Influenza vaccine ... to whom and when?
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Close interactions are existing between poultry husbandry and poultry health. The more housing systems and the environment of the animals can be controlled, the less the general risk of disorders in poultry flocks--especially of diseases which are caused by the introduction of microoganisms. Resulting deterimental effects will affect not only the animals themselves, but also pose a risk indirectly for humans via food originating from animals under production. Also, by keeping the risk of infections as low as possible, the use of therapeutics can be avoided. This will reduce the risk of residues in food of animal origin. In summary, with all probability open poultry husbandry systems, especially those including free range systems pose increased risks for poultry health and consequently for the quality of food originating from poultry production. At least, those systems require highest standards of biosecurity, defined as management, location, farm layout, cleaning and desinfection incl. pest control programs, immunization and specific veterinary monitoring concepts to prevent infections.
Influenza virus infection is a leading cause of pediatric hospitalization in winter, as well as respiratory syncytial virus infection. Effective methods of prophylaxis not only for high-risk patients, but also for healthy young children is indispensable. In Japan, a mass immunization program for the prevention of influenza in schoolchildren was conducted between 1962 and 1993. Vaccinating schoolchildren against influenza reduces mortality from influenza among the elderly. Moreover, the programs probably protected young children from developing severe complications of influenza.
Public concern about the safety of vaccines began when vaccination began, in the 18th century. Major resistance to vaccinations in the 1980s threatened to shut down vaccine manufacture and immunization programs. The US Congress responded with legislation in 1986-1987 that established a compensation program, communication strategies, and a process of objective, science-based analysis by the Institute of Medicine of whether childhood vaccines cause any of an array of possible adverse events. Since then, research, detection, communication, and education related to vaccine safety have improved but remain less than perfect. All of us who care about children, our own or in the abstract, will serve our children best if we remain vigilant and open-minded in considering issues of vaccine safety, and if we base our conclusions and actions on science, not emotion.
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The article focuses on the Brazilian government's role in implementation of immunization policies and in the emergence of a government structure involving production and quality control of immunobiologics. It examines Brazil's National Immunization Program, creation of the National Institute for Quality Control in Health, and the Program for Self-Sufficiency in Immunobiologics. It also takes a general look at the political picture that influences participating actors and at changes in Brazil's demographic and epidemiological profile.
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The immunogenicity and safety of Okavax trade mark varicella vaccine, when administered concomitantly with Trimovax trade mark measles, mumps, and rubella (MMR) vaccine, were assessed in 300 Filipino children 12-24 months old. Three groups received Okavax only, Trimovax only, or both vaccines concomitantly. In sera obtained six weeks after vaccination, high varicella antibody geometric mean titers (GMTs) (115 and 79.8 mIU/mL, respectively) and seroconversion rates (>or= 91.9%) were similar for Okavax given alone or concomitantly with Trimovax. High MMR GMTs and seroconversion rates (mumps >or= 94.6%, measles and rubella >or= 98.6%) were not affected by concomitant administration of Trimovax with Okavax. Solicited local and systemic reactions recorded by parents were slightly more numerous after concomitant administration, but the majority of all reactions were mild and transient. The good tolerance and high immunogenicity observed supports the concomitant administration of Okavax and Trimovax to children in their second year of life to protect against four life-threatening diseases while simplifying childhood immunization programs.
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In response to media scares and subsequent falls in measles, mumps and rubella (MMR) vaccine uptake, a case-control study was conducted to identify factors associated with non-uptake of the second dose of the vaccine in children resident in North Wales. Subjects were selected from parents of children scheduled for the second dose between October and December 1997. Postal questionnaires were used to compare knowledge, attitudes and practice of non-acceptors (cases) and acceptors (controls). Of non-acceptors, 92.1% (95% CI 82.2-97.5%) stated that they would allow another child to have at least one dose of MMR, and 39.2% (95% CI 25.8-53.9%) both doses of MMR vaccine. Non-acceptors were more likely to report having obtained information from newspapers/television (OR 2.04, 95% CI 1.03-4.02) or from the general practitioner (OR 2.02, 95% CI 1.07-3.86) and to report having 'a lot' or 'some' influence from newspapers/television (OR 3.52, 95% CI 1.57-7.86). The 'combination of three vaccines in one jab' was identified as a worry by 55.1% (95% CI 40.2-69.3%) of non-acceptors and 38.5% (95% CI 30.6-46.9%) of acceptors. On this evidence, catch-up campaigns would be an effective way of increasing coverage; also health professionals need tools to enable them to communicate effectively in the face of ongoing scares.
Immunization registries are confidential, computerized information systems that collect vaccination data within a geographic area. By consolidating vaccination records from multiple health-care providers, generating reminder and recall notifications, and assessing clinic and vaccination coverage, registries serve as key tools to increase and sustain high vaccination coverage. One of the national health objectives for 2010 is to increase to 95% the proportion of children aged <6 years who participate (i.e., have two or more vaccinations recorded) in fully operational, population-based immunization registries. This report summarizes data from CDC's 2002 Immunization Registry Annual Report (2002 IRAR), a survey of registry activity among immunization programs in the 50 states and the District of Columbia (DC) that receive grant funding under section 317b of the Public Health Service Act. These data indicate that approximately 43% of children aged <6 years are enrolled in a registry; achieving the national health objective will require increased implementation of functional standards to improve data quality.
Despite high immunization rates in this country, many adolescents do not receive all of the recommended vaccines. Each year, more than 3.5 million adolescents in the U.S. enter adulthood lacking recommended immunizations. This article will review the current recommendations for immunization for adolescents, including those for the meningococcal vaccine. The vaccine schedule is continually changing, and it is important that health care providers be up to date and utilize available resources with current information. Primary care providers should review and update immunization records with their adolescent patients on a routine basis.
Vaccines are essential to prevent, control (as for poliomyelitis) or eradicate (as for smallpox) infectious diseases. In some cases, when a curative treatment is not available or efficient, they are the only way to fight the spread of the disease, by prevention. The national recommended childhood immunization schedule may vary each year and in each country (changes in infections characters, outbreaks, new vaccines availability...). In this review, new patterns in childhood vaccination in France are discussed.
OBJECTIVE: To study the epidemiological status on rotavirus diarrhea in Kunming to improve the rotavirus vaccine immunization program. METHODS: A hospital-based sentinel surveillance program for rotavirus was set up among children less than 5 years old with acute diarrhea in Kunming Children's Hospital. Clinical information and fecal specimens were collected and rotavirus were detected by polyacrylamide gel electrophoresis (PAGE) and/or enzyme linked immunosorbent assay (ELISA). Positive specimens were further serotyped or genotyped by ELISA and/or RT-PCR. RESULTS: During the three years of surveillance, 466 specimens were collected. Rotavirus were detected on 246 (52.8%) specimens. 97% of the rotavirus diarrhea cases occurred among children less than 2 years old. There was a peak of admissions for rotavirus diarrhea cases between October and December which accounted for 48% of all the rotavirus hospitalizations each year. Among 204 specimens with G serotyping, the predominant strain was serotype G1 (47.5%) followed by G2 (17.6%), G3 (15.7%), G9 (4.9%) and G4 (1.0%). Mixed infection (2.5%) were rare and 22 specimens (10.8%) remained non-typeable. P genotyping showed P[4], P[8] and P[6] were the most common strains, accounting for 29.3%, 27.6% and 13.8% respectively. P[4]G2 was the most common strain which accounted for 34.1% (14/41) followed by P[8]G1 (29.3%) and P[6]G9 (12.2%). Another 7 uncommon P-G combinations were also identified. CONCLUSION: Rotavirus was the major cause of acute diarrhea in Kunming. An effective rotavirus vaccine for prevention and control of rotavirus diarrhea should be developed.
Wild Poliovirus spreading in rural environment in Adzopé, Côte d'Ivoire In order to determine the level of wild Poliovirus spreading among rural children in an endemic poliomyelitis country 469 stools samples, from children aged between three weeks and twelve years old were processed according to WHO procedures for transportation, conservation, isolation and identification of Poliovirus. Intratypic differenciation was performed by an antigenic method using monoclonal antibodies and a genomic RFLP (Restriction Fragment Length Polymorphism). 50 Poliovirus strains (10.7%) were isolated and analyzed: 15 vaccine-like Poliovirus type 1 (30%), 30 vaccine-like Poliovirus type 2 (60%), 4 vaccine-like Poliovirus type 3 (8%) and one wild Poliovirus type 3 (2%). As expected, in the major cases the duration of post-vaccinal viral excretion did not exceed two months. However, in 14% of cases, it varied between 3 and 9 months after the third OPV dose. This long excretion could be due to an inefficient local intestinal immunity or no local immunity at all, in spite of the three OPV doses. These results argue in favor of an increase of the number of OPV doses in such endemic zones. Moreover, OPV strains are well-known to revert to pathogenicity in vaccinees, therefore, the long term excretion of pathogenic OPV derived strains by a certain amount of vaccinees needs to be considered quite seriously.
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