Many residents had difficulty recognizing true and false contraindications, though third-year residents did better than first-year residents. Failure during residency to utilize 15-month well visits and ill visits in the presence of a fever and the lack of knowledge of true and false vaccine contraindications may be causes of missed opportunities to vaccinate among residents. Immunization practices resulting in missed opportunities to vaccinate seen during during residency may influence later immunization practices.
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Affiliation(s)
- L England
- Division of Infectious Disease, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA
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