镇沅县2006-2010年村级实施免疫规划定点接种的效果分析

目的村级实施免疫规划定点接种降低疫苗损耗,提高接种率分析.平均从2006年的94.14%村级实施预防接种定点接种后疫苗损耗率降低,接种率提高的评价.方法采用我县五年来124个接种点实施儿童预防接种定点接种常规免疫报告疫苗使用损耗和接种率进行统计分析.结果我县实施定点接种前2005年“五苗”损耗系数平均为3.18,接种率平均为91.17%,实施定点接种5年来,“五苗”损耗系数平均为1.50,接种率平均为97.41%,实施定点接种后,“五苗”损耗系数逐年降低,分别为2006年2.04、2007年1.71、2008年1.38、2009年1.27、2010年1.11,接种率逐年提高,分别为2006年97.02%、2007年96.95%、2008年97.85%、2009年98.15%、2010年97.06%.结论定点接种优于分散接种.     

潍坊市2003～2005年儿童计划免疫基础五苗及时接种情况分析

目的了解农村和城区儿童计划免疫"基础五苗"及时接种情况,分析影响及时接种的因素,提出改进措施。方法根据2006年全市的免疫预防工作综合检查接种率调查资料,分析2003～2005年出生的农村和城区儿童的"基础五苗"接种情况。结果农村地区116名2003～2005年出生的儿童"基础五苗"的及时接种率分别为:卡介苗43.75～56.82%、乙肝首针及乙肝疫苗全程87.5～100%,脊灰疫苗、百白破三联疫苗95.45～100%,麻疹疫苗80～100%。城区120名2003～2005年出生儿童的及时接种率分别为:卡介苗86.36～88.64%,乙肝首针及全程84.38～97.72%,脊灰疫苗87.5～95.45%,百白破三联疫苗93.75～95.45%,麻疹疫苗87.5～97.72%。结论:及时提高接种率水平,为儿童建立免疫屏障提供依据。     

2010年宜昌市免疫规划疫苗损耗系数及其影响因素调查

为了掌握宜昌市各地免疫规划疫苗的损耗水平及其影响因素,以便指导疫苗概算和分配计划.为不同地区采取适当的接种方式提供科学依据,按不同地区调查9个县级单位、宜昌市城区21个预防接种门诊,统计各种疫苗损耗率.结果显示:十一种疫苗中,多人份疫苗损耗系数较大,卡介苗为3.39,A群流脑为1.75;单人份疫苗损耗系数差别不大;十一种疫苗平均损耗系数在不同地域类型有显著差异:城市最低(1.33),平原县(1.53)次之,山区县(1.76)最高,供应多人份大包装的疫苗是造成疫苗损耗的直接因素.提示应按不同地域类型计划分配疫苗.     

2个居民区0～7岁儿童计划免疫现状及影响因素分析

目的 探讨影响儿童免疫规划的因素.方法 抽取2个居民小区的1 205名0～7岁儿童,采用相关知识问卷及核查疫苗接种记录的方式,对入组儿童的疫苗接种情况、居住地变更情况、父母文化程度、家长对接种疫苗的态度以及家长免疫规划相关知识的掌握程度做详细调查.结果 2个小区0～7岁儿童计划免疫建卡率为93.61%;五苗的接种率分别为麻疹类疫苗96.38%、卡介苗96.33%、脊髓灰质炎疫苗95.87%、乙肝疫苗94.29%、百白破疫苗96.01%,"五苗"全程接种率为94.59%.结论 0～7岁儿童的计划免疫现状较好,但流动儿童与本区常住儿童相比疫苗接种率和"五苗"全程接种率均较低.所以,应加强流动儿童免疫规划的宣传教育工作,以减少相应传染病的发生率.     

12月龄内儿童五苗免疫及时接种率调查分析

目的了解宁海县跃龙街道城关医院辖区儿童免疫及时接种率情况,提高疫苗接种效果,为控制可免性疾病提供参考依据。方法抽取符合本次调查研究要求辖区户籍儿童、县内流动儿童、外县流动儿童各100名,对12月龄内儿童"五苗"及时接种情况、12月龄内儿童未及时进行"五苗"免疫接种的原因进行回顾性分析。结果 300名12月龄内儿童基础免疫卡介苗的及时接种率为98.7%,脊髓灰质炎疫苗(OPV)的及时接种率为87.7%,百白破混合制剂(DPT)的及时接种率为83.7%,麻疹疫苗(MV)的及时接种率为95.0%,乙型肝炎疫苗(HBV)的及时接种率为94.7%。结论要进一步加大计划免疫接种的宣传力度,增加儿童家长及时带儿童进行免疫接种的意识,同时进一步加大对流动儿童免疫及时接种的管理力度,以进一步提高五苗接种的及时率。     

宁波市2004年疫苗损耗监测评估

为及时了解宁波市预防接种点的疫苗使用情况，科学地制定疫苗使用计划，我们于今年4-10月在镇海区开展常规接种疫苗（卡介苗BCG、脊灰三价糖丸TOPV、百白破三联疫苗DPT、麻疹减毒活疫苗MV）的损耗监测，现将监测结果评估如下。     

宁波市2004年疫苗损耗监测评估

为了及时了解宁波市预防接种点的疫苗使用情况，科学地制定疫苗使用计划，我们于2004年4-10月在镇海区开展常规接种疫苗（卡介苗BCG、脊灰三价糖丸TOPV、百白破三联疫苗DPT、麻疹减毒活疫苗MV）的损耗监测，现将监测结果评估如下。     

新泰市计划免疫实行乡镇定点、定时接种情况调查

新泰市自1998年开始以乡镇为单位建立接种门诊，实行集中式接种，为了解建证、建卡率，卡介苗(BCG)、脊髓灰质炎疫苗(OPV)、百百破三联制剂(DPT)、麻疹疫苗(MV)、乙肝疫苗(HBV)(以下统称“五苗”)全程接种率和及时接种情况以及影响因素，进一步推动儿童计划免疫工作，于2003年10月抽取部分0～4岁儿童进行调查。     

基于全科医护团队网格化管理对"家庭式流动"儿童免疫规划的影响

目的探讨基于全科医护团队网格化管理对社区"家庭式流动"儿童免疫规划的影响。方法采用便利抽样法从郑州市4个辖区(管城区、金水区、二七区、郑东新区)内5家社区卫生服务中心抽取660名0～6岁儿童的家长或监护人作为调查对象,现场发放调查问卷。调查"家庭式流动"儿童国家免疫规划(NIP)疫苗接种情况,包括卡介苗(BCG)、脊髓灰质炎疫苗(OPV)、百白破疫苗(DPT)、麻疹疫苗(MV)、乙肝疫苗(HepB)。统计基于全科医护团队网格化定位管理后"家庭式流动"儿童的计划免疫接种率。了解流动儿童未及时接种的原因。另抽查郑州市某社区2014—2018年流动儿童基础疫苗完成率和加强疫苗完成率。结果回收有效问卷616份,回收率为93.33%。外省户籍和无户籍流动儿童NIP疫苗接种率低于本省外市户籍流动儿童,外省户籍和无户籍流动儿童NIP疫苗接种率低于本市外区户籍的流动儿童,差异有统计学意义(均P<0.05)。流动儿童基础免疫接种率(BCG接种率、OPV接种率、DPT接种率、MV接种率、HepB接种率、五苗接种率、五苗合格率)均低于常住儿童接种率,差异有统计学意义(均P<0.05)。流动儿童未及时接种的主要原因为监护人工作忙而忘记接种程序及时间或没时间带儿童去接种。实施全科医护团队网格化管理后,2018年五苗全程接种率高于2014年五苗全程接种率,差异有统计学意义(P<0.05)。0～6岁流动儿童基础疫苗完成率和加强疫苗完成率呈现整体上升的趋势。结论流动儿童基础免疫疫苗接种率较低,特别是外省和无户籍的流动儿童。基于全科医护团队网格化定位管理流动儿童计划免疫接种,能有效促进流动儿童疫苗接种率的提高。     

2007∽2011年儿童免疫规划疫苗接种率调查分析

目的了解该接种门诊儿童免疫规划疫苗接种情况,为免疫预防提供科学依据。方法根据我科儿童预防接种信息管理系统的资料,对2007年1月1日—2011年12月31日之间出生的儿童国家免疫规划疫苗的接种情况进行分析。结果该接种门诊五苗的接种率分别为卡介苗和乙肝疫苗第1、2剂〉98%,乙肝疫苗第3剂〉94%（2010年除外）,脊髓灰质炎疫苗〉95%,百白破联合疫苗和麻疹疫苗〉93%;及时接种率分别为卡介苗〉90%,乙肝疫苗第1、2剂〉93%,乙肝疫苗第3剂〉83%,脊髓灰质炎疫苗〉80%,百白破联合疫苗〉86%,麻疹疫苗〉78%;加强免疫（或复种）接种率分别为脊髓灰质炎疫苗〉52%,百白破联合疫苗〉63%,含麻疹类疫苗〉71%。结论各种疫苗的接种率均处于较高水平,但是及时接种率低于接种率,加强免疫（或复种）接种率低于基础免疫（或初种）。需进一步加强疫苗的接种和及时接种。     

Effect of warming adult diphtheria-tetanus vaccine on discomfort after injection: a randomised controlled trial

OBJECTIVE: To determine whether warming or rubbing adult diphtheria tetanus (ADT) vaccine immediately before administration affects its temperature and reduces the incidence of pain. DESIGN: Double-blind, randomised controlled trial and in-vitro temperature study. SETTING: Emergency department (ED) of a regional hospital between April and December 2001. PATIENTS: Convenience sample of 150 patients aged 16 years or over who presented to the ED requiring ADT booster vaccination. INTERVENTION: Patients were randomised to receive vaccine that was "cold" (no deliberate warming), "rubbed" between the palms for 1 minute, or "warmed" in a 37 degrees C incubator; vaccine was administered as recommended in Australian guidelines. MAIN OUTCOME MEASURES: Incidence of pain and pain score on McGill Present Pain Intensity Questionnaire at 5 minutes, 24 hours and 48 hours after injection; and temperature of vaccine after preparation for simulated administration. RESULTS: The "cold" vaccine had significantly lower temperature (mean, 19.1 degrees C; 95% CI, 17.5-20.7 degrees C) than the "warmed" vaccine (mean, 28.9 degrees C; 95% CI, 28.4-29.4 degrees C) and "rubbed" vaccine (mean, 26.9 degrees C; 95% CI, 24.5-29.3 degrees C). There was no significant difference in incidence of pain between the groups who received vaccine prepared in different ways at any follow-up (5 min: P = 0.62; 24 h: P = 0.58; 48 h: P = 0.61) or overall (P = 0.99). Among those who completed follow-up, incidence of pain at any time was 77/138 (56%); there was no difference in their time-averaged pain scores (P = 0.63) or peak pain scores (P = 0.60). CONCLUSIONS: Warming or rubbing ADT vaccine does not reduce the incidence of pain after administration. Regardless of how ADT vaccine is prepared, its temperature approaches ambient by the time it is injected.     

猪圆环病毒疫苗研究进展

猪圆环病毒主要侵害断奶仔猪和育肥猪,可以引起多种猪圆环病毒相关性疾病,养猪业的健康发展带来巨大威胁。本文结合国内外对猪圆环病毒疫苗的研究结果,对其研究进展进行了综合论述,并对新型猪圆环病毒疫苗的研究作了展望,为有效防控该病提供参考。     

The ERA strain of rabies vaccine

An antigenic extinction trial in cats showed that the ERA rabies vaccine had superior antigenic properties over Flury H.E.P. C.E.O. and killed tissue culture rabies vaccine.Dogs and cats on a duration of immunity study of ERA rabies vaccine were challenged with fox salivary gland "street" rabies virus. The results of this challenge show a duration of immunity of five years in dogs and four years in cats.Vaccination of dams in late pregnancy with ERA rabies vaccine resulted in transference of maternal antibody to the newborn, in both cattle and dogs. This maternally derived antibody interfered with the successful active immunization of the young calf. Calves free of antibodies for rabies could be successfully vaccinated as early as 17 days of age and were able to withstand a challenge with virulent "street" rabies virus two years later.     

Hepatitis B Immunisation in Health Care Workers

Background

Hepatitis B virus (HBV) infection is an important occupational risk in health care workers (HCW). In spite of HBV vaccine availability in Armed Forces, the high prevalence of HBV infection in HCW continues to be a problem. The study was undertaken to study the HBV vaccine-compliance among HCW.

Methods

A cross-sectional study was conducted at a tertiary care hospital. HCW were requested to fill up the pre set questionnaire to assess the HBV vaccination coverage.

Result

Amongst 254 HCW, only 57.7% were vaccinated against HBV. The vaccine compliance was lowest among housekeeping professionals. The mean age at vaccination was high (30.5 years). Amongst the vaccine non-compliant subjects, 34.3% were above 30 years of age. 32.2% HCW completed primary vaccination after spending more than 10 years in the profession. Accessibility of HBV vaccine, knowledge and perception of HBV risk were important factors in vaccine non-compliance.

Conclusion

Due to low and delayed HBV vaccine-compliance, HCW continue to be at the risk of occupational HBV. Health education highlighting occupational risk of HBV, accessibility of vaccine and mandatory vaccination of HCW is recommended to increase HBV vaccine compliance among HCW.Key Words: Health care workers, Hepatitis B virus, Occupational risk, Hepatitis B vaccine     

Measles in the 1980s

We detail aspects of measles immunization programmes in several countries. Live measles vaccine has been available in Australia for 16 years, yet, in 1981, there were outbreaks of measles in the State of New South Wales (population 5 200 000) which led to 2200 admissions to hospital and five deaths. In response to complaints of "vaccine failure", a survey determined that 22.5% of children with measles seen by general practitioners and 10.3% of those admitted to hospitals had been previously immunized. There was no evidence of waning immunity, and noparticular batch of vaccine was implicated. The vaccine failures are attributed in part to failure of seroconversion in some recipients when immunized at 12 months of age as a result of interference by transplacentally acquired antibodies. As more of the susceptible population is vaccinated, there will be fewer cases of measles, but among these cases will be an increasing proportion of cases occurring in previously vaccinated individuals. The equation to calculate this expected proportion of "vaccine failures" is given. We support the measures to increase immunization compliance.     

Ethical issues in using a cocaine vaccine to treat and prevent cocaine abuse and dependence

A "cocaine vaccine" is a promising immunotherapeutic approach to treating cocaine dependence which induces the immune system to form antibodies that prevent cocaine from crossing the blood brain barrier to act on receptor sites in the brain. Studies in rats show that cocaine antibodies block cocaine from reaching the brain and prevent the reinstatement of cocaine self administration. A successful phase 1 trial of a human cocaine vaccine has been reported. The most promising application of a cocaine vaccine is to prevent relapse to dependence in abstinent users who voluntarily enter treatment. Any use of a vaccine to treat cocaine addicts under legal coercion raises major ethical issues. If this is done at all, it should be carefully trialled first, and only after considerable clinical experience has been obtained in using the vaccine to treat voluntary patients. There will need to be an informed community debate about what role, if any, a cocaine vaccine may have as a way of preventing cocaine addiction in children and adolescents.     

Antibody to Hepatitis B Surface Antigen in Vaccinated Health Care Workers

Background

Health care workers (HCWs) in Armed Forces are immunised against Hepatitis B virus (HBV), however they are not subjected to anti-HBs (antibody to Hepatitis B surface antigen) assessment after primary vaccination. The present study was undertaken to determine the protection offered by HBV vaccine in HCW.

Methods

Cross-sectional study was carried out at tertiary care hospital. A total 146 HBV vaccine compliant HCW were evaluated for quantitative anti-HBs by enzyme immune assay.

Result

129 (88.4%) subjects had protective levels of anti-HBs. Higher age at vaccination was an important risk factor in low vaccine response. Decline in anti-HBs with time was evident. Anti-HBs levels were more than 10mIU/ml in subjects even after 11 years of primary vaccination. There was no difference in protection in booster and non booster groups.

Conclusion

Age is the most important factor in HBV vaccine response. Booster dose of HBV vaccine is not necessary in healthy HCW for atleast ten years after primary vaccination. The study recommends early primary vaccination of HCW and ‘initial’ anti-HBs assay for confirmation of vaccine response.Key Words: Anti-Hepatitis B surface antigen, Health care workers, Hepatitis B virus vaccine     

Using Electronic Medical Records to Enhance Detection and Reporting of Vaccine Adverse Events

We implemented an automated vaccine adverse event surveillance and reporting system based in an ambulatory electronic medical record to improve underreporting and incomplete reporting that prevails in spontaneous systems. This automated system flags potential vaccine adverse events for the clinician when a diagnosis is entered, prompts clinicians to consider the vaccine as a cause of the condition, and facilitates reporting of suspected adverse events to the Vaccine Adverse Event Reporting System (VAERS).During five months, a total of 33,420 vaccinations were administered during 14,466 encounters. There were 5,914 follow-up contacts by vaccinees within 14 days of the vaccination visits; 686 (11.6%) generated an alert. Clinicians submitted VAERS reports for 23 of these (0.69 per 1,000 vaccine doses), which is almost 6 times the dose-based reporting rate to VAERS. ¹ Clinician surveys indicated that it took a minimal amount of time to respond to the alerts. Of those who felt that an alert corresponded to an actual vaccine adverse event, the majority used the reporting feature to file a VAERS report.We believe that elicited surveillance via real time prompts to clinicians holds substantial promise. By coupling simplified reporting with the initial prompt, clinicians can consider and report a vaccine adverse event electronically in a few moments during the office visit.     

Judge "not satisfied" that whooping cough vaccine causes permanent brain damage

A report is given of the British High Court ruling which, unless overturned on appeal, will stop all future payments under the government's no fault scheme for compensation for permanent brain damage caused by the pertussis vaccine. The Lord Justice indicated that although he had believed that the vaccine could cause permanent brain damage when he had embarked on the case, he was more impressed by the "quality of evidence and reasoning" of the ten experts called by the vaccine manufacturer than by the mechanism of injury proposed by the nine experts called by the plaintiff. He also concluded that examination of the data compiled by the National Childhood Encephalopathy Study failed to show that brain damage was caused by the vaccine rather than by an underlying condition.     

Towards the development of the ideal malaria vaccine. A decade of progress in a difficult field

Malaria remains one of the world's most serious diseases, affecting the lives of up to 500 million people. The rapid development of drug resistance enhances the need for the development of a vaccine. Since the first cloning of malaria proteins early in the last decade, there have been a number of "subunit" vaccine trials involving humans and monkeys. During this time, our understanding of the basic immunobiology of malaria has increased; different immune mechanisms are required to combat the different stages in the life cycle of the parasite, and the future vaccine will have to stimulate these different effector mechanisms. There has been steady progress over the last decade toward an effective vaccine, but a great deal of further effort is still required.