An advisory committee statement (ACS). National Advisory Committee on Immunization (NACI). Statement on smallpox vaccination.
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Canada↗
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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.
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Infectious diseases of childhood and their anesthetic implications.
In western world, infectious diseases in childhood have dramatically decreased in recent years. The first reason is related to the better socio-economic conditions but the highly efficiency of immunizations programs cannot be forgotten. Nevertheless children can be still exposed to infections, as vaccines are not able to completely protect all treated patients. Anesthesiologists should be aware of the basic mechanism of immunization as it is well known that anesthesia and surgery themselves reduce human immune response. In fact, nitrous oxide depresses bone marrow function, while halothane, nitrous oxide again and isoflurane reduce neutrophil biocidal activity. On the contrary, all the anesthesia techniques (peripheral anesthesia) which inhibit stress responses have beneficial effect on the immune system function. Not urgent procedures requiring anesthesia should be deferred for three weeks after vaccination when all the related symptoms will be over. Also important is the knowledge of the incubation period that is the time from contact with a person affected by the infectious illness until the onset of the typical disease. During these periods elective anesthesia must not be performed. On the other hand, if anesthesia is delivered, the patient's ability to react can be compromised and it is possible to have florid disease exacerbation including related complications.
Anesthesia↗
[Pneumococcal vaccine for all children].
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Canada↗
Hepatitis B surface antibody response of household contacts of hepatitis B virus carriers in Palestine.
To evaluate the effectiveness of hepatitis B virus (HBV) vaccination of household contacts of HBV carriers in Tulkarm district, Palestine, quantitative hepatitis B surface (anti-HBs) antibody response in 161 household contacts was measured after vaccination. A seroprotective anti-HBs response (titre > or = 10 IU/L) was elicited in all vaccinated subjects. Of these 2.5% had titres of 10-99 IU/L, 61.5% 100-999 IU/L and 36.0% > or = 1000 IU/L. The number of vaccination doses had no effect on the achievement of seroprotection. HBV infection was demonstrated in 13 cases and their anti-HBV titres were in the range 25-350 IU/L.
Adolescent↗
Influence of infectious bursal disease on the development of immunity to Eimeria tenella.
Specific-pathogen-free (SPF) chicks infected with infectious bursal disease (IBDV) virus at one day of age or midway (7 days) through a two-week immunization program for Eimeria tenella showed significantly less (P less than or equal to 0.05) protection against coccidal challenge as measured by lesion scores than chicks given IBDV after 14 days of coccidial immunization. The chicks showed complete protection to later coccidial challenge administered on Day 21. Bursae were markedly smaller from IBDV-infected chicks than from uninfected controls, and pathological changes were extensive. Virus-neutralization tests demonstrated that titers to IBD were higher in chicks exposed to the virus than in unexposed controls.
Animals↗
Immunization coverage rates among two-year-olds in Kansas.
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Child, Preschool↗
Evaluation of immunization coverage at local level.
Two simple methods were employed for evaluating immunization activities in three rural health districts of Zaire, with a view to improving service delivery. One method involves the use of cumulative frequency graphs for monitoring progress at the health centre level towards the achievement of coverage targets. The other requires a clinic-based audit and a population-based survey of children aged 12-23 months to ascertain whether they have been immunized against measles at the appropriate time. These approaches can help to identify operational problems and to motivate the people in charge of immunization at local level.
Child, Preschool↗
Immunization practices of primary care practitioners and their relation to immunization levels.
OBJECTIVES: To assess variations in immunization practices and attitudes among primary care providers and to relate these characteristics to the immunization levels of their patients. SETTING: Monroe County, New York. DESIGN: Survey of pediatricians (n = 96) and family practitioners (n = 44) to assess immunization practices and attitudes and medical chart reviews for 1884 patients of 32 physicians who practice in the city of Rochester to measure immunization levels. ANALYSIS: Tabular analyses for survey responses (chi 2 test and Fisher's Exact Test); logistic regression to assess the relation between provider responses and measured immunization levels. RESULTS: Responses by pediatricians and family practitioners were similar. Most providers did not routinely immunize during acute-illness visits but did immunize during follow-up or chronic-illness visits. Few used tracking systems to identify underimmunized children. Most practitioners immunized children who had colds but withheld immunizations from children who had fevers or otitis media. Most providers agreed with expanding immunization programs to include sick visits, health department clinic visits, and community site visits, but most thought that they should not be provided at emergency department visits, except for very-high-risk children. Immunization levels at 10 months of age were positively correlated with private practice setting (P = .001) but negatively correlated with immunizing at acute- (P < .01) or chronic-illness (P < .05) visits, Medicaid coverage (P < .05), and high rates of appointments that were not kept (P < .001). CONCLUSIONS: Primary care providers' immunization practices and attitudes vary and do not always follow established guidelines for immunization delivery. Many providers of high-risk children are already attempting to improve immunization delivery by using patient reminders and by immunizing children at acute- or chronic-illness visits. Improving provider immunization practices to deliver childhood immunizations more effectively must be part of our efforts to resolve this nation's childhood immunization problem.
Adolescent↗
Beliefs and practices of Ontario midwives about influenza immunization.
With an increasing number of births in Ontario being conducted by midwives, we undertook a survey of the beliefs and practices of 256 licensed Ontario midwives and student midwives about immunization, particularly against influenza. Overall, 42.9% (48/112) of midwives considered that they knew a lot about immunization; however, 36.2% (38/105) reported no education about immunization during their training. A small majority (55.9%) were in favour of vaccination in general and only 2 of 113 reported spending more than 1h discussing vaccination with their clients. Only 26.9% reported having received influenza vaccine in the previous season (compared to 60% of all health care workers in Ontario). Overall, only 37% believed that influenza vaccine is effective, and 22% believed that the vaccine was a greater risk than influenza. Graduation in 1998 or prior was associated with belief in the effectiveness in vaccine, having been vaccinated, and recommending vaccine to clients. Midwives who reported being immunized themselves were more likely to believe in the safety and efficacy of influenza vaccine, and to recommend vaccination to their clients (26% versus 3%, p=0.001). If greater attention is not focused on promoting the utility of immunization to midwives, the success of population immunization programs may be compromised.
Confidence Intervals↗
[Study of the protective capacity of scorpion venom Buthus occitanus tunetanus polymerised to glutaraldehyde in mice strains with different haplotypes].
The immune response obtained against the toxic fraction of the scorpion venom Buthus occitanus tunetanus detoxified by polymerisation with glutaraldehyde, was analysed for low inbred mice having different haplotypes: C57BL/6 (H-2b) et BALB/c (H-2d) and the SWISS outbred mouse. This three strains of mice, immunized with the polymeric form of Bot-G50 are able to induce an immune response with bumoral mediation. The anti-polymers antibodies obtained from immunized mice, cross-react with the native Bot-G50 fraction. Indeed, in vitro protection experiments demonstrated that immune sera were neutralizing (between 150 and 235 micrograms of Bot-G50 ml). The in vivo protection assays showed that immunized mice could resist the challenge by high amount of toxic fraction (between 70 and 80 micrograms of Bot-G50). This protection was found to be long-lived, since immunized SWISS mice could resist the challenge by 4 DL50 of the toxic fraction (80 micrograms) six month after the start of the immunized program.
Animals↗
The United States--The Netherlands Round Table Conference on immunization. Summary report.
A group of public health scientists from the United States and The Netherlands met at a Bicentennial Round Table Conference December 1-2, 1982, to discuss the latest developments in immunization against infectious diseases, focusing on pertussis, poliomyelitis, measles, and rubella. The major differences in immunization practices in the two countries are: (a) In The Netherlands, inactivated polio vaccine is used exclusively; in the United States, the oral polio vaccine is used. Polio-myelitis has virtually disappeared from both countries. (b) In The Netherlands, the pertussis component of DTP (diphtheria, tetanus, pertussis) is not given to children over the age of 1 year, whereas in the United States, it is given to children up to their seventh birthday. (c) Rubella vaccine is given only to girls at ages 11-12 years in The Netherlands, but to all children at ages 12-15 months in the United States. (d) Mumps vaccine is not administered to children in The Netherlands, but in the United States it is given routinely to children at 12-15 months (in combination with measles and rubella vaccine). The participants concluded that both the United States and The Netherlands have effective immunization programs that have significantly reduced the impact of these diseases.
Adolescent↗
Genetic characterization of wild-type measles viruses in Cambodia.
Cambodian authorities in collaboration with the World Health Organization (WHO) are implementing a measles control plan in this measles endemic country. Genetic characterization of Cambodian wild-type measles viruses was performed to determine the genotypes involved in outbreaks, and to measure the level of virus circulation in a geographic area just beginning to implement the measles control program. Seventy-two sequences of the C terminus of the nucleoprotein gene of measles virus were obtained from 88 patients. Samples were taken from 35 among 519 outbreaks reported to the Cambodian National Immunization Program between March 2001 and June 2002. The sequences were grouped into 10 lineages which all belonged to genotype D5. The maximum nucleotide divergence was 1.3%.
Adolescent↗
Immunizations in children.
In 1992, there was a setback in measles vaccination for developing countries as high-titre vaccines were withdrawn following reports of excess mortality in vaccine recipients. The importance of continuing polio vaccination in industrialized countries was emphasized by an outbreak of paralytic polio among an unimmunized community in the Netherlands. Immunization programs are now increasingly using the Jeryl Lynn strain of mumps vaccine following reports of meningoencephalitis associated with the Urabe strain. A hepatitis A vaccine has become generally available and hepatitis B vaccine is being introduced into more childhood programs in countries where the disease is highly prevalent. Trials of group B meningococcal meningitis vaccines have yielded disappointing estimates of efficacy, particularly in younger children. Earlier reports of invasive bacterial infections after pertussis immunization have not been confirmed.
Bacterial Infections↗
Ethical dilemmas in current planning for polio eradication.
Intensification of polio eradication efforts worldwide raises concerns about costs and benefits for poor countries. A major argument for global funding is the high benefit-cost ratio of eradication; however, financial benefits are greatest for rich countries. By contrast, the greatest costs are borne by poor countries; the Pan American Health Organization has estimated that host countries bore 80% of costs for polio eradication in the Americas. The 1988 World Health Assembly resolution setting up the Polio Eradication Initiative carried the proviso that programs should strengthen health infrastructures. Drastic cuts in donor funding for health make this commitment even more important. Two international evaluations have reported both positive and negative effects of polio and Expanded Programme on Immunization programs on the functioning and sustainability of primary health care. Negative effects were greatest in poor countries with many other diseases of public health importance. If poor countries are expected to divert funds from their own urgent priorities, donors should make solid commitments to long-term support for sustainable health development.
Developed Countries↗
Cost-effectiveness of prenatal screening and immunization for hepatitis B virus.
Perinatal transmission of hepatitis B virus is associated with substantial morbidity and mortality, yet controversy still exists regarding the value of routine screening of pregnant women in the United States and subsequent immunization of their at-risk neonates. To evaluate the cost-effectiveness of such a screening and immunization program, we developed a decision analysis model and obtained data from published reports, chart review, and a Delphi survey to determine outcome probabilities and costs. When considering direct and indirect costs, routine screening and immunization would be cost-effective at a prevalence of 0.06%, significantly lower than the national prevalence of 0.2%. At an annual national birth rate of 3.5 million births, a national policy of routine screening of all pregnant women would result in an annual net savings of more than $105 million. In the high-risk groups, as many as 140 cases of acute neonatal hepatitis and as many as 1400 cases of chronic liver disease would be prevented yearly per 100,000 pregnant women screened, at a net annual savings of as much as $765 million.
Carrier State↗
Compliance with influenza immunization: a survey of high-risk patients at a family medicine clinic.
BACKGROUND: Realizing that influenza is an important health problem and that vaccination rates continue to be low, our primary survey goal was to find factors that affect patient compliance with the influenza immunization program at the Swedish Family Medicine Clinic in Seattle, Washington. METHODS: Five hundred nineteen high-risk patients from a total clinic population of 4926 were mailed a questionnaire that asked about their influenza immunization history, their assessment of their influenza risk, and their reasons for obtaining or not obtaining the influenza vaccination. RESULTS: The survey results revealed several important issues about this group: many patients were not aware of their increased risk for influenza; reminder letters were helpful, especially for older patients; younger high-risk patients were less likely to comply with immunization recommendations than older patients; and patients who were noncompliant with immunization recommendations in previous years would likely continue to be noncompliant. CONCLUSIONS: To improve influenza immunization rates, the following interventions are recommended: (1) reminder letters should be sent to patients at appropriate times to explain their risk factors, (2) younger high-risk patients should receive intensive education about the importance of influenza immunization and why they are considered to be at increased risk, and (3) high-risk patients who have failed to obtain the vaccination in previous years should be the target of intensified efforts.
Adolescent↗
No evidence for a new variant of measles-mumps-rubella-induced autism.
OBJECTIVE: A link has been postulated between measles-mumps-rubella (MMR) vaccine and a form of autism that is a combination of developmental regression and gastrointestinal symptoms that occur shortly after immunization. This hypothesis has involved 3 separate claims: 1) that there is new phenotype of autism involving regression and gastrointestinal symptoms, 2) that this new variant is responsible for the alleged rise of autism rates, and 3) that this phenotype is associated with biological findings suggestive of the persistence of measles infection. We tested the first of these claims. If this new "autistic enterocolitis" syndrome had some validity, then 1 or several of the following 6 predictions should be supported by empirical data: 1) childhood disintegrative disorder has become more frequent, 2) the mean age of first parental concern for autistic children who are exposed to MMR is closer to the mean immunization age than in children who are not exposed to MMR, 3) regression in the development of children with autism has become more common in MMR-vaccinated children, 4) the age of onset for autistic children with regression clusters around the MMR immunization date and is different from that of autistic children without regression, 5) children with regressive autism have distinct symptom and severity profiles, and 6) regressive autism is associated with gastrointestinal symptoms and/or inflammatory bowel disorder. METHODS: Three samples were used. Epidemiologic data on 96 children (95 immunized with MMR at a median age of 13.5 months) who were born between 1992 and 1995 and had a pervasive developmental disorder diagnosis as reported in a recent UK survey (post-MMR sample) were compared with data from 2 previous clinical samples (1 pre-MMR [n = 98] and 1 post-MMR [n = 68]) of autistic patients. All patients were assessed with the standardized Autism Diagnostic Interview (ADI), allowing rigorous comparison of age at first parental concerns and rates of regression across samples. Reliability was excellent on ADI scores, age of parental concern, and developmental regression. Furthermore, data on bowel symptoms and disorders were available in the epidemiologic survey from both pediatric and parental sources, and immunization dates were obtained from computerized records. RESULTS: The prevalence of childhood disintegrative disorder was 0.6/10 000 (95% confidence interval: 0.02-3.6/10 000); this very low rate is consistent with previous estimates and is not suggestive of an increased frequency of this form of pervasive developmental disorder in samples of children who are immunized with MMR. There was no difference in the mean age at first parental concern between the 2 samples exposed to MMR (19.3 and 19.2 months) and the pre-MMR sample (19.5 months). Thus, MMR immunization was not associated with a shift toward an earlier age for first parental concerns. Similarly, the rate of developmental regression reported in the post-MMR sample (15.6%) was not different from that in the pre-MMR sample (18.4%); therefore, there was no suggestion that regression in the developmental course of autism had increased in frequency since MMR was introduced. In the epidemiologic sample, the subset of autistic children with regression had no other developmental or clinical characteristics, which would have argued for a specific, etiologically distinct phenotype. Parents of autistic children with developmental regression detected the first symptoms at a very similar age (19.8 months) to those of autistic children without regression (19.3 months). Moreover, the mean intervals from MMR immunization to parental recognition of autistic symptoms were comparable in autistic children with or without regression (248 vs 272 days; not significant). In the epidemiologic sample, gastrointestinal symptoms were reported in 18.8% of children. Constipation was the most common symptom (9.4%), and no inflammatory bowel disorder was reported. Furthermore, there was no association between developmental regression and gastrointestinal symptoms (odds ratio: 0.63; 95% confidence interval: 0.06-3.2; not significant), and only 2.1% of the sample experienced both problems, a rate that did not exceed chance expectations. CONCLUSIONS: No evidence was found to support a distinct syndrome of MMR-induced autism or of "autistic enterocolitis." These results add to the recent accumulation of large-scale epidemiologic studies that all failed to support an association between MMR and autism at population level. When combined, the current findings do not argue for changes in current immunization programs and recommendations.
Age of Onset↗
[Postmarketing surveillance of secondary effects of vaccines].
Despite a continuous search for safer and more efficacious vaccines, adverse events continue to occur following vaccine administration. Adverse events are usually mild. Serious adverse events that could result in death or permanent sequelae are extremely rare. In all cases, benefits associated with immunization greatly outweigh the risks. Due to the large number of doses administered, it is probable that there are purely temporal associations between some adverse events and vaccine administration. Since immunization is sometimes mandatory with vaccines usually administered to healthy individuals and their benefits expanded to the community at large, adverse events are difficult to accept. Primary objectives of vaccine-associated adverse events surveillance is the early detection and appropriate and quick response to such events in order to lessen the negative impact on immunization programs and on the health of the individuals. Specific aspects of vaccine postmarketing surveillance are presented.
Drug Monitoring↗