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At least 1,387 records · Page 77Linked to original sources
PubMed2004

[Survey of vaccination and viral infections for children with severe myoclonic epilepsy in infancy].

A study group for establishment of a proposed immunization program for neurologically high risk children (Chief, Kihei Maekawa) sponsored by the Ministry of Health, Labour and Welfare of Japan is preparing a proposal for patients with epilepsy. Severe myoclonic eplepsy in infancy (SMEI) is an intractable epilepsy which often presents with status epilepticus and triggered by hyperthermia and viral infections. In this study we investigated the history of vaccination in children with SMEI to compare the risk of vaccination with that of natural contraction of infection. Fifty-eight patients with SMEI, aged from 2 to 25 years, were enrolled in this study. A total of 359 vaccines were given to these subjects. The vaccination rates were high for BCG (71%) and polio (1st; 71%, 2nd; 53%), and then fell gradually after the onset of SMEI (DPT-1st; 48%. DPT-2nd; 45%, DPT-3rd; 38%, DPT-4th; 24%, mumps; 21%, varicella; 19%, rubella 31%). However, the measles vaccine was given at a relatively high rate (55%) before the age of three. When patients suffered from measles, rubella, mumps or influenza, they had a high risk of severe neurological complications, such as convulsive status, disturbance of consciousness and encephalopathy. These complications were documented in 63% of all episodes of naturally contracted infections. This rate was significantly higher (p < 0.0001) than that associated with vaccination (7.2%). However, hyperthermia and convulsion developed more frequently (p = 0.012) after measles vaccine was given, as compared to other vaccines. Thus, administration of these vaccines to patients with SMEI in conjunction with other preventive measures against seizure induced by hyperthermia, may meet the needs of their parents.

Adolescent↗
PubMed2004

Proceedings of the Meningococcal Vaccine Strategy World Health Organization satellite meeting, 10 March 2004, Auckland, New Zealand.

From 1991 to the end of 2003 there have been 5293 cases and 216 deaths from meningococcal disease in New Zealand. On 10 March 2004, the New Zealand Ministry of Health hosted a special meeting to release the first results of the clinical trial in 16 to 24 month olds of a new vaccine (MeNZB), which has been tailor-made to provide protection against the New Zealand epidemic strain. These proceedings summarise the key points from the meeting presentations and highlight some of the important issues considered in the subsequent discussion. In the toddler age-group trial, 75% of the MeNZB recipients exhibited a four-fold or greater rise in serum bactericidal antibodies after three doses of MeNZB--compared with 4% of the control vaccine recipients. Local reactions to MeNZB and the control vaccine were common, especially injection site tenderness. These data, along with data from New Zealand clinical trials in four other age groups and efficacy and safety data from the Norwegian parent vaccine, were used to support the application for a licence to use MeNZB in a proposed mass immunisation programme for 0-19 year olds. During the immunisation programme, a comprehensive safety monitoring programme will be in place to monitor for any adverse reactions following MeNZB immunisation. This will include real-time hospital-based monitoring in the regions first to roll out the vaccine.

Adolescent↗
PubMed2004

[Protection of children born to hepatitis-B-infected mothers].

The vaccination schedule implemented on 1 March 2003 for the approximately 1000 Dutch children per year born to hepatitis-B-virus-infected mothers is under discussion. The Health Council of The Netherlands and TNO have both published reports which reveal that the current schedule does not fulfil its objectives, as too many children are completely missed and many of the vaccinated children do not receive their scheduled vaccinations on time. Furthermore, doubts have been expressed about the effectiveness of the present vaccination schedule. In line with one of the schedules proposed by the Health Council we suggest the introduction of a 4-dose vaccination, in which the first vaccination is given immediately after the birth of the child. The subsequent vaccinations can then take place after 2, 4 and 11 months. These are the ages at which other children are also vaccinated against hepatitis B in accordance with the Dutch national vaccination programme. Furthermore, we advise an improved surveillance to ensure compliance with the individual vaccination schedules for these children. If data from the hepatitis-B screening of pregnant women, the regional vaccination registers, and the vaccinations actually administered are linked, then it will be possible to take swift action if a child is late for a hepatitis-B vaccination. In our opinion, this can best be achieved if a single national organisation is made responsible for the entire process, starting from the collection of the hepatitis-B data of pregnant women up to concluding the scheme, whether or not the serologic response is checked.

Female↗
PubMed2004

[Increased risk of hepatitis B due to incomplete or untimely immunisation in one-quarter of infants of hepatitis-B-virus carriers].

OBJECTIVE: To determine the frequency of an increased risk of infection in children of hepatitis-B-virus carriers due to incomplete or untimely hepatitis-B immunisation. DESIGN: Descriptive. METHOD: Dates of birth and hepatitis-B immunisations were collected for all documented children of hepatitis-B-virus carriers in the vaccination registers, born in 2000 in The Netherlands. To assess the possible increased risk of infection, criteria were drawn up for the completeness and timeliness of the immunisations and on the basis of these the number of children who possibly had an increased risk of infection was determined. RESULTS: In total, 731 of the 769 children (95%) had received hepatitis-B immunoglobulins and at least 3 vaccinations. For 200 children (26%) the deviation from the immunisation schedule was so great that the child was possibly (temporarily) inadequately protected. CONCLUSION: A quarter of the children of hepatitis-B-virus carriers were immunised incompletely or at the wrong time. This calls for an adjustment of the immunisation schedule and national guidelines in which the responsibilities and tasks are clearly defined.

Female↗
PubMed2003

Introduction of inactivated poliovirus vaccine into oral poliovirus vaccine-using countries.

Given the progress already made towards the goal of global eradication of poliomyelitis LE (polio), the risk of paralytic poliomyelitis is changing in many geographical areas. Vaccination against polio will need to continue because of the threat of wild poliovirus importation. However, an increasing number of polio-free countries are determining that the risk of paralytic poliomyelitis associated with continued routine immunization using oral poliovirus vaccine (OPV) is greater than the risk of importation or laboratory handling of wild poliovirus. Some of these countries have introduced inactivated poliovirus vaccine (IPV)--a safe and effective alternative for routine immunization--using one of two approaches: replacement of OPV by IPV and introduction of a sequential IPV/OPV schedule. Countries considering such changes should conduct a thorough evaluation of the epidemiological, financial and operational implications before finalizing a change in policy. Tropical developing countries pose a special challenge for policy formulation on IPV. In these countries, given the unresolved issues related to the immunogenicity of IPV when administered in the WHO/Expanded Programme on Immunization (EPI) vaccination schedule, the continued focal circulation of wild poliovirus on two continents, the relatively high cost of IPV and the operational complexities of introducing this vaccine, WHO does not--as of July 2003--recommend the adoption of IPV alone or in a sequential schedule. It is expected that this position will be reviewed late 2004 and, if appropriate, revised according to the additional information that has become available on IPV effectiveness, logistic implications, and on further progress towards polio eradication. WHO is encouraging operational studies and introduction projects to evaluate these issues.

Developing Countries↗
PubMed2005

[Pediatrics. Conjugate anti-pneumoccoccal vaccine: what are the results four years after introduction?].

Considerable morbidity and mortality are related to pneumococcal disease predominantly in high risk populations: infants and young children, the elderly and the immunocompromised. A recent heptavalent conjugate anti-pneumococcal vaccine, introduced in the routine immunization program in the United States in 2001, has been shown to be spectacularly effective in the prevention of invasive disease in the very young in contrast to the pre-existing polysaccharide vaccine. As a consequence, horizontal transmission throughout the community is decreased with a reduction in disease rates in non-vaccinated adults. Finally the conjugate vaccine also provides an effective tool for reduction of drug-resistant pneumococcal strains. A review of the existing anti-pneumococcal vaccines, their direct and indirect effects and their recommended use in Switzerland.

Child, Preschool↗
PubMed2004

Tetanus immunisation policy in England and Wales--an overview of the literature.

Current UK policy on immunisation for tetanus has changed in the light of evidence that five doses of vaccine probably provides sufficient protection as long as high-risk wounds are managed with tetanus immunoglobulin. This paper reviews the evidence base for tetanus immunisation policy in England and Wales: the epidemiology of tetanus, vaccination coverage and response to tetanus toxoid, and population immunity to tetanus. The paper highlights gaps in our current knowledge of tetanus vaccination and policy implementation, and makes recommendations for further investigations.

England↗
PubMed2004

Increasing hepatitis B vaccine coverage in prisons in England and Wales.

The most frequently reported risk factor for hepatitis B infection in England and Wales is injecting drug use (38%). Since approximately 61% of injecting drug users (IDUs) had been imprisoned and less than 40% had received hepatitis B vaccine, a prison based hepatitis B vaccination programme was set up in 2001. At the 42 establishments participating in this study, all prisoners were offered vaccine at reception. Prisoners over 18 years were vaccinated using the 0, 7 and 21 days schedule and those under 18 years, using the 0, 1 and 2 months schedule. As far as possible a fourth dose was given to all after 12 months. In 2003, 14,163 prisoners received at least one dose of vaccine and altogether 26,265 doses were administered. A further 1111 prisoners reported they had already been vaccinated against hepatitis B. The median vaccine coverage rate was 17% (range 0-94%). Despite low coverage levels, the vaccination programme in prisons can be said to have vaccinated a sizable number of young, male prisoners, a group that have previously been shown to be at high risk of infection. The prisons which achieved vaccine coverage levels over 50% had designated nursing staff who ran the vaccination clinics.

Adolescent↗
PubMed1992

Preventing influenza: the physician's role.

Influenza remains a preventable cause of illness and death in this country. Vaccination is the most cost-effective method for preventing influenza, and yet vaccination rates continue to be less than 30% to 40% for targeted high-risk groups. Physicians are in a unique position to provide the leadership and impetus needed to improve influenza vaccination rates for targeted groups. Contributors to physicians' success will include adequate knowledge of influenza and the vaccine, objective measures of current performance, and the ability to develop and implement successful immunization programs. It is likely that administrative and organizational changes in clinical practice will provide the critical elements for success.

Education, Medical, Continuing↗
PubMed2005

Rubella antibodies in normal pregnant women at Srinagarind Hospital, Khon Kaen, Thailand.

BACKGROUND: Rubella infection in pregnant women, especially in the first trimester, can result in serious neonatal morbidity and mortality. To stem a series of rubella outbreaks in Thailand (in 1967, 1974 and 1978), the Ministry of Public Health launched the National Expanded Program on Immunization (EPI) in 1986. The Mump-Measles and Rubella (MMR) vaccine was given to all graduated primary school girls. OBJECTIVE: To determine the immune status to rubella in healthy pregnant women visiting the Antenatal Care Clinic (ANC) at Srinagarind University Hospital. DESIGN: Descriptive study. SETTING: Antenatal Care Clinic at Srinagarind Hospital. MATERIAL AND METHOD: Between January15 and May 17, 2004, 150 normal pregnant women (between 15 and 40 years of age) were included. After a complete history was taken and a physical examination performed, informed consent was signed; serum was collected for testing for rubella antibodies at the same time as routine prenatal check up in normal pregnant women including CBC, red blood cell indices, Rh blood group, VDRL, HBs Ag, andAntiHIV The ELISA technique was used to detect maternal rubella IgG antibodies. OUTCOME MEASURE: Rubella IgG antibody level. RESULTS: Three-quarters (112/150) of the pregnant women had immunity to rubella, 7% (11 cases) were indeterminate and 18% (27 cases) had no immunity. CONCLUSION: The cost of screening for rubella IgG antibodies was 150 baht using the HAI technique and 350 baht/case using the ELISA technique. The latter is more available but twice as expensive, so repeating rubella immunization for all high school females would be more cost effective and provide more certain protection.

Adolescent↗
PubMed2005

[Immunization in the elderly--necessary, helpful, superfluous?].

For all adults, vaccinations against tetanus, diphtheria, poliomyelitis, pertussis, TBE (in endemic regions) and specific vaccinations for travelers are recommended. In addition to this standard protection, the Robert-Koch Institute also recommends--in particular for over-60-year-olds--an annual vaccination against influenza, as well as against pneumococci that must be repeated every six years.

Age Factors↗
PubMed2005

Influenza vaccination in Mississippi, 1992-2003: trends, subgroup comparisons, and forecast.

OBJECTIVES: We examined longitudinal trends in relative frequency of influenza vaccination in the state of Mississippi. METHODS: An influenza vaccination questionnaire was used to assess status among 20,078 adults who were sampled in random-digit-dialed telephone surveys administered in 1992, 1993, 1995, 1997, 1999, 2001, 2002, and 2003. Time trends were evaluated using logistic regression models in which the status of influenza vaccination was regressed on the respondents' gender, race, education, and household income. RESULTS: In Mississippi, influenza vaccination rates increased substantially during 1992-2003 irrespective of gender, race/ethnicity, age, education, and household income. The increases showed a significant linear trend. Non-Hispanic blacks were significantly less likely to have been vaccinated for influenza compared to non-Hispanic whites without accounting for gender, age, education, and household income. Having a college degree was associated with higher vaccination rates among older Mississippians after adjusting for other factors. CONCLUSIONS: Although vaccination coverage is increasing, the national goal for 2010 does not appear achievable without new initiatives. Meanwhile, we should continue to provide funding for the immunization program and to educate the population regarding their compliance.

Adolescent↗