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At least 451 records · Page 25Linked to original sources
PubMed2006

Surveillance for influenza admissions among children hospitalized in Canadian immunization monitoring program active centers, 2003-2004.

OBJECTIVES: Influenza is a common childhood infection that may result in hospitalization. Our objectives were to (1) determine characteristics of children hospitalized for influenza and disease manifestations and (2) obtain baseline data before implementation of new recommendations for routine immunization of young children and their caretakers against influenza. METHODS: All of the children hospitalized with laboratory-confirmed influenza at 9 Canadian tertiary care hospitals during the 2003-2004 influenza season were identified from virology laboratory reports, and their charts were reviewed. RESULTS: There were 505 children admitted because of influenza. Fifty-seven percent were < 2 years old. Previously healthy children accounted for 58% of all of the cases. Pulmonary and neurologic disorders were the most common underlying chronic conditions. Fever and cough were the most frequent manifestations. Seizures occurred in 9% of cases. Serious complications included myocarditis (2), encephalopathy (6), and meningitis (1). There were 3 influenza-related deaths. Mean duration of hospitalization was 5.3 days. Twelve percent of children required ICU admission, and 6% required mechanical ventilation. Antibiotic therapy was administered in 77% of cases, and 7% received anti-influenza drugs. Information on influenza vaccination was available for 84 of 154 children identified as vaccine candidates. Twenty two had received vaccine, but only 7 children had been fully immunized > 14 days before the onset of illness. CONCLUSIONS: Healthy young children and children with chronic conditions are at risk for serious illness with influenza. Ongoing surveillance is needed to evaluate the impact of changing immunization recommendations on the burden of influenza illness in children.

Adolescent↗
PubMedDate not supplied

[Inclusion of hepatitis B vaccination in the Expanded Program of Immunization: feasibility study in the medical region of Kolda (Senegal)].

Hepatitis B is highly endemic in Senegal. The prevalence of hepatitis B antigens in the population was estimated to be 10 to 12% in 1982. According to the WHO recommendations, a hepatitis B vaccination program (HBV) was launched in 10 medical centers in the Kolda medical region to assess the feasibility of including HBV in the EPI. The epidemiological impact of HBV was also investigated by comparison of the vaccinated zone (VZ) to a control non vaccinated zone (NVZ). HBV coverage had a pattern similar to that of DPT-IPV, but at a lower level: the overall coverage with HBV was only 37.5%, and the drop out rate for HBV1-3 was only 34.4%. In addition, the coverage of the under one year age group was insufficient: 45% for HBV3 as compared to 78% for DPT3 (p < 0.0001). Routine vaccination records in the medical centers in the VZ were consistent with the findings of cluster surveys. Hepatitis B markers were less prevalent among vaccinated that non vaccinated children (8 versus 18.5%, p < 0.001). HB antigenemia was significantly less frequent in the VZ than the NVZ (3.9 versus 10.9, p < 0.0001), and the difference was even larger for all hepatitis markers (7.4 versus 23.7%, p < 0.0001). This study therefore suggests that the inclusion of HBV in the EPI should be continued and strengthened in less accessible regions by an adapted social mobilization program. HBV could then be extended to the whole medical district of Kolda in association with regular epidemiological and serological surveillance.

Child, Preschool↗
PubMedDate not supplied

[HEPATITIS B.VACCINATION IMPACT ON ACUTE DISEASE,CHRONIC CARRIERS AND HEPATOCARCINOMA INCIDENCE]

BACKGROUND: Hepatitis B virus is the cause of acute disease and several chronic conditions, such as chronic hepatitis, cirrhosis and liver cancer.In 1982, hepatitis B vaccine was developed. Since 1984, many immunization programs against hepatitis B were implemented in several countries and 15 years later we can visualize some epidemiological changes in those countries.OBJECTIVE: To review the papers published about the results of hepatitis B immunization programs in several countries from Asia, Africa, Europe (Italy) and Peru, since 1984.METHODS: Pertinent literature was identified in MEDLINE (1980-2000) and references quoted in published papers. RESULTS: The impact of vaccination against hepatitis B over the incidence of acute disease, chronic carriers, hepatitis B virus prevalence and hepatocarcinoma incidence, was anayzed.The following results were obtained: In Afragola (Italy), a reduction of acute disease incidence from 63 cases/100,000 population before the vaccination (1983), to 3 cases/100,000 population after the vaccination (1997), was obtained HBsAg carriers rate decreased: From 13.4% to 3.7% in the general population and from 6.8% to 0.7% in infant population.Infection prevalence: From 66.9% to 34.2% in general population. In Taiwan:HBsAg carriers rate decreased: From 10.0% to <1.0% in children from 1 to 10 years old.Infection prevalence: From 38.0% to 16.0% in children under 13 years old. In Peru:Infection prevalence: From 24.4-30.4% to 2.3-5.1% in children of 3 and 4 years old. In Senegal:HBsAg carriers rate decreased: From 18.7% to 2.2% in children. In Gambia:HBsAg carriers rate decreased: From 10.0% to 0.6% in children.Finally, the hepatocarcinoma incidence in children from 6 to 14 years old, decreased from 0.70/100,000 children to 0.36/100,000 (p<0.01) in Taiwan.CONCLUSION: The results of these studies support the hypothesis that the vaccination against the hepatitis B virus infection reduce the incidence of acute disease, carriers rate, prevalence of the infection and hepatocarcinoma incidence.

Journal Article↗
PubMed2006

General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP).

This report is a revision of General Recommendations on Immunization and updates the 2002 statement by the Advisory Committee on Immunization Practices (ACIP) (CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices and the American Academy of Family Physicians. MMWR 2002;51[No. RR-2]). This report is intended to serve as a general reference on vaccines and immunization. The principal changes include 1) expansion of the discussion of vaccination spacing and timing; 2) an increased emphasis on the importance of injection technique/age/body mass in determining appropriate needle length; 3) expansion of the discussion of storage and handling of vaccines, with a table defining the appropriate storage temperature range for inactivated and live vaccines; 4) expansion of the discussion of altered immunocompetence, including new recommendations about use of live-attenuated vaccines with therapeutic monoclonal antibodies; and 5) minor changes to the recommendations about vaccination during pregnancy and vaccination of internationally adopted children, in accordance with new ACIP vaccine-specific recommendations for use of inactivated influenza vaccine and hepatitis B vaccine. The most recent ACIP recommendations for each specific vaccine should be consulted for comprehensive discussion. This report, ACIP recommendations for each vaccine, and other information about vaccination can be accessed at CDC's National Center for Immunization and Respiratory Diseases (proposed) (formerly known as the National Immunization Program) website at http//:www.cdc.gov/nip.

Adolescent↗
PubMed1998

[Epidemiology of invasive Hemophilus influenzae B infections in Bedouins and Jews; conjugate Hib vaccines].

From 1989 to 1996, 139 cases of invasive Hemophilus influenzae B (Hib) infections were identified in children in the Negev, 110 of which occurred before introduction of the conjugate vaccine (1989-92). At that time there were 60.5 cases of Hib per 100,000 in the Negev among children under 5 years of age. During 1995-1996, when Hib conjugate vaccine was part of the regular immunization program, Hib decreased to 6.5 cases per 100,000 in that age group. The effectiveness of PRP-OMP vaccine was 96.5% among Jews and 89% among Bedouins, and the efficacy of the immunization program was 99.99%. This degree of success exceeded all expectations based on the literature. During the whole study period, Hib infections were more frequent among Bedouins than Jews. There was no significant difference in the occurrence of Hib among Jews in the Negev before and after the vaccine was introduced. Hib among Bedouins in the Negev was significantly more frequent than in the Israeli population as a whole before the vaccine was introduced. That gap narrowed after the vaccine was introduced because of the decrease in morbidity among the 2 groups.

Arabs↗
PubMed1979

Pertussis vaccine--an analysis of benefits, risks and costs.

Using decision analysis, we estimated the benefits, risks and costs of routine childhood immunization against pertussis. Without an immunization program, we predict that there would be a 71-fold increase in cases and an almost fourfold increase in deaths (2.0 to 7.6) per cohort of one million children. With a vaccination program, we predict 0.1 case of encephalitis associated with pertussis and five cases of post-vaccination encephalitis; without a program, there would be only 2.3 cases of encephalitis associated with pertussis. Community vaccination would reduce by 61 per cent the costs related to pertussis. Our analysis supports continuation of vaccination in routine childhood immunization programs, but suggests the need for more reliable data on complications from the vaccine, further study of the epidemiology of pertussis and development of a less toxic vaccine.

Child↗
PubMed1996

Guidelines for prevention and control of hepatitis A in American Indian and Alaska Native communities.

The Aberdeen Area Indian Health Service, South Dakota Department of Health, and the Centers for Disease Control and Prevention have collaborated since 1985 to investigate hepatitis A in Indian communities in the Northern Plains and to implement clinical trials of hepatitis A vaccine. After licensure of the hepatitis A vaccine in February 1995, community wide immunization programs have been implemented effectively in several communities experiencing hepatitis A outbreaks. The state health department, tribal health departments, Indian Health Service facilities, Head Start programs and schools have provided hepatitis A immunizations to children aged 2-12 years in each of these communities after obtaining parental consent. Culturally-specific educational materials were developed and extensive health education efforts were provided by IHS and tribal programs. Hepatitis A contacts age 2-12 were offered the hepatitis A vaccine at the same time they were offered passive immunization with immune globulin. To date over 70% of parents contacted by letter or in person have returned consent forms to have their children immunized. Higher response rates were obtained in communities where home visits were made to explain this program in more detail. The outbreaks appear to have stopped after 70% or more of the children aged 2-12 years were immunized. Immunization programs are being implemented in all Northern Plains Indian communities utilizing hepatitis. A vaccine from the Vaccine For Children Program. These efforts will likely eliminate hepatitis A as a health problem for Indian communities.

Adolescent↗
PubMedDate not supplied

[Haemophilus influenzae type b meningitis in the state of Paraná, Brazil]

OBJECTIVE: During the second half of 1996, the municipalities of Londrina and Curitiba (State of Paraná, Brazil) included Haemophilus influenzae type b (Hib) vaccine into their routine vaccination regimen, approximately 30 months before its introduction into the National Immunization Program. The present study aimed at verifying the incidence of meningitis caused by Hib among children in Londrina, Curitiba, and in the remaining municipalities of the State, before and after the introduction of this vaccine into the immunization program. METHODS: An observational and retrospective study was carried out. The study included all cases of Haemophilus influenzae type b meningitis recorded by the epidemiological surveillance system in Londrina and by the State of Paraná Health Secretariat between 1992 and 1999 among children aged less than 5 years. The incidence rates of Hib meningitis were calculated per 100,000 children aged less than five years. RESULTS: After the introduction of Hib vaccine, an important reduction in the incidence rate of Haemophilus influenzae type b meningitis was observed in Londrina (from 23.91 in 1996 to 2.79 in 1999). A Similar decrease was observed in Curitiba. In the remaining localities of the state, which had not introduced the vaccine till mid-1999, the incidence rate remained almost unchanged. CONCLUSION: Regular vaccination against Hib was effective in reducing the incidence rate of meningitis amongst children younger than five years in Londrina and Curitiba. In order to maintain this low incidence rate, adequate vaccination coverage and strict epidemiological surveillance should be guaranteed.

Journal Article↗
PubMed1996

A brief history and inventory of immunizations.

This article attempts to summarize succinctly the origins, past history, present armamentarium, and possible future directions of immunizing agents. Individual discoveries and governmental initiatives have led to large-scale immunization programs that have proven the success of this primary preventive tool. Examples of missed opportunities have been noted. Like previous vaccines, the newer vaccines will require scientific proof of efficacy and public acceptance. Unlike other primary preventive tools (chlorination of water, pasteurization of milk), future successful immunization programs will require active participation, of the public and continuous governmental education in order to protect its citizens.

History, 18th Century↗
PubMed1998

The introduction of Haemophilus influenzae type b immunization into the United Kingdom: practical steps to assure success.

Haemophilus influenzae type b (Hib) vaccine was introduced into the routine childhood immunization program in the UK in October, 1992. The implementation was coordinated on a national basis, taking account of market research of the information needs of both the public and health professionals. Vaccine distribution arrangements were linked to the scheduling of children for immunization, which was implemented through a national computerized system of calling children for immunization. All children commencing immunization were called for three doses of Hib vaccine. Children < 1 year of age were called back for three doses of vaccine; children >1 but <4 years were called for one dose. No boosters were given. National coverage from the outset of the campaign exceeded 90%; it is now 95% and the incidence of invasive Hib infection has declined by >95%. Some of the lessons learned from the UK introduction may be of relevance to other countries presently considering the implementation of Hib immunization into their routine immunization programs.

Child, Preschool↗
PubMed2004

Adult tetanus, diphtheria and pertussis immunization: knowledge, beliefs, behavior and anticipated uptake.

BACKGROUND: Lifetime protection against pertussis has been adopted as a goal of immunization programs in Canada. To anticipate adult coverage with a combined product containing tetanus (T) and diphtheria (d) toxoids and acellular pertussis (aP) vaccine as a booster dose, we conducted a survey of households in British Columbia, Canada. METHODS: In a random telephone survey involving 800 adults, 25 years of age and older, we assessed current behaviors related to adult Td immunization and beliefs regarding pertussis vaccine under various scenarios relevant to adult decision-making. RESULTS: Forty-five percent of participants reported having received tetanus vaccine within the previous 10 years; this rate was lowest amongst elderly persons 65 years of age or more (28%). On multi-variate analysis, being up-to-date with tetanus immunization was independently associated with belief that an adult should be immunized against tetanus and perception that tetanus is life-threatening and inversely associated with being elderly. At baseline, 59% of respondents indicated willingness to receive pertussis immunization if provided free; this increased to 76% following sequential information about communicability and severity of pertussis illness and safety, efficacy and convenience of vaccine and up to 87% if accompanied by physician or nurse recommendation. Sixty-three percent of adults indicated they would receive the vaccine if required to pay $40.00 (Cdn) for it. CONCLUSIONS: Personal risk perception, public funding and physician recommendation are important to adults when considering tetanus and pertussis immunization. These factors may be relevant as immunization programs are expanded to include more adults generally.

Adult↗
PubMed1996

Prospects for the use of new vaccines in developing countries: cost is not the only impediment.

Global immunization programs represent a great public health success story. Evidence from every region documents substantial reductions in morbidity and mortality following widespread use of vaccines developed years ago. Development and introduction of new vaccines and vaccine combinations aimed at the industrialized world market are occurring at a fast pace. A number of political and economic factors will influence the rate at which developing country immunization programs incorporate those new vaccines that could have a major public health impact. Perhaps the greatest determinant of this rate is the extent to which international and bilateral agencies and national governments appreciate the potential value of new vaccines.

Costs and Cost Analysis↗
PubMed1987

Four years of measles elimination in the Czech Socialist Republic.

In 1982, Czechoslovakia succeeded in eliminating measles infection throughout the country. The paper describes the strategy of the measles immunization program following its introduction in 1969, showing it to reflect the objective epidemiological situation as revealed by the regular immunological surveys carried out in a broad population sample. As it turned out, decisive for achieving and maintaining a permanent measles elimination in the country was the introduction of second vaccination into the regular immunization schedule. Since 1982, its timing of is from 6 to 10 months after primary immunization. Over the 4-year period between 1982 and 1985, confirmed measles occurred only sporadically in the CSR, 115 cases altogether, and of these as many as 67 were classified as imported or their immediate contacts (38 measles patients were tourists from abroad). Of these 115 measles cases, 52 had had vaccination prior to acquiring the disease, 46 were individuals who had never before been vaccinated and in the remaining 17 patients no vaccination data were available. The vaccine failures, at least in 18 cases, could have been explained by the primary immunization prior to reaching 15 months of age. According to the estimates, at least 670 thousand cases of measles, 470 deaths, 100 thousand complications and some 33 thousand hospitalizations had been averted between 1972 and 1985 on the territory of CSR as a result of the introduction of the measles immunization program in Czechoslovakia.

Adolescent↗
PubMed2004

Progress toward implementation of a second-dose measles immunization requirement for all schoolchildren in the United States.

In 1998, the Advisory Committee on Immunization Practices and the American Academy of Pediatrics recommended that states ensure that all children in grades kindergarten through 12 receive 2 doses of measles-mumps-rubella (MMR) vaccine by 2001. In 2000, the National Immunization Program surveyed states, the District of Columbia, and United States territories, commonwealths, and protectorates to assess progress toward this goal. Almost all respondents (53 [98%] of 54) reported a second-dose requirement for entry to elementary school, middle school, or both. By fall of 2001, most (82%) school-aged children in the United States were in grades requiring a second dose of measles vaccine. For 29 responding programs, the requirement did not yet affect all grades. By 2009, 52 of 54 responding programs will require a second dose for all grades. Although not all states have achieved coverage of all schoolchildren with 2 doses of MMR vaccine, most states are well on their way toward this goal.

Adolescent↗
PubMedDate not supplied

[Surveillance of secondary effects of vaccination].

Although modern vaccines are usually well tolerated and efficacious, no vaccine is totally safe nor totally efficacious and adverse events have been reported following the use of each of them. International collaboration in the use, testing, and surveillance of vaccines would help limit these problems. National immunization programs must rely on comprehensive and timely surveillance and have the capability to react quickly to minimise negative outcomes. In each individual case, it may be difficult to demonstrate or rule out a relationship between a vaccine and an adverse event because there is usually no clear marker of etiology. Postmarketing surveillance of vaccines could be defined as the coordinated, structured, systematic, ongoing collection of data on the impact of licensed vaccines and their subsequent epidemiologic analysis and dissemination to manufacturers, regulators, health care providers, and the public. Managers of immunization programs have the responsibility for determining the risks associated with each vaccine, for constantly weighing the risks and benefits of vaccine use, and for minimizing the risks. Postmarketing surveillance of illness following administration of immunizing agents permits: 1) identification of illness or other side effects caused by immunizing agents; 2) estimation of the incidence of serious side effects of immunization; 3) monitoring for unusually high rates of adverse events (including lot-by-lot surveillance); 4) raising of health care providers' awareness to the risks and/or safety measures in administering vaccines; 5) identification of issues that require epidemiological research; and 6) identification of problems that require immediate epidemiological investigation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adverse Drug Reaction Reporting Systems↗
PubMedDate not supplied

GAVI and the Vaccine Fund--a boon for immunization in the developing world.

The Global Alliance for Vaccines and Immunization (GAVI) and The Vaccine Fund are two major global initiatives adopted with the objectives of improving access to immunization services particularly in the underdeveloped and developing countries and introduction of new but under-used vaccines in the developing countries in particular where these diseases are highly prevalent. GAVI is a collaborative mission that brings together governments in developing and industrialized countries, UNICEF, WHO, the World Bank, the Bill & Melinda Gates Foundation, vaccine manufacturers and all other stake holders to harness the strengths and experiences of multiple partners in immunization. The Vaccine Fund is a financing mechanism established to mobilize resources to serve the mission of GAVI. This article reviews the objectives, strategies, organization and the funding issues of this global initiative. In the Indian perspective, GAVI is presently playing a major role in introduction of Hepatitis-B vaccine for infants in India. The article outlined the pilot project currently being implemented by GoI and the future prospects of integrating Hepatitis-B vaccine and auto disable syringes into the routine immunization program as well as strengthening the routine immunization services when the government decides to expand the project.

Child↗