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At least 289 records · Page 16Linked to original sources
PubMed1998

Update on childhood immunization.

Changes made in 1997 and 1998 in the U.S. childhood immunization schedule are discussed, with a focus on the use of poliovirus, pertussis, and combination vaccines. Oral poliovirus vaccine (OPV), the vaccine of choice for all four doses in the polio immunization series since 1962, can cause vaccine-associated paralytic poliomyelitis (VAPP). The inactivated poliovirus vaccine (IPV) has not been associated with VAPP but must be administered by injection and provides inferior intestinal immunity. With the reduced threat of poliovirus importation into the United States, the risk of VAPP, although low, has become less acceptable. The Centers for Disease Control and Prevention accordingly recommended a shift from OPV to IPV in the childhood immunization schedule for the United States, effective January 1997. A sequential OPV and IPV series is recommended, but the schedule includes an OPV-only option, which may be preferred in order to avoid the required injections, and an IPV-only option, which is recommended for immunocompromised persons and their contacts. Concern over local and systemic reactions associated with whole-cell pertussis vaccines, in addition to controversy over a possible relationship between the whole-cell vaccine and neurologic damage, has led to the development of new diphtheria and tetanus toxoids and acellular pertussis vaccine products for use in the diphtheria and tetanus toxoids and pertussis immunization series. Several combination products were licensed in 1997, and more are on the way. This will mean fewer inoculations for children. Increased use of IPV and acellular pertussis products could reduce the frequency of VAPP due to OPV and the local and systemic reactions associated with whole-cell pertussis vaccine.

Adolescent↗
PubMed1986

High rate of insufficient antibody titers after single-day immunization with human diploid-cell-strain vaccine against rabies.

We examined the possibility of simplifying the currently recommended immunization schedule against rabies. Four groups of 11 healthy volunteers were each immunized with either one, two, four, or eight doses of 0.1 ml human diploid cell vaccine (HDCV) intradermally on 1 single day. Antibody titers in serum were determined using a rapid fluorescent focus inhibition test. Geometric mean antibody titers 10, 30 and 90 days after immunization were all greater than 0.5 IU/ml, which is considered protective. A dose-proportional increase in the geometric mean antibody titer was observed for all four groups. However, at each dose level, at least 1 of the 11 volunteers on day 30 and 2 of the 11 volunteers on day 90 had insufficient antibody titers less than 0.5 IU/ml. Single-day immunization against rabies with HDCV vaccine cannot be recommended because of the unacceptably high failure rate.

Adolescent↗
PubMed1987

[Immunological effectiveness of a 2d revaccination against diphtheria performed at intervals extended up to 7-10 years].

The present article deals with the data on the duration of antidiphtheria immunity, induced by the primary cycle of immunization with adsorbed DPT vaccine, with the aim of considering the problems of optimizing the immunization schedule for children. The prolongation of the interval before the second booster immunization to 7-10 years produces no negative influence on the effectiveness of immunization. Besides, the study has shown that after the main complex of immunizations with adsorbed DPT vaccine protective immunity to diphtheria is retained in 90.3-96.8% of children covered by this study for 9-10 years. These data point to high immunological effectiveness of adsorbed DPT vaccine and to the possibility of prolonging the intervals between booster immunizations to 10 years, as well as decreasing the number of booster immunizations in the immunization schedule for children.

Adolescent↗
PubMed1995

Antibody response of low birth weight infants to Haemophilus influenzae type b polyribosylribitol phosphate-outer membrane protein conjugate vaccine.

OBJECTIVE: To evaluate the effectiveness in low birth weight (LBW) infants of the currently recommended immunization schedule for conjugated Haemophilus influenzae type b (HIB) vaccine. METHODS: We quantified antibody responses in 36 preterm infants with a mean birth weight of 1060 g and a mean gestational age of 28 weeks. Infants were immunized with 0.5 mL of HIB vaccine at 2 and 4 months' postnatal age. Specific HIB antibodies were quantified on cord blood, immediately before each immunization and 2 months after the last immunization. RESULTS: Even though the geometric mean titers increased significantly during the study period, they were still markedly lower than values reported in term infants. After the second immunization, only 24 infants (67%) attained antibody concentrations of more than 0.25 micrograms/mL, defined as seropositivity. Also, only 53% of infants achieved antibody concentrations of more than 1.0 micrograms/mL compared with 92% as reported in term infants. Stepwise logistic regression identified gestational age of 27 weeks or less and the amount of intravenous immunoglobulin received as the significant variables influencing the antibody response after the first immunization. The incidence of side effects was negligible. CONCLUSIONS: We conclude that LBW infants, and especially those born at 27 or less weeks' gestation, do not respond as effectively to the HIB vaccine. We speculate that reevaluation of the current immunization schedule may be required for very LBW infants.

Antibodies, Bacterial↗
PubMed2001

Considerations for hepatitis B as part of a combination vaccine.

BACKGROUND: In 1991 the Advisory Committee on Immunization Practices (ACIP) developed a comprehensive strategy to eliminate the transmission of hepatitis B virus in the United States, which includes immunization of all infants. Today, as the number of recommended childhood vaccinations increases, combination vaccines are needed to simplify the immunization schedule and improve coverage levels. METHODS: A review of the literature was performed to determine the considerations that should be taken when hepatitis B virus vaccine (HepB) is included as part of a combination vaccine. RESULTS: A combination vaccine that incorporates HepB and other routine infant vaccine antigens has been developed for administration at 2, 4 and 6 months of age. Clinical studies have demonstrated that administration of HepB, either as a monovalent or combination vaccine at 2, 4 and 6 months of age, induces a seroprotective immune response similar to that achieved with monovalent HepB administered at 0, 1 and 6 months of age. In addition the combination vaccine results in similar or fewer adverse reactions compared with separate administration of its components. Infants given a dose of monovalent HepB at birth will receive a total of four doses of HepB when the combination is used. The extra dose of HepB has not led to increased adverse reactions. CONCLUSIONS: A HepB-containing combination vaccine administered at 2, 4 and 6 months of age is as safe and immunogenic as separate administration of its components and will help simplify the childhood immunization schedule.

Hepatitis B↗
PubMed1999

Predictors of childhood immunization completion in a rural population.

Despite the availability of effective vaccines, immunization rates among two-year old children continue to be low in many areas of the United States including rural West Virginia. The goal of this study was to identify barriers to childhood immunization in rural West Virginia and determine factors that were important in the completion of the childhood immunization schedule. A telephone survey was used to collect data from a randomly selected sample of 316 mothers, of two-year olds, from 18 rural counties of West Virginia. Results indicated that two-thirds or 65% of the children in the study sample had completed their recommended immunizations by two years of age. Immunization barriers identified in this study include: living in health professional shortage areas, lack of health insurance, negative beliefs and attitudes regarding childhood immunizations, problems accessing the immunization clinic, and a perception of inadequate support from the immunization clinic. Results of the structural equation modeling, using LISREL-8, indicated that 20% of the variation in immunization completion (R2 = 0.197) was explained by attitude towards immunization and perceived support received from the immunization clinic. Furthermore, 42% of the variation in attitude towards immunization (R2 = 0.419) was explained by immunization-related beliefs, and 28% of the variation in immunization-related beliefs (the R2 = 0.277) was explained by general problems faced during immunization and perceived clinic support. The study concluded that positive immunization-related beliefs and attitudes, support from the immunization clinic, and ease of the immunization seeking process are important factors in the timely completion of the childhood immunization schedule.

Child↗
PubMed1995

Therapy of pediatric AIDS.

Therapy of pediatric AIDS utilizes antiretroviral compounds; antibiotic, antifungal, and antiparasitic agents; and both active and passive immunization in a multifactorial approach. Currently, newly diagnosed pediatric AIDS cases are acquired predominantly through vertical transmission from HIV-infected mothers. Pediatric AIDS research is focused on strategies to prevent vertical transmission of HIV infection as well as therapy against opportunistic and progressive HIV disease. Zidovudine remains first-choice therapy for HIV infection and can reduce the rate of vertical transmission of HIV. Didanosine is also approved to treat HIV infection in pediatric AIDS. Other reverse transcriptase inhibitors are under investigation as alternative or combination therapies because of HIV resistance to zidovudine and didanosine. Alternative therapies for opportunistic infections are being investigated. Passive immunity with intravenous immunoglobulin is being reevaluated to determine efficacy in combination with other therapies. Finally, vaccination against usual childhood diseases with standard immunization schedules produces limited immunity, and alternative vaccination protocols warrant further investigation.

AIDS-Related Opportunistic Infections↗
PubMed1989

Enhanced induction of thyroid cell MHC class II antigen expression in rats highly responsive to thyroglobulin.

Initial experiments demonstrated that the degree of autoantibody and proliferative T cell responses to syngeneic rat thyroglobulin differed markedly between Buffalo (high responder) and Fisher (low responder) rats after classical immunization schedules. While varying immune responsiveness may be due to qualitative and quantitative T and B cell differences, the role of thyroid cell MHC class II antigens may be pivotal to the onset of autoimmune thyroiditis in such animal models. We, therefore, examined the induction of MHC class II antigens in thyroid monolayers derived from Buffalo and Fisher rats treated with methimazole (0.1% in their water) for 4 weeks to induce mild thyroid hyperplasia. After thyroidectomy, thyroid cell monolayers were prepared and exposed to recombinant rat gamma-interferon (gamma IF; 10-1000 U/ml) for 1-7 days in the presence and absence of TSH (1 mU/ml). Both Buffalo and Fisher thyroid monolayers responded to gamma IF with MHC class II antigen expression when assessed by laser flow cytometry using MRC OX-6 monoclonal anti-RT1.B. In both types of culture, TSH enhanced MHC class II antigen expression in the presence of gamma IF to the same degree. However, there was a consistently earlier and greater degree of MHC class II antigen expression in Buffalo thyroid monolayers compared to Fisher monolayers, a phenomenon not explicable on the basis of fibroblast contamination as assessed by cytokeratin staining. These data demonstrate that end-organ sensitivity to MHC class II antigen expression may be important in the pathogenesis of autoimmune thyroid disease.

Animals↗