PubMed Health⌕ Search

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 1,567 records · Page 87Linked to original sources
PubMedDate not supplied

[An epidemic of meningococcal meningitis in the region of Savanes in Togo in 1997: research and control strategies].

Neisseria meningitidis is responsible for high levels of morbidity and mortality in the developing countries of the African meningitis belt. There are frequent meningococcal meningitis epidemics in this region affecting almost 1,000 people in every 100,000 (1%). Epidemics generally occur during the dry season but the interval between epidemics is variable (between 2 and 25 years). The reasons for these recurrent epidemics are unclear. There is a safe and effective polysaccharide vaccine against meningococci A and C. Unfortunately, the immunity it provides decreases with time, especially in young children (aged less than 5 years) and it is thus not included in the Expanded Program on Immunization (EPI). WHO recommends mass vaccination using a threshold approach. This control strategy is effective if vaccination begins very soon after the threshold is crossed. There was an outbreak of group A meningococcal meningitis in the Savanes region of northern Togo in December 1996. The national surveillance system put out an alert and control measures were implemented. These involved improvement of the surveillance system, and containment immunization in villages for early cases followed by a mass immunization campaign in the entire region, distribution of oily chloramphenicol and decentralized case management. The target population for mass vaccination included everyone older than 6 months of age living in the Savanes region. The aim was to vaccinate at least 80% of the target population. There were 2,992 cases of meningitis reported in the Savanes region between December 1996 and May 1997 (in a population of about 500,000). This gives a cumulative incidence rate of 581 per 100,000 population. The epidemic was bimodal, with the first peak in the number of cases occurring at the end of January and the second peak in March. There were 60,700 vaccinations in two of the four districts of the region in December and January, as part of the containment strategy and 346,469 vaccinations in the four districts of the region during February, as part of the mass vaccination campaign. By the end of the mass campaign, 67.3% of the target population in the region as a whole had been vaccinated, with 61% vaccinated in the Kpendjal district and 78% in the Oti district. There was an increase in the number of cases 2 weeks after the end of the mass vaccination campaign. This was attributed to the inadequate level of vaccination achieved. Only 52% of the urban population of Dapaong were vaccinated. The national surveillance system put out an alert early in the epidemic. The intervention was planned and adapted according to the progression of the epidemic, and national and international efforts were well coordinated. This emphasizes the importance of a rapid reaction from the surveillance system and of the choice of strategy for dealing with meningitis epidemics in sub-Sahelian Africa.

Adolescent↗
PubMed2005

The role of BH3-only proteins in the immune system.

Programmed cell death--also known as apoptosis--has a crucial role in the immune system of mammals and other animals. It removes useless cells and potentially dangerous cells, including lymphocytes, and is involved in killing pathogen-infected or damaged cells. Defects in this process have been found to cause or contribute to diseases of the immune system, including immunodeficiency, autoimmunity, lymphoma and leukaemia. This review describes BH3-only proteins, a pro-apoptotic subgroup of the BCL-2 family, and their role in the development and function of the immune system.

Animals↗
PubMed2003

Apoptosis in the development and maintenance of the immune system.

Programmed cell death is essential for the development and maintenance of cellular homeostasis of the immune system. The Bcl-2 family of proteins comprises both pro-apoptotic and anti-apoptotic members. A subset of pro-apoptotic members, called 'BH3-only' proteins, share sequence homology only in the minimal death domain, designated the Bcl-2 homology 3 (BH3) domain. BH3-only proteins operate as upstream sentinels, selectively sensing both intrinsic and extrinsic death stimuli. They communicate this information to the pro-apoptotic 'multidomain' members Bax or Bak--a process that is antagonized by anti-apoptotic members of the Bcl-2 family. The functional balance of pro-apoptotic versus anti-apoptotic influences, which operates at organelles, determines whether a lymphocyte will live or die. BH3-only molecules, often working in concert, compete for downstream multidomain pro- and anti-apoptotic BCL-2 members to control serial stages of lymphocyte development and homeostasis.

Animals↗
PubMed2006

Transcriptional regulator Id2 mediates CD8+ T cell immunity.

Transcriptional programs that initiate and sustain the proliferation, differentiation and survival of CD8(+) T cells during immune responses are not completely understood. Here we show that inhibitor of DNA binding 2 (Id2), an antagonist of E protein transcription factors, was upregulated in CD8(+) T cells during infection and that expression of Id2 was maintained in memory CD8(+) T cells. Although Id2-deficient naive CD8(+) T cells recognized antigen and proliferated normally early after infection, effector CD8(+) T cells did not accumulate because the cells were highly susceptible to apoptosis. Id2-deficient CD8(+) T cells responding to infection had changes in the expression of genes that influence survival and had altered memory formation. Our data emphasize the importance of Id2 in regulating gene expression by CD8(+) T cells and the magnitude of effector responses, suggesting a mechanism involving Id protein- and E protein-mediated survival and differentiation of mature T cells.

Adoptive Transfer↗
PubMed2002

Childhood vaccination providers in the United States.

OBJECTIVES: This study sought to provide a characterization of US childhood vaccination providers. METHODS: The state was used as the analytic unit in examining 1997 data from the National Immunization Survey and the Vaccines for Children program, state immunization reports, and natality records. RESULTS: Overall, 57% of children were vaccinated in the private sector, 18% were vaccinated in the public sector, and 25% were vaccinated by a mixture of providers. Of the 50 883 immunization sites, 81% were private and 19% public. Average patient load was 77 infants per site. Private-sector patient loads were lower than public-sector loads. CONCLUSIONS: US childhood vaccination provider capacity is adequate. Efforts to raise coverage rates should focus on increasing preventive care use among children, improving the vaccination performance of providers, and ensuring continuity of care.

Child↗
PubMed1999

Impact of North Carolina's universal vaccine purchase program by children's insurance status.

OBJECTIVE: To examine the impact of a new universal purchase vaccine program on immunization rates of children with different types of insurance. DESIGN: Ecologic study using parent telephone interviews, medical chart abstraction in sites of outpatient care, and insurance verification with Medicaid and private insurers. SETTING: State of North Carolina. PARTICIPANTS: Of a random birth certificate sample of 4385 children born in North Carolina during 1994 and 1995, 507 were excluded. A total of 2767 children had completed parent interviews; 95% of those had medical chart abstraction and insurance data. MAIN OUTCOME MEASURES: Immunization rates at each month during the first 2 years of age, site of delivery for immunizations and well-child visits, and insurance status. RESULTS: In month-by-month comparisons, children born in 1995 had immunization rates 4% to 10% higher than their 1994 counterparts. By 24 months of age, 84% of the 1995 cohort had completed the primary immunization series, compared with 79% of the 1994 cohort (P<.001). In all insurance subgroups, 1995 immunization rates were higher than 1994 rates. The largest increases occurred among privately insured children with no well-child coverage, children who had periods of being uninsured, and children enrolled in Medicaid exclusively or with private insurance. More children in the 1995 cohort received immunizations in the private sector. CONCLUSIONS: Implementation of North Carolina's universal purchase program was associated with improved immunization rates, especially for children with inadequate insurance for well-child care. However, insurance status still influences the ability of children to receive immunizations on schedule.

Adolescent↗
PubMed1994

Immunization requirements for pharmacy students.

OBJECTIVE: To identify current immunization requirements for pharmacy students throughout the US. DESIGN: Self-administered questionnaire. SETTING: Seventy-five colleges and schools of pharmacy in the US. MAIN OUTCOME MEASURES: Immunization policies, immunologic requirements, timing of vaccination in relation to the beginning of clerkship experience, payment, mechanism to revise policies. DATA ANALYSIS: Descriptive statistics. RESULTS: Overall, 57 programs (81 percent) have an immunization program in place, but 13 programs (19 percent) have no immunization program. More than 50 percent of the colleges or schools reported requiring that pharmacy students have measles, mumps, rubella, tetanus, and purified protein derivative of tuberculin (PPD) vaccinations upon entry of clerkship. Only 25 college or schools of pharmacy (44 percent) required students to have the hepatitis B vaccine and 8 (14 percent) to have a PPD evaluation upon completion of clerkship experience. Responsibility for the immunization program was shared evenly between the clerkship coordinator and the student health clinic. Approximately 65 percent of programs maintain an immunization record on file for each student. Completion of immunizations was required in 36 schools (64 percent) before entering clerkship activities, 15 (26 percent) before entrance to the professional program, and 3 (5 percent) in the first year of the program. Six schools (11 percent) had a program in place for less than one year, 27 (47 percent) between one and five years, and 24 (42 percent) for more than five years. At the majority of schools, students are responsible for the cost of immunization. CONCLUSIONS: Most schools of pharmacy do not adhere to the specific immunization recommendations described by the Centers for Disease Control and Prevention for healthcare workers. Pharmacy schools need to reexamine their immunization policies and update them to reflect the most current standards. We suggest a policy for immunization of pharmacy students.

Clinical Clerkship↗
PubMedDate not supplied

Four years of lessons learned: The 2001-2004 Maryland influenza prevention seasons.

More than 36,000 Americans die and 200,000 more are hospitalized because of influenza every\year. Despite the wide availability of a vaccine to prevent influenza, the vast majority of Americans go unimmunized. The Maryland Department of Health and Mental Hygiene (DHMH) and the Maryland Partnership for Prevention (MPP) collect data about the state's local health departments' influenza season practices and experiences and compile them into the annual Maryland Influenza Season Final Report. The report becomes a tool for DHMH, MPP, and the state's 24 local health departments to plan improvements in influenza vaccination services. This article chronicles four influenza seasons. Influenza season challenges experienced in three of the last four influenza seasons underscore the importance of coordination and communication efforts to ensure that vaccine is efficiently delivered to the most vulnerable populations. The partnership between DHMH and MPP has facilitated access to information on ordering and administration practices, communication systems, community partnerships, and lessons learned, thus enabling the state of Maryland to continually optimize its influenza vaccination promotion efforts.

Communication↗
PubMed2005

Cost effectiveness analysis of strategies for child health in developing countries.

OBJECTIVE: To determine the costs and effectiveness of selected child health interventions-namely, case management of pneumonia, oral rehydration therapy, supplementation or fortification of staple foods with vitamin A or zinc, provision of supplementary food with counselling on nutrition, and immunisation against measles. DESIGN: Cost effectiveness analysis. DATA SOURCES: Efficacy data came from published systematic reviews and before and after evaluations of programmes. For resource inputs, quantities came from literature and expert opinion, and prices from the World Health Organization Choosing Interventions that are Cost Effective (WHO-CHOICE) database, RESULTS: Cost effectiveness ratios clustered in three groups, with fortification with zinc or vitamin A as the most cost effective intervention, and provision of supplementary food and counselling on nutrition as the least cost effective. Between these were oral rehydration therapy, case management of pneumonia, vitamin A or zinc supplementation, and measles immunisation. CONCLUSIONS: On the grounds of cost effectiveness, micronutrients and measles immunisation should be provided routinely to all children, in addition to oral rehydration therapy and case management of pneumonia for those who are sick. The challenge of malnutrition is not well addressed by existing interventions.

Child↗
PubMed2000

[Development of immunizing agents against dengue].

The four serotypes of dengue flaviviruses are transmitted mainly by the Aedes aegypti mosquito, and some epidemics have been attributed to Ae. albopictus, Ae. polynesiensis, and various species of the Ae. scutellaris complex. The risk factors involved in dengue mortality and morbidity are related to the human host (genetic characteristics of infected persons; lifestyles, immune status, and health conditions of people; basic sanitation of dwellings; and water supply) and to the virus (genetic variability between and among serotypes, different pathogenicities, and geographic distribution). Notwithstanding the lack of knowledge of the immunopathobiology of dengue fever, important advances have been made in terms of a protective immune response, using attenuated dengue viruses or antigens produced by means of recombinant technologies. Efforts have been made since the 1940s to develop dengue vaccines. Immunity acquired from natural infection is specific for each serotype, and as many as three different serotype infections have been reported in one individual. For this reason, a tetravalent vaccine may likely be needed. Candidate vaccines against the four serotypes have been tested in volunteers and have proven to be immunogenic and safe. Although attenuated live virus vaccines are promising, more study is needed regarding their effectiveness and safety. Currently, several studies are ongoing to develop dengue vaccines using antigens from structural proteins (particularly E glycoprotein) and nonstructural proteins, with recombinant DNA technology and other biomolecular technologies. With the same goal, various expression vectors are being used, including Escherichia coli, baculovirus, vaccinia virus, and yellow fever virus. Unfortunately, no satisfactory results have been obtained in humans. The need for effective dengue vaccines is great, given the serious worldwide problem of the transmission of the four serotypes. Effective immunization against dengue would contribute to its prevention, with a positive cost-benefit relationship. Endemic dengue affects young children, and they should be immunized through the Expanded Program on Immunization.

Antigens, Viral↗
PubMed2002

Report of the WHO Commission on Macroeconomics and Health: a critique.

The World Health Organization has been able to interest some of the world's top economists in joining the Commission on Macroeconomics and Health, to study macroeconomics of health services for the poor peoples of the world. The commission has been ahistorical, apolitical, and atheoretical. It has adopted a selective approach to conform to a preconceived ideology. It has ignored earlier work done in this field. And it has pointedly ignored such major developments in the health services as the Alma-Ata Declaration. These failings have brought the quality of the scholastic work to an almost rock-bottom level. The commission's tunnel vision in its recommendations on so important a subject is not surprising. Its emphatic recommendations for perpetuating vertical programs against major communicable diseases (tuberculosis, AIDS, and malaria) on the grounds that such programs have proved convenient to "donors" reveals the real motivations for an almost openly ideology-driven agenda. This is a serious danger signal for scholars who wish to take a scientific attitude toward program formulations for the poor that provide maximum returns from limited resources. The concept of DALYs (disability adjusted life years) is bristling with gross infirmities. The WHO-generated data used for DALY calculations, converted into dollar terms, are patently invalid, unreliable, and not comparable between and even within countries.

Acquired Immunodeficiency Syndrome↗