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 919 records · Page 51Linked to original sources

PubMed2005

Effects of extra immunization efforts on routine immunization at district level in Pakistan.

A study was made of the effects of extra immunization activities on routine immunization coverage at district level in Pakistan in a secondary analysis of data from UNICEF and the Pakistan national census. Linear regression analysis was made on data from 107 districts to estimate the effects of extra immunization efforts in the national neonatal tetanus programme on the coverage rate of the third dose of diphtheria-pertussis-tetanus (DPT3) after controlling for other potential confounding factors. The districts that implemented extra national neonatal tetanus immunization were at risk of having lower routine DPT3 coverage than those that did not. Additional immunization efforts, without additional resources, may reduce the effect of the routine Expanded Programme on Immunization.

Cluster Analysis↗

PubMed1999

Evaluation of the effectiveness of routine measles vaccination: case-control study.

A retrospective case-control study was conducted in two primary schools located in eastern region of Cairo to evaluate the protective value of routine measles vaccination. A total of 230 children who had a previous measles illness were identified over 3 months period. Each case was matched to two controls based on age and sex. Vaccination status of the study children was ascertained through reviewing vaccination certificates The overall measles vaccine effectiveness was estimated at 53% (95% CI 71%-26%) There was an association between age of measles vaccination and vaccine effectiveness (VE) Primary vaccination failure due to young age of measles vaccination is the likely explanation of the low measles vaccine effectiveness. Adoption of two-dose measles vaccination policy with the second dose being given at older age needs to be considered to correct the problem of vaccine failure.

Bias↗

PubMed1989

Barriers to influenza vaccine acceptance. A survey of physicians and nurses.

The Immunization Practices Advisory Committee (ACIP) recommends that health care providers who contact high-risk patients receive influenza immunization annually. There are few available data on hospital employees' acceptance of these recommendations or their attitudes about influenza immunization. In a hospital where no formal influenza immunization program was in place, a survey of 193 nursing personnel and physicians showed that only 2.1% received the 1986-1987 trivalent influenza vaccine and 3.2% the monovalent A/Taiwan/1/86 vaccine before the 1986-1987 influenza season. An influenza-like illness developed in a total of 35.3% of hospital employees during the influenza season, and 76.6% of them cared for patients while ill. Fear of adverse reactions, avoidance of medications, and the inconvenience of vaccine administration were frequently cited reasons for declining immunization. Hospital employees would be more inclined to receive future influenza immunization if vaccine administration were more accessible and if they were informed that immunization were a national health care policy. During the influenza season, nurses and physicians should be considered a uniformly susceptible reservoir of infection capable of transmitting influenza to patients. Moreover, ACIP guidelines alone probably will not lead to acceptable immunization rates among health care providers; organized institutional efforts to promote immunization of health care providers may be required.

Attitude of Health Personnel↗

PubMed1999

Extended follow-up of antibody levels and antigen responsiveness after 2 Haemophilus influenzae type b conjugate vaccines.

Although immunization programs with Haemophilus influenzae type b (Hib) conjugate vaccines have dramatically reduced disease incidence, few data are available regarding the duration of protection after vaccination. We measured serum anti-polyribosylribitol phosphate (PRP) levels in healthy 4- to 5- year-old children previously given 4 doses of PRP-T vaccine (at 2, 4, 6, and 18 months) or 1 dose of PRP-D vaccine (at 19 months) during clinical trials to assess antibody persistence. Concurrent with other preschool immunizations, half of the children were randomly assigned to receive a PRP-T booster immunization to assess responsiveness. Among 136 subjects who were primed with PRP-D, the baseline geometric mean concentration of antibody was 0.7 microg/mL (95% CI 0.5 to 0.9). Concentrations were <0.15 microg/mL in 24 (17.6%) subjects. Among 212 children who were primed with PRP-T, the geometric mean concentration was 2.2 microg/mL (95% CI 1.9 to 2.5) (P <.001). Only 2 (0.9%) had concentrations <0.15 microg/mL. Four weeks after PRP-T immunization, geometric mean concentrations had increased to 98.4 and 102.0 microg/mL, respectively. Responses were strong even in those with low or undetectable preimmunization antibody levels. Spontaneous increases in antibody levels were seen in 9 (5.2%) of 172 subjects not given additional PRP-T. We concluded that among 4- to 5-year-olds, anti-PRP levels remained above 0.15 microg/mL in nearly all children after PRP-T priming and in most after PRP-D priming, and that both groups were able to respond vigorously to restimulation, consistent with persistent immune memory.

Antibodies, Viral↗

PubMedDate not supplied

Immunization against swine influenza in the Yale University Community.

Nineteen percent of the approximately 30,000 members of the Yale community aged 18 through 59 received swine influenza monovalent vaccine (A/New Jersey/1976) during the three days of a mass immunization program in Nov. 1976. Based on 1508 card questionnaires received, 71.2 percent of the vaccine recipients experienced a sore arm, 23.4 percent headache, 13.4 percent chilliness, and 9.7 percent feverishness or fever. The sore arm was judged as severe in 5.9 percent as was the headache in 4.2 percent. Other reactions were regarded as severe in less than 2 percent. All reactions were reported more commonly by women than mean and all decreased with age.Serologic tests carried out at the start of the immunization period revealed that influenza A/New Jersey/1976 antibody was absent from 78.6 percent of the recipients; almost all persons under 25 lacked this antibody. A significant antibody rise occurred in 78.3 percent of those receiving a single dose of monovalent vaccine. Somewhat better antibody responses occurred in 36-59 year olds than in those age 17-25 (84.9 vs 75.5 percent); the geometric mean antibody titer was also much higher (1:136.8 vs 1:31.2). However, the presence of pre-existing homologous antibody did not significantly improve the antibody response to the vaccine. Cross-reacting antibody rises to A/Victoria/1975 were found in 16.2 percent of the recipients of monovalent vaccine.

Adolescent↗

PubMed1993

Haemophilus influenzae type b carriage and immunity four years after receiving the Haemophilus influenzae oligosaccharide-CRM197 (HbOC) conjugate vaccine.

Late in 1991, before the implementation of a national immunization program against Haemophilus influenzae type b (Hib) in the United Kingdom, we performed a 4-year follow-up of 120 children who in 1987 had been enrolled in an immunogenicity trial in which 60 of them (vaccinees) received an Hib conjugate vaccine (HbOC) at the same time as diphtheria-tetanus toxoid-pertussis vaccine at the ages of 3, 5 and 9 months. Sixty others (controls) received only diphtheria-tetanus toxoid-pertussis vaccine at the same ages and were not subsequently immunized against Hib. We investigated Hib pharyngeal colonization using the antiserum agar method and the concentrations of serum IgG antibody to the type b capsule by enzyme-linked immunosorbent assay. At 4 years of age the Hib colonization rates in vaccinees and controls were 8% (5 of 60) and 5% (3 of 60), respectively. The children colonized with Hib had greater serum anti-capsular IgG concentrations than did noncolonized children (P < 0.001), and colonized vaccinees tended to have higher concentrations than colonized controls (P = 0.053). Regardless of Hib colonization status vaccinees had greater antibody concentrations than controls (P < 0.001). Forty-nine percent of vaccinees had an antibody concentration > 1 microgram/ml. There was an inverse relationship between the Hib colony count on culture and the serum IgG concentration. These data indicate that the increase in serum antibody concentration after immunization with an Hib conjugate vaccine is sustained and that immunization primes for a booster response on exposure to Hib. There may be a relationship between previous Hib conjugate immunization and the density of Hib colonization in children.

Antibodies, Bacterial↗

PubMed2000

The global poliomyelitis eradication initiative: progress and challenges.

In 1988, The World Health Assembly committed WHO and its member states to the goal of poliomyelitis eradication by the year 2000. Global progress in implementation of strategies include routine and supplementary immunisation, AFP surveillance strategy and mopping up. Progress made in global polio eradication within 10 years has been dramatic. Challenges consist of tailoring and fine tuning strategies and sustaining adequate levels of findings. Although the intensified effort will increase needed resources in the short term, it will save costs in the long term.

Adolescent↗

PubMed1995

Prevention of hepatitis B virus transmission by immunization. An economic analysis of current recommendations.

OBJECTIVE: To evaluate the outcome of immunization strategies to prevent hepatitis B virus (HBV) transmission. DESIGN AND SETTING: A decision model was used to determine the incremental effects of the following hepatitis B immunization strategies in a birth cohort receiving immunization services in the public sector: (1) prevention of perinatal HBV infection, (2) routine infant vaccination, or (3) routine adolescent vaccination. MAIN OUTCOME MEASURES: Over the lifetime of the cohort, the reduction in infections and medical and work-loss costs of HBV-related liver disease were determined for each strategy and compared with the outcome without immunization. RESULTS: Prevention of perinatal infection and routine infant vaccination would lower the 4.8% lifetime risk of HBV infection by at least 68%, compared with a 45% reduction for adolescent vaccination. From a societal perspective, each strategy was found to be cost saving, but was not cost saving with respect to direct medical costs. The estimated cost per year of life saved was $164 to prevent perinatal HBV infection, $1522 for infant vaccination, and $3730 for adolescent vaccination. CONCLUSIONS: Routine vaccination of infants in successive birth cohorts to prevent HBV transmission is cost-effective over a wide range of assumptions. While economically less attractive than infant vaccination, adolescent vaccination could serve to protect those children who were not vaccinated as infants.

Adolescent↗

PubMed2000

Pediatric vaccine compliance.

Immunization programs have produced a significant trend toward reducing the occurrence of disease in the United States. The resurgence of vaccine-preventable diseases, however, is a reminder that many goals have not yet been achieved. The methods discussed in this article may be useful in delivering vaccines to the pediatric population.

Child↗

PubMed1997

Pandemic influenza: confronting a re-emergent threat. The 1976 experience.

The Swine Influenza Immunization Program began in January 1976 with an outbreak of swine influenza among trainees at Ft. Dix, New Jersey. The program ended in December 1976 after an increased incidence of Guillain-Barre syndrome was attributed to the vaccine. The issues and events of 1976 provide valuable lessons for the future. A thorough and objective review of the swine flu program should be a prerequisite for influenza pandemic planning. Strong consideration should be given to creating separate structures for risk assessment and risk management. Risk assessment estimates the probability of a pandemic, the options available for control, and the relative benefits of those options as situations change. Risk management is the political response to that assessment.

Humans↗

PubMed2004

A mucosally targeted subunit vaccine candidate eliciting HIV-1 transcytosis-blocking Abs.

A vaccine that would engage the mucosal immune system against a broad range of HIV-1 subtypes and prevent epithelial transmission is highly desirable. Here we report fusing the mucosal targeting B subunit of cholera toxin to the conserved galactosylceramide-binding domain (including the ELDKWA-neutralizing epitope) of the HIV-1 gp41 envelope protein, which mediates the transcytosis of HIV-1 across the mucosal epithelia. Chimeric protein expressed in bacteria or plants assembled into oligomers that were capable of binding galactosyl-ceramide and G(M1) gangliosides. Mucosal (intranasal) administration in mice of the purified chimeric protein followed by an i.p. boost resulted in transcytosis-neutralizing serum IgG and mucosal IgA responses and induced immunological memory. Plant production of mucosally targeted immunogens could be particularly useful for immunization programs in developing countries, where desirable product traits include low cost of manufacture, heat stability, and needle-free delivery.

AIDS Vaccines↗

PubMed1999

First rotavirus vaccine licensed: is there really a need?

The first rotavirus vaccine was licensed in the United States on 31 August 1998 for the prevention of severe rotavirus diarrhea in children. Despite this landmark in new vaccines, many pediatricians and public health professionals in Europe are uncertain of the need for this vaccine for the routine immunization of infants. In Europe, ample evidence suggests that rotavirus is the most common cause of hospitalizations for severe diarrhea among children, but proper studies documenting the disease burden of rotavirus or the cost-effectiveness of a rotavirus immunization program have only been conducted in the United Kingdom following epidemiologic models used in the United States. All children are infected with rotavirus during their first few years of life, 30-50% of diarrheal hospitalizations among children <5 years are due to this agent, and, by the age of 5 years, between 1 in 40 and 1 in 77 children in Europe and the United States may be hospitalized for rotavirus. The first vaccine is a live, oral preparation combining four different serotypes of rotavirus and administered in three doses with other childhood immunizations. The good efficacy against severe rotavirus diarrhea, the low risk of adverse side effects and the positive cost-effectiveness equation have led the two major immunization advisory groups in the U.S. to recommend this vaccine for routine use in American infants. European physicians and policy-makers should re-examine the epidemiology and disease burden of rotavirus diarrhea now that an effective method of prevention is at hand.

Child↗

PubMed2003

Childhood cancer among Alaska Natives.

OBJECTIVE: The primary purpose of this study was to examine the occurrence of cancer in Alaska Native (AN) children (under age 20). Although several studies have compared differences in cancer incidence between white and black children, few have examined cancer among Alaska Natives/American Indians. We know of no published article describing cancer incidence in AN children. We compared our findings with those of American Indian children of New Mexico and of Alaska white children. Data on mortality, survival, and prevalence are also included. Alaska Native is the term used collectively for the inhabitants whose ancestors occupied the area before European contact of what is now the state of Alaska. Alaska Natives include Eskimo, Indian, and Aleut groups. Although the 3 major groups differ in culture, language, and probably genetics, there are similarities in numerous social and economic indicators. The Northern Eskimo of Alaska (Inupiat) are related to Canadian and Greenland Inuit. Indians in Alaska include Athabaskan (in the interior of the state), who share commonalities with Canadian Athabaskan as well as with Navajo and Apache in the southwestern United States. Tlingit, Haida, and Tsimshian groups reside primarily in the southeast panhandle of the state. The panhandle Indian groups are similar to those of British Columbia. METHODS: Data on cancer incidence are from the Alaska Native Tumor Registry, 1969-1996. We studied children under age 20 to make our results comparable to national data as presented in the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Pediatric Monograph. Population data for AN are based on census data and Indian Health Service intercensal estimates. Data for US whites and New Mexico Indians are from the National Cancer Institute's SEER program. Calculations were made using SEERStat software. Data for Alaska whites are for the years 1996-2000. (The Alaska Cancer Registry has collected data for all Alaskans only since 1996). Odds ratios (ORs) of rates with 95% confidence intervals (CIs) were calculated. RESULTS: The rate among all AN children (both sexes) for all cancers combined is similar to that of US whites (OR: 1.0; 95% CI: 0.8-1.1). Examination of childhood cancer rates by ethnicity, however, reveal that rates are significantly lower for Indian (OR: 0.6; 95% CI: 0.4-0.8) but not significantly different for Eskimo or Aleut children. For most International Classification of Childhood Cancers groups, incidence rates for AN children are also similar to those of US whites. However, AN children are at significantly higher risk for hepatic tumors (OR: 13.1; 95% CI: 7.9-20.5), particularly hepatocellular carcinoma (OR: 43.8; 95% CI:24.4-75.1) and retinoblastoma (OR: 2.8; 95% CI: 1.3-5.3). By ethnic group, rates for hepatocellular carcinoma are significantly high only for Eskimo. Rates for all AN children are lower for neuroblastoma (OR: 0.1; 95% CI: 0.1-0.6) and lymphoma (OR: 0.5; 95% CI: 0.3-0.9), particularly Hodgkin's disease (OR: 0.2; 95% CI: 0.0-0.5). On the basis of 5 years of data, rates for Alaska white children do not seem to differ from those of US white children. Because of our findings of differences between AN and US whites, we reviewed data of other relevant populations, specifically American Indian data from the New Mexico SEER registry. Using SEER data and SEER software, we calculated rates for New Mexican American Indians (NMAI) and compared them with US white rates. Rates for all cancers combined among NMAI are significantly lower than for US white (OR: 0.8). However, similar to AN children, the rate among NMAI for retinoblastoma is higher compared with US whites (OR: 2.5; 95% CI:1.4-4.5). Similar to AN, NMAI also seem to be at low risk for neuroblastoma (OR: 0.2; 95% CI: 0.1-0.7), lymphoma as a group (OR: 0.1; 95% CI: 0.0-0.3), and, specifically, Hodgkin's disease (OR: 0.1; 95% CI: 0.0-0.4). Rates among NMAI children are low for central nervous system tumors (OR: 0.5; 95% CI: 0.3-0.7). The average annual age-adjusted cancer mortality rate among AN children is lower but not significantly lower than that of US white children (28.6 vs 37.3 per million). CONCLUSIONS: Comparison of AN rates for all cancers combined are similar to those of US and Alaska white children but seem higher than those of NMAI. Differences between AN and US whites exist for select International Classification of Childhood Cancers groups. The most striking rate differences are found in hepatic tumors, largely because of elevated rates of hepatitis B-associated hepatocellular carcinoma. All children in our study with hepatocellular carcinoma were hepatitis B antigen positive. A statewide hepatitis B virus immunization program was begun in late 1982. Although 16 children who were born before 1983 developed hepatocellular carcinoma, no children who were born in the 20 years since hepatitis B immunization was instituted among infants have received a diagnosis of hepatocellular carcinoma, a significant difference. Comparing AN and US white childhood cancer rates after removing hepatocellular carcinoma cases from both populations results in an OR of 0.8 (95% CI: 0.7-1.0). Thus, if no increase in other childhood cancers occurs in the coming generations, then rates for childhood cancer may soon be significantly lower than those in US white children. Rates are low for all lymphomas, largely because of very low rates of Hodgkin's disease. Rates are also low for neuroblastoma. It is reassuring that rates for AN children are not in excess and do not seem to be increasing. There is concern among the population regarding environmental exposure, including ionizing radiation. Our data do not show excess childhood leukemia or thyroid cancers, malignancies for which radiation is known to increase risk.

Adolescent↗

PubMed1998

Control of hepatitis B in central and eastern Europe (CEE) and the Newly Independent States (NIS): recommendations of the October 1996 meeting in Siófok, Hungary.

The prevention and control of hepatitis B virus (HBV) infection constitutes a major health policy priority especially in countries belonging to the CEE and the NIS (the former Soviet Union). Many of these countries report high prevalence rates of HBV infection, clinical disease and even high mortality. The Viral Hepatitis Prevention Board (VHPB) jointly organized with the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC) a meeting to bring together managers of national immunization programs, hepatitis experts and senior officials from ministries of health. The meeting was held in Siófok, Hungary from 6 to 9 October 1996. The aim of the meeting was to put the prevention of hepatitis B on the political agenda and to speed up the progress of the countries in central and eastern Europe and the Newly Independent States towards the implementation of universal childhood vaccination against hepatitis B. The epidemiology of hepatitis B in the countries concerned was discussed, the different strategies for prevention of hepatitis B reviewed, major elements in priority setting elaborated, with emphasis on health economics and strategies for resource mobilization outlined: national and international experts exchanged views during six workshops (resource mobilization: monitoring and surveillance; vaccines and immunization; vaccine production, quality control and regulation issues; nosocomial transmission and diagnostics). A major outcome of the meeting was a consensus statement and recommendations for action. These recommendations concerned the countries of the region but also 'partners in development' and the WHO, insisting that the international agencies should support technically and financially the hepatitis B prevention efforts of the countries.

Commonwealth of Independent States↗

PubMedDate not supplied

Late morphologic consequences of measles: a lethal and debilitating lung disease among the poor.

Pneumonia that occurs within 28 days of the onset of measles rash is a common cause of severe pulmonary morbidity and/or death among poor children. The prevalence of such pneumonia can be related to the effectiveness of measles immunization programs. For 20 of 57 new cases of bronchiectasis in children undergoing bronchography, a strong causal relationship to measles was found. The lungs of 21 unselected children who died in the wake of measles were examined. Severe necrosis of bronchi and bronchioles was found in those children who had developed intercurrent adenovirus and herpesvirus infections. Bacterial suppuration produced a less severe necrosis. It is suggested that intercurrent adenovirus and herpesvirus infections that occur following measles are the most important initiating causes of follicular bronchiectasis in childhood. The severity of these supervening infections may be mediated by the transient immune suppression that occurs as a consequence of both measles and inadequate nutrition.

Adenovirus Infections, Human↗

PubMed1996

[Vaccination of children in 1996].

Immunization against Haemophilus influenzae b and hepatitis B during infancy, as well as the administration of a second dose of measles-mumps-rubella vaccine around the age of 12, are the significant additions brought to the childhood immunization program in recent years. The availability in the near future of the acellular pertussis vaccines illustrates the efforts made to reduce the side effects associated with the use of some vaccines. The high cost of these acellular vaccines, together with the absence of combined Haemophilus influenzae or hepatitis B vaccines, represent their current limitations.

Bacterial Capsules↗

PubMed1993

Feline leukemia virus. Immunization and prevention.

Our understanding of the pathogenesis of FeLV infection is little changed from what was described by Hardy and his colleagues in the mid-1970s. The prevention of FeLV infection consists, first, of avoiding the agent and, second, of providing optimum immunologic resistance. In multi-cat environments, the former is achieved through test-and-removal methods perennially reviewed in the literature and by minimizing exposure to outdoor cats. The latter is possible by attempting to maintain a low-stress, pathogen-free household and by the use of appropriate, effective immunization programs. Simple immunologic concepts used for the development of vaccines against feline distemper and rabies have evolved to enable generation of products that can now protect against retroviruses. The use of more complex biologic methods, such as recombinant technology and the manipulation of antigen presentation, bears encouragement, so that perhaps one day the most destructive of feline infectious diseases may be checked.

Animals↗

PubMed2004

Benefits of routine immunizations on childhood survival in Tari, Southern Highlands Province, Papua New Guinea.

BACKGROUND: Non-specific beneficial as well as deleterious effects of childhood immunizations have been reported in areas of high mortality. This study aimed to determine the effects of diphtheria-tetanus-whole-cell-pertussis (DTP), BCG, hepatitis B, and measles vaccines on mortality in the highlands of Papua New Guinea (PNG). METHODS: Demographic events for children born in 1989-1994 who were under monthly demographic surveillance in Tari were recorded from birth until age 2 years, out-migration, death, or the end of the study period. Data on BCG, hepatitis B, DTP, measles and pneumococcal polysaccharide vaccination were collected monthly from clinic records. To allow for different characteristics of immunized and non-immunized children, analysis included conditioning on a propensity score for vaccination, adjusting for differences in children's background characteristics. RESULTS: In all, 101/3502 children (3%) who had at least one vaccine died between ages 29 days and 24 months were compared to 112/546 (21%) who had none. BCG was associated with lower mortality in the 1-5 month age group (hazard ratio [HR] = 0.17, 95% CI: 0.09, 0.34), measles vaccine with lower mortality at age 6-11 months (HR = 0.42, 95% CI: 0.17, 1.01), and pneumococcal polysaccharide vaccine with lower mortality at age 12-23 months (HR = 0.42, 95% CI: 0.19, 0.93). One or more doses of DTP was associated with lower overall mortality (HR = 0.27, 95% CI: 0.16, 0.44), particularly in the 1-5 month age group (HR = 0.19, 95% CI: 0.10, 0.34), and also in those who had had prior BCG (HR = 0.45, 95% CI: 0.22, 0.91). CONCLUSION: Routine immunizations are effective in reducing overall mortality in young children in an area of high mortality. In particular, DTP, whether considered separately or in addition to BCG, was associated with a lowering of overall mortality, in contrast to findings reported from Guinea-Bissau.

BCG Vaccine↗