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Assessment of compliance with the expanded program on immunization schedule in King Khalid University Hospital.

Analysis of 1,068 immunization records was carried out to assess the degree of compliance with the expanded program on immunization (EPI) schedule in King Khalid University Hospital. The overall compliance was found to be 66%, whereas individual vaccine compliance ranged between 28% to 88%. These results show that the EPI schedule is not strictly followed in this institution. A modification of the EPI schedule and the consideration of other strategies are suggested to achieve 100% coverage by 1990.

Humans↗

Two injections of diphtheria-tetanus-pertussis-polio vaccine as the backbone of a simplified immunization schedule in developing countries.

From studies of antibody levels induced against poliovirus types 1, 2, and 3 and against diphtheria and tetanus toxins as well as from epidemiologic studies comparing the protective effect in children of two and three doses of diphtheria-tetanus-pertussis (DTP) vaccine, respectively, it can be concluded that two injections of DTP-polio vaccine administered at least four months apart will induce immunity against the four diseases. An immunization schedule can be built up in which bacille Calmette-Guérin (BCG) vaccine is given simultaneously with the first DTP-polio injection at the age of three to eight months and vaccination against measles and--if needed--yellow fever is performed simultaneously with the second DTP-polio immunization at the age of nine to 14 months.

Developing Countries↗

[Antigenic properties of concentrated antirabies vaccine in accelerated immunization schedules].

The study of purified rabies vaccine (tissue culture origin), concentrated 100 fold, in animal experiments has shown that the preparation, if introduced intramuscularly in 2 or 3 injections, has high antigenic activity. The intramuscular injections of the vaccine at an interval of 21 days or at intervals of 21 and 30 days after the first injection has proved to be the optimum immunization schedule ensuring a sufficiently high accumulation of virus-neutralizing antibodies by days 30--45. To achieve higher antibody titers, the vaccine may be introduced intradermally after 2 indispensable intramuscular injections of the preparation.

Animals↗

Hepatitis B vaccination in children with acute lymphoblastic leukemia: results of an intensified immunization schedule.

In an earlier study only 10.5% of 162 patients developed protective levels of antibody (anti-Hbs) to a series of three double dose immunization with Hepatitis B virus (HBV) vaccine (Engerix B, Smith Kline Beecham). A second study was conducted giving five primary doses at monthly intervals followed by a booster 1 year after the first dose. Serum antibodies were detected in 30% of patients who received all six doses of vaccine, and in only 19% were antibody levels protective. Infection with HBV occurred in 43% of patients.

Child↗

Vaccination against hepatitis A: comparison of different short-term immunization schedules.

A total of 114 healthy young adults were immunized with hepatitis A vaccine using different vaccination schedules. Individuals received either a single dose (group 1), two doses given simultaneously (group 2), two doses at days 0 and 14 (group 3) or at days 0 and 28 (group 4), or three doses at days 0, 7 and 21 (group 5). Two weeks after a single dose, seroconversion rates between 77 and 85% were achieved (groups 1, 3, 4). All individuals immunized with two doses within two weeks (groups 2, 3, 5) had antibodies to hepatitis A vaccine (anti-HAV positive) by week 3; these participants also showed clearly higher mean anti-HAV values (geometric mean titres, GMTs) at this time than those individuals vaccinated only once. GMTs at week 8 were 560 IU/l in group 5, 236, 339 and 428 IU/l in groups 2-4 and 102 IU/l in group 1. Of participants with anti-HAV at week 8, 82 were again tested 4 months later; all were still seropositive. Ten individuals were tested during the first three weeks at 3-4 day intervals for anti-HAV immunoglobulin M (IgM); specific IgM responses were not detectable before day 10 but were present in eight of 10 vaccinees by day 14.

Adult↗

Studies on the optimal immunization schedule of experimental animals. VI. Antigen dose-response of aluminum hydroxide-aided immunization and booster effect under low antigen dose.

The dose-response relationships of a viomycin (VM) immunogen for total immunoglobulin (Ig) G and anti-VM antibody response of mouse using aluminum hydroxide as adjuvant was studied. The condition required to absorb a protein on aluminum gel was first established. The effective immunogen dose for total and specific IgG response of mouse using aluminum hydroxide as the adjuvant was found to be in the narrow range of 5 to 20 micrograms, and 10 micrograms per mouse was optimal. The most effective number and intervals of booster injections were studied; when mice were immunized with a lower antigen dose than the optimal, both the number and interval period of booster injections greatly affected the immune response; the more boosters were given, the higher was the response level of specific IgG. The results are contrary to those obtained by immunizing with the optimal or a higher antigen dose.

Adjuvants, Immunologic↗

Expanded programme on immunization (EPI) immunization schedules in the WHO Western Pacific Region, 1995.

There are 36 countries/areas in this Region; Mongolia was transferred to the Western Pacific Region in 1995. No data are available from the Cook Islands, Nauru, and New Caledonia (Tables 1-3). BCG is used in all but 6 countries/areas (American Samoa, Australia, Guam, New Zealand, Northern Mariana Islands and Palau). Most countries/areas give BCG at birth; Japan gives it at 3 months, the Republic of Korea at 4 weeks, and Samoa at 5 years of age. Nine countries give 2 doses of BCG and 4 give 3 doses, up to 15 years of age. Mongolia gives 4 doses up to 18 years of age. Diphtheria-pertussis-tetanus (DPT) vaccine is used as a primary series of 3 doses in all countries/areas; 17 countries give 1 to 3 booster doses of DPT vaccine in the first year of life or later. Diphtheria-tetanus (DT) booster doses are given in Brunei Darussalam, Mongolia and New Zealand. Td is also given in New Zealand. Oral poliovirus vaccine (OPV) is used in a primary series of 3 doses simultaneously with DPT vaccine in all countries/areas. Eight countries/areas use an additional dose of OPV at birth (Cambodia, Fiji, Hong Kong, Kiribati, Lao People's Democratic Republic, Marshall Islands, Papua New Guinea and Tuvalu). A booster dose of OPV in the second year of life is used in 9 countries/areas and a booster dose of OPV is given to schoolchildren in 16 countries/areas. Measles vaccine is given in all countries/areas from 8-15 months of age usually in the form of monovalent measles vaccine, except in Macau. In 4 countries/areas, it is given in the form of measles-mumps-rubella (MMR) vaccine (Guam, Hong Kong, Palau and Singapore). The 2-dose policy is implemented in 4 countries/areas (American Samoa, New Zealand, Palau, and Samoa). In Australia and Palau, the second dose is given as MMR vaccine. The age at the second dose varies from 4 to 13 years of age. Rubella vaccine is given in 4 countries/areas to girls between 10 and 14 years of age (Fiji, French Polynesia, Japan and Macau). In Hong Kong, it is not specified if only girls receive rubella vaccine. In Australia and New Zealand, rubella vaccine is given to seronegative women immediately after delivery. Hepatitis B is used in all but 7 countries/areas (Cambodia, China, Guam, Kiribati, Lao People's Democratic Republic, Tokelau and Viet Nam). All countries which give hepatitis B vaccine use 3 primary doses in infancy, the first dose being given at birth in 23 countries/areas. In Australia and Japan, this vaccine is given to groups at risk. Tetanus toxoid (TT) is used for pregnant or nonpregnant women of childbearing age. It is used in 14 countries/areas, but in Australia and Palau the target group is schoolchildren. The schedules include 2-5 doses of TT.

Adolescent↗

[Childhood immunization schedule 2001-2002. Advisory Committee on Vaccines of the Spanish Association of Pediatrics].

In 1994 the Spanish Association of Pediatrics founded the Advisory Committee on Vaccines with the aim of providing advice on matters related to childhood immunizations and of implementing vaccination schedules. The latest recommendations concern the immunization schedule for 2001-2002, in which indications for the inactivated poliovirus vaccine instead of the attenuated poliovirus vaccine are of prime importance. The advisability of including the vaccine against chicken pox in healthy children is stressed.

Adolescent↗

Immunogenicity of live attenuated SA14-14-2 Japanese encephalitis vaccine--a comparison of 1- and 3-month immunization schedules.

Live attenuated SA14-14-2 Japanese encephalitis (JE) vaccine has been safe and effective in >100 million immunized children, but its current administration schedule of two doses given a year apart does not lend itself to inclusion in established Expanded Program of Immunization (EPI) schedules of childhood immunization. Immune responses to immunization at shorter intervals were compared in middle-school-aged children immunized with two doses separated by 1 month (n = 116) or 2.5 months (n = 115). Two vaccine lots were compared. Seroconversion to the vaccine was observed in 100% of vaccinees immunized in the 1-month schedule and in 94% (lot 2) and 100% (lot 1) of vaccinees immunized in the 2.5-month schedule. Geometric mean titers were almost 2-fold higher with the longer schedule. The routine administration of JE SA14-14-2 vaccine to infants in an EPI schedule should be possible using either interval.

Adolescent↗