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 1,153 records · Page 64Linked to original sources

PubMedDate not supplied

Current measles control in Tanzania.

Measles is one of the major public health problems in Tanzania and is recognized as such by the population. Since 1975 measles vaccination has been given as part of the national expanded immunization program. On the basis of the findings of measles surveys and a vaccination trial, the policy of vaccination at six months of age has been changed to that of vaccination at nine months of age, and malnourished children are now vaccinated. Vaccination coverage is unsatisfactory because many villages are too far from health units and because measles vaccination has low credibility. The epidemiology of measles appears to be changing as a result of vaccination, and the age of vaccination may have to be modified in the future. A policy of vaccinating each child twice is being considered as well as one of vaccinating sick children who are attending maternal and child health clinics. At present eradication of measles is not a realistic target for countries such as Tanzania.

Age Factors↗

PubMedDate not supplied

Control of measles in Brazil.

Measles is regarded as a major public health problem in Brazil, accounting for much of the morbidity and mortality among children younger than five years of age. Rates of immunization have risen steadily since the National Immunization Program (NIP) was set up in 1973, reaching a maximum of 72.1% in 1981. However, the impact of the program cannot yet be demonstrated because of variations in reporting and of operational problems involved in the maintenance of efficient routine vaccination in most states. Changes in NIP field strategies after 1980 included the organization of campaigns in areas where the rates of vaccination are lowest, particularly in northern and northeastern Brazil.

Adolescent↗

PubMedDate not supplied

Surveillance and control of poliomyelitis in The Netherlands.

Inactivated poliovirus vaccine was introduced to the national immunization program in The Netherlands in 1957. A compliance rate of approximately 95% has existed since 1967. Only one of the 148 reported cases of paralytic poliomyelitis (from 1966 to 1982) occurred in an individual who had been vaccinated against poliomyelitis. Apart from sporadic imported cases, local outbreaks as well as an epidemic in 1978 were observed among certain susceptible Protestant populations. These unvaccinated groups, whose members--scattered as they are among the Dutch population--form a closed community, have to be considered at high-risk as long as importation of wild poliovirus strains occurs regularly. Endemic persistence of wild poliovirus in The Netherlands has, however, virtually disappeared. Potent inactivated poliovirus vaccine appears to be highly immunogenic and confers protection of long duration.

Adolescent↗

PubMedDate not supplied

Aspects of rubella infection in Brazil.

The notification of rubella infections is not obligatory in Brazil. The epidemiologic data available are restricted to some urbanized areas like the state of Rio de Janeiro, where outbreaks of rubella were observed in 1968, 1974, and 1981 and minor increases in the number of notified cases occurred in 1975, 1977, and 1978. The highest morbidity rate registered in the state of Rio de Janeiro was 48.7 per 100,000 population in 1981. Serologic studies show that approximately 80% of the general population has antibody to rubella by the age of 20 years. For 1976-1983, it is estimated that a minimum of 30 cases of congenital rubella syndrome should have occurred in the state of Rio de Janeiro, but there is evidence that a greater number occurred and that the number was particularly high in the postepidemic periods. Although available commercially in Brazil, the rubella vaccine is not available through the governmental immunization program. Increase in use of rubella vaccine in Brazil should be considered for the future.

Adult↗

PubMedDate not supplied

Control of typhoid fever in Bangkok, Thailand, by annual immunization of schoolchildren with parenteral typhoid vaccine.

The number of cases of typhoid fever in Bangkok, Thailand, began to increase sharply in 1974 and peaked in 1976. In 1977, as part of a national typhoid immunization program, Thai schoolchildren aged seven to 12 years began to receive annually a single 0.25-ml subcutaneous dose (2.5 x 10(8) organisms) of a heat/phenol-inactivated typhoid vaccine. Isolations of Salmonella typhi in Bangkok decreased from 880 (4.6% of all blood cultures) in 1976 to 54 (0.3% of all blood cultures) in 1985. The case ratio of S. typhi to Salmonella paratyphi A infection declined from 4.1:1 before the epidemic (1970-1973) to 0.9:1 after the epidemic (1984-1985), and the proportion of cases of typhoid fever occurring among children aged seven to 12 years significantly decreased from 30% to 10%. During the same periods S. paratyphi A isolation rates did not significantly decrease (in terms of either total number or percentage of cases) in school-aged children. Thus, mass vaccination of schoolchildren in Thailand with the heat-inactivated typhoid vaccine has been closely associated with a sharp decline in typhoid fever in Bangkok during an epidemic and with continuous control after the epidemic.

Child↗

PubMed2006

Measuring immunization coverage among preschool children: past, present, and future opportunities.

Control of vaccine-preventable diseases depends on maintaining high levels of immunization coverage. Immunization coverage among preschool children remains suboptimal in some areas and sociodemographic subgroups, as well as for more recently introduced vaccines, leaving susceptible young children vulnerable to complications from vaccine-preventable diseases. This paper reviews approaches historically used to measure immunization coverage among preschool children in the United States. The strengths and weaknesses of various approaches to measuring immunization coverage among preschool children are explored, with emphasis on the current means to measure national immunization coverage-the National Immunization Survey. Methods for measuring immunization coverage among preschool children at local and state levels are also evaluated. Future opportunities and challenges for measuring immunization coverage at the local, state, and national levels are explored.

Centers for Disease Control and Prevention, U.S.↗

PubMed2002

The sustainability of hepatitis B immunization within the Universal Immunization Programme in India.

Based on the recommendations of the World Health Organization, India as a member-state is likely to implement universal immunization against hepatitis B through the existing Universal Immunization Programme (UIP). A pilot project is already under progress in two municipal zones of Delhi. This paper begins by reviewing epidemiological features of hepatitis B in India, some established aspects and other emerging trends. The gaps in the existing knowledge base are also given due consideration. The current recommendation is to deliver the vaccine at zero-day for infants in the absence of facilities for antenatal screening and immunoglobulin administration. The paper explores the potential pitfalls for integrating the proposed hepatitis B vaccination with the DPT (diphtheria/pertussis/tetanus) schedule. Based on the findings of the National Family Health Survey, the likely coverage for the states is estimated for both the schedules--zero-day and with DPT. The performance of the pilot phase is reviewed through the results of a coverage survey. The paper also estimates the resources that should be committed to launch the universal immunization of hepatitis B vaccination and the sustainability issues thereof. The paper finally concludes with the position that hepatitis B immunization will 'sink or sail' with the UIP. Further, this should act as an engine for recharging the infrastructure and functioning of the public health system and promote general preventive practices like universal precautions.

Diphtheria-Tetanus-Pertussis Vaccine↗

PubMed1994

Measles control in Kinshasa, Zaire improved with high coverage and use of medium titre Edmonston Zagreb vaccine at age 6 months.

BACKGROUND: To improve measles control in Kinshasa, Zaire, a project to increase vaccine coverage was begun in 1988, and in 1989, the city vaccination programme changed measles vaccination policy from Schwartz vaccine at age 9 months to medium titre Edmonston Zagreb (EZ) vaccine at age 6 months. We report the impact of the programme on measles incidence and mortality. METHODS: Data on vaccine coverage were obtained from cluster sample surveys conducted every 1-2 years and from routine reports of vaccine doses administered. Data on measles incidence and mortality were obtained from sentinel surveillance sites. The serological response to EZ measles vaccine was evaluated at a health centre in 1989 and in a community survey in 1990. RESULTS: Measles vaccine coverage estimated in cluster surveys increased from 50% of the 1984 birth cohort to 89% of the 1989 birth cohort, accepting either a home-based record or a verbal history of vaccination. Reported measles incidence per 10,000 [corrected] population decreased by over 90%, from 37.5 in 1980 (early vaccination years) to 1.6 in 1991. There was a relative decrease in the proportion of cases aged < 9 months (32% of cases in 1986-1987 and 23% of cases in 1990-1991) and an increase in the proportion aged > 23 months (29% of cases in 1986-1987 and 43% in 1990-1991). According to ELISA assays, 74-76% of children seroresponded to EZ vaccine administered at age 6-7 months under routine programme conditions. CONCLUSIONS: Measles can be controlled in urban areas, although it is difficult to determine how great a contribution vaccination at age 6 months makes over and above the achievement of high coverage.

Antibodies, Viral↗

PubMed1984

Seroepidemiology of hepatitis B in Tennessee prisoners.

A prevalence serosurvey was performed on an 11.7% sample of the 6,503 adult male inmates in Tennessee prisons. On the basis of the sample, 0.9% of the prisoners possessed hepatitis B surface antigen, and 29.5% had one or more serum markers for hepatitis B virus (HBV). Thirty-two possible risk factors were analyzed for association with possession of HBV serum markers. The significant risk factors for possession of HBV markers in this population were found to be age, intravenous drug use while not incarcerated, intravenous drug use while incarcerated, race, education, military service history, and duration of prior and current imprisonments, in that order of importance. Given the modest contribution of incarceration to overall risk, mass immunization of prisoners against HBV seems unwarranted. Prisoners with unusually long sentences or who use intravenous drugs in prison are subgroups at particularly high risk. The logistic model can be used to target a serological screening and immunization program.

Adolescent↗

PubMed1995

Lombok Hepatitis B Model Immunization Project: toward universal infant hepatitis B immunization in Indonesia.

The Lombok Hepatitis B (HB) Model Immunization Project was the first mass infant HB immunization project in Indonesia. Key aspects were the procurement of low-cost HB vaccine, integration into routine infant immunization services, and delivery of the first dose in the home within 1 week of birth. The project achieved > 90% coverage with 3 doses of vaccine. The prevalence of HB surface antigen was 1.4% in infants who received 3 doses (with the first dose within 7 days of birth) and 3.0% in those who received the first dose > 7 days after birth, compared with a baseline prevalence of 6.2% (P < .001 in each case). Most vaccine failures occurred in children born to HBe antigen-positive mothers. Antibody prevalence and titers did not correlate with protection. HB vaccine can be successfully integrated into the Expanded Programme on Immunization (EPI), strengthening the EPI and significantly reducing chronic HB infection.

BCG Vaccine↗

PubMed1997

Combined immunization of infants with oral and inactivated poliovirus vaccines: results of a randomized trial in The Gambia, Oman, and Thailand. WHO Collaborative Study Group on Oral and Inactivated Poliovirus Vaccines.

To assess an immunization schedule combining oral (OPV) and inactivated poliovirus vaccines (IPV), a clinical trial was conducted in The Gambia, Oman, and Thailand. Children were randomized to receive OPV at birth and at 6, 10, and 14 weeks of age; OPV at birth followed by both OPV and IPV at 6, 10, and 14 weeks of age; or placebo at birth followed by IPV at 6, 10, and 14 weeks of age. Serum specimens were available at 24 weeks for 1291 (77%) of 1685 enrolled infants. In the combined-schedule group, the proportion of children seropositive at 24 weeks was 95%-99% for type 1, 99%- 100% for type 2, and 97%-100% for type 3. In The Gambia and Oman, the combined schedule performed significantly better than OPV for type 1 (95%-97% vs. 88%-90%) and type 3 (97%-99% vs. 72%-73%). Across the study sites, IPV given at 6, 10, and 14 weeks of age provided inadequate protection against poliovirus. The combined schedule provided the highest levels of serum antibody response, with mucosal immunity equivalent to that produced by OPV alone.

Antibodies, Viral↗

PubMed1997

Humoral and mucosal immunity in infants induced by three sequential inactivated poliovirus vaccine-live attenuated oral poliovirus vaccine immunization schedules. Baltimore Area Polio Vaccine Study Group.

The relative immunity induced by sequential administration of inactivated poliovirus vaccine (IPV) produced in human diploid cells and live attenuated oral poliovirus vaccine (OPV) was evaluated by randomization of 510 infants to receive IPV and OPV sequentially according to one of three experimental schedules, IPV only, or OPV only. The antibody response to two IPV doses was lower than expected. However, for each of the IPV-OPV sequential schedules, the first OPV dose significantly enhanced seroconversion rates and geometric mean microneutralization antibody titers. Three months after the final dose, 96%-99%, 99%-100%, and 81%-100% of infants had antibodies to poliovirus types 1, 2, and 3, respectively, and subjects with two or more prior OPV doses were significantly less likely than those with none or one prior OPV dose to excrete virus in feces after an OPV challenge. Sequential IPV-OPV immunization is now recommended for routine use in the United States. The optimal schedule consists of two IPV doses followed by two OPV doses.

Antibodies, Viral↗

PubMed1997

Sequential and combined use of inactivated and oral poliovirus vaccines: Dolj District, Romania, 1992-1994.

To determine the feasibility of a vaccination strategy that would reduce the risk of vaccine-associated paralysis while retaining a barrier against the spread of wild poliovirus, a 2-year project was undertaken using enhanced-potency inactivated poliovirus vaccine (IPV) administered at 2 and 3 months of age followed by doses of both IPV and oral poliovirus vaccine (OPV) administered at 4 and 9 months of age. Vaccination coverage by 12 months of age with three or more doses of IPV and two doses of OPV among 16,566 infants eligible for vaccination was > 95% and > 80%, respectively. Among 51 children from whom blood samples were obtained 45 days after their third dose of IPV and first dose of OPV, 100% had serum neutralizing antibodies (reciprocal titer > or = 10) to all three poliovirus types. No cases of paralytic poliomyelitis due to either wild or vaccine-related strains were reported. The project demonstrated the feasibility, safety, and high immunogenicity of sequential use of IPV followed by OPV in Romania.

Antibodies, Viral↗

PubMed2026

Multi-sampling allows intra-tumoral heterogeneity querying and vulnerability profiling in glioblastoma.

BACKGROUND: Glioblastoma (GBM) remains a devastating cancer with limited treatment options, largely due to its heterogeneity. While supramaximal resection has recently provided survival benefits, therapeutic profiling of different tumor compartments, particularly its infiltrative edge remains largely unexplored. METHODS: Here, we leveraged magnetic resonance imaging (MRI)-guided multi-sampling, collecting 2 cores and 2 margins per case, to query GBM heterogeneity. Whole-exome and RNA-seq with drug testing in two patient-derived 3D models were used to reveal similarities and differences in genomic and transcriptomic makeups, cellular compositions, and drug responses across cores and margins. Bioinformatics interrogations further identified response biomarkers. RESULTS: Mutation analysis showed that oncogenes exhibited a higher degree of spatial heterogeneity than tumor suppressor genes, regardless of MRI status. While the mesenchymal transcriptional subtype with extracellular matrix remodeling, stress response, and immune programs were preferentially enriched in enhancing cores, proneural tumors with neurological processes favored non-enhancing margins. Using a 15-drug GBM-targeted panel, ERK (ulixertinib) and PI3K pathway (paxalisib, CC-115) inhibitors showed preferential efficacy in enhancing cores and non-enhancing margins, respectively. The anti-apoptosis, pan-Bcl2 agent navitoclax and the epigenetic drug trotabresib represented the most effective, tumor-wide monotherapies. Importantly, drug combinations generally outperformed single agents across all regions. CONCLUSIONS: This work demonstrates the regional heterogeneity of therapeutic vulnerabilities in GBM ex vivo, showing various drugs with tumor-wide or MRI-enhancement informed activity. These findings offer preclinical bases of numerous monotherapies and drug combinations for future clinical trial design.

Humans↗

PubMed1999

Role of schools in the transmission of measles in rural Senegal: implications for measles control in developing countries.

Patterns of measles transmission at school and at home were studied in 1995 in a rural area of Senegal with a high level of vaccination coverage. Among 209 case children with a median age of 8 years, there were no deaths, although the case fatality ratio has previously been 6-7% in this area. Forty percent of the case children had been vaccinated against measles; the proportion of vaccinated children was higher among secondary cases (47%) than among index cases (33%) (prevalence ratio = 1.36, 95% confidence interval (CI) 1.04-1.76). Vaccinated index cases may have been less infectious than unvaccinated index cases, since they produced fewer clinical cases among exposed children (relative risk = 0.55, 95% CI 0.29-1.04). The secondary attack rate was lower in the schools than in the homes (relative risk = 0.31, 95% CI 0.20-0.49). The school outbreaks were protracted, with 4-5 generations of cases being seen in the two larger schools. Vaccine efficacy was found to be 57% (95% CI -23 to 85) in the schools and 74% (95% CI 62-82) in the residential compounds. Measles infection resulted in a mean of 3.8 days of absenteeism per case, though this did not appear to have an impact on the children's grades. Among the index cases, 56% of children were probably infected by neighbors in the community, and 7% were probably infected at health centers, 13% outside the community, and 24% in one of the three schools which had outbreaks during the epidemic. However, most of the school-related cases occurred at the beginning and therefore contributed to the general propagation of the epidemic. To prevent school outbreaks, it may be necessary to require vaccination prior to school entry and to revaccinate children in individual schools upon detection of cases of measles. Multidose measles vaccination schedules will be necessary to control measles in developing countries.

Absenteeism↗

PubMed1982

A controlled comparison of joint reactions among women receiving one of two rubella vaccines.

While transient rheumatic side-effects are not uncommon in women receiving any of the attenuated rubella virus vaccines yet developed, few comparative data are available on the only rubella vaccine currently available in the United States - the RA 27/3 vaccine. In this study, the frequency and severity of joint reactions were compared among seronegative women receiving HPV77DE5 vaccine (n = 59) or RA 27/3 vaccine (n = 53), and in seropositive vaccinees receiving either vaccine (n = 60). The proportions of vaccinees developing arthralgia/arthritis were similar (29 per cent and 26 per cent, respectively) in the seronegative groups, and were significantly higher than in the seropositive control group (3%). The onset of symptoms was earlier and their duration was briefer in those receiving RA 27/3 vaccine compared to the HPV77DE5 vaccine recipients. No chronic or recurrent symptoms were observed. These data, along with previous studies, suggest that while transient rheumatic reactions following rubella vaccination are not uncommon, they are not associated with serious disability and should not interfere with ongoing immunization programs.

Adult↗

PubMed1984

Guillain-Barré syndrome and its relationship to swine influenza vaccination in Michigan, 1976-1977.

Active surveillance to detect all patients with Guillain-Barré syndrome who had had onset of illness from July 1, 1976 through April 30, 1977 was undertaken in Michigan after indications that the syndrome might be associated with the National Influenza Immunization Program of 1976-1977. Hospital record room librarians, neurologists, and neurosurgeons reported the greatest number of cases; coded hospital discharge records were the best means of ascertaining case occurrence. This differed from national surveillance, which relied essentially on reports that neurologists and other clinicians sent to state epidemiologists and then to the Centers for Disease Control; hospital discharge lists were not systemically reviewed nationally. A total of 79 of the Michigan cases were in persons who had not received swine influenza vaccine, while 46 cases were in persons who had received it. For unvaccinated adults, the incidence of Guillain-Barré syndrome during the 10-month surveillance period was 0.36 cases per 10(6) person-weeks; for adults with onset within six weeks of vaccination, it was 2.31 cases per 10(6) person-weeks. After six weeks post-vaccination, the rate decreased to 0.17 cases per 10(6) person-weeks. The attributable risk for acquiring Guillain-Barré syndrome within six weeks after receiving swine influenza vaccine was 11.70 cases per 10(6) persons vaccinated.

Adolescent↗

PubMed1986

Geographic variation in infant loss of maternal measles antibody and in prevalence of rubella antibody.

Maternal and cord measles and rubella antibodies were compared in 15 populations from Brazil, Ecuador, Chile, India, Jordan, Nigeria, South Africa, Taiwan, and the United States. Review of the literature concerning these countries showed that a higher proportion of children 6-12 months of age responded immunologically to measles vaccine in areas with low per capita product than in wealthier populations. The authors show that this difference reflects differences in maternal antibody titer and differences in efficiency of transport of measles immunity across the placenta. No variation in the half-life of passive measles immunity in the infant was found in comparing three geographic areas. When these biologic factors are fully evaluated, it should be possible to predict the response to be expected from vaccination at any particular age without directly testing the vaccine in children below and above generally recommended ages for vaccination. With regard to rubella, high antibody prevalence rates were found in most of the developing countries, as well as in the United States, and these countries are therefore unlikely to encounter widespread problems with congenital rubella. However, Taiwan, and all of four areas of Brazil have prevalence rates which are no higher than those which pertained in the United States prior to establishment of the rubella immunization program. The authors believe that protection of the infants in these countries is a matter of high priority, but that, if approached hastily, it could exacerbate the problem.

Adult↗