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At least 811 records · Page 45Linked to original sources
PubMed1979

Immune function in systemic lupus erythematosus. Impairment of in vitro T-cell proliferation and in vivo antibody response to exogenous antigen.

Peripheral blood mononuclear cells from 46 systemic lupus erythematosus (SLE) patients showed reduced ability to proliferate in vitro in response to the soluble antigen, tetanus toxoid, as compared with 96 normal controls. Special studies of 27 untreated SLE patients also revealed significantly decreased blastogenic responses to tetanus toxoid. In both the total and untreated SLE populations, decreased mean tetanus antibody titers also were found as compared with the control population. However, the reduction in antibody titer and blastogenic response was not strictly parallel. A limited immunization program was initiated in low-responding volunteers from the SLE and normal populations. Three out of four SLE patients did not develop a significant blastogenic response despite increases in anti-tetanus titers after immunization, whereas all normals showed significant increases in both blastogenic and antibody responses. The accumulated evidence indicated that the unresponsiveness was the result of a defect in T-cell function. Monocyte reactivity was demonstrated to be normal, and no evidence was found for the presence of suppressor cells, inhibition by immune complexes, or increased prostaglandins to explain the defect.

Antibodies, Bacterial↗
PubMedDate not supplied

The complicated task of monitoring vaccine safety.

Vaccination is an essential component of modern public health programs and is among our most cost-effective medical interventions. Yet despite vaccines' clear effectiveness in reducing risks of diseases that previously attacked large proportions of the population, caused many deaths, and left many people with permanent disabilities, current vaccination policies are not without controversy. Vaccines, like all other pharmaceutical products, are not entirely risk-free; while most known side effects are minor and self-limited, some vaccines have been associated with very rare but serious adverse effects. Because such rare effects are often not evident until vaccines come into widespread use, the Federal government maintains ongoing surveillance programs to monitor vaccine safety. The interpretation of data from such programs is complex and is associated with substantial uncertainty. A continual effort to monitor these data effectively and to develop more precise ways of assessing risks of vaccines is necessary to ensure public confidence in immunization programs.

Adverse Drug Reaction Reporting Systems↗
PubMed1998

Immunizations for international travel.

Immunization recommendations for international travelers is a complex subject that takes into consideration the geographic destination, planned activities during travel, health conditions at destination, length of trip, and underlying health status of the traveler. The final immunization program is also determined by how much time is available before departure and the worldwide availability of vaccines and their cost. In some cases, preventive behaviors and chemoprophylaxis may protect against the risk of infection when immunizations are unavailable or unobtainable.

Bacterial Vaccines↗
PubMed2002

Communicable disease control: an introductory course for MPH students.

Persons preparing for careers in public health practice need a solid academic grounding in the principles of communicable disease control before arriving on the job. We have developed an introductory course in infectious disease control for the Master of Public Health program in Jerusalem, which includes instruction in the following broad areas: How do micro-organisms spread and cause disease? How do we investigate and control an outbreak? What are the basics of primary prevention by immunization and what can mass immunization accomplish? What is the importance of routine ongoing communicable disease surveillance? What are the essentials of Travel Medicine? How can public health officials provide useful information to a concerned citizenry by intelligent cooperation with the media? How can immunization programs and other programs for infectious disease control be kept current with the help of expert advisory committees? What are the best resources available to the public health practitioner in the area of infectious disease control? Armed with the essentials, the practitioner will have the tools to approach communicable disease problems in an orderly and rational way even in an atmosphere of public and professional ignorance and apprehension.

Communicable Disease Control↗
PubMed1991

The establishment and validation of the mobile immunization team concept at a clinic level.

Faced with unacceptably low and declining overall immunization compliance, as well as specific flu immunization compliance, the Executive Committee of a 32-person Air National Guard clinic asked the nursing service to devise a method of correcting these deficiencies as rapidly as possible and maintaining immunization compliance at a rate of 90% or better of the total patient population of approximately 1,100 full-time and Guard personnel for whom the clinic was responsible. The concept of a mobile immunization team was devised and validated over a 2-year interval. In order to successfully develop and implement this concept, command emphasis and a high level of cooperation from both clinic personnel and the Unit Commanders involved was requested and received. The make-up of the team, risk management, the timing and place of team visits, and record keeping were among the problems addressed and resolved. The mobile immunization team concept was a success, achieving excellent overall immunization compliance and outstanding compliance with the flu immunization program over a 2-year period.

Health Promotion↗
PubMedDate not supplied

Elimination of poliomyelitis in Finland.

In Finland paralytic poliomyelitis has disappeared after immunization programs carried out exclusively with inactivated poliovirus vaccine (IPV). A sharp decrease in the number of patients with poliomyelitis occurred after mass vaccination in 1960-1961, when 51% of the population had received the complete primary vaccination. Immunity is maintained by continuous vaccination of infants, whose vaccination rate is close to 98%. Intensive poliovirus surveillance in 1972-1974 revealed that dissemination of the virus has also virtually ceased. Serologic surveys indicate that greater than or equal to 90% of individuals older than 15 years of age possess antibodies to all viral types, but in the younger age groups the proportion with antibodies to types 1 and 3 is lower, a finding that is alarming, especially in the case of type 3. Revaccination of seronegative children and conscripts has induced rapid booster-like responses, indicating that fully vaccinated individuals, although without demonstrable antibodies, are protected against poliomyelitis. The new, improved IPV developed in Holland induces satisfactory antibody titers in all vaccinees, with two injections--or perhaps even one--leading to long-lasting immunity.

Adolescent↗
PubMed1991

A case of neonatal tetanus.

The morbidity and mortality from neonatal tetanus are preventable. It is largely a disease of developing countries. This single case of neonatal tetanus in southern Florida must serve as an indicator for the need for health care professionals to evaluate the degree of utilization of maternal health services and the impact of immunization programs for those women at risk, in this case, women who have migrated from developing countries.

Female↗
PubMed1978

Antibody studies in the Kuru region. Immunological epidemiology of population groups in and adjacent to the Kuru region in Papua New Guinea. I. Enteroviruses.

A serological survey is reported for antibodies to Coxsackie, ECHO and polioviruses on sera collected in the kuru region of Papua New Guinea during earliest European contacts with kuru-affected and control populations through the period of highest kuru incidence. The results are discussed in the light of increasing European contact over the period of investigation. Suggestions are made concerning possible immunization programs with polioviruses.

Adolescent↗
PubMedDate not supplied

Immunizations in pregnancy. A public health perspective.

With the successful implementation of childhood immunization programs in the United States, an increasing percentage of vaccine-preventable infections now occur in adults. By providing primary care services to adult women, midwives are in a unique position to halt the spread of these infections. Immunizations are often avoided in pregnancy and the early post partum period, however, in the mistaken belief that vaccines are harmful to the fetus or neonate. This article, the first in a two-part series on immunizations, reviews the current epidemiology of vaccine-preventable diseases, discusses the indications and precautions for vaccine usage in pregnancy and the early postpartum period, and presents the current recommendations from the American Committee on Immunization Practices for the most commonly administered adult immunizations: tetanus-diphtheria, hepatitis B, influenza, pneumococcal, measles, mumps, rubella, and varicella.

Adult↗
PubMed1998

Prevention of work-related disability.

INTRODUCTION: The cost of work-related injury is large and is rising in many states. Managed care providers are being asked to assist with solutions, particularly in the area of facilitating return to work. Kaiser Permanente of the Northwest responded by developing the Kaiser on-the-job program, which includes processes to facilitate the primary, secondary, and tertiary prevention of work-related disability. METHODS: This paper describes the role that managed care can play in the prevention of work-related disability through consultation, training, immunization programs, and targeted screening and case management interventions. A quality and case management system is described, which gives physicians feedback on modified work and time-off authorization by diagnosis. RESULTS: The results demonstrate statistically significant decreasing physician-authorized average time loss for low back cases from 1991 through 1995 (17.8 disability days per case in 1991 and 15 per case in 1995, P = .01). According to Oregon State Accident Insurance Fund (SAIF Corporation) data, the Kaiser on-the-job average total claims cost was reduced 33% for disabling cases as compared to two other health care organizations (P = .002). CONCLUSION: The methods utilized here to prevent work-related disability appear effective. They are relevant to many managed care program models and their efforts to improve workplace health and productivity.

Accidents, Occupational↗
PubMed2005

Vaccine presentations and delivery technologies--what does the future hold?

There is an urgent need to change the presentations and delivery technologies of current vaccines. Until recently, these factors had not been key criteria in the selection of vaccines for program use. Recent and current changes in the field of vaccines and their delivery lead the authors to postulate that a major paradigm shift will take place over the next decade to revolutionize vaccine presentation and delivery in national immunization programs. The programmatic needs for certain vaccine presentations will increasingly dictate elements of vaccine development and manufacture. Over the next decade, an inexorable drift towards firstly, single-dose preparations, and secondly, delivery technologies other than the conventional needle and syringes is anticipated. A unified system capable of delivering multiple antigens as a single dose is urgently needed; however, changing the status quo of vaccine manufacture is not easy. The market predominantly produces vaccines delivered by needle and syringe. Profits for manufacturers from sales to developing countries are marginal at best, and there is little financial incentive to change. Global leaders will need to take bold decisions and begin demanding vaccines which have a presentation that lends them to safer, more practical delivery systems. If a strong enough case can be made to restructure the vaccine manufacturing industry, either through market forces, global bodies, such as the World Health Organization and the United Nations Children's Fund, or both, a dramatic change could be brought about that will make vaccine delivery simpler and safer. A globally coordinated approach to funding research and the introduction of a multiple-antigen, single-dose delivery system is urgently needed. The needs are clear, and this review argues that if the case is presented strongly enough, the resources will be found.

Animals↗
PubMedDate not supplied

Cooperative effort leads to success.

Collaboration, coordination and communication were some of the key ingredients that enabled nurses in Northwestern British Columbia to successfully carry out a measles immunization program. This is a good example of nurses working in partnership with the community.

Adolescent↗
PubMed1997

[Recommendations for active immunization in patients with altered immunocompetence and/or with specific risks. Consulting Committee on Immunizations, Chilean Society of Infectology].

Although vaccines are powerful public health tools, are unwarrantedly denied or incompletely administered to patients with altered immunocompetence. The Advisory Immunization Committee presents an updated revision, according to the local epidemiological reality, that may guide the care of these patients. Recommendations are centered in patients with congenital immunodeficiencies, HIV infected individuals, offspring of HIV infected mothers, and subjects with medical conditions that increase the susceptibility towards one or more infectious disease. In each case, the indications and contraindications of immunizations included in the Extended Immunization Program or special vaccines, recommended for special groups, are analyzed. Special situations that must be considered in each risk group are also analyzed.

HIV Infections↗
PubMed2001

Vaccination visits in early childhood: just one more visit to be fully vaccinated.

BACKGROUND: This study characterizes the healthcare visits at which children receive vaccinations, including the number of these visits and the number of vaccinations that are administered. METHODS: The 1999 National Immunization Survey (NIS) is a nationally representative sample of children aged 19 to 35 months, verified by provider records, that is conducted to obtain estimates of vaccination coverage rates. We describe the number of healthcare visits in which one or more vaccinations were given, the number of vaccinations given at these visits, and the number of visits and vaccinations needed for an underimmunized child to complete the recommended vaccination series. RESULTS: Of the children who did not receive all doses of the recommended vaccinations (4:3:1:3:3 vaccination series), three fourths had four or more immunization visits. Vaccination coverage increased as the number of visits increased, and children who had completed the series were more likely to receive multiple vaccinations than those who had not. Most children (70.7%) received a maximum of four vaccinations in any immunization visit. The majority of children (73.5%) who had not completed the 4:3:1:3:3 vaccination series needed only a single visit to complete the series. The majority (61.7%) of children who needed only one visit also needed only one additional vaccination. CONCLUSIONS: While estimated national coverage for all recommended vaccinations is considerably below the Healthy People 2000 and Healthy People 2010 goal of 90%, achieving this goal is in essence just one visit away. If all children who needed one more visit were to receive that final visit, the national coverage among children 19 to 35 months for all recommended vaccinations would be 93%.

Child, Preschool↗
PubMed2005

Epidemiology of pertussis.

The World Health Organization recommended that a pertussis incidence of <1 case per 100,000 population be achieved in Europe by 2000. Available data indicate that this goal has generally not been achieved, and the incidence is actually rising in some countries. Understanding the reasons for this increased incidence may lead to better global control of pertussis. In the majority of countries where pertussis is a notifiable disease, a case-based national surveillance system is in place. However, different case definitions, methods of diagnosis and reporting and surveillance systems make direct intercountry comparisons difficult, and pertussis is not a statutory notifiable disease in every country. Nevertheless the general consensus is that reported incidences are probably considerably lower than the actual incidence of pertussis; underreporting is common. Prolonged cough may be the only clinical feature in adolescents or adults, who may present for diagnosis late (precluding laboratory confirmation) or not at all. When they do present, their condition is often misdiagnosed because, in part, clinicians continue to perceive pertussis as a childhood disease. Despite underreporting, an increased incidence of infant, adolescent and adult pertussis has been observed worldwide since the introduction of widespread vaccination. This is of concern because adolescents and adults have been identified as a source of transmission of pertussis to very young infants who are unimmunized or partially immunized and thus more vulnerable to disease-related complications and higher mortality. In recent years, acellular pertussis vaccines have been incorporated into the immunization schedules of many developed countries, gradually replacing whole cell vaccines. Dosing schedules vary between countries, although primary immunization with 3 doses of the pertussis vaccine within the first 6 months of life exists in most countries. Only Australia, Austria, Canada, France and Germany have incorporated an adolescent booster dose into their current immunization schedules, in recognition of the rising incidence of pertussis in adolescents and adults. Despite high coverage rates for primary immunization in infants and children, pertussis continues to be a global concern, with increased incidence widely noted. This global epidemiologic summary highlights differences worldwide in pertussis reporting, incidence and approaches to prevention. It underscores a general shift in the age distribution of pertussis toward older groups. Understanding the link between these observations may lead to better informed global control strategies, especially those pertaining to immunization schedules and use of pertussis vaccine.

Adolescent↗
PubMedDate not supplied

Pediatric immunization update 2002.

The field of pediatric immunizations is growing and changing as new vaccines are becoming available and previous diseases are being eradicated. Due to the complexity and evolution of vaccine-preventable diseases, pediatric health care providers must routinely review the current childhood immunization recommendations. A review of immunology and the principles of vaccination provide background knowledge for information pertaining to disease transmission and the current recommended vaccine schedule. Vaccine administration guidelines and techniques are presented in table format. An overview of new vaccine research and development and a discussion of vaccine safety and immunization resources are also included.

Child↗