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Nicole Boulianne

Publications and source records attributed to Nicole Boulianne.

14 recordsLinked to original sources
PubMed2006

Impact of the quebec school-based hepatitis B immunization program and potential benefit of the addition of an infant immunization program.

Ten years after a school-based hepatitis B immunization program was implemented, we conducted a study to assess the impact of the program, vaccine failures, risk factors and the number of cases potentially preventable by the addition of an infant vaccination program. The preteen vaccination program is highly effective. An infant immunization program would bring additional benefits.

Adolescent↗
PubMed2005

Comparative long term immunogenicity of two recombinant hepatitis B vaccines and the effect of a booster dose given after five years in a low endemicity country.

BACKGROUND: Few data are available concerning the long term immunogenicity of the pediatric doses of hepatitis B vaccines given to preteenagers. The long term effect of the booster dose in teenagers is unknown. We evaluated the immunogenicity of 2 pediatric hepatitis vaccines after primary vaccination and after a booster dose. METHODS: A prospective 15-year follow-up study of the immunogenicity of 2 hepatitis B vaccines was initiated in 1995 in Quebec City, Canada. One year apart, 1129 children 8-10 years old received Engerix-B 10 microg (EB), and 1126 received Recombivax-HB 2.5 microg (RB) vaccine after a 0-, 1-, 6-month schedule. After 5 years, one-third of the 2 cohorts were randomly selected. A booster dose of EB 10 microg or RB 5 microg was administered according to the vaccine used in the primary immunization. Antibodies were measured before, 1 month after and 1 year after the booster injection. RESULTS: Before the booster dose, anti-HB surface antibody (HBs) was detected in 94.7% of the EB subjects and in 95.2% of the RB subjects (P = 0.85). The geometric mean titer (GMT) was higher in the EB than in the RB group (252 mIU/mL versus 66 mIU/mL, P < 0.0001). One month after the booster, 99.7% of subjects in the EB group and 99.6% in the RB group had a detectable anti-HBs, and 99.0 and 99.3%, respectively, had anti-HBs > or =10 mIU/mL. The anti-HBs GMT was 113,201 mIU/mL in the EB and 16,623 mIU/mL in the RB groups (P < 0.0001). One year after the booster, 99.3% of subjects in the EB group and 100% in the RB group had detectable anti-HBs, and 97.9 and 98.5% respectively, had anti-HBs > or =10 mIU/mL. The anti-HBs GMT was 14,028 mIU/mL in the EB and 3437 mIU/mL in the RB group (P < 0.0001). CONCLUSIONS: The immunity persists for at least 5 years after the primary vaccination with both pediatric vaccines in 99% of children vaccinated at the age of 8-10 years. It confirms that no booster is needed at that point.

Analysis of Variance↗
PubMed2004

Effectiveness of a mass immunization campaign using serogroup C meningococcal conjugate vaccine.

CONTEXT: Meningococcal polysaccharide vaccines are of limited effectiveness. New protein-polysaccharide conjugate vaccines have yet to be evaluated in field conditions. OBJECTIVE: To assess the effectiveness of a serogroup C conjugate meningococcal vaccine in an outbreak setting. DESIGN, SETTING, AND PARTICIPANTS: Population-based observational study of cases of invasive serogroup C meningococcal disease from 1996 through 2002 in Quebec identified from the provincial registry of notifiable diseases and from the provincial reference laboratory. In 2001, a mass immunization campaign with a conjugate vaccine was conducted to control an emerging epidemic. The number of vaccinated individuals was extracted from meningococcal immunization registries. MAIN OUTCOME MEASURES: Incidence of invasive meningococcal disease before and 1 year after the campaign in vaccinated and unvaccinated individuals. RESULTS: Vaccination coverage of those 2 months to 20 years was 82.1%. After the campaign, the number of cases of serogroup C disease decreased from 58 in 2001 to 27 in 2002, and the incidence from 7.8 per million to 3.6 per million. Vaccine effectiveness was found to be 96.8% (95% confidence interval, 75.0%-99.9%). There was no observed increase in the incidence of the other serogroups. CONCLUSION: The new conjugate vaccine was effective in controlling an emerging epidemic of serogroup C meningococcal disease, as well as providing short-term protection across a wide age range.

Adolescent↗
PubMed2004

Immunogenicity of two paediatric doses of monovalent hepatitis B or combined hepatitis A and B vaccine in 8-10-year-old children.

Hepatitis A and B vaccines are highly immunogenic in three-dose schedules. To obtain an equivalent result in children with two paediatric doses would be of significant benefit. The purpose of this study was to measure the immunogenicity of a two-dose schedule in children with two licensed recombinant HBsAg containing vaccines given at paediatric doses, one of them combined with hepatitis A. Seven-hundred and four healthy school children aged 8-10 years were recruited in an open label study to receive either Twinrix Pediatric (360 El.U HAV antigen; 10 microg HBsAg) or Recombivax (2.5 microg HBsAg) vaccine intramuscularly 6 months apart. The seroconversion (>/=1 mIU/ml for anti-HBs antibodies and >/=33 mIU/ml for anti-HAV antibodies), seroprotection (anti-HBs >/=10 mIU/ml) rates and the geometric mean titers (GMTs) were determined 4-8 weeks after the second dose. The anti-HBs seroconversion rate was 97.1% with Twinrix and 97.2% with Recombivax. The seroprotection rates were 96.5 and 94.4%, respectively (P = 0.17). The GMT was higher with Twinrix than with Recombivax (3248 mIU/ml versus 742 mIU/ml, P < 0.0001). All the children vaccinated with Twinrix seroconverted to HAV and the GMT was 5168 mIU/ml. The obtained results suggest that two paediatric doses of hepatitis vaccines are highly immunogenic in 8-10-year-old children. This schedule could facilitate a greater vaccine acceptance and the addition of hepatitis A vaccine to existing adolescent universal hepatitis B virus immunization programs.

Canada↗
PubMed2003

Oculo-respiratory syndrome following influenza vaccination: evidence for occurrence with more than one influenza vaccine.

We assessed the occurrence of oculo-respiratory syndrome (ORS) following two influenza vaccines: Fluviral (Shire Biologics) or Vaxigrip (Aventis Pasteur). ORS was identified amongst 5.3 and 4.6% of recipients, respectively (P=0.54). With both vaccines, the risk of ORS was much greater in individuals who had ORS the previous year (2000) than in those without such history. In multivariate analysis, the odds ratio for ORS for patients with a prior history of ORS varied between 9.4 and 9.6 (P<0.001) whereas that comparing Fluviral and Vaxigrip varied between 1.5 and 1.9 (P=0.02-0.05). ORS is an adverse event that is present with more than one vaccine and may be present with any influenza vaccines to a greater or lesser degree.

Adult↗
PubMed2003

[Public health: the control of meningococcal disease in Quebec].

A first outbreak of serogroup C meningococcal disease occurred in the province of Quebec in 1990-1992 and lead to a mass immunization campaign using polysaccharide vaccines. In 2001, a second outbreak was identified and a mass vaccination campaign was carried out, using the newly licensed conjugate vaccine. Clinical, epidemiological, economic and social studies were instrumental in the decision making for implementing these control programs.

Disease Outbreaks↗
PubMed2002

Preadolescent non- and hyporesponders following three doses of hepatitis B vaccine need only one more dose.

A small proportion of healthy children fail to develop antibodies against hepatitis B after three doses of vaccine. Few data are available regarding the optimal re-immunization strategy. We measured the immune response 1 month after a single supplementary dose of recombinant hepatitis B vaccines in 18 young preadolescents who were non- or hyporesponsive after a regular primary course of three doses of recombinant hepatitis B vaccines. Among them, 100% seroconverted and 89% reached the seroprotective titer of 10 milli-International Units (mIU)/ml. Most healthy children, particularly if they are hyporesponders, will have reached the seroprotective level after one dose and will not need further injections.

Child↗
PubMedDate not supplied

Ineffectiveness of the current strategy to prevent hepatitis A in travelers.

BACKGROUND: Each year, a large number of Canadians travel to regions of the world where hepatitis A remains endemic. Many of these travelers are not immune and the current preventive strategy relies wholly on self-referral to a travel clinic. All of the costs associated with such a visit are assumed by the traveler. We estimated the effectiveness of this strategy. METHODS: This case-control study included 108 travel-related hepatitis A cases with onset of disease between 1997 and 1999 and 620 controls who traveled during the same period. RESULTS: Hepatitis A was strongly associated with high-risk travel (Odds Ratio = 7.2, 95% Confidence Interval 1.76-29.4), but only 7% of cases were found in this category. The risk of hepatitis A was 5 times lower in travelers who visited a travel clinic than in those who did not (80% efficacy). However, only 14% of the controls visited a travel clinic. As a result, the effectiveness of the current strategy is estimated to be 11% (80% of 14%). CONCLUSIONS: Hepatitis A in travelers can be prevented effectively by attendance at a travel clinic. Unfortunately, most travelers do not visit such clinics prior to departure. Even if all high-risk travelers were to visit a travel clinic and receive vaccination, this would have negligible impact on the number of travel-related hepatitis A cases (approximately 7% reduction). The current strategy for the prevention of hepatitis A in travelers is ineffective and should be reexamined.

Adult↗
PubMedDate not supplied

A population-based comparison between travelers who consulted travel clinics and those who did not.

BACKGROUND: Travel to hepatitis A-endemic countries is frequent among North Americans. Such travel carries significant risks for the individuals themselves and for the general population. We documented the patterns of use of travel clinics in a large Canadian adult population. METHODS: Travelers who had visited a hepatitis A-endemic country between 1990 and the time of the survey in 1999 were eligible. Subjects were identified from a representative sample of 4,002 adults from the two largest Canadian provinces. They were contacted by random digit dialing and interviewed by telephone. RESULTS: Only 15% of trips had been preceded by a visit to a travel clinic. The probability of visiting a travel clinic was approximately 10 times greater for travelers considered to be in the high-risk category than for those in the low-risk category, but the former represented only 2% of the total. The probability of visiting a travel clinic was approximately 23 times greater for travelers who were aware of the health risks in their country of destination. Income level was not associated with attendance at a travel clinic, and cost was rarely mentioned as a reason for not attending such a travel clinic before departure. CONCLUSIONS: Each year, millions of Canadian travelers go to hepatitis A-endemic countries without consulting a travel clinic. Active steps must be taken by public health authorities to improve their utilization of health services and prevent the accrued health risk for these travelers.

Adult↗
PubMedDate not supplied

Impact of vaccine cost and information about complications of varicella on parental decision regarding varicella vaccine.

BACKGROUND: The influence of providing information about complications of disease and vaccine cost on parental decision to vaccinate against varicella was assessed. METHOD: During telephone interviews of 330 parents of infants aged 9 months, parents were asked if they would agree to have their child vaccinated and were presented information first about varicella complications and then about cost of the vaccine. RESULTS: When complications were explained but information about cost was not, 94% of parents were favourable toward having their child vaccinated. When complications were not explained but cost was presented, this percentage was only 34%. When both cost and complications were presented, 60% of parents were favourable toward the vaccine. INTERPRETATION: In improving receptivity towards varicella vaccine, parents should always be presented data regarding varicella complications by their health care provider.

Chickenpox↗
PubMedDate not supplied

[Why are some children incompletely vaccinated at the age of 2?].

OBJECTIVE: A survey was conducted in the Province of Quebec to document the factors associated with an incomplete immunization status among 2-year-old children. METHODS: Parents of 430 completely and 266 partially vaccinated children selected from the computerized vaccination register agreed to participate. RESULTS: The non-simultaneous administration of the 2nd MMR and 4th DPT-P-Hib at 18 months of age was responsible for 46% of incompleteness. The following characteristics were significantly associated with an incomplete immunization status: being a single parent, > or = 2 children in the family, an older age at first immunization (> or = 3 months), parent's preference for postponing the second vaccine when two injections are scheduled for the same visit, perception of lack of information about vaccination, and disagreement with immunization recommendations. CONCLUSION: One of the key points of this study is the impact of the non-simultaneous administration of the two vaccines at 18 months. Factors such as being a single parent and older age at first immunization might be used to design an early intervention for children who are most likely to be incompletely immunized. Even if parents are favourable towards immunization, they need to be well informed about the associated risks and benefits.

Diphtheria Toxoid↗
PubMedDate not supplied

[Usefulness of a vaccination registry and the management of consent: the case of Quebec].

CONTEXT: The Quebec Public Health Act provides for the creation of a central vaccination registry. However, details of how such a registry would be used have not been established. This study seeks to document the opinion of both the public and of health workers about the usefulness of the registry, consent for enrolment, access to the data and the right of withdrawal. METHODS: Individual interviews and discussion groups were held with parents, senior citizens and health workers. The material collected was recorded, transcribed and analyzed qualitatively using MAXQDA software. RESULTS: The usefulness of a vaccination registry seems to meet with general agreement, as does the idea of obtaining broad-based consent at enrolment. However, this consensus starts to crumble on questions of determining the rules governing access to the registry. Some favour limited consent, authorizing each access, while others, more numerous, prefer a broad-based consent giving access to all individuals authorized under the law. Opinions are even more divided on the question of giving the user the right to not record certain vaccines, particularly when they may be considered sensitive and a possible cause of prejudice. DISCUSSION: The more the information is considered sensitive by users, the more they seek to have access to the register and entries into it controlled and to apply some kind of specific consent, limited in scope, rather than a broad-based consent. This study lets us draw lessons applicable to the computerization and networking of medical records.

Access to Information↗
PubMedDate not supplied

[Portrait of the formation in vaccination training offered to Quebec nurses in the workplace].

INTRODUCTION: Nurses carry out essential functions in the area of immunization in Québec and their role has broadened considerably since January 2003, following legislative modifications. However, the training received may not always allow nurses to fill this role satisfactorily. This study seeks to document the training in immunization offered to Québec nurses in the workplace. METHOD: A questionnaire was mailed to the directors or heads of nursing care (DSI/RSI) in 477 health care establishments in Québec in March 2003. RESULTS: Health care establishments in Québec offer more training to nurses on the job (68%) than at the moment of hiring (43%). These percentages vary widely according to the type of establishment. More than 90% of the local community service centres (CLSC) that responded offer training to their nurses. The indications/contraindications of immunization products and emergencies related to vaccination represent the themes most frequently dealt with. Only 38% of respondents affirm that the nurses in their institution are "very favourable" to vaccination. DISCUSSION: Almost all Québec CLSCs, which is where most immunization activities are carried out, offer training in vaccination to their nurses. On the other hand, few hospital centres (CH) and long-term care establishments (CHSLD) do so. Further documentation should be carried out on the impact of less than optimal training on the promotion of immunization programs by nurses.

Attitude of Health Personnel↗