SEARCH · PubMed Health

Results for “Immunization Programs”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources

PubMed2007

The effect of changing from whole-cell to acellular pertussis vaccine on the epidemiology of hospitalized children with pertussis in Canada.

BACKGROUND: Between July 1997 and April 1998, universal childhood immunization programs in Canada changed from using a whole-cell pertussis to a 5-component acellular pertussis-containing vaccine. To assess effects on pertussis epidemiology of this nationwide change, we analyzed hospitalizations during 1991-2004 using the Canadian Immunization Monitoring Program, Active (IMPACT) pertussis database. METHODS: IMPACT is an active surveillance network based in 12 pediatric tertiary-care hospitals across Canada. Characteristics of hospitalized cases of pertussis were compared by type of vaccine received or by birth date (if immunization records were unavailable or the child was unvaccinated). Age-stratified incidence rates were calculated by year and vaccine type. RESULTS: Two thousand ninety-six cases of pertussis were admitted to IMPACT centers, 1174 during the whole-cell vaccine program (WCV-P) and 842 during the acellular vaccine program (ACV-P). Pertussis incidence among children <5 years old decreased significantly during the ACV-P, causing an increase in the residual proportion of cases either too young to be immunized (<2 months old: ACV-P 39% versus WCV-P 26.1%; P < 0.0001) or too young for a second dose (2-3 months old: 42.9% versus 34.2%, respectively; P < 0.0001). A significantly smaller proportion of cases (ACV-P 15.1% versus WCV-P 27.3%) occurred in infants who were old enough (4-11 months of age) to have received 2 or 3 doses of vaccine. CONCLUSIONS: With ACV-P, pertussis hospitalizations in children 4-59 months old decreased in frequency, consistent with improved vaccine effectiveness, but remained prominent among very young infants. Improved control strategies are needed to reduce infections among infants too young for pertussis vaccination.

Adolescent↗

PubMed2001

Vaccination status of children in the Women, Infants, and Children (WIC) Program: are we doing enough to improve coverage?

BACKGROUND: Vaccination-promoting strategies in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been shown to produce dramatic improvements in coverage and other health outcomes. OBJECTIVES: To determine national and state-specific population-based vaccine coverage rates among preschool children who participate in the WIC program, and to describe the strategies for promoting vaccination in WIC. DESIGN/METHODS: Demographic data, WIC participation, and vaccination histories for children aged 24 to 35 months in 1999 were collected from parents through the National Immunization Survey. The healthcare providers for the children in the survey were contacted to verify and complete vaccination information. We defined children as up-to-date (UTD) if they had received four doses of diphtheria and tetanus toxoids and pertussis vaccine (DPT), three doses of poliovirus vaccine, one dose of measles-mumps-rubella vaccine (MMR), and three doses of Haemophilus influenzae type b vaccine (Hib) by 24 months. Description of state-level vaccination-promoting activities in WIC was collected through an annual survey completed by the state WIC and immunization program directors. RESULTS: Complete data were collected on 15,766 children, of whom 7783 (49%) participated in WIC sometime in their lives. Nationally, children who had ever participated in WIC were less well-immunized at 24 months compared to children who had not: 72.9% UTD (95% CI, 71.3-74.5) versus 80.8% UTD (95% CI, 79.5-82.1), respectively. In 42 states, 24-month coverage among WIC participants was less than among non-WIC participants, including 13 states where the difference was > or = 10%. Vaccination activities linked with WIC were reported from 76% of 8287 WIC sites nationwide. States conducting more-frequent interventions and reaching a higher proportion of WIC participants had 40% higher vaccination coverage levels for the WIC participants in that state (p<0.05). CONCLUSIONS: Children served by WIC remain less well-immunized than the nation's more-affluent children who do not participate in WIC. Thus, WIC remains a good place to target these children. This study provides evidence that fully implemented WIC linkage works to improve vaccination rates. Strategies that have been shown to improve the vaccination coverage levels of WIC participants should be expanded and adequately funded to protect these children.

Aid to Families with Dependent Children↗

PubMed1995

Abundance of three mosquito vectors in Okinawa with relevance to disease risk.

The abundances of three mosquito vectors on Okinawa were determined using New Jersey light traps and compared with data from an identical survey in 1969. The focal distribution of the primary vector of Japanese encephalitis (JE), Culex tritaeniorhynchus Giles, indicates that exposure risks are not uniform throughout the island. The populations of the primary vectors of JE and malaria appear to be declining, resulting in significant changes in the relative abundances of mosquito species. These changes have implications for the current dependent JE immunization program as well as for the possible reintroduction of malaria to Okinawa.

Animals↗

PubMedDate not supplied

Progress on the childhood immunization initiative.

President Clinton submitted the Comprehensive Childhood Immunization Initiative Act to Congress in April 1993. The objective of the legislation is to protect all children in the United States by their second birthday against nine vaccine-preventable infectious diseases. As originally introduced in the Congress the initiative called for (a) Federal purchase and distribution of recommended childhood vaccines for all children, (b) improving the public health capacity to deliver vaccine, (c) establishing a State-based national immunization information and tracking system, and (d) expanding immunization education and mobilization efforts directed to health care providers and parents. The authors review the progress and current status of the initiative, updating a previous progress report. The President's legislative proposal, modified by Congress, was enacted August 10, 1993. Several key provisions of the original legislation, deferred by Congress, may be incorporated in subsequent legislation or implemented through existing authorities. Therefore, the evolving framework for the initiative derives not from a single legislative mandate, but expands current immunization program activities and adds important new and complementary activities. As mentioned in the original title of the legislation, this is a "comprehensive" effort to address the problem of under-immunization in U.S. preschool children.

Adolescent↗

PubMed1996

The merits of varicella vaccination for varicella non-immune health care workers.

Immunity against varicella can be reliably established by history and, if negative, confirmed or refuted by serology. If non-immune, the merits of varicella vaccine for a health care worker (HCW) can be stated clearly: Protection from a disease which may be particularly severe in an adult, and evading the inconvenience (investigation time and possible work restriction) and cost of managing an exposure. This paper discusses implementation of a varicella immunity program for HCWs at Columbia Presbyterian Hospital in Oklahoma City.

Adult↗

PubMed2004

Immunizing children to protect against the increasing risk of hepatitis A in adolescents and young adults in South Korea.

We evaluated the CR326F strain (VAQTA) derived hepatitis A vaccine in Korean children and adolescents >2 years of age to consider a future immunization program. In our study, the pediatric two-dose regimen of VAQTA was found to be generally well tolerated and resulted in 100% (95% CI 94.8, 100.0) seroconversion after 2 doses. Immunizing children with the HAV vaccine routinely should be considered in South Korea, particularly in areas where recent outbreaks have occurred.

Adolescent↗

PubMed1995

[Assessment of vaccination coverage of the basic schedule for the 1st year of life].

Immunization coverage was evaluated in all 12-23 month-old children living in the area were five years before a Primary Care Practice had been set up. All children were investigated through home visits, checking of the immunization chart and relying on mothers' information. In 1986, a baseline study had identified an immunization coverage of under 60% for each of the scheduled vaccines. The current study confirmed that coverage was of 87% for three doses of DTP, 89% for Sabin, 88% for one dose of measles vaccine and 79% for BCG. Despite the high coverage achieved for each specific vaccine, when the basic schedule for the first year was verified, it was observed that only 75% of the children had received the full scheme. Immunization coverage is uneven in different census tracts, being higher in the poorest and more remote areas, where seam the health was given extra attention. A comparison with the routine administrative evaluation of the immunization coverage showed that this underestimated the real coverage. Maternal immunization uptake was also evaluated (antitetanus vaccine during pregnancy) and only 49% of the women were found to be adequately protected. The information collected led to a reorganization of the whole immunization program in a 100% coverage.

Brazil↗

PubMed1997

Ten-year neonatal hepatitis B vaccination program, The Netherlands, 1982-1992: protective efficacy and long-term immunogenicity.

From 1982 to 1989, 705 infants born to HBsAg-positive mothers entered the Dutch neonatal hepatitis B vaccination program and received passive-active hepatitis B immunization in three randomized controlled trials testing variations in time of starting active vaccination, dose and type of vaccine, and number of hepatitis B immunoglobulin (HBIg) injections. A meta-analysis of individual patient data of the three randomized trials was performed to determine which independent host and vaccination related factors influence protective efficacy and long-term immunogenicity, and to assess whether hepatitis B vaccination concomitant with standard DKTP vaccination provides optimal protection. Statistical methodology included multivariate logistic regression analysis. Eight infants (1.1%), all born to HBeAg-positive mothers, became HBsAg carriers within the first year of life. The protective efficacy rate (PER) of passive-active immunization at 12 months follow-up was 92% for the total group of children from 114 HBeAg-positive mothers with no significant differences between children starting active immunization at birth or at 3 months of age, between infants starting at 3 months of age receiving one or two doses of HBIg or between those receiving plasma derived or recombinant vaccine. The only factor that affected the PER significantly was the level of maternal HBV DNA; PER was 100% if maternal HBV DNA was < 150 pg ml-1 and 68% for HBV DNA levels > 150 pg ml-1. After 5 years of follow-up, the group that started active immunization at birth had significantly more infants with loss of seroprotection (anti-HBs levels < 10 IU l-1, 15%) than the corresponding group starting at 3 months of age (anti-HBs < 10 IU l-2, 2%). One of 35 children with loss of seroprotection at 2 years became a HBsAg carrier in the fifth year of follow-up. This meta-analysis shows that the protective efficacy of passive-active hepatitis B vaccination is mainly influenced by material HBV DNA levels, and independent of the time of starting active vaccination at birth or at 3 months of age; long-term immunity was enhanced by starting active vaccination concomitant with DKTP vaccination. These findings allow incorporation of hepatitis B vaccine into the standard infant immunization programs for countries with a passive-active immunization strategy for the control of hepatitis B. Additional measures are needed to protect neonates of highly viremic women.

DNA, Viral↗

PubMed2006

Improving immunization coverage through budgeted microplans and sub-national performance agreements: early experience from Cambodia.

In recent years, Cambodia has demonstrated significant success in specific aspects of immunization with gains through campaign efforts in measles control and polio eradication. In contrast, routine immunization rates have failed to improve over the last five years. In response, the National Immunization Program of the Ministry of Health developed a coverage improvement planning (CIP) process. This paper describes the CIP process in Cambodia, including identified barriers to and strategies for improving coverage. Immunization coverage rose in 8 of 10 pilot districts in the year following the introduction of CIP in 2003. The mean increase in DPT3 coverage across pilot districts on an annual basis was 16%, which provides encouraging early evidence for the effectiveness of the intervention. Factors associated with success in coverage improvement included: (1) development of a needs-based micro-plan, (2) application of performance-based contracting between levels of management, (3) investment in social mobilization, (4) securing finance for health outreach programs and (5) strengthened monitoring systems. Lessons learned will guide program expansion to improve immunization coverage nationally.

Cambodia↗

PubMed2001

Physician perceptions about administration of immunizations outside of physician offices.

BACKGROUND: Expanding nonphysician participation in the administration of immunizations has been suggested as a means of increasing immunization rates. However, there is little information about physician interest in collaborating with nonphysicians to provide out-of-office immunizations. METHODS: All active members of the Iowa Academy of Family Physicians were surveyed by mail. Physicians reported on their collaboration histories, their willingness to collaborate in the future, their concerns with collaboration, and whether they approved of their patients' using nonphysicians for immunizations. RESULTS: Of 898 eligible physicians, 476 (53%) returned questionnaires that were analyzed. Seventy-five percent (n = 357) of the physicians reported that they had voluntarily collaborated with a person outside their office to provide immunizations. Ninety-five percent (n = 452) of physicians indicated a willingness to collaborate in some form in the future. However, physicians had concerns about (a) being able to be kept informed about immunizations their patients receive outside of their offices, (b) adequate training of the nonphysician to administer immunizations and respond to complications of immunization, and (c) loss of preventive health opportunities if patients ceased coming to physicians for routine immunizations. CONCLUSION: The majority of family physicians have collaborated to deliver immunizations and indicate support for nonphysician participation. Almost all physicians would consider future collaborative arrangements although they have concerns about record keeping and the safety of out-of-office immunization programs.

Adult↗

PubMed2004

[Complications of infectious diseases and benefits of immunization].

Significant progress regarding hygiene, nutrition, and antimicrobial treatment as well as immunizations have lead to a significant decline of morbidity and mortality of infectious diseases in the recent past. Furthermore, immunizations are one of the most cost-effective tools for prevention. However, lack of perception of the substantial risks of complications associated with infectious diseases cause doubts about the necessity of immunizations today. This development is highly worrisome and needs to be adequately addressed by informing physicians and the public about the risks of vaccine-preventable diseases, efficiency, safety and benefits of available vaccines, as well as providing convincing arguments justifying current immunization recommendations. These activities are indispensable for successful implementation and continuation of current immunization programs.

Communicable Disease Control↗

PubMedDate not supplied

[Portrait of the formation in vaccination training offered to Quebec nurses in the workplace].

INTRODUCTION: Nurses carry out essential functions in the area of immunization in Québec and their role has broadened considerably since January 2003, following legislative modifications. However, the training received may not always allow nurses to fill this role satisfactorily. This study seeks to document the training in immunization offered to Québec nurses in the workplace. METHOD: A questionnaire was mailed to the directors or heads of nursing care (DSI/RSI) in 477 health care establishments in Québec in March 2003. RESULTS: Health care establishments in Québec offer more training to nurses on the job (68%) than at the moment of hiring (43%). These percentages vary widely according to the type of establishment. More than 90% of the local community service centres (CLSC) that responded offer training to their nurses. The indications/contraindications of immunization products and emergencies related to vaccination represent the themes most frequently dealt with. Only 38% of respondents affirm that the nurses in their institution are "very favourable" to vaccination. DISCUSSION: Almost all Québec CLSCs, which is where most immunization activities are carried out, offer training in vaccination to their nurses. On the other hand, few hospital centres (CH) and long-term care establishments (CHSLD) do so. Further documentation should be carried out on the impact of less than optimal training on the promotion of immunization programs by nurses.

Attitude of Health Personnel↗

PubMed2006

Varicella surveillance practices--United States, 2004.

Varicella became a reportable disease in the United States in 1972, with states reporting weekly aggregate data to the National Notifiable Disease Surveillance System (NNDSS). In 1981, varicella reporting was removed from the national notifiable diseases list because reporting of this common disease was becoming a burden in the absence of a vaccine. This action was followed by additional changes in varicella surveillance practices. In 1995, varicella vaccine was licensed and added to the routine childhood vaccination schedule. In 2002, the Council of State and Territorial Epidemiologists (CSTE) recommended that varicella casebased surveillance be implemented in all states by 2005; in 2003, varicella again was added to the national notifiable diseases list to allow for monitoring of the effect of varicella vaccine on varicella incidence. In 2004, to assess the progress in varicella surveillance in the United States, CDC surveyed immunization program managers in selected public health jurisdictions. This report describes the results of that survey, which indicated that substantial progress has been made toward the implementation of case-based surveillance as recommended by CSTE in 2002. As of 2004, however, 28 jurisdictions still had not implemented case-based surveillance. To monitor the effect of the vaccination program on the changing epidemiology of varicella disease, every state should now be conducting case-based surveillance for varicella. This is particularly important in light of the 2006 recommendation by the Advisory Committee on Immunization Practices for a routine second dose of varicella vaccine for children aged 4-6 years because enhanced surveillance is needed to further monitor varicella epidemiology.

Chickenpox↗

PubMed2000

The association of poverty and low immunization rates in ZIP code areas. A retrospective survey of Minnesota kindergartners.

This study evaluated indicators of poverty in Minnesota ZIP code areas with low childhood immunization rates. During 1996-1997, a retrospective survey of 68,639 Minnesota kindergarten children was conducted; 68% received four doses of diphtheria, tetanus, and pertussis vaccine, three doses of polio vaccine, and one dose of measles, mumps, and rubella vaccine (4:3:1) by 24 months of age. Of 447 ZIP codes further evaluated, 24 (5%; 13 urban and 11 rural) had 4:3:1 immunization rates at 24 months of < or = 50%. None of 159 ZIP codes in which < 5% of residents were below the poverty line had immunization rates < or = 50%, compared with 9 (32%) of 28 ZIP codes with > or = 15% of residents below the poverty line (p < 0.001). Immunization rates were lowest in ZIP codes with a lower median family income and greater proportion of residents below the poverty line. Surveys such as this can help immunization programs target and monitor prevention activities for these pockets of need.

Child↗

PubMed2003

Trust, learning, and vaccination: a case study of a North Indian village.

For US 17 dollars a child can be immunized against six major illnesses. Even at this price, a country such as India would have to spend half its health budget on providing vaccinations. Given the wide variation in immunization costs it may be possible to decrease this cost to more sustainable levels, but to do so we need to arrive at a more thorough understanding of factors affecting household demand for vaccination. Using data on vaccination and pre-natal care collected by the authors in the Garhwal region of India, we explore one aspect of the demand for vaccination in some detail. We show that informational constraints play an important role in the household decision to seek vaccination, and moreover, that learning about the efficacy of vaccinations only through empirical observation may be hard even in environments with variation in vaccination and the high incidence of vaccine-preventable diseases. We argue that when learning about vaccination is inefficient, households use concurrent interventions with easily observable outcomes to evaluate the veracity of a provider's claim regarding preventive care. Hence, the success of immunization programs becomes crucially linked to the success of parallel programs by the same provider.

Adolescent↗

PubMed2003

Tetanus in developing countries: an update on the Maternal and Neonatal Tetanus Elimination Initiative.

Tetanus is a vaccine-preventable disease that yearly causes a total of 309,000 deaths. Of particular concern is maternal and neonatal tetanus (MNT), which can be prevented through immunization of the mother in pregnancy. In 2000, neonatal tetanus alone was responsible for an estimated 200,000 deaths. While the focus is on 57 priority countries, 90% of the neonatal tetanus deaths occur in 27 countries. UNICEF is spearheading the effort to eliminate MNT by the year 2005, with the support of numerous partners. MNT elimination is defined as less than one case of neonatal tetanus per 1000 live births at district level. The main strategies consist of promotion of clean delivery practices, immunization of women with a tetanus toxoid (TT) containing vaccine, and surveillance. Maternal tetanus immunization is, in most developing countries, implemented as part of the routine immunization program. However, large areas remain underserved, due to logistical, cultural, economical or other reasons. In order to achieve the target of MNT elimination by 2005, and to offer protection to women and children otherwise deprived from regular immunization services, countries are encouraged to adopt the "high risk approach". This approach implies that, in addition to routine immunization of pregnant women, all women of child bearing age living in high risk areas are targeted for immunization with three doses of a tetanus toxoid containing vaccine (TT or Td), implemented as "supplemental immunization activities" (SIAs). Through SIAs, about 17 million women have been reached with at least two doses of TT vaccine in the past 3 years, and it is estimated that another 200 million need to be targeted in the years to come. SIAs should substantially reduce the burden of disease. Countries will also have to improve their existing immunization and clean delivery programs to ensure that the elimination of maternal and neonatal tetanus is maintained.

Adult↗

PubMedDate not supplied

Measuring hepatitis B uptake in a new universal infant program.

BACKGROUND: Vancouver-Richmond Health Board has the highest reported rate of hepatitis B in Canada, including an annual average of 25 cases in children under 12 years of age, based on reports from 1994-1997 inclusive. The current provincial adolescent grade-six hepatitis B immunization program does not protect against childhood infection. The regional health board implemented universal infant hepatitis B immunization in September 1998. METHOD: Immunization coverage data were obtained on a random sample of 191 infants born in March 1999 one year after initiation of the program. RESULTS: By eight months of age, 97.9% of children had received some vaccinations. 73.8% of infants had received three doses of hepatitis B vaccine and 12.6% had received two doses. In comparison, 89% had received three doses and 7.9% two doses of DPTP-Hib vaccine. 13.1% of infants had not received any hepatitis B vaccine. For a majority (67%) of these children, their physician's lack of awareness or lack of acceptance of the program constituted the reason for no hepatitis B vaccine uptake. Only one parent cited adverse publicity as the reason for refusing vaccination. INTERPRETATION: This survey reveals a successful first year of the program without harm to the pre-existing childhood vaccination programs. Hepatitis B vaccine uptake can be improved by increased awareness among physicians and parents.

British Columbia↗

PubMed1997

Varicella vaccination for healthcare workers at a university hospital: an analysis of costs and benefits.

OBJECTIVE: To demonstrate the costs and benefits of vaccinating varicella-susceptible healthcare workers at a university hospital with live, attenuated varicella-zoster virus vaccine. DESIGN: Retrospective review of employee medical records and data on the cost of special paid absence for susceptible healthcare workers after exposure to varicella or herpes zoster. SETTING: A 988-bed tertiary-care university hospital. RESULTS: In 1994, 224 hospital employees (3.4%) were susceptible to the varicella-zoster virus. There were 40 exposures to varicella and herpes zoster in that year, involving 29 of the susceptible employees. Nine (31%) of the exposed susceptibles became varicella immune by indirect fluorescent antibody testing subsequent to exposure. Seventeen (59%) have had multiple varicella exposures and special paid absences while employed by the hospital. In 1994, wages paid to healthcare workers while furloughed for the communicable period following varicella exposure totaled $38,463.93. An additional $24,748.74 was paid to replacement workers during that same time. Varicella vaccine to immunize all 224 susceptibles in 1994 would have cost $17,920. Absences due to varicella and herpes zoster exposure also result in disruptions to patient care. CONCLUSIONS: Varicella vaccination for varicella-susceptible healthcare workers at a university hospital would result in financial savings and improved patient care. We recommend that other institutions consider the costs and benefits of adopting a varicella immunization program for their susceptible employees.

Chickenpox↗