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At least 289 records · Page 16Linked to original sources
PubMed1993

Integration of hepatitis B immunization in the Expanded Program on Immunization of the Child Survival Project.

The Expanded Program on Immunization (EPI) is a component of the Child Survival Project (CSP) whose objectives are to reduce the incidence rates of six childhood diseases (Measles, Diphtheria, Pertussis, Tetanus, Tuberculosis, Poliomyelitis) and to reduce the number of infant deaths from those diseases by increasing effective vaccination coverage. In 1991, the CSP/EPI developed a national plan to introduce national immunization of infants against hepatitis B in an attempt to control the magnitude and seriousness of the damage which viral hepatitis causes in terms of morbidity, mortality and serious sequelae as hepatitis B is an endemic disease in Egypt causing an important public health problem which requires urgent control. This presentation will discuss the integrated effort undertaken to plan and implement the program, the different challenges it faces, control studies being performed as well as the proposed objectives of the hepatitis B vaccination program.

Child↗
PubMed1999

Lessons from 12 years of comparative risk projects.

Can an analytical tool for comparing environmental risks and policy activities be used to evaluate their relative efficacy in ultimately changing the allocation of public funds? Some insight is possible through a review of comparative risk projects that have been carried out at the city, state, and national levels, as well as among Indian tribes, over the past 12 years. The lessons from this review should apply to the field of public health. For every comparison of environmental issues, such as clean-air standards with fish consumption advisories, there is a parallel discussion of public health priorities and strategies, such as antismoking and pregnancy prevention programs, immunization programs and disease surveillance efforts, or well-baby clinics and food safety programs. Lessons from comparative risk projects and processes may offer the public health community new ways of thinking about using stakeholder assessment processes in developing public health policy.

Environmental Health↗
PubMed2001

Results of the expanded program on immunization in the Macedonian refugee camps.

OBJECTIVES: This report summarizes the results of the Macedonian refugee camps' Expanded Program on Immunization. METHODS: Government agencies and nongovernmental organizations implemented an immunization program consisting of 3 mass vaccination campaigns in each of the 7 camps. Before the second mass campaign, weekly immunization clinics were initiated in each camp. Children younger than 48 months were immunized against 8 antigens according to a schedule established by the Macedonian Ministry of Health. RESULTS: Immunization coverage rates in the second campaign were 91% in Cegrane and 73% in Brazda. Coverage rates of the weekly clinics averaged 93%. CONCLUSIONS: Initiating an expanded immunization program in the absence of a stable population is problematic.

Child, Preschool↗
PubMed2003

Facilitating the WHO expanded program of immunization: the clinical profile of a combined diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type b vaccine.

BACKGROUND: Vaccines are important weapons in the fight against infectious diseases. The World Health Organization (WHO) Expanded Program on Immunization (EPI) has been extended to include recommendations for hepatitis B and Haemophilus influenzae type b (Hib) vaccinations. The WHO has recommended that combined vaccines be used where possible, to reduce the logistic costs of vaccine delivery. This paper reviews the efficacy, safety and cost-effectiveness of Tritanrix-HB/Hib, the only commercially available combined diphtheria, tetanus, whole cell pertussis, hepatitis B and conjugated Hib vaccine. METHODS: The immunogenicity and reactogenicity results of five published clinical trials involving Tritanrix-HB/Hib in a variety of immunization schedules and countries were reviewed. Based on these data and cost-effectiveness studies, an assessment of its suitability for use in national immunization programs was made. RESULTS: Tritanrix-HB/Hib has shown excellent immunogenicity in clinical trials using a variety of schedules, with no reduced immunogenicity observed for any of the components of the combined vaccine. It has similar reactogenicity to DTPw vaccines alone. Pharmacoeconomic analyses have shown combined DTP-HB/Hib vaccines to be cost-effective compared to separate vaccines. CONCLUSIONS: Replacement of DTPw vaccination by Tritanrix-HB/Hib can be done without modifying the existing national immunization programs. This should facilitate widespread coverage of hepatitis B and Hib vaccinations and their rapid incorporation into the EPI.

Antibodies, Bacterial↗
PubMed1996

Control of rubella in Israel: progress and challenge.

Despite a high-compliance school girl rubella immunization program since 1973 and a program for the immunization of women of childbearing age since 1980, sporadic cases of the congenital rubella syndrome (CRS) continue to occur in Israel, particularly following rubella epidemics. At highest risk for a child with CRS are unimmunized Arab women and immigrants from Ethiopia, although CRS has also occurred in infants of immunized non-immigrant women. In order to make progress towards the elimination of congenital rubella, the Israel Ministry of Health has incorporated into its rubella immunization program the intermediate goal of interrupting endemic rubella transmission in the country. To this end, universal rubella vaccination at age one began in 1989, a second dose at age six years was introduced in 1994, inclusion of boys in the program aimed at 12-year-olds began in late 1995, and catch-up campaigns to immunize never-immunized children, boys and girls, are planned. Moreover, women of childbearing age will be encouraged to receive a second dose of rubella vaccine. While the WHO goal of no indigenous CRS by the year 2000 will not be met, it is expected that in the coming decade substantial additional progress towards the elimination of CRS will be made.

Adolescent↗
PubMed1999

An integer programming model for vaccine procurement and delivery for childhood immunization: a pilot study.

The National Immunization Program of the Centers for Disease Control and Prevention has identified several challenges that must be faced in childhood immunization programs to deliver and procure vaccines to protect against the common preventable diseases. The biomedical challenge is how to combine and formulate products to take advantage of new vaccines without requiring additional injections. A programmatic challenge is to incorporate then into already crowded immunization schedules. The economic challenge is to make wise procurement choices from among a growing number of competing products. This paper reports the results of a pilot study using operations research methodologies to address the third of these challenges. The pilot is an integer programming model for procuring vaccines for a set of childhood diseases. The model is studied under various scenarios (minimum total cost, next lowest total cost, maximum total cost, minimum total cost with all manufacturers represented). The results of this pilot study demonstrate how a practical set of operations research tools can be developed to guide vaccine selection and procurement, which might stimulate the development of innovations in new vaccines to meet the challenges of disease control through immunization.

Centers for Disease Control and Prevention, U.S.↗
PubMed1992

[Immunization of hepatitis B vaccine integrated with expanded program on immunization schedule in children].

We studied the immunization of hepatitis B vaccine integrated with of EPI. 180 children (0-9 months of age) from three towns of Shunde County were randomly divided in to three groups (two trial groups and one control group). Which were vaccinated by three different immunization schedule. The serum antibodies to different vaccines were measured before and after immunization. The results show that the seroconversion rate and GMT of each EPI vaccine are conformed with the expected EPI indexes. The seroconversion rate of anti-HBs antibody is found no significantly different among the three groups. The titres of pertussis agglutinating and three types polio neutralizing antibody is higher in trial groups than that in the control group. We conclude that the immunization of hepatitis B vaccine can be integrated into the EPI schedule. And third dose of hepatitis B vaccine can be simultaneously given with measles vaccine.

Child↗
PubMedDate not supplied

The declining prevalence of hepatitis B virus infection among Asian and Pacific Islander children.

PURPOSE: This article provides a review of the literature on the decline of hepatitis B virus (HBV) infection in Asian and Pacific nations having universal hepatitis B immunization programs. METHODS: Papers on the epidemiology of HBV infection and hepatitis B immunization programs in Asian and Pacific nations were located by searching MEDLINE and libraries for publications in English, and by contacting hepatitis B experts. PRINCIPAL FINDINGS: High endemicity for HBV in Asian and Pacific nations was partly caused by a cycle of high infectiousness, perinatal transmission, and chronic infection from early ages. Higher prevalence of infection has been found in men, some families, communities, and ethnic groups, and in people with high risk behaviors and situations, such as attending day care, getting injections, or sharing personal items. Incidence of acquisition of infection is about 2%-5% per year. Prevalence of HBV infection was declining in some nations before commencing hepatitis B immunization programs, probably because of improvements in medical practices and living conditions. Twenty-seven of 34 Pacific and East and Southeast Asian nations have attained >70% hepatitis B vaccination coverage in infants, and twelve have documented reducing infection or liver cancer to fractions of their former rates. But the immunization programs may be causing natural selection of mutant hepatitis B viruses, necessitating study of the mutants, and modification of serological tests and vaccines. CONCLUSIONS: Practical implications for U.S. health professionals are: increasing HBV screening and hepatitis B vaccination of adolescents and adults from Asian and Pacific nations can prevent many infections and disease cases; most children coming from high coverage Asian and Pacific nations will be immune and few infected; we can learn much from these successful programs; and we should still make efforts to immunize Asian and Pacific children in the United States, and help Asian and Pacific nations which do not yet have highly successful hepatitis B immunization programs.

Asian↗
PubMedDate not supplied

Hepatitis B immunization in a low-incidence province of Canada: comparing alternative strategies.

This study provides a comparative cost-effectiveness analysis of three universal immunization programs for hepatitis B virus (HBV). Using three theoretical cohorts of infants, 10-year-olds, and 12-year-olds, a universal immunization program was compared with a prenatal screening/newborn immunization program involving testing of prepartum women and immunization of newborns of HBsAg-positive mothers. A Markov long-term outcome model used Manitoba data to estimate costs and health outcomes across the lifespan. The model was based on an HBV incidence rate of 19/100,000 and a discount rate of 5% and incorporated the most recent treatment advances (interferon therapy). Cost-effectiveness was calculated as the ratio of dollars spent per year of life saved, with costs determined from the perspective of a third-party payer. The universal infant-immunization program, although not cost-saving, was associated with a low, economically attractive cost-effectiveness ratio of $15,900 (Canadian) per year of life saved, a figure substantially lower than the ratios of $97,600 and $184,800 (Canadian) associated with the universal programs for 10- and 12-year-olds, respectively. Cost-effectiveness ratios were found to be sensitive to changes in immunization costs, HBV incidence rates, and the rate at which protective antibody levels are lost over time: If these variables move in the directions suggested by current trends, the authors anticipate an increasing economic appeal of universal programs well into the future. A universal program of HBV immunization for infants appears to be economically practical in regions where HBV infection rates are low and stable.

Carcinoma, Hepatocellular↗
PubMed2001

Changes in Expanded Program for Immunization coverage for mother and child in Krakor, Cambodia 1996--1998.

We evaluated a training intervention aimed at enhancing the roles of health centre staff, Village Health Volunteers (VHVs) and Traditional Birth Attendants (TBAs) within the Expanded Program for Immunization (EPI) in the district of Krakor, Cambodia. We conducted population-based surveys to determine the coverage of the EPI at baseline (1996) and after the intervention (1998), using data from health cards for mothers and their children and history data. Statistically significant changes over the 2-year period were apparent for tetanus, BCG, polio and DTP, supporting the positive impact the training intervention had on immunization coverage in the district.

Adult↗
PubMedDate not supplied

A benefit-cost analysis of two-dose measles immunization in Canada.

In 1992, because of the limitations of the one-dose measles immunization program, the National Advisory Committee on Immunization (NACI) recommended a two-dose measles immunization program to eliminate measles. More recently, NACI recommended also a special catch-up program to prevent predicted measles outbreaks and to achieve an earlier elimination of measles. The objective of this study was to complete a benefit-cost analysis of a two-dose immunization program with and without a mass catch-up compaign compared with the current one-dose program. The resulting benefit: cost ratios vary between 2.61:1 and 4.31:1 depending on the strategy used and the age of the children targeted. Given the parameters established for this analysis, the benefits of a second-dose vaccination program against measles far outweight the costs of such a program under all scenarios.

Adolescent↗
PubMed1998

[Representative early summer meningoencephalitis vaccination rates of school children in Styria].

Since the introduction of the Austrian TBE (tick-borne encephalitis) vaccination program in 1981 immunization coverage of children has not been investigated sufficiently. We investigated the influence of geographic and sociodemographic factors on the immunization coverage of school children in order to identify subpopulations with low immunization coverage. To this end a representative cross-sectional study was carried out in the county of Styria, Austria. The target population were children in the first, fourth and seventh year of school education. Therefore, the sample consisting of 3,196 children was divided into three age groups. children aged around 7, 10 and 13 years. The information concerning the immunization status of each child was recorded by means of an anonymous questionnaire given to parents by the classroom teachers on advice of the supervisory school authority. This procedure ensured the high overall response rate of 85.0%. The prevalence of at least one TBE vaccination was 91.4% for the 7 year old, 97.3% for the 10 and 97.1% for the 13 year old. The prevalence of basic TBE immunization was 84.0%, 91.7% and 92.3% resp. The lowest vaccination rates were found in families with four or more children and for those children who had mothers of the lowest educational level. Thus, for the future management of immunization programs it is crucial to put special emphasis on the identified population groups with deficient immunization coverage. The overall vaccination rates can be judged as satisfactory in the 13 year old children.

Adolescent↗
PubMedDate not supplied

A bi-state, metropolitan, school-based immunization campaign: lessons from the Kansas City experience.

INTRODUCTION: Through school-based immunization programs, large numbers of children can be vaccinated in a cost-effective manner. Information from successful programs can be valuable to communities, schools, or pediatric health care providers considering the implementation of a school-based immunization program. The purpose of this study was to identify factors considered key to the success of a large bi-state, metropolitan, multi-school district, school-based, hepatitis B immunization program. METHOD: Immunizations were offered to 14,865 sixth-grade students in 16 school districts at 123 public and private school buildings. Personnel from 6 health departments and numerous volunteers administered the vaccines. Twenty-two semistructured interviews were conducted with a representative sample of program participants from schools, health departments, and the coordinating immunization coalition. A qualitative, grounded theory analysis was performed using data from the interviews. RESULTS: The following categories emerged and were considered important issues in the success of a school-based program: organization, time, obtaining consent, educational opportunity, school support, and student tracking. DISCUSSION: School-based immunization programs can be successful, but they require a coordinated effort with school support to meet the challenges of obtaining consent and tracking students.

Child↗