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Rha B, Curns AT, Lively JY, Campbell AP, Englund JA, Boom JA, Azimi PH, Weinberg GA, Staat MA, Selvarangan R, Halasa NB, McNeal MM, Klein EJ, Harrison CJ, Williams JV, Szilagyi PG, Singer MN, Sahni LC, Figueroa-Downing D, McDaniel D, Prill MM, Whitaker BL, Stewart LS, Schuster JE, Pahud BA, Weddle G, Avadhanula V, Munoz FM, Piedra PA, Payne DC, Langley G, Gerber SI. Respiratory Syncytial Virus-Associated Hospitalizations Among Young Children: 2015-2016. Pediatrics 2020; 146:peds.2019-3611. [PMID: 32546583 DOI: 10.1542/peds.2019-3611] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of hospitalized acute respiratory illness (ARI) among young children. With RSV vaccines and immunoprophylaxis agents in clinical development, we sought to update estimates of US pediatric RSV hospitalization burden. METHODS Children <5 years old hospitalized for ARI were enrolled through active, prospective, population-based surveillance from November 1, 2015, to June 30, 2016, at 7 US pediatric hospital sites. Clinical information was obtained from parent interviews and medical records. Midturbinate nasal and throat flocked swabs were collected and tested for RSV by using molecular diagnostic assays at each site. We conducted descriptive analyses and calculated population-based rates of RSV-associated hospitalizations. RESULTS Among 2969 hospitalized children included in analyses, 1043 (35%) tested RSV-positive; 903 (87%) children who were RSV-positive were <2 years old, and 526 (50%) were <6 months old. RSV-associated hospitalization rates were 2.9 per 1000 children <5 years old and 14.7 per 1000 children <6 months old; the highest age-specific rate was observed in 1-month-old infants (25.1 per 1000). Most children who were infected with RSV (67%) had no underlying comorbid conditions and no history of preterm birth. CONCLUSIONS During the 2015-2016 season, RSV infection was associated with one-third of ARI hospitalizations in our study population of young children. Hospitalization rates were highest in infants <6 months. Most children who were RSV-positive had no history of prematurity or underlying medical conditions, suggesting that all young children could benefit from targeted interventions against RSV.
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Affiliation(s)
| | | | - Joana Y Lively
- Division of Viral Diseases and.,IHRC, Inc, Atlanta, Georgia
| | - Angela P Campbell
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Julie A Boom
- Texas Children's Hospital, Houston, Texas.,Departments of Pediatrics and
| | - Parvin H Azimi
- University of California, San Francisco Benioff Children's Hospital Oakland, Oakland, California
| | - Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Mary A Staat
- Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rangaraj Selvarangan
- University of Missouri-Kansas City School of Medicine, Children's Mercy, Kansas City, Missouri
| | | | - Monica M McNeal
- Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Christopher J Harrison
- University of Missouri-Kansas City School of Medicine, Children's Mercy, Kansas City, Missouri
| | - John V Williams
- University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Peter G Szilagyi
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California
| | - Monica N Singer
- University of California, San Francisco Benioff Children's Hospital Oakland, Oakland, California
| | | | | | - Darius McDaniel
- Division of Viral Diseases and.,Maximus Federal, Atlanta, Georgia
| | | | | | | | - Jennifer E Schuster
- University of Missouri-Kansas City School of Medicine, Children's Mercy, Kansas City, Missouri
| | - Barbara A Pahud
- University of Missouri-Kansas City School of Medicine, Children's Mercy, Kansas City, Missouri
| | - Gina Weddle
- University of Missouri-Kansas City School of Medicine, Children's Mercy, Kansas City, Missouri
| | - Vasanthi Avadhanula
- Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Flor M Munoz
- Texas Children's Hospital, Houston, Texas.,Departments of Pediatrics and.,Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Pedro A Piedra
- Texas Children's Hospital, Houston, Texas.,Departments of Pediatrics and.,Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
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2
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Rha B, Peret TCT, Wang L, Lively JY, Curns A, Campbell AP, Boom JA, Azimi PH, Weinberg GA, Staat MA, Selvarangan R, Halasa NB, Englund JA, Klein EJ, Harrison CJ, Stewart LS, Szilagyi PG, Nayakwadi. Singer M, Avadhanula V, McNeal M, Figueroa-Downing D, Prill MM, Whitaker BL, Payne DC, Lindstrom S, Thornburg NJ, Gerber SI, Langley G, Langley G. 2328. Human Respiratory Syncytial Virus Subgroups among Hospitalized Infants in the United States, 2015–2016. Open Forum Infect Dis 2019. [PMCID: PMC6810179 DOI: 10.1093/ofid/ofz360.2006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is a major cause of severe acute respiratory illnesses (ARI) in young children. Circulation of RSV subgroups A and B can vary by season and geographic location, and may have implications for disease susceptibility, outcomes, and prevention measures. We investigated RSV subgroup distribution among samples collected in the New Vaccine Surveillance Network. Methods Prospective active surveillance for hospitalized ARI was conducted from November 1, 2015 to June 30, 2016 among children < 12 months of age at seven pediatric hospital sites. Mid-turbinate nasal and throat flocked swabs (combined when both available) and/or tracheal aspirates were collected and tested for RSV at each site using real-time reverse transcription polymerase chain reaction (rRT–PCR) assays; RSV A/B subgroup results were available from four sites that did their own subgroup testing (Cincinnati, Kansas City, Houston, and Oakland). At three sites (Rochester, Nashville, Seattle), approximately 50 RSV-positive specimens were sampled based on the monthly distribution for each site and 1:1 distribution by gender, and then assayed for subgroup at CDC. Patient information was obtained from medical records; chi-square tests were used to compare the distribution of A and B subgroups by site. Results Of 704 RSV-positive hospitalized infants, subgroup data from 586 were analyzed; 340 (58%) were RSV A and 246 (42%) were RSV B. The median age for both RSV A and RSV B patients was 2 months. Subgroup distribution varied by geographic location, with the overall proportion of RSV A ranging from 18–83% across sites (P < 0.01). Peak RSV A and B detections by month varied by site, occurring from November–February (figure). Conclusion During the 2015–2016 season, RSV A and B subgroups co-circulated among hospitalized infants enrolled at seven US sites. The predominance of RSV subgroup varied by geographic location. Continued surveillance and additional subgroup testing over multiple seasons should improve understanding of the epidemiologic significance of RSV infections by subgroup. ![]()
Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Brian Rha
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Lijuan Wang
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joana Y Lively
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aaron Curns
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Julie A Boom
- Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
| | | | - Geoffrey A Weinberg
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Mary A Staat
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | | | - Janet A Englund
- Seattle Children’s Hospital/University of Washington, Seattle, Washington
| | | | | | | | | | | | | | - Monica McNeal
- Cincinnati Children’s Hospital Medical Center Oak Campus, Cincinnati, Ohio
| | | | - Mila M Prill
- Centers for Disease Control & Prevention, Atlanta, Georgia
| | | | - Daniel C Payne
- Centers for Disease Control and Prevention, Atlanta, Georgia, Atlanta, Georgia
| | | | | | - Susan I Gerber
- Centers for Disease Control and Prevention, Atlanta, Georgia
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3
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Rha B, Campbell AP, McDaniel D, Selvarangan R, Halasa N, Englund J, Boom JA, Azimi PH, Weinberg GA, Staat MA, Singer MN, Sahni LC, McNeal M, Klein EJ, Harrison CJ, Williams JV, Yu J, Figueroa-Downing D, Prill MM, Whitaker BL, Curns AT, Langley GE, Payne DC, Gerber SI. 751. Acute Respiratory Illness Hospitalizations Among Young Children: Multi-Center Viral Surveillance Network, United States, 2015–2016. Open Forum Infect Dis 2018. [PMCID: PMC6255643 DOI: 10.1093/ofid/ofy210.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Viral infections are a significant cause of severe acute respiratory illnesses (ARI) in young children. Understanding the current epidemiology of these viruses is important for informing treatment and prevention measures. We describe the New Vaccine Surveillance Network (NVSN) and report preliminary results from 2015 to 2016. Methods Prospective active surveillance for hospitalized ARI was conducted from November 1, 2015 to June 30, 2016 among children <5 years of age at seven pediatric hospital sites (figure) using a broad case definition based on admission diagnoses. Parent interviews and medical chart reviews were performed, and mid-turbinate nasal and throat flocked swabs and/or tracheal aspirates were tested for adenovirus, human metapneumovirus (HMPV), influenza, parainfluenza viruses (PIV) 1–3, respiratory syncytial virus (RSV), and rhinovirus/enterovirus using molecular diagnostic assays at each site. Asymptomatic controls <5 years of age were also enrolled. Results Among 2,974 hospitalized children with ARI whose specimens were tested for viruses, 2,228 (75%) were <2 years old, with 745 (25%) 0–2 months, and 309 (10%) 3–5 months old. The majority were male (58%; n = 1,732) and 63% (n = 1,093) had no documented comorbid conditions. The median length of stay was 2 days; 1,683 (57%) received supplemental oxygen, 435 (15%) were admitted to intensive care, 95 (3%) required mechanical ventilation, and 1 (<1%) died. Viruses were detected in 2,242 (75%) children with ARI, with >1 virus detected in 234 (8%). RSV was detected in 1,039 (35%) children with ARI, HMPV in 245 (8%), influenza in 104 (4%), and PIV-1, PIV-2, and PIV-3 in 49 (2%), 2 (<1%), and 78 (3%), respectively. Rhinovirus/enterovirus was detected in 849 (29%) and adenovirus in 118 (4%) children with ARI, but were also detected in 18% (n = 227) and 5% (n = 60), respectively, of the 1,243 controls tested; the other viruses were more rarely detected in controls. Conclusion During the 2015–2016 season, viral detections were common in young children hospitalized for ARI at seven US sites. NVSN combines clinical data with current molecular laboratory techniques to describe respiratory virus epidemiology in cases of hospitalized pediatric ARI in order to inform current and future prevention, treatment, and healthcare utilization measures. ![]()
Disclosures N. Halasa, Sanofi Pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee. J. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support. Novavax: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Alios: Investigator, Research support. MedImmune: Investigator, Research support. J. V. Williams, Quidel: Board Member, Consulting fee. GlaxoSmithKline: Consultant, Consulting fee.
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Affiliation(s)
- Brian Rha
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela P Campbell
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Darius McDaniel
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Natasha Halasa
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Janet Englund
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Julie A Boom
- Texas Children’s Hospital, Houston, Texas
- Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
| | - Parvin H Azimi
- UCSF Benioff Children’s Hospital Oakland, Oakland, California
| | - Geoffrey A Weinberg
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Mary A Staat
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Monica N Singer
- UCSF Benioff Children’s Hospital Oakland, Oakland, California
| | | | - Monica McNeal
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | | | | | | - Joana Yu
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- IHRC, Atlanta, Georgia
| | | | - Mila M Prill
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brett L Whitaker
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aaron T Curns
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gayle E Langley
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Daniel C Payne
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan I Gerber
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Campbell AP, Rha B, Ogokeh C, Englund J, Halasa NB, Selvarangan R, Staat MA, Weinberg GA, Azimi PH, Boom JA, McNeal M, Sahni LC, Singer MN, Szilagyi PG, Harrison CJ, Klein EJ, Yu J, Figueroa-Downing D, Payne DC, Fry AM. 721. Clinical Respiratory Syndromes and Association with Influenza Clinical Diagnostic Testing and Antiviral Treatment among Children Hospitalized with Acute Respiratory Illness, 2015–2016. Open Forum Infect Dis 2018. [PMCID: PMC6255580 DOI: 10.1093/ofid/ofy210.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background We investigated clinical influenza testing and treatment in children hospitalized with acute respiratory illness (ARI) who had distinct respiratory syndromes. Methods Children <18 years old with ARI were enrolled at seven hospitals in the New Vaccine Surveillance Network (NVSN) between November 1, 2015–June 30, 2016. ICD10 admission diagnosis codes were grouped to define syndromes of bronchiolitis, asthma, pneumonia, and croup. At clinician discretion, influenza testing with a rapid influenza diagnostic test or molecular assay was performed on respiratory samples. As part of the study, each site performed influenza testing using molecular assays on mid-turbinate nasal and throat swabs from all enrolled children. Analysis was restricted to influenza season; children who received antivirals before hospitalization were excluded. Results Among 2,134 children with available ICD10 codes, on preliminary analysis 1,119 (52%) had influenza testing ordered by a clinician: 111 (10%) were positive, and 57 (51%) of 111 received antiviral treatment. Of the 2,134, 858 (40%) had one of the four mutually exclusive syndromes (table). Hospital clinical testing per clinician discretion was influenza positive in 16 of the 858 children (percent positivity per syndrome ranged from <1% to 38%; table). Research study testing of children not undergoing clinical influenza testing identified 11 additional positives. Antiviral treatment was highest for pneumonia patients. Conclusion Understanding testing and treatment practices by clinical syndrome may help to identify missed opportunities for influenza diagnosis and treatment. Table: Disclosures J. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support. Novavax: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Alios: Investigator, Research support. MedImmune: Investigator, Research support. N. B. Halasa, sanofi pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee.
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Affiliation(s)
- Angela P Campbell
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Constance Ogokeh
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Janet Englund
- Department of Pediatrics, University of Washington, Seattle, Washington
| | | | | | - Mary A Staat
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Geoffrey A Weinberg
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Parvin H Azimi
- UCSF Benioff Children’s Hospital Oakland, Oakland, California
| | - Julie A Boom
- Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
| | - Monica McNeal
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Leila C Sahni
- Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
| | | | - Peter G Szilagyi
- University of Rochester School of Medicine and Dentistry, Rochester, New York
- University of California at Los Angeles, Los Angeles, California
| | | | - Eileen J Klein
- University of Washington/Seattle Children’s Hospital, Seattle, Washington
| | - Joana Yu
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- IHRC, Atlanta, Georgia
| | | | - Daniel C Payne
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia M Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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5
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Sahni LC, Piedra P, Munoz F, Boom J, Azimi PH, Selvarangan R, Halasa N, Englund J, Weinberg G, Payne D, Figueroa-Downing D, Fry AM, Campbell AP, Gerber S, Rha B. Viruses Associated With Acute Respiratory Illnesses (ARI) in Hospitalized Pediatric Patients 5-17 Years of Age in the United States. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Leila C. Sahni
- Immunization Project, Texas Children's Hospital, Houston, Texas
| | | | - Flor Munoz
- Pediatric Infectious Diseases, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Julie Boom
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- Immunization Project, Texas Children's Hospital, Houston, Texas
| | | | | | - Natasha Halasa
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Janet Englund
- Infectious Disease/CCTR, Seattle Children's Hospital, Seattle, Washington
| | - Geoffrey Weinberg
- Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Daniel Payne
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Alicia M. Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela P. Campbell
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan Gerber
- Division of Viral Diseases/Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Figueroa-Downing D, Baggio ML, Baker ML, Dias De Oliveira Chiang E, Villa LL, Eluf Neto J, Evans DP, Bednarczyk RA. Factors influencing HPV vaccine delivery by healthcare professionals at public health posts in São Paulo, Brazil. Int J Gynaecol Obstet 2016; 136:33-39. [PMID: 28099706 DOI: 10.1002/ijgo.12004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/06/2016] [Accepted: 09/30/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the association between Brazilian healthcare providers' characteristics and their knowledge, perceptions, and practices regarding the HPV vaccine. METHODS An observational cross-sectional study was conducted at five public health posts in São Paulo between July 28 and August 8, 2014. Healthcare professionals directly involved in patient care were asked to complete a written survey. Factors associated with routine verification of HPV vaccination status were evaluated using Poisson regression. RESULTS Among 200 participants included, 74 (38.5%) reported never and 70 (36.5%) reported always asking about HPV immunization status. Doctors were significantly less likely to report always asking than were community health agents (5/39 [12.8%] vs 32/60 [53.3%]; adjusted prevalence ratio [aPR] 0.25 [95% confidence interval (CI) 0.07-0.91]). Knowledge about the correct dosing schedule was associated with always rather than never verifying vaccination status (aPR 2.46 [95% CI 1.06-5.70]). CONCLUSION Knowledge and attitude played secondary roles in influencing HPV vaccine verification. Community health agents were crucial for vaccine promotion; continued education and support of this group is essential for the sustained success of HPV immunization efforts in Brazil.
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Affiliation(s)
- Daniella Figueroa-Downing
- Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Misha L Baker
- Department of Behavioral Science and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Luisa L Villa
- The Cancer Institute of the State of São Paulo, São Paulo, Brazil.,Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jose Eluf Neto
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.,Oncology Foundation of São Paulo, São Paulo, Brazil
| | - Dabney P Evans
- Departments of Behavioral Science and Health Education and Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert A Bednarczyk
- Departments of Behavioral Science and Health Education and Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Cancer Prevention and Control Program, Winship Cancer Institute, Atlanta, GA, USA.,Emory Vaccine Center, Atlanta, GA, USA
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Bednarczyk RA, Figueroa-Downing D, Ault K. Reply. Am J Obstet Gynecol 2016; 214:667-8. [PMID: 26767793 PMCID: PMC10121144 DOI: 10.1016/j.ajog.2015.12.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 12/29/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Robert A Bednarczyk
- Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Emory University; Cancer Prevention and Control Program, Winship Cancer Institute; and Emory Vaccine Center, Atlanta, GA.
| | - Daniella Figueroa-Downing
- Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Kevin Ault
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS
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8
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Bednarczyk RA, Figueroa-Downing D, Ault K. Why is it appropriate to recommend human papillomavirus vaccination as cervical cancer prevention? Am J Obstet Gynecol 2016; 214:490-493. [PMID: 26529369 DOI: 10.1016/j.ajog.2015.10.920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/22/2015] [Accepted: 10/27/2015] [Indexed: 10/22/2022]
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Baker ML, Figueroa-Downing D, Chiang EDDO, Villa L, Baggio ML, Eluf-Neto J, Bednarczyk RA, Evans DP. Paving pathways: Brazil's implementation of a national human papillomavirus immunization campaign. Rev Panam Salud Publica 2015; 38:163-166. [PMID: 26581058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 04/13/2015] [Indexed: 06/05/2023] Open
Abstract
In 2014, Brazil introduced an HPV immunization program for girls 9-13 years of age as part of the Unified Health System's (SUS) National Immunization Program. The first doses were administered in March 2014; the second ones, in September 2014. In less than 3 months more than 3 million girls received the first dose of quadrivalent HPV vaccine, surpassing the target rate of 80%. This paper examines three elements that may influence the program's long-term success in Brazil: sustaining effective outreach, managing a large technology-transfer collaboration, and developing an electronic immunization registry, with a focus on the State of São Paulo. If these three factors are managed, the Government of Brazil is primed to serve as a model of success for other countries interested in implementing a national HPV vaccination program to decrease HPV-related morbidity and mortality.
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Affiliation(s)
- Misha L Baker
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | | | | | - Luisa Villa
- Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | - José Eluf-Neto
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Robert A Bednarczyk
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Dabney P Evans
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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