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PubMed2003

Serological response and poliovirus excretion following different combined oral and inactivated poliovirus vaccines immunization schedules.

A controlled study was conducted in Karachi, Pakistan to compare humoral and mucosal immune responses against polioviruses in infants who received oral poliovirus vaccine (OPV) at birth and at 6, 10, and 14 weeks according to the Expanded Program on Immunization (EPI) with infants who received either three doses of inactivated poliovirus vaccine (IPV) at 6, 10, and 14 weeks together with OPV or one additional dose of IPV at 14 weeks together, with the last dose of OPV. A total of 1429 infants were enrolled; 24-week serum specimens were available for 898 infants (63%). They all received a challenge dose of OPV type 3 at 24 weeks of age. The addition of three doses of IPV to three doses of OPV induced a significantly higher percentage of seropositive children at 24 weeks of age for polio 1 (97% versus 89%, P<0.001) and polio 3 (98% versus 92%) compared to the EPI schedule. However, the one supplemental dose of IPV at 14 weeks did not increase the serological response at 24 weeks. Intestinal immunity against the challenge dose was similar in the three groups. Combined schedules of OPV and IPV in the form of diphtheria-pertussis-tetanus-IPV vaccine (DPT-IPV) may be useful to accelerate eradication of polio in developing countries.

Antibodies, Viral↗
PubMed1985

Excretion of live attenuated polioviruses in the faeces of orally vaccinated children. Comparison of two immunization schedules.

The excretion of live, attenuated poliovirus vaccine strains was determined in the feces of Prague Infants home children given 10(5) PFU of type 1 and 2 and 2.10(5) PFU of type 3 vaccine in a routine annual mass campaign. The first two faeces specimens examined in each vaccinee prior to immunization were negative for the virus. A total of 476 stool specimens were collected from 37 children at weekly intervals for a period of 18 weeks. The presence of type 1 poliovirus in the faeces of children given monovalent type 1 vaccine was detectable for 9 weeks, with a maximum in first week, and the virus was isolated in 74.2% of vaccinees. The timing of bivalent type 2 and type 3 vaccine was 9 weeks after monovalent type 1 immunization. The excretion of these two types of poliovirus was found to persist for at least 6 weeks. Type 2 poliovirus was isolated in all vaccinees, type 3 in 70.4% of children. The highest percentage of children excreting type 2 poliovirus was recorded in the first week, the excretion of type 3 peaked three weeks after bivaccine administration. The excretion peaks were reached relatively early postvaccination, with type poliovirus reaching the highest titre per 1 g of faeces. After revaccination (one year later) with monovalent type 1 vaccine, the vaccine strain of type 1 poliovirus could be detected for 6 weeks and was present in the highest percentage of positive stool samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1996

Expanded programme on immunization (EPI). Immunization schedules in the WHO African region, 1995.

There are 48 countries/areas in this Region (Tables 1-3). No data are available from Reunion and Saint Helena. BCG is given at birth in 46 countries. Diphtheria-pertussis-tetanus (DPT) vaccine is used as a primary series of 3 doses in 46 countries. In 35 countries, DPT is given from 6 weeks of age; in 6 countries at 2 months of age (Angola, Botswana, Burkina Faso, Congo, Gambia and Zambia); and in 5 countries at 3 months of age (Algeria, Mauritius, Seychelles, Swaziland and Zimbabwe). Eight countries give 4 doses of DPT (Benin, Burundi, Congo, Equatorial Guinea, Rwanda, Seychelles, South Africa and Zambia) while 2 countries give 5 doses of DPT (Algeria and Togo). Diphtheria-tetanus (DT) is given in 3 countries: in Botswana at 6 years, in Mauritius at 2 and 5 years and in South Africa at 5 years of age. No Td* is given in any of the countries in this Region. Oral poliovirus vaccine (OPV) is used in a primary series of 3 doses simultaneously with DPT vaccine in all countries. Eighteen countries give OPV at birth. Measles vaccine is given at 9 months of age in 45 countries. Seychelles gives measles vaccine at 15 months of age. None of these countries give a combined measles-mumps-rubella (MMR) vaccine. Rubella vaccine alone is also not given in any of the countries in the Region. Hepatitis B vaccine is used in 7 countries (Botswana, Gabon, Gambia, Nigeria, South Africa, Uganda and Zimbabwe). It is given in 2 doses in 2 countries (Gambia and Nigeria) and at birth in 4 countries (Botswana, Gabon, Gambia and Nigeria). Thirty-one countries are at risk for yellow fever. However, yellow fever vaccine is given only in 10 countries (Central African Republic, Chad, Côte d'Ivoire, Gabon, Gambia, Ghana, Niger, Sao Tome and Principe, Senegal and Togo). Six countries give yellow fever vaccine at 9 months, Chad gives it at 6 months, Gabon and Sao Tome and Principe at 1 year of age and Togo at 10 months. Tetanus toxoid (TT) is used for pregnant women or non-pregnant women of childbearing age. The schedules include 2 to 5 doses. Forty-two countries use a 5-dose schedule. TT is given to schoolchildren in 5 countries (Botswana, Comoros, Guinea, Lesotho and Madagascar).

Africa↗
PubMed1996

Comparison of a rapid hepatitis B immunization schedule to the standard schedule for adults.

We report a prospective, randomized, single-blinded trial comparing immunogenicity of rapid (0, 1, and 2 months) versus standard schedule (0, 1, 6 months) hepatitis B vaccinations of healthy adults with recombinant hepatitis B vaccine (Engerix-B, 20 micrograms i.m.) (230 of 234) negative to hepatitis B were randomized and completed the study. Groups were similar in age, weight, race, and obesity rate, but the rapid schedule group had more women. Both groups reached > or = 100 mIU/mL at a similar rate, but a higher seroprotection rate at > or = 500 mIU/mL was reached by the standard schedule. No demographic variables influenced the effect of dose schedule on anti-hepatitis B titer. We conclude that rapid schedule vaccination gives a rate that is quicker than, and identical to, the rate of seroprotection of the standard schedule vaccination.

Adult↗
PubMed1998

Comparison of two immunization schedules with an inactivated hepatitis A vaccine (AvaximTM).

BACKGROUND: Inactivated hepatitis A vaccines are licensed with a vaccination schedule based on two injections of vaccine given at least 6 months apart. METHODS: Two vaccination schedules for the inactivated hepatitis A vaccine, AvaximTM (Pasteur Mérieux Connaught, Lyon, France), were compared in a monocentric, randomized, open trial. Two doses of the vaccine were given at intervals of either 6 months (0-6 month group) or 12 months (0-12 month group) to 96 adult volunteers. Anti-hepatitis A virus (HAV) antibody titers were determined in a blind fashion using the modified RIA (mRIA) HAVABtrade mark assay. After excluding subjects with positive preimmunization anti-HAV titers and those with protocol deviations, both groups were still comparable by sex ratio and mean age. RESULTS: Four weeks (28 6 4 days) after the first dose, the seroconversion (SC) rate of initially HAV-seronegative subjects (antibody titer < 20 mIU/mL) was 100% in the 0-6 month group and 96. 9% in the 0-12 month group, with corresponding geometric mean titer (GMT) values (95% CI) of 369 mIU/mL (274-497 mIU/mL) and 445 mIU/mL (292-679 mIU/mL), respectively. After 6 months, SC was obtained in all subjects, and the corresponding GMT values were 349 mIU/mL and 359 mIU/mL in the 0-6 month group and the 0-12 month group, respectively. Four weeks after the booster dose given at 6 months, a 14.5-fold rise in GMT was observed. In the 0-12 month group, anti-HAV GMT values decreased by only 20% from 6 months to 12 months with a pre-booster GMT value of 286 mIU/mL at the 12-month evaluation. Four weeks after the booster given at 12 months, a 22. 5-fold rise in GMT was observed. Statistical analysis showed that the two vaccination schedules were comparable in their ability to boost antibody titers. Unsolicited reactions to vaccination were not different to those reported during earlier trials. Less than 12% of the vaccinees reported reactions after the first dose (11/93), or after the booster dose (11/92). CONCLUSIONS: This trial demonstrated antibody persistence is excellent for at least 12 months after one dose of this vaccine, and that a booster may be given at any time between 6 and 12 months after primary immunization.

Adolescent↗
PubMed2005

A new DTPw-HBV/Hib vaccine is immunogenic and safe when administered according to the EPI (Expanded Programme for Immunization) schedule and following hepatitis B vaccination at birth.

New combination vaccines and reliable sources of vaccine components are essential to ensure the success of mass immunisation programmes in the 21st century. We evaluated a new combined diphtheria-tetanus-whole-cell-pertussis-hepatitis B vaccine, extemporaneously mixed with a Haemophilus influenzae type b conjugate vaccine (DTPw-HBV/Hib) containing 2.5 microg PRP in 913 Philippino infants, administered according to the EPI schedule at 6, 10 and 14 weeks of age after a birth dose of hepatitis B vaccine (HBV; trial DTPw-HBV/Hib-001). One month after the third dose of DTPw-HBV/Hib (N = 182), 99.4% and 94.2% of subjects had anti-PRP antibody levels > or =0.15 microg/mL and > or =1.0 microg/mL, respectively. In addition, 95.9%, 100.0% and 87.6% of subjects had seroprotective antibody concentrations against diphtheria, tetanus and hepatitis B, respectively. The seroprotection rate to hepatitis B increased significantly to 94.3% in subjects who received a dose of HBV at birth. The pertussis vaccine response rate was > or =95%. Seroprotection/vaccine response rates to all antigens after DTPw-HBV/Hib were at least as good as those observed after vaccination with GSK Biologicals' licensed Tritanrix HepB/Hiberix (containing 10 microg PRP) which was used as comparator. Although redness >20 mm in diameter and fever > or = 37.5 degrees C (axillary route) occurred more often after the new DTPw-HBV/Hib vaccine (p < 0.05), other Grade 3 adverse events occurred similarly between the groups. The new DTPw-HBV/Hib vaccine was as immunogenic and well tolerated as the licensed control vaccine when administered according to the immunologically challenging EPI schedule. A birth dose of HBV is important to maximize protection against hepatitis B in endemic regions where the EPI schedule is in place.

Antibodies, Bacterial↗
PubMedDate not supplied

Hepatitis-B vaccine introduction into the routine immunization schedule--Andhra Pradesh experience.

Hepatitis B is a viral infection of the liver and is serious global public health problem with a high risk of death from cirrhosis of the liver and liver cancer, diseases that kill about one million persons each year globally. Globally, of the 2 billion people who have been infected with the hepatitis B virus (HBV), more than 350 million have chronic (lifelong) infections. It is preventable with safe and effective vaccines that have been available since 1982. Although the vaccine will not cure chronic hepatitis, it is 95% effective in preventing chronic infections from developing, and is the first vaccine against a major human cancer. More than 160 countries have already added this vaccine to their routine immunization programmes. Available epidemiologic studies in India and AP indicate that India is in intermediate endemic status (with a prevalence of 2 to 7%) and the best way to reduce the prevalence as per the strategies outlined by WHO is to introduce Hep-B vaccine into routine immunization. AP is the first State in India to introduce Hep-B vaccine in the routine immunization in a phased manner. In-spite of the initial apprehensions and slow take up, the program is proven to be successful and Govt. of India has made budgetary provisions in the 10th plan for introduction in rest of India.

Hepatitis B↗
PubMed2004

[Alternative immunization schedule and combined vaccines in paediatric practice].

European countries individually implement their national immunisation schedules adjusted to their economic situation, epidemiological risks and other socio-political factors. The polish schedule of compulsory vaccination includes an obligatory part financed by the state and the recommended one financed individually by parents of patients themselves. The officially registered multi component vaccines my become an alternative for the obligatory schedules. Benefits of combined vaccine comprise: reduced number injections per visit and reduced number of exposures to possible injection pain; less or no exposure to thiomersal; less time spent in doctor visit, less waste and increased injection safety with fewer syringes, reduced immunisation programme costs and facilitated addition data collection through easier documentation and simplified implementation of immunisation programmes.

Child↗
PubMed2002

[Immunization schedules in Spain in 2002. When will they be unified?].

In the middle of the year 2002, there still are distinct calendars for vaccinations in Spain. The Ministry of Health and Consumption proposed on calendar for 2001, the Spanish Association of Pediatrics another, quite different, and the 17 Autonomous Communities each recommend their own calendar, even though there are numerous similarities among these. There is no justifiable reason for this disparity and it does not seem reasonable that these circumstances, which create tremendous confusion and many problems among the general population as well as health professionals, should continue for any longer. Infectious diseases susceptible to vaccination have some almost identical clinical epidemiological traits in all the geographical regions in our country and the germs responsible for these disease behave similarly in all areas. This article reviews the epidemiological situation of those diseases which are included in the distinct immunization programs, and others not yet included, and it carries out a critical analysis of the recommendations which these programs make regarding their prevention.

Communicable Disease Control↗
PubMed1996

Expanded programme on immunization (EPI). Immunization schedules in the WHO South-East Asia region, 1995.

There are 10 countries in this Region. BCG is given at birth and up to 1 week of life in 5 countries: Bangladesh, Democratic People's Republic of Korea, India, Indonesia and Nepal (Table 1). In 3 other countries, BCG is given from birth up to 1 year of age (Bhutan, Myanmar and Thailand) and in the remaining 2 countries, BCG is offered from birth to 3 years of age (Maldives) and to 5 years of age (Sri Lanka).

Asia, Southeastern↗