北京市昌平区流动儿童计划免疫现状及对策

目的 结合北京市昌平区流动人口特点及相关传染病发病情况进行分析,探索流动人口计划免疫管理对策.方法 对近年来昌平区预防接种情况、相应传染病发病率、计划免疫工作人员情况及流动人口聚集地儿童的免疫接种率及其影响因素等进行综合分析.结果 流动人口传染病发病明显高于该地人口,流动儿童的建卡率、建证率及各种疫苗调查接种率均低于该地儿童.结论 流动人口为昌平区传染病发病的重点人群,流动儿童疫苗接种率较低,流动儿童预防接种管理有待加强.     

做好计划免疫工作 提高适龄儿童预防接种率

有计划地利用疫苗进行适龄儿奄预防接种,以提高人群免疫水平,达到控制以至最终消灭相应传染病。做好寅传教育,规范操作程序,按照科学免疫程序进行预防接种,提高接种质量。改进措施,提高接种率。     

合山市2006—2015年免疫规划疫苗针对传染病的流行特征分析

目的 分析合山市免疫规划疫苗针对传染病流行特征,为进一步探讨防控策略和措施提供参考.方法 采用描述流行病学方法对合山市2006—2015年免疫规划疫苗针对传染病的报告数据进行分析.结果 10年间合山市共报告免疫规划疫苗针对传染病8种4029例,死亡10例.甲肝、破伤风、麻疹和乙脑的年均发病率在0.08/10万~2.68/10万之间,呈低水平发病.流行性腮腺炎和风疹年均发病率分别为21.47/10万和11.73/10万,发病呈下降趋势.肺结核和乙肝发病率最高,年均发病率分别为171.96/10万和100.13/10万,且以20岁以上成年人为主,成年人的肺结核和乙肝分别占全人群发病的97.90%和93.95%.结论 合山市疫苗针对传染病防控效果良好,应继续保持高水平的接种率和对重点人群实施有效的免疫策略.     

如东县掘港镇入园入学预防接种证查验及补种效果分析

入园入学查验预防接种证是保证儿童及时获得国家免疫规划疫苗接种、控制学校相关传染病发生的有效措施[1-2].为了解儿童预防接种证查验及国家免疫规划疫苗接种情况,杜绝校园内免疫空白现象,防止疫苗相关传染病在幼托机构和学校内的传播和蔓延,指导今后的免疫规划工作,根据《江苏省入托入学儿童预防接种证查验及疫苗补种工作实施方案》要求,2013年9月掘港镇卫生所对辖区内新入园入学及转学儿童开展了预防接种证查验工作,现将查验及补种结果报告如下.     

预防接种纠纷及防范对策分析

接种疫苗是预防控制传染病最有效、最经济的方法.随着儿童免疫接种工作全面普及,预防接种纠纷呈增多趋势.本研究立足接种门诊工作实际研究提出了预防接种纠纷形成的原因:疫苗接种反应、预防接种事故、免疫失败、疫苗病例、偶合疾病和医患矛盾激化等.同时提出了包括严格疫苗管理、正确掌握禁忌症、规范接种操作、做好宣传教育和提高接种人员素质等防范预防接种纠纷的对策和措施.     

中国非免疫规划疫苗接种现状和影响因素浅析北大核心

随着中国疫苗事业的不断发展,非免疫规划疫苗作为国家预防接种策略的组成部分在预防传染性疾病中发挥了重要的作用;但是非免疫规划疫苗接种率远低于免疫规划疫苗。本文综述了中国疫苗事业发展历程以及非免疫规划疫苗的应用进程、接种现状和影响因素,展望了非免疫规划疫苗的发展前景。     

健康教育是搞好计划免疫的根本措施

健康教育是计划免疫工作的重要内容。通过健康教育干预免疫预防,普及社区人群对传染病的免疫预防知识,增强自愿免疫预防的自我保健能力,可提高各种疫苗接种率。健康教育是为计划免疫工作创造良好社会环境不可缺少的工作环节和手段,是做计划免疫工作的重要保障。我区自1990年以来,进行计划免疫健康教育,推动了计划免疫工作顺利开展。1 通过大量的信息传播,让社区人群认识到计划免疫的重要性,可提高接种率 计划免疫是根据疫情监测和人群免疫状况分析,按照规定的免疫程序,有计划的利用疫苗进行预防接种,以提高人群免疫水平,达到控制乃至最终消灭针对传染病的目的。计划免疫是预防、控制、消除、消灭危害儿童健康和生命安全传染病的最经     

接种疫苗是预防疾病的必要手段

我国实行预防为主的医疗指导方针.在疾病的预防中,接种疫苗是最重要的预防手段.特别强调在儿童时期规范预防接种,对于防治疾病,尤其是防治传染病非常重要. 我国实行计划免疫政策,根据小儿的免疫特点和传染病发生的情况制定预防接种程序,通过疫苗接种来提高人群的免疫水平,达到控制和消灭传染病的目的.按照国家卫健委的规定,婴儿必须在1岁之内完成卡介苗、乙肝疫苗、脊髓灰质炎疫苗、百白破疫苗、麻疹减毒疫苗的基础免疫.同时,乙型脑炎疫苗、流行性脑脊髓膜炎疫苗、麻腮风疫苗、甲型肝炎病毒疫苗也是计划免疫内需要接种的疫苗.其他疫苗如水痘疫苗、手足口病疫苗、流感疫苗、轮状病毒疫苗等接种,根据自愿原则,自费接种;最近还正在开展3岁以上的儿童新型冠状病毒肺炎疫苗的免费接种.     

预防接种疫苗风险因素分析及应对策略探讨

预防接种疫苗是阻断病原体传播和降低疫苗针对传染病发病率的重要手段。随着我国扩大免疫规划及非免疫规划疫苗品种的增加，以及开展新型冠状病毒疫苗大规模接种以来，南通市通州区辖区内疫苗接种门诊工作量加大，疫苗预防接种风险随之增加。这些风险因素主要来自疫苗本身、受种者自身、预防接种实施过程、当前新冠疫情大背景下人员聚集性接种带来的疾病传播风险等方面。其应对策略在于提高疫苗纯度和质量，规范疫苗进货、运输、储存管理，对受种者进行科学的禁忌症筛查，加强接种人员培训，规范接种流程，精准预约，避免人员聚集，落实消毒措施，降低感染风险等。     

东柳街道疑似预防接种异常反应监测结果

<正>随着我国免疫规划疫苗接种覆盖人群不断扩大,接种率逐年提高,预防接种不良反应的发生也有所增加。通过预防接种,疫苗针对疾病的发病得到了大幅度下降,在低发病的同时,疑似预防接种异常反应(Adverse event following immunization,AEFI)受到越来越广泛的关注。     

中国传染病防治70年成效显著

新中国成立之初,我国的天花、鼠疫、霍乱、痢疾、伤寒、麻疹、白喉、百日咳、流脑、腮腺炎、血吸虫、黑热病、出血热、钩体病、乙脑、斑疹伤寒、疟疾、黑热病、麻风、猩红热、红眼病等传染病肆虐,严重危害人民群众的健康。70年来,我国政府高度重视传染病防治,陆续出台一系列方针政策和法律法规,组织全国力量进行传染病防治,取得了举世瞩目的成就。传染病大规模的暴发、流行已经非常少见,大多数法定管理传染病发病和死亡水平迅速下降,已较长时期维持在低水平。天花被消灭,脊灰、丝虫病、麻风病、新生儿破伤风陆续被消除。麻疹、白喉、百日咳、流脑、乙脑、甲肝、腮腺炎、风疹、结核病等疫苗针对疾病发病均大幅减少并维持在极低水平。儿童乙肝感染和发病明显下降,到达控制阶段性目标。霍乱、痢疾、伤寒等肠道传染病,钩体病、血吸虫病等自然医源性传染病,斑疹伤寒、疟疾、黑热病等虫媒传染病发病降至历史最低,有的接近消除水平。传染病死亡在死因顺位中从第一位降到第十位,传染病防治的成效对提高中国人民的健康水平和期望寿命贡献巨大。     

Report on WHO meeting on immunization in older adults: Geneva,Switzerland, 22–23 March 2017

Many industrialized countries have implemented routine immunization policies for older adults, but similar strategies have not been widely implemented in low- and middle-income countries (LMICs). In March 2017, the World Health Organization (WHO) convened a meeting to identify policies and activities to promote access to vaccination of older adults, specifically in LMICs. Participants included academic and industry researchers, funders, civil society organizations, implementers of global health interventions, and stakeholders from developing countries with adult immunization needs. These experts reviewed vaccine performance in older adults, the anticipated impact of adult vaccination programs, and the challenges and opportunities of building or strengthening an adult and older adult immunization platforms. Key conclusions of the meeting were that there is a need for discussion of new opportunities for vaccination of all adults as well as for vaccination of older adults, as reflected in the recent shift by WHO to a life-course approach to immunization; that immunization in adults should be viewed in the context of a much broader model based on an individual’s abilities rather than chronological age; and that immunization beyond infancy is a global priority that can be successfully integrated with other interventions to promote healthy ageing. As WHO is looking ahead to a global Decade of Healthy Ageing starting in 2020, it will seek to define a roadmap for interdisciplinary collaborations to integrate immunization with improving access to preventive and other healthcare interventions for adults worldwide.     

Adult vaccination coverage--United States, 2010

Immunizations are recommended throughout life to prevent infectious diseases and their sequelae. Adult coverage, however, remains low for most routinely recommended vaccines and well below Healthy People 2020 targets. In October 2011, the Advisory Committee on Immunization Practices (ACIP) approved the adult immunization schedule for 2012. Apart from influenza vaccination, which is now recommended for all adults, other adult vaccines target different populations based on age, certain medical conditions, behavioral risk factors (e.g., injection drug use), occupation, travel, and other indications. To assess adult (≥19 years) vaccination coverage for select vaccines, CDC analyzed data from the 2010 National Health Interview Survey (NHIS). This report summarizes the results of that analysis for pneumococcal, hepatitis A, hepatitis B, herpes zoster (shingles), and human papillomavirus (HPV) vaccines, as well as tetanus antigen-containing vaccines (including tetanus, diphtheria, and acellular pertussis vaccine [Tdap]), by selected characteristics (age, vaccination target group status, and race/ethnicity). Influenza vaccination coverage estimates for the 2010-11 influenza season have been published separately. Compared with results of the 2009 NHIS survey, increases in coverage were observed only for Tdap vaccination for persons aged 19-64 years (1.6 percentage point increase to 8.2%), zoster vaccination among persons aged ≥60 years (4.4 percentage point increase to 14.4%), and ≥1 dose HPV vaccination in women aged 19-26 years (3.6 percentage point increase to 20.7%); coverage for the other vaccines was unchanged at <70%. These data indicate only limited recent improvements in vaccination coverage among adults in the United States. Substantial increases are needed to reduce the occurrence of vaccine-preventable diseases among adults.     

Lebenslanges Impfen

The importance of vaccinations during childhood as a basic element of health care is universally accepted. In contrast a discrepancy can be found in Europe between vaccination recommendations for older people and the actual vaccination rates despite strong evidence for the effectiveness of immunization against the flu, pneumococcal diseases, and other vaccine-preventable infectious diseases. Older Europeans are not sufficiently inoculated against these diseases and thus are not adequately protected. A crucial goal for European health care policy is thus to develop strategies to overcome barriers to vaccination.This brief report summarizes the methods applied worldwide to promote vaccination and lists measures that decision makers should take to improve vaccination rates and thus support healthy aging. The four strategic goals are: (1) promotion of lifelong vaccination programs to lower the burden of disease due to vaccine-preventable infectious diseases and foster healthy aging; (2) improve vaccination rates among medical personnel and strengthen their decisive role as vaccination providers; (3) broaden the range of vaccinations offered to patients; and (4) improve information given to patients and their knowledge.     

Preventing infectious diseases for healthy ageing: The VITAL public-private partnership project

Prevention of infectious diseases through immunisation of the growing ageing adult population is essential to improve healthy ageing. However, many licenced and recommended vaccines for this age group show signs of waning of the protective effect due to declining immune responses (immuno-senescence) and decreasing vaccine uptake. Today’s major challenge is to improve vaccine effectiveness and uptake and to deploy efficient vaccination strategies for this age group. The Vaccines and InfecTious diseases in the Ageing popuLation (VITAL) project, with partners from 17 academic & research groups and public institutes as well as seven industry collaborators, aims to address this challenge. The ambition is to provide evidence-based knowledge to local decision makers. Using a holistic and multidisciplinary approach and novel analytical methods, VITAL will provide tools that allow the development of targeted immunisation programs for ageing adults in European countries. The project is based on four pillars focussing on the assessment of the burden of vaccine-preventable diseases in ageing adults, the dissection of the mechanisms underlying immuno-senescence, the analysis of the clinical and economic public health impact of vaccination strategies and the development of educational resources for healthcare professionals. By the end of the project, a clear, detailed, and integrated program should be available for implementing a consistent, affordable, and sustainable vaccination strategy for ageing adults with regular evaluations of its impact over time.     

Standards for adult immunization practices

Since the Standards for Adult Immunization Practices were first published in 1990, healthcare researchers and providers have learned important lessons on how to better achieve and maintain high vaccination rates in adults. The success rate of childhood immunization far exceeds the success rate of adult immunization. Thus, information and practices that will produce higher success rates for adult vaccination are crucial, resulting in overall societal cost savings and substantial reductions in hospitalizations and deaths. The Standards, which were developed to encourage the best immunization practices, represent the collective efforts of more than 100 people from more than 60 organizations. The revised Standards are more comprehensive than the 1990 Standards and focus on the accessibility and availability of vaccines, proper assessment of patient vaccination status, opportunities for patient education, correct procedures for administering vaccines, implementation of strategies to improve vaccination rates, and partnerships with the community to reach target patient populations. The revised Standards are recommended for use by all healthcare professionals and all public and private sector organizations that provide immunizations for adults. All who are involved in adult immunization should strive to follow the Standards in order to create the same level of success achieved by childhood vaccination programs and to meet the Healthy People 2010 goals.     

Older adults: panoramic view on the COVID-19 vaccination

In December 2020, COVID-19 vaccination started in many countries, with which the world community hopes to stop the further spread of the current pandemic. More than 90% of sick and deceased patients belong to the category of older adults (65 years and older). This category of the population is most vulnerable to infectious diseases, so vaccination is the most effective preventive strategy, the need for which for older adults is indisputable. Here we briefly summarize information about age-related changes in the immune system and present current data on their impact on the formation of the immune response to vaccination. Older age is accompanied by the process of biological aging accompanied by involution of the immune system with increased susceptibility to infections and a decrease in the effect of immunization. Therefore, in the ongoing mass COVID-19 vaccination, the older adults are a growing public health concern. The authors provide an overview of the various types of COVID-19 vaccines approved for mass immunization of the population by the end of 2020, including older adults, as well as an overview of strategies and platforms to improve the effectiveness of vaccination of this population. In the final part, the authors propose for discussion a system for assessing the safety and monitoring the effectiveness of COVID-19 vaccines for the older adults.     

2004—2008年铜川市免疫规划疫苗针对传染病流行特征分析

目的分析2004-2008年铜川市免疫规划疫苗针对传染病流行特征,了解流行趋势,探讨进一步控制疫苗针对传染病的防治措施。方法采用描述流行病学方法,对疫情网2004-2008年疫苗针对传染病的报告数据用Excel系统进行分析。结果2004-2008年脊髓灰质炎、白喉、新生儿破伤风、炭疽和钩体病无病例报告,共报告免疫规划疫苗针对传染病10种10 784例,死亡30例,流脑、百日咳、乙脑、肾综合症出血热、甲肝和风疹的年均发病率在0.07/10万~4.59/10万之间,呈低水平发病;麻疹年均发病率为6.83/10万;流行性腮腺炎年均发病率为22.60/10万,发病有上升趋势;乙肝(133.51/10万)和肺结核(85.64/10万)的发病在较高水平,发病数占总病例数的84.52%,且以成人(20岁~)为主,成人的肺结核和乙肝分别占了91.30%和85.27%。结论免疫是预防控制传染病最为有效的手段,预防和控制疫苗针对传染病应采取以预防接种为主的综合性防治措施,保持高水平的接种率,对重点人群实施有效的免疫策略,增加免疫覆盖面,并做好疫苗针对传染病的疾病监测。     

Acellular pertussis vaccine use in risk groups (adolescents, pregnant women, newborns and health care workers): a review of evidences and recommendations

Background

Pertussis is an acute infectious illness, caused by the bacteria Bordetella pertussis and commonly known as “whooping cough”. Waning immunity after vaccination or after natural infection contributes significantly to the increasing incidence rates in adolescents and adults. Prevention of pertussis in industrialized countries is mainly based on immunization with acellular vaccines in combination with other antigens. A booster dose with an adult-formulation tetanus-diphtheria toxoid and acellular pertussis vaccine (Tdap) is now recommended for all adolescents by several countries, and replacement of the decennial Td dose with a single or more doses of Tdap is recommended for adults.

Objective

Our review aims at describing the current knowledge on the impact of acellular pertussis vaccination in adolescents and adults, with particular focus on specific risk groups: adolescents, pregnant women and their newborns, and health care workers (HCWs), and secondly at suggesting possible immunization strategies.

Methods

Data were retrieved by searches of Pubmed, references, from relevant articles and open-access websites.

Results

In countries where an adolescent booster dose was adopted, a certain decrease of incidence rates was observed. No serologic correlate of protection after immunization exists, but subjects with high antibody levels against pertussis antigens are less likely to develop the disease. Tdap vaccine was demonstrated to induce antibodies to pertussis antigens exceeding those associated with efficacy in infants, in both adolescents and adults. Tdap use in pregnant women seems to be safe and might represent a useful tool in order to prevent pertussis cases in the first months of life. Neonatal immunization with monovalent acellular pertussis vaccine can efficiently prime T and B cells and act as a basis for future immune responses. Cocooning strategies involving all those surrounding newborns have started to be implemented. Their impact on infant pertussis cases will be evaluated in the coming years. Coverage in HCWs should be increased, given their important role in pertussis transmission in health care settings.

Conclusions

Despite the more recent position paper of WHO gives priority to infant and childhood vaccination against pertussis and leaves adolescent, adult and risk group immunization as an option for the future, data are quickly accumulating to support the need to consider pertussis vaccination as a crucial preventative intervention even in adolescents and special risk groups.     

Impfprogramme im Spannungsfeld zwischen individueller Autonomie und allgemeinem Wohl

Vaccinations are among the most effective and cost-effective means to prevent serious infectious diseases. Actual vaccination rates, however, still fall short of their full potential to reduce morbidity and mortality both in industrialized and lowincome countries. Therefore, strategies to increase immunization rates are ethically and economically mandated, raising the following ethical issue: To what extent is it ethically appropriate to restrict individual autonomy by compulsory immunization requirements in order to achieve a sufficient collective protection of the community? Restrictions of individual autonomy are ethically justified if the following five conditions are met: (1) proven benefit, (2) favourable benefit-risk-ratio, (3) acceptable cost-benefit ratio, (4) as little restrictions as possible and (5) fair and transparent decision procedures. Depending on how far these five criteria are met, different strengths of recommendation result for each specific immunization program. However, there are good ethical and pragmatic arguments against compulsory vaccination enforced by law. Rather, one should try to strengthen public support and trust in vaccination programs by a proactive and persuasive information policy.