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PubMed1999

The Hib immunization programme in the Oxford region: an analysis of the impact of vaccine administration on the incidence of disease.

In May 1991 an immunization programme against Haemophilus influenzae type b (Hib) infection began within the Oxford region. We validate a deterministic mathematical model of Hib by comparison with the incidence of disease in the Oxford region, 1985-97. The comparison of model results with observed outcome allows an exploration of some of the poorly understood properties of the immunization programme. Model results and observed incidence are consistent with a vaccine that blocks the acquisition of carriage. Similarly, the data suggest that factors other than experience of Hib carriage are likely to have generated acquired immunity to Hib disease prior to the introduction of vaccination. Hence it is unlikely that waning of vaccine-derived protection will result in a resurgence of disease. The inclusion in the immunization schedule of a booster dose, as used in other countries, would have provided very little extra benefit.

Carrier State↗

PubMed1993

Immunization status and demographic characteristics of New Zealand infants in the first 6 months of life.

In the Royal New Zealand Plunket Society's 1990-91 cohort study, of 3902 children, 985 (25.2%) had fallen behind the immunization schedule by 6 months of age. These children were more likely to be from lower socio-economic groups or to have mothers who were older, with high or low education, or of higher parity. The infants were also more likely to be from non-European families, or to have unemployed fathers. Eight hundred and ten (82.2%) of the incompletely immunized children at that age could be brought up-to-date with their immunizations by a single visit to the doctor. The most common reason for delaying immunization was that the baby was sick. This was a false contraindication in 69.2, 79.0 and 78.4% of these children at the 6 week, 3 month and 5 month immunization, respectively.

Cohort Studies↗

PubMedDate not supplied

[Immunoprophylaxis of poliomyelitis in Ukraine with the use of inactivated vaccine].

In connection with the cessation of the circulation of "wild" poliovirus on the territory of the European region, including Ukraine, the strategy of the vaccinal prophylaxis of poliomyelitis is reviewed. Its main aims are the creation of a high level of the specific protection of the population, the prophylaxis of vaccine-associated paralytic poliomyelitis and a decrease in the intensity of the circulation vaccine polioviruses. These aims may be achieved only by the inclusion of vaccinations with inactivated poliomyelitis vaccine (IPV) into the immunization schedule. IPV "Imovax Polio" produced by the firm "Aventis Pasteur" (France) has been shown to have low reactogenicity and high effectiveness, especially with respect to type 3 poliovirus, under the conditions of Ukraine. On the basis of our studies all children, starting from the age of 3 months, are recommended to be vaccinated first with two injections of IPV, followed by further immunization with oral vaccine.

Antibodies, Viral↗

PubMed1991

Epidemiology of pertussis in Hungary.

Reliable data in Hungary on the incidence of pertussis have been available since the introduction in 1931 of obligatory notification. Immunization against pertussis was introduced compulsorily in 1953 with a combined diphtheria-tetanus-pertussis vaccine. Since that time the method of preparation, quality and quantity of the vaccine as well as its immunization schedule underwent several important modifications. As a result of vaccination the incidence of pertussis dropped from 56.967 cases (594.4 per 100,000 inhabitants) in 1953 to 16 cases (0.2 per 100,000 inhabitants) in 1989.

Child↗

PubMed2006

Immunogenicity and safety of measles-mumps-rubella, varicella and Haemophilus influenzae type b vaccines administered concurrently with a fourth dose of heptavalent pneumococcal conjugate vaccine compared with the vaccines administered without heptavalent pneumococcal conjugate vaccine.

BACKGROUND: Prevnar [heptavalent pneumococcal conjugate vaccine (PCV7)] is licensed in the United States for routine administration in infants and may be coadministered with other infant vaccines. Safety and immunogenicity data on the coadministration of the fourth dose of PCV7 with measles-mumps-rubella (MMR), varicella and Haemophilus influenzae type b (Hib) vaccines are limited. METHODS: Children 12-15 months of age received either MMR with PCV7 (group 1) or MMR without PCV7 (group 2). All subjects received Hib and varicella vaccines. Group 2 received PCV7 6-9 weeks after MMR vaccination. Sera for analysis of all non-PCV7 antibodies were collected just before administration of MMR vaccine and 6 weeks later. Optimal antigen responses were assessed with the use of predetermined antibody titers. The primary end point was >90% response rate (all antigens). Noninferiority was defined as <10% difference between groups. Local and systemic reactions and postvaccination adverse events were monitored and compared between groups. RESULTS: A total of 694 subjects (347 per group) were enrolled. After immunization with MMR plus PCV7 concurrently, or MMR followed 6 weeks later by PCV7, the percentages of subjects seroconverting were significantly greater than 90% for all antigens. The difference between the 2 groups was significantly less than 10%. CONCLUSION: The immune response to MMR, Hib and varicella vaccines, when administered concurrently with a 4th (booster) dose of PCV7, was noninferior to that of these vaccines when given without PCV7. These results support concomitant administration of PCV7 with MMR, varicella and Hib as part of the recommended immunization schedule for children 12-15 months of age.

Antibodies, Bacterial↗

PubMed2001

Routine childhood immunizations.

The immunizations recommended in the 2001 Childhood Immunization Schedule are safe and effective. Newly approved vaccines, like the pneumococcal conjugate vaccine, hold the promise of eliminating or dramatically reducing persistent causes of childhood morbidity and mortality in the United States.

Child, Preschool↗

PubMed1977

Antibody persistence after primary immunization with trivalent oral poliovirus vaccine.

Five years after primary infant immunization with trivalent oral poliovirus vaccine, employing either a three-dose primary series as recommended by the U.S. Public Health Service Advisory Committee on Immunization Practices (ACIP) or a four-dose series as recommended by the Committee on Infectious Diseases of the American Academy of Pediatrics. 115 children were serologically tested for persistence of neutralizing antibodies by the microneutralization test. Of the 57 individuals immunized according to the ACIP recommendation, antibody persistence was demonstrated in 92% for type 1 poliovirus, 98% for type 2, and 84% for type 3. Of those 58 individuals originally receiving a four-dose primary infant immunization series, the persistence of antibody was 98% to type 1, 98% to type 2, and 87% to type 3. Twenty-one of 24 negative sera showed neutralizing ability when tested by a more sensitive plaque reduction test. Thus, individuals completing either immunization schedule demonstrated satisfactory persistence of neutralizing antibody to all three poliovirus types over a five-year period.

Antibodies, Viral↗

PubMed1990

[The reactogenicity and immunological efficacy of a Klebsiella vaccine in donors].

Klebsiella vaccine, when injected subcutaneously to donors, proved to be faintly reactogenic and safe. The injection of the vaccine had no effect on changes in the morphological composition of peripheral blood and on liver function. In persons with the initially low content of IgG an increase in this characteristic was observed after immunization. No changes in the synthesis of IgE occurred in healthy donors under the influence of immunization. The vaccine was shown to be immunogenic when introduced according to immunization schedules comprising 3 and 5 injections, the titer of Klebsiella antibodies increasing 3- to 5-fold.

Adult↗

PubMed1988

Stochastic humoral expression of human growth hormone epitopes.

Competition experiments between insolubilized monoclonal antibodies (mAb) and polyclonal antisera has led to the description of the humoral expression of human growth hormone (hGH) epitopes. This study was carried out with sera from mice and hamsters submitted to different immunization schedules: chronic administration of the antigen, secondary response and conventional hyperimmunization. The results indicated the absence of a unique immunodominant epitope in hGH; a significant individual variation of antibody (Ab) population titres with time; changes with time in the relative proportion of one Ab population with respect to the others; and the occurrence of Ab enhancing the 125I-hGH binding to five mAb depending upon the individuals and the time of immunization. Heterocliticity towards non-human GH was also detected. Although most of the animals showed cross-reacting Ab, two out of 12 mice, chronically injected, developed heteroclitic Ab. The data suggest that the humoral response to different epitopes of a protein antigen during the maturation of the immune response is a stochastic process leading to transient humoral immunodominance, enhancing Ab populations and heterocliticity, depending upon individual characteristics, either in outbred or inbred populations.

Animals↗

PubMed1997

Poliomyelitis prevention: recommendations for use of inactivated poliovirus vaccine and live oral poliovirus vaccine. American Academy of Pediatrics Committee on Infectious Diseases.

A change in the recommendations for routine immunization of children is indicated because of the reduced risk of exposure to wild-type polio viruses and the continued occurrence of vaccine-associated paralytic poliomyelitis after oral polio vaccine (OPV). All children should receive four doses of vaccine before the child enters school. Regimens of sequential inactivated polio vaccine (IPV) and OPV, IPV only, or OPV only are acceptable. Each regimen has advantages and disadvantages. In special circumstances, one of the regimens is preferred or recommended. Because logistical problems with the current childhood immunization schedule may make these new recommendations difficult to implement immediately, their adoption likely will be gradual. Nevertheless, assuming continued progress toward global eradication and the development of new combination products, the routine use of an IPV-only regimen is likely to become desirable and feasible in future years.

Humans↗

PubMed2004

[Children immunization in France: an update].

Vaccines are essential to prevent, control (as for poliomyelitis) or eradicate (as for smallpox) infectious diseases. In some cases, when a curative treatment is not available or efficient, they are the only way to fight the spread of the disease, by prevention. The national recommended childhood immunization schedule may vary each year and in each country (changes in infections characters, outbreaks, new vaccines availability...). In this review, new patterns in childhood vaccination in France are discussed.

Adolescent↗

PubMed1998

Response to conjugate Haemophilus influenzae B vaccine among infants in Niamey, Niger.

Despite near elimination of Haemophilus influenzae b (Hib) meningitis from several industrialized countries following introduction of conjugate Hib vaccines into infant immunization schedules, Hib remains a major cause of meningitis and pneumonia in resource-poor countries. In Niger, Hib causes nearly 200 cases of meningitis per 100,000 children < one year of age, and > 40% of cases are fatal. We evaluated the immunogenicity of Hib polysaccharide-tetanus toxoid conjugate vaccine (PRP-T) administered in the same syringe as diphtheria-tetanus-pertussis (DTP) vaccine among infants in Niger. Infants were randomized into group 1 (PRP-T at six, 10, and 14 weeks), group 2 (PRP-T at 10 and 14 weeks), or a control group (meningococcal A/C polysaccharide vaccine). By 14 weeks of age, all subjects in groups land 2 had > or = 0.15 microg/ml of anti-PRP antibody, and 82% versus 76% had > or = 1.0 microg/ml of antibody (P=not significant). By nine months of age the proportion of infants with > or = 0.15 and > or = 1.0 microg/ml was group I=97% and 76%; group 2=93% and 67%; controls=10% and 2.6%. Four weeks after the first, second, and third doses of PRP-T, infants in group 1 showed geometric mean titers (GMTs) of 0.19, 3.97, and 6.09 microg/ml while infants in group 2 had GMTs of 2.40 and 4.41 microg/ml four weeks after the delayed first and second doses. Both PRP-T groups had significantly higher GMTs at 18 weeks and nine months of age than infants in the control group. The Hib PRP-T vaccine was immunogenic in infants in Niger. The strong response after PRP-T was initiated one month after the first DTP vaccination may reflect carrier priming. Two dose schedules of PRP-T should be given serious consideration, particularly if their reduced cost permits vaccine introduction that would be otherwise unaffordable.

Antibodies, Bacterial↗

PubMed1992

Early immunization of neonates with trivalent oral poliovirus vaccine.

Described is the evaluation in Brazil of the immune response of early immunization with trivalent oral poliovirus vaccine (TOPV). A total of 85 normal neonates from São Paulo were assigned one of the following immunization schedules: group A--one dose of TOPV at birth and subsequent doses at 2, 4, and 9 months of age; or group B--one dose of TOPV at 2, 4 and 6 months of age. Blood samples were collected sequentially from the mother at delivery, from the umbilical cord, and from the child at 2, 4, 6, 9 and 12 months of age for assay of poliovirus neutralizing antibodies. Administration of TOPV at birth, in addition to establishing immunity against poliomyelitis at an earlier stage, produced a superior immune response to poliovirus type 3. At the end of the first year, the proportion of susceptible individuals was 3.7% in group A and 25.9% in group B. When immunization against poliomyelitis is started at birth, excellent seroconversion rates are obtained from the third dose onward.

Age Factors↗

PubMed2006

Modeling future changes to the meningococcal serogroup C conjugate (MCC) vaccine program in England and Wales.

The UK meningococcal serogroup C conjugate (MCC) vaccine program has successfully controlled serogroup C disease, due to high vaccine effectiveness and substantial herd immunity. However, children immunised at 2, 3 and 4 months of age receive only short-term direct protection and may be at risk of disease 15 months after vaccination. To investigate this we applied a mathematical model to predict the future epidemiology of serogroup C disease, with and without changes to the immunization schedule. Only a few cases of serogroup C disease were predicted to occur over the next few years because of persisting herd immunity, even without a change to the vaccine schedule. The inclusion of a booster dose is likely to improve the impact of the MCC program and reducing the number of doses in infancy will improve cost-effectiveness and create space in the schedule for the addition of other vaccines.

Adolescent↗

PubMed1998

A comparative efficacy trial in Germany in infants who received either the Lederle/Takeda acellular pertussis component DTP (DTaP) vaccine, the Lederle whole-cell component DTP vaccine, or DT vaccine.

BACKGROUND: The goal of the trial was to determine the efficacy of a multicomponent acellular pertussis vaccine against Bordetella illnesses in comparison with a whole-cell product and DT. DESIGN: In a randomized, double-blind fashion, 2- to 4-month-old infants received 4 doses of either DTP or DTaP vaccine at 3, 4.5, 6, and 15 to 18 months of age. The controls received 3 doses (3, 4.5, 15 to 18 months of age) of DT vaccine. The DTP vaccine was Lederle adsorbed vaccine (licensed in the United States) and DTaP was Lederle/Takeda adsorbed vaccine. Follow-up for vaccine efficacy started 2 weeks after the third dose (DTP/DTaP) and at the same age (6.5 months) in DT recipients. Reactogenicity of all doses of all three vaccines was documented by standardized parent diary cards. In addition, all subjects were monitored for respiratory illnesses and serious adverse events by biweekly phone calls. RESULTS: From May 1991 to January 1993, a total of 10 271 infants were enrolled: 8532 received either DTP or DTaP and 1739 received DT. Specific efficacy against B pertussis infections with cough >/=7 days duration was 83% (95% confidence interval [CI]: 76-88) and 72% (95% CI: 62-79) for DTP and DTaP, respectively; results for DTP and DTaP based on >/=21 days of cough with either paroxysms, whoop or posttussive vomiting (PWV) were 93% (95% CI: 89-96) and 83% (95% CI: 76-88), respectively. For DTaP vaccine, efficacy was higher after the fourth dose as compared with its efficacy after the third dose (78% vs 62% for cough >/=7 days and 85% vs 76% for cough >/=21 days with PWV). For DTP vaccine, efficacy was less varied after the third and fourth dose (78% vs 85% for cough >/=7 days and 93% vs 93% for cough >/=21 days with PWV). In contrast with DTP, the DTaP vaccine had some efficacy against B parapertussis infection (point estimate for cough >/=7 days: 31% [95% CI: -10-56]). All vaccines were generally well-tolerated. However, side reactions were significantly less after DTaP compared with DTP. CONCLUSIONS: Like other multicomponent acellular pertussis vaccines, the Lederle/Takeda DTaP vaccine demonstrated good efficacy against mild and typical pertussis due to B pertussis infections. Interestingly, it also may have some efficacy against B parapertussis. Based on the results of this trial, the vaccine was licensed in the United States in December 1996 for all 5 doses of the currently recommended immunization schedule in this country.

Bordetella Infections↗

PubMedDate not supplied

The hepatitis B immunization campaign for children in the Federated States of Micronesia.

Hepatitis B has long been recognized as hyperendemic among persons residing in the western Pacific. Effective control strategies have not been described. From December 1988 through October 1989, the Federated States of Micronesia (FSM) conducted a campaign to immunize children through age 6 years with three doses of hepatitis B (HB) vaccine. In addition, HB vaccination was incorporated into the routine immunization schedule for all children born in FSM, with the first dose given to newborns. Between December 1988 and October 1989, a total of 64,085 doses of HB vaccine were administered to the children. After the start of the campaign, the subject group was enlarged to include children through 15 years of age in the States of Yap and Kosrae. Fifty-nine percent of the enlarged group in all States received a complete series of HB vaccinations. During each client encounter, individual immunization records were examined and diphtheria-pertussis-tetanus, oral polio vaccine, and measles-mumps-rubella antigens were administered to children who were not adequately immunized. The annual immunization assessment for 1990 showed coverage improved significantly from previous years in every FSM State.

Child, Preschool↗

PubMed1994

Childhood immunization guidelines: current and future.

Recent additions to the immunization schedule include acellular pertussis vaccine, and hepatitis B vaccine for all infants and selected adolescents. The third dose of OPV is recommended at 6 months of age and the first dose of MMR vaccine at 12 to 15 months. A new vaccine against Haemophilus influenzae type b has been licensed. Children aged 6 months and older with asthma, diabetes, or heart disease should receive influenza vaccine. Children aged 2 years and older with asplenia, immunosuppression, and nephrotic syndrome may be candidates for pneumococcal immunization.

Bacterial Capsules↗

PubMed1995

Compliance with immunization against hepatitis B. A pragmatic study in sexually transmitted disease clinics.

The efficacy of a vaccine is based primarily on the adherence of the subject to the immunization schedule. This paper compares the compliance rates (CR) for the third dose of hepatitis B virus (HBV) vaccine given according to one of two vaccination schedules among subjects attending two sexually transmitted disease (STD) clinics, and the potential influence of place of vaccine administration (STD clinic or at a vaccination centre). Heterosexual, anti-HBc seronegative subjects (n = 331) were randomized to a 0-1-6 month (n = 161) or a 0-1-2-12 month schedule (n = 170) in this prospective, randomized, parallel pragmatic study. Some subjects (n = 50) attended and were vaccinated at one STD clinic (centre A), whereas 281 attended another clinic (centre B) but were referred to a vaccination centre for administration of vaccine. About 31% (103/331) of the subjects received at least three vaccine doses. On assessing the CR at the 3rd dose in all randomized subjects, we observed that administration of the vaccine at the STD clinic attended (A) was associated with a significantly better CR (p < 0.01) than that of the subjects referred to a vaccination centre (B), while the CR is not affected by the schedule. On the other hand, the 0-1-2-12 schedule was associated with a significantly better CR (p = 0.02) at the 3rd dose than the 0-1-6 month schedule among subjects who comply with the first two doses; the actual site of vaccine administration (in situ (A) versus referred (B)) does not affect the CR.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗