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Ssebagereka A, de Broucker G, Ekirapa-Kiracho E, Kananura RM, Driwale A, Mak J, Mutebi A, Patenaude BN. Equity in vaccine coverage in Uganda from 2000 to 2016: revealing the multifaceted nature of inequity. BMC Public Health 2024; 24:185. [PMID: 38225582 PMCID: PMC10790460 DOI: 10.1186/s12889-023-17592-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 12/26/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND This study analyses vaccine coverage and equity among children under five years of age in Uganda based on the 2016 Uganda Demographic and Health Survey (UDHS) dataset. Understanding equity in vaccine access and the determinants is crucial for the redress of emerging as well as persistent inequities. METHODS Applied to the UDHS for 2000, 2006, 2011, and 2016, the Vaccine Economics Research for Sustainability and Equity (VERSE) Equity Toolkit provides a multivariate assessment of immunization coverage and equity by (1) ranking the sample population with a composite direct unfairness index, (2) generating quantitative measure of efficiency (coverage) and equity, and (3) decomposing inequity into its contributing factors. The direct unfairness ranking variable is the predicted vaccination coverage from a logistic model based upon fair and unfair sources of variation in vaccination coverage. Our fair source of variation is defined as the child's age - children too young to receive routine immunization are not expected to be vaccinated. Unfair sources of variation are the child's region of residence, and whether they live in an urban or rural area, the mother's education level, the household's socioeconomic status, the child's sex, and their insurance coverage status. For each unfair source of variation, we identify a "more privileged" situation. RESULTS The coverage and equity of the Diphtheria-Pertussis-Tetanus vaccine, 3rd dose (DPT3) and the Measles-Containing Vaccine, 1st dose (MCV1) - two vaccines indicative of the health system's performance - improved significantly since 2000, from 49.7% to 76.8% and 67.8% to 82.7%, respectively, and there are fewer zero-dose children: from 8.4% to 2.2%. Improvements in retaining children in the program so that they complete the immunization schedule are more modest (from 38.1% to 40.8%). Progress in coverage was pro-poor, with concentration indices (wealth only) moving from 0.127 (DPT3) and 0.123 (MCV1) in 2000 to -0.042 and -0.029 in 2016. Gains in overall equity (composite) were more modest, albeit significant for most vaccines except for MCV1: concentration indices of 0.150 (DPT3) and 0.087 (MCV1) in 2000 and 0.054 and 0.055 in 2016. The influence of the region and settings (urban/rural) of residence significantly decreased since 2000. CONCLUSION The past two decades have seen significant improvements in vaccine coverage and equity, thanks to the efforts to strengthen routine immunization and ongoing supplemental immunization activities such as the Family Health Days. While maintaining the regular provision of vaccines to all regions, efforts should be made to alleviate the impact of low maternal education and literacy on vaccination uptake.
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Affiliation(s)
| | - Gatien de Broucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
- International Vaccine Access Center, Johns Hopkins University, Baltimore, USA.
| | | | | | - Alfred Driwale
- Uganda National Expanded Program On Immunization (UNEPI), Ministry of Health, Kampala, Uganda
| | - Joshua Mak
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- International Vaccine Access Center, Johns Hopkins University, Baltimore, USA
| | - Aloysius Mutebi
- Makerere University School of Public Health, Kampala, Uganda
| | - Bryan Nicholas Patenaude
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- International Vaccine Access Center, Johns Hopkins University, Baltimore, USA
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García FJÁ, Tejada AMG, Heras IG, de Arce AI, Llop FM, Herreros FN, Martín JJP, Marchuet PS, Rodríguez JV. Vaccination schedule for adolescents. Consensus of the AEV, CAV-AEP and SEMA. An Pediatr (Barc) 2023; 99:122-128. [PMID: 37487775 DOI: 10.1016/j.anpede.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 07/26/2023] Open
Abstract
We present the consensus document on the immunization schedule for adolescents developed by 3 scientific societies: the Spanish Association of Pediatrics (AEP), through its Advisory Committee on Vaccines (CAV-AEP), the Spanish Society of Adolescent Medicine (SEMA) and the Spanish Association of Vaccinology (AEV). There are particularities in infectious disease during adolescence, such as an increased susceptibility to pertussis, poorer outcomes of chickenpox, mumps and hepatitis A, a high incidence of sexually transmitted infections or increased prevalence of meningococcal carriage. The document analyses the schedule for adolescents in the context of vaccination policy overall. It contemplates the vaccines to be included in the immunization schedule for healthy adolescents: against invasive meningococcal disease (tetravalent ACWY and B), against human papillomavirus (which should be gender-neutral), against pertussis, against influenza and against SARS-CoV-2 (in unvaccinated individuals and at-risk groups). It is worth noting that the 4CMenB vaccine appears to confer some protection against gonococcal infection, which would be a considerable added value for adolescents. The vaccination of adolescents belonging to risk groups or travelling abroad also needs to be contemplated, as is the case in any other age group. Vaccination against hepatitis A, which is included in the routine immunization schedule of Catalonia, Ceuta and Melilla from the second year of life, should also be considered a priority in adolescents traveling to endemic areas.
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Affiliation(s)
- Francisco José Álvarez García
- Centro de Salud de Llanera. Asturias, Departamento de Medicina, Universidad de Oviedo, Comité Asesor de Vacunas de la Asociación Española de Pediatría, Spain.
| | - Ana María Grande Tejada
- Hospital Materno Infantil de Badajoz, Departamento de Medicina. Universidad de Extremadura, Asociación Española de Vacunología, Spain
| | - Ignacio Güemes Heras
- Unidad de Cuidados Intensivos de Neonatología y Pediatría, Hospital La Salud, Universidad Católica de Valencia, Sociedad Española de Medicina de la Adolescencia, Spain
| | - Antonio Iofrío de Arce
- Centro de Salud El Ranero, Murcia, Comité Asesor de Vacunas de la Asociación Española de Pediatría, Spain
| | | | - Félix Notario Herreros
- Servicio Pediatría y Adolescencia, Clínica Rosario, Grupo HLA, Albacete, Sociedad Española Medicina de la Adolescencia, Spain
| | - Jaime Jesús Pérez Martín
- Dirección General de Salud Pública y Adicciones, Comunidad de Murcia, Asociación Española de Vacunología, Spain
| | - Pepe Serrano Marchuet
- Equipo de Pediatría territorial del Garraf, Barcelona, Comité Asesor de Vacunas de la Asociación Española de Pediatría, Spain
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da Silva TMR, Sá ACMGND, Prates EJS, Freitas Saldanha RD, da Silva TPR, Silva Teixeira AMD, Beinner MA, de Oliveira SR, de Sá ATN, Matozinhos FP, Vieira EWR. Temporal and spatial distribution trends of polio vaccine coverage in less than one-year old children in Brazil, 2011-2021. BMC Public Health 2023; 23:1359. [PMID: 37452296 PMCID: PMC10349464 DOI: 10.1186/s12889-023-16192-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Low polio vaccine coverage can result in the spread of Poliovirus to areas free from viral circulation. This study analyzed the temporal trends and spatial distribution of polio vaccine coverage in one year-old children in Brazil, between 2011 and 2021. METHODS This was an ecological, time-series study (2011 to 2021) with annual vaccine coverages against poliomyelitis, extracted from the Information System of the National Immunization Program from the 26 States and the Distrito Federal (DF). The percentage reductions in vaccination coverage in Brazil and in the Regions were calculated. Prais-Winsten regression models were used to analyze time series for the Regions and States, and spatial analysis identified the distribution of clusters (high-high; low-low; high-low and low-high) of vaccination coverages across Brazilian municipalities, using a 5% significance level. RESULTS From 2011 to 2021, the coverage of polio vaccines decreased by 29,9%. There was a progressive increase observed in clusters resulting in low vaccination coverages (140 low-low Brazilian municipalities in 2011 vs. 403 in 2021), mostly reported in the North and Northeast regions of the country. There was a downward trend in vaccination coverages in 24 of the 26 States and DF (p ≤ 0.05). CONCLUSIONS The reduction in polio vaccine coverage, as observed in the North and Northeast regions of Brazil, may favor the spread of Poliovirus. Therefore, vaccination strategies should be prioritized for children residing in areas with sharp and recurrent declines in vaccination coverages, including travelers, migrants, and refugees.
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Affiliation(s)
- Tércia Moreira Ribeiro da Silva
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil.
| | | | - Elton Junio Sady Prates
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Thales Philipe Rodrigues da Silva
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Mark Anthony Beinner
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | - Suelen Rosa de Oliveira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Fernanda Penido Matozinhos
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | - Ed Wilson Rodrigues Vieira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
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Al-Jabri M, Rosero C, Saade EA. Vaccine-Preventable Diseases in Older Adults. Infect Dis Clin North Am 2023; 37:103-121. [PMID: 36805008 DOI: 10.1016/j.idc.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Older adults are at an increased risk of vaccine-preventable diseases partly because of physiologic changes in the immune and other body systems related to age and/or accumulating comorbidities that increase the vulnerability to infections and decrease the response to vaccines. Strategies to improve the response to vaccines include using a higher antigenic dose (such as in the high-dose inactivated influenza vaccines) as well as adding adjuvants (such as MF59 in the adjuvanted inactivated influenza vaccine).
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Affiliation(s)
- Maha Al-Jabri
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue - Mailstop Fol. 5083, Cleveland, OH 44106, USA; Case Western Reserve University, Cleveland, OH, USA
| | - Christian Rosero
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue - Mailstop Fol. 5083, Cleveland, OH 44106, USA; Case Western Reserve University, Cleveland, OH, USA
| | - Elie A Saade
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue - Mailstop Fol. 5083, Cleveland, OH 44106, USA.
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Durmuş Sarıkahya S, Güden E, Sümeyye Yorulmaz D. Childhood vaccine hesitancy in two regions with different socioeconomic backgrounds in Turkey. Z Gesundh Wiss 2023:1-10. [PMID: 36855466 PMCID: PMC9948781 DOI: 10.1007/s10389-023-01854-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
Aim This study investigated childhood vaccine hesitancy in two regions with different socioeconomic backgrounds in Kayseri, Turkey. Subject and methods The study population consisted of all people over 18 years of age admitted to two family health centers (No 65 and 103) in a city center for any reason. Results Participants living in the high socioeconomic status (SES) region had a significantly lower mean rating on the CVHQ (Childhood Vaccine Hesitancy Questionnaire - see below) than those living in the low SES region. Conclusion Vaccine hesitancy is the main reason for vaccine refusal. Therefore, authorities should provide adequate and accurate information about the significance of vaccines to raise public awareness.
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Affiliation(s)
| | - Emel Güden
- Kayseri Provincial Health Directorate, AR-GE Project Management and Consultancy Unit, Kayseri, Türkiye
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Sharma K, Das S, Goswami A. A Study on Acute Membranous Tonsillitis, Its Different Etiologies and Its Clinical Presentation in a Tertiary Referral Centre. Indian J Otolaryngol Head Neck Surg 2022; 74:4543-8. [PMID: 33907680 DOI: 10.1007/s12070-021-02572-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/13/2021] [Indexed: 02/07/2023] Open
Abstract
Membranous tonsillitis is the infection of the palatine tonsils where the exudation from the crypts coalesce to form a membrane over the tonsillar surface. It is a stage ahead of the acute follicular tonsillitis. There are different etiologies for membrane formation over the tonsils. The commonest cause in the present scenario is still Corynebacterium diphtheriae. A one year prospective study was conducted on patients presenting with membranous tonsillitis in a tertiary referral centre in North-East India. Proper history was taken, clinical examination and all the necessary investigations were done. The patients were managed conservatively, while a few patients required tracheostomy. In our one year study, we found that majority of the patients presenting with acute membranous tonsillitis were males (65%) and 35% were females. Most of the cases were seen in 6-12 years of age and belonged to the lower socioeconomic group, and also to the lower Assam belt. Most of the cases were seen in the months of November to January. This prospective study gives a view of the different etiologies of acute membranous tonsillitis, its presentation and how its management affects the outcome of the patients and also affects the mortality and morbidity. This study also shows that diphtheria is still prevalent in the current Indian scenario and thus, proper implementation of the vaccination programs and prompt reporting of the cases should be done to prevent outbreaks.
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Lee DID, Vanderhout S, Aglipay M, Birken CS, Morris SK, Piché-Renaud PP, Keown-Stoneman CDG, Maguire JL. Delay in childhood vaccinations during the COVID-19 pandemic. Can J Public Health 2022; 113:126-134. [PMID: 35060107 PMCID: PMC8773389 DOI: 10.17269/s41997-021-00601-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES In many jurisdictions, routine medical care was reduced in response to the COVID-19 pandemic. The objective of this study was to determine whether the frequency of on-time routine childhood vaccinations among children age 0-2 years was lower following the COVID-19 declaration of emergency in Ontario, Canada, on March 17, 2020, compared to prior to the pandemic. METHODS We conducted a longitudinal cohort study of healthy children aged 0-2 years participating in the TARGet Kids! primary care research network in Toronto, Canada. A logistic mixed effects regression model was used to determine odds ratios (ORs) for delayed vaccination (> 30 days vs. ≤ 30 days from the recommended date) before and after the COVID-19 declaration of emergency, adjusted for confounding variables. A Cox proportional hazards model was used to explore the relationship between the declaration of emergency and time to vaccination. RESULTS Among 1277 children, the proportion of on-time vaccinations was 81.8% prior to the COVID-19 declaration of emergency and 62.1% after (p < 0.001). The odds of delayed vaccination increased (odds ratio = 3.77, 95% CI: 2.86-4.96), and the hazard of administration of recommended vaccinations decreased after the declaration of emergency (hazard ratio = 0.75, 95% CI: 0.60-0.92). The median vaccination delay time was 5 days (95% CI: 4-5 days) prior to the declaration of emergency and 17 days (95% CI: 12-22 days) after. CONCLUSION The frequency of on-time routine childhood vaccinations was lower during the first wave of the COVID-19 pandemic. Sustained delays in routine vaccinations may lead to an increase in rates of vaccine-preventable diseases.
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Affiliation(s)
- Da In Diane Lee
- Department of Paediatrics, St. Michael's Hospital, 61 Queen Street East, 2nd Floor, Toronto, ON, M5C 2T2, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shelley Vanderhout
- Department of Paediatrics, St. Michael's Hospital, 61 Queen Street East, 2nd Floor, Toronto, ON, M5C 2T2, Canada.,Department of Nutritional Sciences, Medical Sciences Building, University of Toronto, 1 King's College Circle, Room 5253, Toronto, ON, M5S 1A8, Canada
| | - Mary Aglipay
- Department of Paediatrics, St. Michael's Hospital, 61 Queen Street East, 2nd Floor, Toronto, ON, M5C 2T2, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Catherine S Birken
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Nutritional Sciences, Medical Sciences Building, University of Toronto, 1 King's College Circle, Room 5253, Toronto, ON, M5S 1A8, Canada.,Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada.,Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, ON, Toronto, Canada
| | - Shaun K Morris
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, ON, Toronto, Canada.,Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
| | - Pierre-Philippe Piché-Renaud
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, ON, Toronto, Canada.,Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada
| | - Charles D G Keown-Stoneman
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Applied Health Research Centre, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Jonathon L Maguire
- Department of Paediatrics, St. Michael's Hospital, 61 Queen Street East, 2nd Floor, Toronto, ON, M5C 2T2, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. .,Department of Nutritional Sciences, Medical Sciences Building, University of Toronto, 1 King's College Circle, Room 5253, Toronto, ON, M5S 1A8, Canada. .,Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, ON, Toronto, Canada. .,Applied Health Research Centre, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
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Aksnes BN, Walldorf JA, Nkwenkeu SF, Zoma RL, Mirza I, Tarbangdo F, Fall S, Hien S, Ky C, Kambou L, Diallo AO, Aké FH, Hatcher C, Patel JC, Novak RT, Hyde TB, Medah I, Soeters HM, Jalloh MF. Vaccination information, motivations, and barriers in the context of meningococcal serogroup A conjugate vaccine introduction: A qualitative assessment among caregivers in Burkina Faso, 2018. Vaccine 2021; 39:6370-6377. [PMID: 34579975 PMCID: PMC8519392 DOI: 10.1016/j.vaccine.2021.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND In March 2017, Burkina Faso introduced meningococcal serogroup A conjugate vaccine (MACV) into the Expanded Programme on Immunization. MACV is administered to children aged 15-18 months, concomitantly with the second dose of measles-containing vaccine (MCV2). One year after MACV introduction, we assessed the sources and content of immunization information available to caregivers and explored motivations and barriers that influence their decision to seek MACV for their children. METHODS Twenty-four focus group discussions (FGDs) were conducted with caregivers of children eligible for MACV and MCV2. Data collection occurred in February-March 2018 in four purposively selected districts, each from a separate geographic region; within each district, caregivers were stratified into groups based on whether their children were unvaccinated or vaccinated with MACV. FGDs were recorded and transcribed. Transcripts were coded and analyzed using qualitative content analysis. RESULTS We identified many different sources and content of information about MACV and MCV2 available to caregivers. Healthcare workers were most commonly cited as the main sources of information; caregivers also received information from other caregivers in the community. Caregivers' motivations to seek MACV for their children were driven by personal awareness, engagements with trusted messengers, and perceived protective benefits of MACV against meningitis. Barriers to MACV and MCV2 uptake were linked to the unavailability of vaccines, immunization personnel not providing doses, knowledge gaps about the 15-18 month visit, practical constraints, past negative experiences, sociocultural influences, and misinformation, including misunderstanding about the need for MCV2. CONCLUSIONS MACV and MCV2 uptake may be enhanced by addressing vaccination barriers and effectively communicating vaccination information and benefits through trusted messengers such as healthcare workers and other caregivers in the community. Educating healthcare workers to avoid withholding vaccines, likely due to fear of wastage, may help reduce missed opportunities for vaccination.
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Affiliation(s)
| | - Jenny A Walldorf
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | | | - Robert L Zoma
- Institut National de Statistique et Démographie, Ouagadougou, Burkina Faso
| | | | | | | | | | - Cesaire Ky
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | | | | | | | - Cynthia Hatcher
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Jaymin C Patel
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Ryan T Novak
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Terri B Hyde
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Isaïe Medah
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Heidi M Soeters
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
| | - Mohamed F Jalloh
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
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9
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Mura M, Haus-Cheymol R, Tournier JN. Immunization on the French Armed Forces: Impact, organization, limits and perspectives. Infect Dis Now 2021; 51:583-589. [PMID: 34581277 DOI: 10.1016/j.idnow.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/08/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022]
Abstract
Vaccination plays a key role in the prevention of the infectious diseases, which the armed forces are exposed to during overseas deployments. Historically, the French military health service have always contributed greatly to progress in vaccination. The military immunization schedule has often been used as a model for the national schedule. It is a powerful tool, which is constantly evolving to take into account the risks of infection inherent in deployment and to include new scientific data, while still remaining aware of the limitations of vaccination from an individual and collective standpoint. In the current context of increasingly fast emergence or re-emergence of pathogens with a high epidemic potential, developing preventive medical measures is more necessary than ever before, and the French military health service is actively participating.
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Affiliation(s)
- M Mura
- Institut de recherche biomédicale des armées, unité Bactériologie et biothérapies anti-infectieuses et immunité, 1 place du Général-Valérie-André, BP73, Brétigny-sur-orge Cédex, France; Walter Reed Army Institute of Research, 503 Robert Grant Avenue, MD20910 Silver Spring, USA
| | - R Haus-Cheymol
- Direction centrale du service de santé des armées, Division expertise stratégie de santé de défense, Bureau plans de santé, France
| | - J-N Tournier
- Institut de recherche biomédicale des armées, unité Bactériologie et biothérapies anti-infectieuses et immunité, 1 place du Général-Valérie-André, BP73, Brétigny-sur-orge Cédex, France; Institut Pasteur, Innovative vaccine Laboratory, 28, rue du docteur Roux, 75015 Paris, France.
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10
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Zaman K, Kovacs SD, Vanderende K, Aziz A, Yunus M, Khan S, Snider CJ, An Q, Estivariz CF, Oberste MS, Pallansch MA, Anand A. Assessing the immunogenicity of three different inactivated polio vaccine schedules for use after oral polio vaccine cessation, an open label, phase IV, randomized controlled trial. Vaccine 2021; 39:5814-5821. [PMID: 34481702 DOI: 10.1016/j.vaccine.2021.08.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/23/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND After global oral poliovirus vaccine (OPV) cessation, the Strategic Advisory Group of Experts on Immunization (SAGE) currently recommends a two-dose schedule of inactivated poliovirus vaccine (IPV) beginning ≥14-weeks of age to achieve at least 90% immune response. We aimed to compare the immunogenicity of three different two-dose IPV schedules started before or at 14-weeks of age. METHODS We conducted a randomized, controlled, open-label, inequality trial at two sites in Dhaka, Bangladesh. Healthy infants at 6-weeks of age were randomized into one of five arms to receive two-dose IPV schedules at different ages with and without OPV. The three IPV-only arms are presented: Arm C received IPV at 14-weeks and 9-months; Arm D received IPV at 6-weeks and 9-months; and Arm E received IPV at 6 and 14-weeks. The primary outcome was immune response defined as seroconversion from seronegative (<1:8) to seropositive (≥1:8) after vaccination, or a four-fold rise in antibody titers and median reciprocal antibody titers to all three poliovirus types measured at 10-months of age. FINDINGS Of the 987 children randomized to Arms C, D, and E, 936 were included in the intention-to-treat analysis. At 10-months, participants in Arm C (IPV at 14-weeks and 9-months) had ≥99% cumulative immune response to all three poliovirus types which was significantly higher than the 77-81% observed in Arm E (IPV at 6 and 14-weeks). Participants in Arm D (IPV at 6-weeks and 9-months) had cumulative immune responses of 98-99% which was significantly higher than that of Arm E (p value < 0.0001) but not different from Arm C. INTERPRETATION Results support current SAGE recommendations for IPV following OPV cessation and provide evidence that the schedule of two full IPV doses could begin as early as 6-weeks.
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Affiliation(s)
- Khalequ Zaman
- International Centre for Diarrheal Disease, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Stephanie D Kovacs
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Kristin Vanderende
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Asma Aziz
- International Centre for Diarrheal Disease, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Mohammed Yunus
- International Centre for Diarrheal Disease, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Sara Khan
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Cynthia J Snider
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Qian An
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Concepcion F Estivariz
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - M Steven Oberste
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Mark A Pallansch
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Abhijeet Anand
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
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11
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Raguindin PF, Morales-Dizon M, Aldaba J, Mangulabnan LP, Reyes RP, Batmunkh N, Ducusin MJ, Lopez AL. Timeliness of childhood vaccinations in the Philippines. J Public Health Policy 2021; 42:53-70. [PMID: 33398056 PMCID: PMC7979588 DOI: 10.1057/s41271-020-00255-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 12/02/2022]
Abstract
Timeliness of vaccinations is rarely part of monitoring in a routine immunization program. We reviewed infant immunization and conducted caregiver interviews in three regions in the Philippines from January to October 2016. We randomly selected thirty public health centers, one for each region. We defined timeliness of the receipt of antigen as within 4 weeks after the recommended age at vaccination. We assessed a total of 986 infants for timeliness of vaccination. The median age of receipt of vaccine was at 2.7 weeks (BCG), 10.1 weeks (Penta 1), and 21.7 weeks (Penta 3) compared to the recommended 0, 6, and 14 weeks of age, respectively. We found timely receipt only in 74.4% for BCG, 70.3% for Penta 1, and 39.1% for Penta 3 recipients. Thus, alongside declining immunization coverage, the infants in the Philippines had substantial delays in vaccine receipt.
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Affiliation(s)
- Peter Francis Raguindin
- Institute of Child Health and Human Development, National Institutes of Health – University of the Philippines Manila, Manila, Philippines
- Present Address: Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Merrylle Morales-Dizon
- Institute of Child Health and Human Development, National Institutes of Health – University of the Philippines Manila, Manila, Philippines
| | - Josephine Aldaba
- Institute of Child Health and Human Development, National Institutes of Health – University of the Philippines Manila, Manila, Philippines
| | - Lailani P. Mangulabnan
- Department of Health, Center for Health Development Region 3, San Fernando City, Pampanga Philippines
| | - Renelyn P. Reyes
- Department of Health, Center for Health Development Region 6, Iloilo City, Iloilo Philippines
| | - Nyambat Batmunkh
- Vaccine Preventable Diseases and Immunization, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Maria Joyce Ducusin
- Department of Health, Disease Prevention and Control Bureau, Manila, Philippines
| | - Anna Lena Lopez
- Institute of Child Health and Human Development, National Institutes of Health – University of the Philippines Manila, Manila, Philippines
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12
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García-Serrano C, Mirada G, Marsal JR, Ortega M, Sol J, Solano R, Artigues EM, Estany P. Compliance with the guidelines on recommended immunization schedule in patients with inflammatory bowel disease: implications on public health policies. BMC Public Health 2020; 20:713. [PMID: 32429900 PMCID: PMC7236120 DOI: 10.1186/s12889-020-08850-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/05/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) have a higher risk of developing opportunistic infections due to either the disease itself or to treatment with immunosuppressants. This risk can be reduced through vaccination. The aim of this study was to determine the prevalence of compliance with the guidelines on recommended immunization schedule in patients with IBD in the health district of Lleida, Spain. METHODS Descriptive, cross-sectional, retrospective study of data at December 31, 2016. The reference population was formed by adults with a clinical diagnosis of IBD. The dependent variable was "compliance with the guidelines on recommended immunization schedule". Variables were sex, age, residence, diagnosis, vaccination against measles, mumps, rubella, varicella, tetanus-diphtheria, influenza, pneumococcus, meningococcus C, hepatitis B, and hepatitis A. Data were obtained from electronic medical records. For the data analysis, mean (standard deviation), prevalence with 95% confidence intervals, χ2 test and Mann-Whitney test were used. RESULTS Compliance did not exceed 65% for any of vaccines analysed in the 1722 studied patients with ulcerative colitis or Crohn's disease. Significant differences across age groups were found in compliance for measles, mumps, rubella, varicella, tetanus, diphtheria and influenza in both ulcerative colitis and Crohn's disease and for meningococcus C and hepatitis A exclusively in ulcerative colitis. CONCLUSIONS Compliance in patients with IBD is low. Thus, prevention of immunopreventable diseases or their complications is not maximized in this kind of patients. Greater awareness of how vaccines can reduce the risk of vaccine-preventable infections is needed among both patients and healthcare professionals.
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Affiliation(s)
- Cristina García-Serrano
- Catalan Health Institute (ICS), Primary Care, Lleida, Spain.,Lleida Institute for Biomedical Research (IRBLleida), Lleida, Spain
| | - Glòria Mirada
- Faculty of Nursery and Physiotherapy, University of Lleida, Lleida, Spain.,Catalan Agency of Public Health, Lleida, Spain
| | - Josep R Marsal
- Cardiovascular Epidemiology Unit, Cardiology Department, Vall d'Hebron University Hospital, CIBERESP, Lleida, Spain
| | - Marta Ortega
- Catalan Health Institute (ICS), Primary Care, Lleida, Spain.,Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Lleida, Spain.,Faculty of Medicine, University of Lleida, Lleida, Spain.,Research Group in Therapies in Primary Care (GRETAPS), Lleida, Spain
| | - Joaquim Sol
- Catalan Health Institute (ICS), Primary Care, Lleida, Spain. .,Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Lleida, Spain. .,Metabolic Physiopathology Group, Department of Experimental Medicine, University of Lleida-IRBLleida, Lleida, Spain.
| | - Rubén Solano
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Lleida, Spain
| | - Eva M Artigues
- Catalan Health Institute (ICS), Primary Care, Lleida, Spain.,Faculty of Nursery and Physiotherapy, University of Lleida, Lleida, Spain.,Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Lleida, Spain.,Research Group in Therapies in Primary Care (GRETAPS), Lleida, Spain.,Research Group in Health Education (GREpS), Department of Nursery and Physiotherapy, University of Lleida, Lleida, Spain
| | - Pepi Estany
- Catalan Health Institute (ICS), Primary Care, Lleida, Spain
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13
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Choi EH, Park SE, Kim YJ, Jo DS, Kim YK, Eun BW, Lee TJ, Lee J, Lee H, Kim KH, Cho HK, Cho EY, Kim JH. Recommended immunization schedule for children and adolescents: Committee on Infectious Diseases of the Korean Pediatric Society, 2018. Korean J Pediatr 2019; 62:252-256. [PMID: 31163961 PMCID: PMC6642926 DOI: 10.3345/kjp.2019.00227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/29/2019] [Indexed: 11/27/2022]
Abstract
The Committee on Infectious Diseases of the Korean Pediatric Society recommended immunization schedule for children and adolescents aged 18 years or younger in the 9th (2018) edition of Immunization guideline. This report provides the revised recommendations made by the committee and summarizes several changes from the 2015 guideline. National immunization program (NIP) launched a human papillomavirus (HPV) immunization for girls aged 12 years in 2016. NIP has also expanded age indication for inactivated influenza vaccine (IIV) to 12 years of age in the 2018-2019 season. Quadrivalent IIVs with a full dose (0.5 mL) are approved for all children of 6 months or older. Recommendations of live attenuated influenza vaccine were removed. For inactivated Japanese encephalitis vaccine, first 2 doses are considered as the primary series. Recommendations for use of newly introduced vaccines (diphtheria-tetanus-acellular pertussis/inactivated poliovirus/Haemophilus influenzae type b, 9-valent HPV, new varicella vaccine, new quadrivalent IIV, and attenuated oral typhoid vaccine) were added. Lastly, monitoring system for adverse events following immunization was updated. Other changes can be found in the 9th edition of Immunization guideline in detail.
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Affiliation(s)
- Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Su Eun Park
- Department of Pediatrics, School of Medicine, Pusan National University, Pusan, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Dae Sun Jo
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea
| | - Yun-Kyung Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Byung-Wook Eun
- Department of Pediatrics, School of Medicine, Eulji University, Daejeon, Korea
| | - Taek-Jin Lee
- Department of Pediatrics, CHA University School of Medicine, Pocheon, Korea
| | - Jina Lee
- Department of Pediatrics, University of Ulsan College of Medicine, Ulsan, Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Hwan Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye-Kyung Cho
- Department of Pediatrics, Gachon University College of Medicine, Incheon, Korea
| | - Eun Young Cho
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jong-Hyun Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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14
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Gohar A, Abdeltawab NF, Shehata N, Amin MA. Preclinical study of safety and immunogenicity of combined rubella and human papillomavirus vaccines: Towards enhancing vaccination uptake rates in developing countries. Papillomavirus Res 2019; 8:100172. [PMID: 31185296 DOI: 10.1016/j.pvr.2019.100172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/11/2019] [Accepted: 06/07/2019] [Indexed: 11/24/2022]
Abstract
Rubella vaccine was not part of national immunization programs (NIP) in several countries in the Middle East and North Africa (MENA), South-East Asia (SEA), and South Africa regions until the year 2000. Therefore, immunization coverage of females older than 20 years old in these countries has been the focus of national campaigns for rubella elimination in developing countries. Vaccines against human papillomavirus (HPV) are not part of NIPs in developing countries. To enhance the advantages of rubella-directed immunization campaigns and to increase HPV vaccine uptake in developing countries, this study aimed to test the stability, potency, efficacy and safety of a combined rubella and HPV vaccine. Female BALB/c mice were immunized subcutaneously with proposed combined HPV16/HPV18 VLP and rubella vaccine at weeks (W) 0, 3 then with HPV vaccine at W 7. Immunized mice developed antigen-specific antibodies against rubella and HPV significantly higher than mice immunized with rubella or HPV vaccine alone. The combined vaccine induced significantly higher splenocyte proliferation than control groups. In addition, pro-inflammatory cytokines IL-4, IL-6, IL-2, and IFNγ levels were significantly higher in mice immunized with the combined vaccine than control groups. Overall, the combined vaccine was safe and immunogenic offering antibody protection as well as eliciting a cellular immune response against rubella and HPV viruses in a single vaccine. This combined vaccine can be of great value to females above 20 years old in the SEA, MENA and South Africa regions offering coverage to rubella vaccine and a potential increase in HPV vaccine uptake rates after appropriate clinical testing.
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15
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Yang X, Zhang D, Ou W. Pneumococcal vaccination patterns among persons aged 65 years or older in the United States: A retrospective database analysis. Vaccine 2018; 36:7574-7579. [PMID: 30391053 DOI: 10.1016/j.vaccine.2018.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study investigated the patterns of pneumococcal disease vaccination, the time between two different pneumococcal vaccine doses and factors associated with series completion. METHODS A retrospective claims database analysis was conducted using the Clinformatics DataMart™ database. Adults who turned 65 years between January 1st, 2013 to June 30th, 2017 and were continuously enrolled (≥15 months) in the Medicare Advantage plans to June 30th, 2017 were included in this study. Pneumococcal vaccination patterns included: PCV13-PPV23, PPV23-PCV13, or receiving PPV23 or PCV13 only. Pneumococcal vaccination series completion was defined as receiving PCV13-PPV23 or PPV23-PCV13 from 65 years old to June 30th, 2017 while non-completion was defined as receiving only PCV13 or only PPV23 from 65 years old to June 30th, 2017. A multivariable logistic regression model was used to identify factors associated with pneumococcal vaccination series completion. RESULTS A total of 224,132 adults were included in this study. Most received no pneumococcal vaccination (49%), while 34.3% received only one vaccine. Series completion occurred in 16.8% of adults. Some adults received only one vaccination: 11.6% received PPV23 and 22.7% received PCV13. The mean time between vaccinations was 420.8 days (approximately 14 months) for the PCV-PPV23 series, and 595.5 days (approximately 20 months) for the PPV23-PCV13 series. Adults were significantly more likely to complete pneumococcal vaccination series if they had at least one doctor's office, outpatient visit, or pharmacy visit versus no visits, or received an influenza vaccination in the first year after turning 65 years than those who did not (All: P < 0.001). CONCLUSION Despite the 2014 recommendation, percentages of pneumococcal vaccination series completion were found to be low, aligning with recent literature. This highlights the need to improve series completion, given the increased risk and associated economic burden of pneumococcal disease in adults aged ≥65 years.
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Affiliation(s)
- Xiaoqin Yang
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA.
| | - Dongmu Zhang
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
| | - Wanmei Ou
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
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16
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Kim J, Kim JE, Bae JM. Incidence of varicella in children in Jeju-do, Korea, 2005-2016: age-period-cohort analysis. Epidemiol Health 2018; 40:e2018054. [PMID: 30428643 PMCID: PMC6302224 DOI: 10.4178/epih.e2018054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/08/2018] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea. METHODS The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2-13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis. RESULTS As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do. CONCLUSIONS The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.
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Affiliation(s)
- Jinhee Kim
- Jeju Center for Infection Control, Jeju, Korea
| | - Ji-Eun Kim
- Jeju Center for Infection Control, Jeju, Korea
| | - Jong-Myon Bae
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
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17
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Abstract
Vaccinations are among the most effective preventive measures modern medicine has to offer. They lead both to individual protection in those vaccinated and in many cases to the protection of others against transmission of the infection; however, the acceptance of vaccinations in Germany has declined rather than increased in recent years. Paradoxically, this is very much due to the success of the vaccinations: due to successful immunization campaigns, numerous diseases have become so rare that they have disappeared from the consciousness of the population. Travel medicine counselling offers an excellent opportunity to fill in gaps in immunization.
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Affiliation(s)
- Tomas Jelinek
- BCRT - Berliner Centrum für Reise- und Tropenmedizin, Friedrichstr. 134, 10117, Berlin, Deutschland. .,Institut für medizinische Mikrobiologie, Immunologie und Hygiene, Uniklinik Köln, Köln, Deutschland. .,CRM - Centrum für Reisemedizin, Düsseldorf, Deutschland.
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18
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Odoh C, Sanderson M, Williams EA, Hull PC. Operationalizing outcome measures of human papillomavirus vaccination among adolescents. Public Health 2018; 159:129-32. [PMID: 29609838 DOI: 10.1016/j.puhe.2018.02.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 01/17/2018] [Accepted: 02/18/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES When examining vaccination coverage, researchers must make decisions about how to define outcome measures based on many factors, including the timing of doses. Different operationalizations of the same outcome can often lead to different findings and can affect the ability to make comparisons across studies. This methodological article aimed to illustrate the implications of two options for operationalizing human papillomavirus (HPV) vaccination based on timing: initiation of the first dose at any age vs before the 13th birthday (on time). STUDY DESIGN Cross-sectional observational design. METHODS The 2014 National Immunization Survey for Teens (N = 16,439 adolescents aged 13-17 years) was analyzed using multivariate logistic regression for each outcome measure and effect modification by gender. RESULTS Age was positively associated with initiation at any age but negatively associated with on-time initiation. Gender modified the effect of race/ethnicity for both measures of initiation, but the pattern across groups was different for the two outcomes. Gender modified the effect of provider recommendation for initiation at any age, while gender modified the effects of age and region for on-time initiation. CONCLUSION Decisions of how to operationalize outcomes of HPV vaccine initiation among adolescents can lead to different conclusions about the role of age and gender differences for several predictive variables. To inform the development of public health efforts that promote on-time HPV vaccination among male and female adolescents, researchers should consider the importance of dose timing when operationalizing outcome measures. We recommend including on-time receipt of the HPV vaccine as an outcome measure.
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19
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Wagner AL, Boulton ML, Sun X, Huang Z, Harmsen IA, Ren J, Zikmund-Fisher BJ. Parents' concerns about vaccine scheduling in Shanghai, China. Vaccine 2017; 35:4362-4367. [PMID: 28687407 DOI: 10.1016/j.vaccine.2017.06.077] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Several new vaccines have been introduced into China in recent years, but some parents in China have shown concerns about the scheduling of vaccinations for young infants. This study explores caregiver concerns about children receiving multiple vaccines during a single visit and about vaccine administration in infants <6months, and assesses the degree to which these concerns are associated with ratings of the importance of different sources of vaccine information in Shanghai. METHODS Caregivers of children 8months to 7years presenting at immunization clinics in Shanghai completed a survey about vaccine co-administration and vaccine administration <6months of age. Respondents provided ratings of information from different sources (Internet, family/friends, other parents) and trust in doctors. We analyzed vaccine concerns using linear regression analyses that included these information sources after adjusting for socioeconomic variables. RESULTS Among 618 caregivers, 64% were concerned about vaccine co-administration and 31% were concerned about vaccine administration to infants <6months of age. Higher ratings of Internet as an important source of information were associated with greater concern about co-administration (β=0.11, 95% CI: 0.00, 0.22) and concern about administration at <6months of age (β=0.17, 95% CI: 0.05, 0.28). Higher ratings given to information from other parents corresponded to 0.24 points greater concern about vaccine co-administration (95% CI: 0.04, 0.44). More trust in doctors and ratings of information from friends and family were not associated with vaccine concerns. CONCLUSIONS Caregiver concerns about vaccine scheduling may limit China's flexibility to add vaccines to its official immunization schedule. Reporting information about vaccine safety on the Internet and bringing groups of parents together to discuss vaccines might help to ameliorate concerns about vaccine scheduling.
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Affiliation(s)
- Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Matthew L Boulton
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
| | - Xiaodong Sun
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, NO. 1380, West Zhongshan Road, 200336 Shanghai, China.
| | - Zhuoying Huang
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, NO. 1380, West Zhongshan Road, 200336 Shanghai, China.
| | - Irene A Harmsen
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
| | - Jia Ren
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, NO. 1380, West Zhongshan Road, 200336 Shanghai, China.
| | - Brian J Zikmund-Fisher
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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20
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Scheepers ED, van Lier A, Drijfhout IH, Berbers G, van der Maas NAT, de Melker HE, Knol MJ. Dutch national immunization schedule: compliance and associated characteristics for the primary series. Eur J Pediatr 2017; 176:769-778. [PMID: 28429116 DOI: 10.1007/s00431-017-2904-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 03/11/2017] [Accepted: 04/03/2017] [Indexed: 12/21/2022]
Abstract
UNLABELLED In the Netherlands, the recommended priming immunization schedule for diphtheria, tetanus, pertussis and polio (DTaP-IPV) is at 2, 3 and 4 months of age. We evaluated the compliance with the recommended schedule, as well as its characteristics. We included all infants born between 2007 and 2012 who received minimally one DTaP-IPV vaccination (n = 1,061,578). Infants complied with the schedule if they received the first vaccination between 6 and 9 weeks of age, and the second and third vaccination 2-6 weeks after the first and second vaccination. We examined associations between compliance and several characteristics using log-binomial regression. Compliance for the first, second and third vaccination was 81.6, 88.3 and 84.2%, respectively. Compliance with the total recommended schedule was 64.5%, and increased from 60.1% for 2007 to 68.5% for 2012. Compliance was higher for full-term infants (65.9%), infants with normal birth weight (66.0%) and when both parents were born in the Netherlands (66.8%). CONCLUSION Delayed vaccination during the primary vaccination schedule occurs in one sixth of the Dutch children. Efforts to improve compliance should be focused in particular on preterm infants, infants with low birth weight and infants whose parents are not born in the Netherlands. What is Known: • A delayed start of vaccination leads to a longer period at risk for infectious diseases, e.g. pertussis • Delayed vaccination is associated with several factors including prematurity, low birth weight, family size, birth order, low socioeconomic status and health status of the child What is New: • Compliance with the recommended priming immunization schedule for diphtheria, tetanus, pertussis and polio was 64.5%, and increased from 60.1% for 2007 to 68.5% for 2012 • If the first vaccination was delayed, there was a higher chance that the following vaccinations were administered 'out-of-schedule' as well, resulting in even a higher age at second and third vaccination.
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Affiliation(s)
- Elsemieke D Scheepers
- Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands
| | - Alies van Lier
- Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands
| | - Ingrid H Drijfhout
- Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands
| | - Guy Berbers
- Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands
| | - Nicoline A T van der Maas
- Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands
| | - Mirjam J Knol
- Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands.
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21
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Teimouri F, Kebriaeezadeh A, Zahraei SM, Gheiratian M, Nikfar S. Budget impact analysis of vaccination against Haemophilus influenzae type b as a part of a Pentavalent vaccine in the childhood immunization schedule of Iran. ACTA ACUST UNITED AC 2017; 25:1. [PMID: 28088246 PMCID: PMC5237530 DOI: 10.1186/s40199-017-0166-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/07/2017] [Indexed: 11/10/2022]
Abstract
Background Health decision makers need to know the impact of the development of a new intervention on the public health and health care costs so that they can plan for economic and financial objectives. The aim of this study was to determine the budget impact of adding Haemophilus influenzae type b (Hib) as a part of a Pentavalent vaccine (Hib-HBV-DTP) to the national childhood immunization schedule of Iran. Methods An excel-based model was developed to determine the costs of including the Pentavalent vaccine in the national immunization program (NIP), comparing the present schedule with the previous one (including separate DTP and hepatitis B vaccines). The total annual costs included the cost of vaccination (the vaccine and syringe) and the cost of Hib treatment. The health outcome was the estimated annual cases of the diseases. The net budget impact was the difference in the total annual cost between the two schedules. Uncertainty about the vaccine effectiveness, vaccination coverage, cost of the vaccine, and cost of the diseases were handled through scenario analysis. Results The total cost of vaccination during 5 years was $18,060,463 in the previous program and $67,774,786 in the present program. Inclusion of the Pentavalent vaccine would increase the vaccination cost about $49 million, but would save approximately $6 million in the healthcare costs due to reduction of disease cases and treatment costs. The introduction of the Pentavalent vaccine resulted in a net increase in the healthcare budget expenditure across all scenarios from $43.4 million to $50.7 million. Conclusions The results of this study showed that the inclusion of the Pentavalent vaccine in the NIP of Iran had a significant impact on the health care budget and increased the financial burden on the government. Graphical abstract Budget impact of including Pentavalent vaccine in the national immunization schedule of Iranᅟ![]()
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Affiliation(s)
- Fatemeh Teimouri
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Kebriaeezadeh
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Education, Tehran, Iran
| | - MohammadMahdi Gheiratian
- Department of Emergency Medicine, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shekoufeh Nikfar
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. .,Evidence-Based Medicine Group, Pharmaceutical Sciences Research Group, Tehran University of Medical Sciences, Tehran, Iran.
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Kim JH, Choi EH, Park SE, Kim YJ, Jo DS, Kim YK, Eun BW, Lee J, Lee SY, Lee H, Kim KH, Kim KH. Recommended immunization schedule for children and adolescents: Immunization Guideline (8th edition) released by the Korean Pediatric Society in 2015. Korean J Pediatr 2016; 59:461-465. [PMID: 28194210 PMCID: PMC5300909 DOI: 10.3345/kjp.2016.59.12.461] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 05/30/2016] [Accepted: 06/21/2016] [Indexed: 11/27/2022]
Abstract
This report includes the recommended immunization schedule table for children and adolescents based on the 8th (2015) and revised 7th (2012) Immunization Guidelines released by the Committee on Infectious Diseases of the Korean Pediatric Society (KPS). Notable revised recommendations include: reorganization of the immunization table with a list of vaccines on the vertical axis and the corresponding age on the horizontal axis; reflecting the inclusion of Haemophilus influenzae type b vaccine, pneumococcal conjugate vaccine, and hepatitis A vaccine into the National Immunization Program since 2012; addition of general recommendations for 2 new Japanese encephalitis (JE) vaccines and their interchangeability with existing JE vaccines; addition of general recommendations for quadrivalent meningococcal conjugate vaccines and scope of the recommended targets for vaccination; and emphasizing catch-up immunization of Tdap vaccine. Detailed recommendations for each vaccine may be obtained from the full KPS 8th Immunization Guidelines.
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Affiliation(s)
- Jong-Hyun Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Su Eun Park
- Department of Pediatrics, School of Medicine, Pusan National University, Pusan, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Dae Sun Jo
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea
| | - Yun-Kyung Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Byung-Wook Eun
- Department of Pediatrics, Eulji University School of Medicine, Daejeon, Korea
| | - Jina Lee
- Department of Pediatrics, University of Ulsan College of Medicine, Ulsan, Korea
| | - Soo-Young Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Hwan Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung-Hyo Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
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23
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Vitale F, Costantino C, Restivo V, Casuccio N, Corsello G, Palermo M, Tozzo I. Precise reply and clarifications on behalf of Sicilian Public Health Authorities to the case report published by La Rosa and collegues. Hum Vaccin Immunother 2016; 12:2969-2971. [PMID: 27560654 PMCID: PMC5137532 DOI: 10.1080/21645515.2016.1200777] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
As a results of the case report “Post-rotavirus vaccine intussusception in identical twins: a case report” recently published on Human Vaccines & Immunotherapy by La Rosa et al., the principal Sicilian Public Health Authorities decided to specify several points and underline some important details omitted by the authors. In particular, aims to underline the remarkable benefit for Sicilian Regional Health service after the introduction of the rotavirus vaccination. Universal mass vaccination against rotavirus is properly managed by the Regional Health Authorities and is contributing to a consistent increase of public health in the Sicilian pediatric population; any modification of such a program should be based on robust scientific evidences. Finally, a single case report should not be considered as a basis to recommend a change in the clinical practice but instead a possible point of start for discussion and research.
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Affiliation(s)
- Francesco Vitale
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy.,b Member of the Vaccination Board of the Sicilian Health Department , Palermo , Italy.,c Past President of the Sicilian Section of the Italian Society of Hygiene, Preventive Medicine and Public Health (S.It.I.) , Palermo , Italy
| | - Claudio Costantino
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy
| | - Vincenzo Restivo
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy
| | - Nicolò Casuccio
- b Member of the Vaccination Board of the Sicilian Health Department , Palermo , Italy.,d President of the Sicilian Section of the Italian Society of Hygiene, Preventive Medicine and Public Health (S.It.I.) , Palermo , Italy
| | - Giovanni Corsello
- a Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro" - University of Palermo , Palermo , Italy.,b Member of the Vaccination Board of the Sicilian Health Department , Palermo , Italy.,e President of the Italian Society for Pediatrics (S.I.P.) , Palermo , Italy
| | - Mario Palermo
- b Member of the Vaccination Board of the Sicilian Health Department , Palermo , Italy.,f Director of the Public Hygiene service of the Sicilian Health Department , Palermo , Italy
| | - Ignazio Tozzo
- g Director of the Department of Sanitary Activities and Epidemiological Observatory of the Sicilian Health Department , Palermo , Italy
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24
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Cunha GHD, Galvão MTG, Medeiros CMD, Rocha RP, Lima MAC, Fechine FV. Vaccination status of people living with HIV/AIDS in outpatient care in Fortaleza, Ceará, Brazil. Braz J Infect Dis 2016; 20:487-93. [PMID: 27542868 PMCID: PMC9425449 DOI: 10.1016/j.bjid.2016.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 07/17/2016] [Accepted: 07/24/2016] [Indexed: 11/27/2022] Open
Abstract
Antiretroviral therapy has increased the survival of patients with HIV/AIDS, thus necessitating health promotion practice with immunization. Vaccines are critical components for protecting people living with HIV/AIDS (PLWHA). The purpose of study was to analyze the vaccination status of PLWHA in outpatient care in Fortaleza, Ceará, Brazil. Cross-sectional study performed from June 2014 to June 2015. The screening was done with patients in antiretroviral therapy, 420 patients underwent screening, but only 99 met the inclusion criteria. Data were collected for interviews using forms to characterize sociodemographic, clinical and vaccination situations. Only 14 patients had complete vaccination schedules. The most used vaccines were hepatitis B, influenza vaccine and 23-valent pneumococcal. There was no difference between men and women regarding the proportion of PLWHA with full vaccination schedule or between sex, skin color, marital status, sexual orientation, religion or occupational status. There was no difference between having or not having a complete vaccination schedule and age, years of education, family income or number of hospitalizations. CD4+ T-cells count of patients with incomplete immunization was lower than patients with complete immunization. Health education strategies can be done individually or in groups to explain the importance of vaccination and to remind about doses to be administered. Most patients did not have proper adherence to vaccination schedules, especially due to lack of guidance. Results implied that education in health is important for vaccination adhesion, knowledge of adverse events and continuation of schemes.
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Affiliation(s)
| | | | | | - Ryvanne Paulino Rocha
- Universidade Federal do Ceará (UFC), Departamento de Enfernagem, Fortaleza, CE, Brazil
| | | | - Francisco Vagnaldo Fechine
- Universidade Federal do Ceará (UFC), Centro de Pesquisa e Desenvolvimento de Medicamentos, Fortaleza, CE, Brazil
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Navarro-Alonso JA, Taboada-Rodríguez JA, Limia-Sánchez A. [Toward a New Immunization Schedule in Spain, 2016 (Part 2)]. Rev Esp Salud Publica 2016; 90:E3. [PMID: 26960345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 06/05/2023] Open
Abstract
Immunization schedules are intrinsically dynamic in order to embed the immunologic and epidemiologic changes in any specific geographic Region. According to this, the current study addresses a proposal to modify the Childhood Immunization Schedule in Spain. In order to move from a three plus one schema to a two plus one, we undertake a review of the available literature to explore the immunological and clinical rationale behind this change, including an overview of the potential impact on this schedule of premature infants. Additionally, some recommendations are made regarding those Spanish regions which start hepatitis B vaccination at the newborn period.
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Affiliation(s)
| | | | - Aurora Limia-Sánchez
- Área de Programas de Vacunación. DG Salud Pública, Calidad e Innovación. Ministerio de Sanidad, Servicios Sociales e Igualdad.
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26
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Limia-Sánchez A, Andreu MM, Torres de Mier MDV, Navarro-Alonso JA. [Toward a New Immunization Schedule in Spain, 2016 (Part 1)]. Rev Esp Salud Publica 2016; 90:E2. [PMID: 26960253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 06/05/2023] Open
Abstract
The immunization Schedule is a dynamic public health tool that has incorporated different changes over the years influenced by the epidemiologic situation and the scientific evidence. The Immunization Advisory Committee [Ponencia de Programa y Registro de Vacunaciones], as the Interterritorial Council scientific and technical advisory body, carries out assessments of different programmes and vaccines and proposes changes that after approval will be introduced in the Regions schedule. This article is divided into two parts presenting the rationale followed to propose a new schedule for the immunization against diphtheria, tetanus, pertussis, hepatitis B and invasive disease by Haemophilus influenzae type b. This first part is focused in the reasoning to undertake the assessment, the review of the immunization policy and the impact of immunization in Spain, as well as a review of the immunization schedules in similar countries.
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Affiliation(s)
- Aurora Limia-Sánchez
- Área de Programas de Vacunación. DG Salud Pública, Calidad e Innovación. Ministerio de Sanidad, Servicios Sociales e Igualdad.
| | - María Mar Andreu
- Área de Programas de Vacunación. DG Salud Pública, Calidad e Innovación. Ministerio de Sanidad, Servicios Sociales e Igualdad
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27
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Wang E, Baras Y, Buttenheim AM. "Everybody just wants to do what's best for their child": Understanding how pro-vaccine parents can support a culture of vaccine hesitancy. Vaccine 2015; 33:6703-9. [PMID: 26518397 DOI: 10.1016/j.vaccine.2015.10.090] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/07/2015] [Accepted: 10/16/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although a large majority of parents vaccinate their children, vaccine hesitancy has become more widespread. It is not well understood how this culture of vaccine hesitancy has emerged and how it influences parents' decisions about vaccine schedules. OBJECTIVE We sought to examine how attitudes and beliefs of parents who self-report as pro-vaccine are developed and contribute to immunization decisions, including delaying or spacing vaccines. METHODS Open-ended, in-depth interviews (N=23) were conducted with upper-middle class parents with young children living in Philadelphia. Interview data were coded and key themes identified related to vaccine decision-making. RESULTS Parents who sought out vaccine information were often overwhelmed by the quantity and ambiguity when interpreting that information, and, consequently, had to rely on their own instinct or judgment to make vaccine decisions. In particular, while parents in this sample did not refuse vaccines, and described themselves as pro-vaccine, they did frequently delay or space vaccines. This experience also generated sympathy for and tolerance of vaccine hesitancy in other parents. Parents also perceived minimal severe consequences for deviating from the recommended immunization schedule. CONCLUSION These findings suggest that the rise in and persistence of vaccine hesitancy and refusal are, in part, influenced by the conflicts in the information parents gather, making it difficult to interpret. Considerable deviations from the recommended vaccination schedule may manifest even within a pro-vaccine population due to this perceived ambiguity of available information and resulting tolerance for vaccine hesitancy.
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Affiliation(s)
- Eileen Wang
- Department of History and Sociology of Science, University of Pennsylvania, Suite 303 Claudia Cohen Hall, 249 S. 36th Street, Philadelphia, PA 19104, USA.
| | - Yelena Baras
- School of Nursing, University of Pennsylvania, 416 Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19014, USA.
| | - Alison M Buttenheim
- School of Nursing, University of Pennsylvania, 416 Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19014, USA.
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González R, Campins M, Rodrigo JÁ, Uriona S, Vilca LM. [Influenza vaccination coverage in children with risk conditions in Catalonia]. Enferm Infecc Microbiol Clin 2014; 33:22-6. [PMID: 24556268 DOI: 10.1016/j.eimc.2013.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/03/2013] [Accepted: 12/19/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Influenza vaccination is recommended in Catalonia in children older than 6 months with risk conditions for developing flu-related complications. The aim of this study is to determine influenza vaccine coverage in children with risk conditions and their association with socio-demographic factors and medical variables. MATERIAL AND METHOD Descriptive cross-sectional study of children with risk conditions for developing influenza complications (aged between 6months and 15years old) assigned to Primary Health Care centers in Catalonia at the beginning of the 2011-2012 influenza vaccination campaign. The information on vaccination status and study variables were obtained from data registered on electronic health records by primary care teams. The relationship between influenza vaccination and demographic and medical variables was analyzed using bivariate analysis and a multiple logistic regression model. RESULTS Influenza vaccination coverage was 23.9%. Variables associated with influenza vaccination were: age 2years or older (aOR: 1.6 [1.4-1.7] in children 3-5years old; 1.8 [1.7-2.0] in those 6-10 years, and 2.2 [2.0 -2.4] in children ≥11years]); male sex (aOR: 1.1 [1.0-1.1]); foreign nationality (aOR: 1.2 [1.2-1.3]); age-appropriate immunization according to the systematic immunization schedule (aOR: 3.3 [2.8-3.8]); more than one visit to the primary care physician (5 or more visits) (aOR: 4.1 [3.8-4.4]), and more than one risk condition (3 or more conditions) (aOR: 2.5 [1.6-3.9]). DISCUSSION Compared to other countries, influenza vaccination coverage among children with risk conditions is low in our study. Strategies to improve coverage should be implemented.
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Affiliation(s)
- Roser González
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitario Vall d'Hebron, Barcelona, España.
| | - Magda Campins
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - José Ángel Rodrigo
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Sonia Uriona
- Institut de Recerca Biomédica, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Luz María Vilca
- Institut de Recerca Biomédica, Hospital Universitario Vall d'Hebron, Barcelona, España
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Parker PJ, Gyorkos TW, Dylewski JS, Joshi AK, Franco ED. Prevention of perinatal hepatitis B virus transmission in an obstetric/infant population. Can J Infect Dis 1993; 4:288-91. [PMID: 22346464 DOI: 10.1155/1993/986932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/1992] [Accepted: 02/02/1993] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN This retrospective study reviewed the screening practice and seroprevalence of hepatitis B surface antigen (HBsAg) among all mothers with live births at a teaching hospital in Montreal between November 1, 1990 and April 30, 1991. RESULTS Most women (94%) were screened prenatally and 5.2% postnatally. Screening status could not be determined for 0.8% of women. One-quarter of all postnatal screening results were available only at 48 h or more postdelivery. No infants born to women with postnatal screening or to women with unknown screening status were immunized expectantly. The maternal seroprevalence was 1.08% (95% confidence interval from 0.6, 1.4). All 22 infants born to HBsAg-positive mothers had received hepatitis B immune globulin within 12 h of birth and the first dose of hepatitis B vaccine within 24 h. Follow-up of infants revealed that only 50% had received the second and third doses according to the recommended protocol, with 83% completing the immunization series. CONCLUSION These results indicate that a program of prenatal HBsAg screening and neonatal prophylaxis against hepatitis B can be successfully instituted in a high volume obstetric hospital, and that better monitoring of infants is required to ensure completion of vaccination.
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