A general measles vaccination campaign in urban Guinea-Bissau: Comparing child mortality among participants and non-participants

BackgroundMeasles vaccination campaigns targeting children aged 9–59 months are conducted every three years in Guinea-Bissau. Studies have demonstrated beneficial non-specific effects of measles vaccine. We compared mortality one year after the December 2012 measles vaccination campaign in Bissau city for children who received campaign measles vaccine with children who did not receive campaign measles vaccine.MethodsField workers from Bandim Health Project registered all children living in the Bandim Health Project’s study area who received measles vaccination at the campaign posts. Children not seen during the campaign were visited at home and campaign participation status was assessed. We compared mortality rates of participants vs. non-participants in Cox regression models.Results5633 children aged 9–59 months (85%) received campaign measles vaccination and 1006 (15%) did not. During the subsequent year 16 children died. Adjusted for background factors, the hazard ratio (HR) comparing measles vaccinated versus unvaccinated was 0.28 (95% CI: 0.10–0.77). The benefit was larger for girls (HR: 0.17 (0.05–0.59)) and for children who had received routine measles vaccine before the campaign (HR: 0.15 (0.04–0.63)).ConclusionsWe found indications of strong beneficial non-specific effects of receiving measles vaccine during the 2012 campaign, especially for girls and children with previous routine measles vaccination. Measles vaccination campaigns may be an effective way of improving child survival.     

江西省2000年口服脊髓灰质炎疫苗"扫荡"式免疫活动实施状况分析

江西省于2000年3、4月,在全省开展了两轮口服脊髓灰质炎疫苗"扫荡"式免疫,接种对象为1995年1月1日以后出生的儿童.两轮各接种了2331312人和2365016人,其中包括"零"剂次免疫儿童63883人和40415人,分别占服苗人数的2.72%和1.68%.与1999/2000年度强化免疫相比较,"扫荡"式免疫同年龄组服苗人数的增幅均＞8%."扫荡"式免疫两轮报告接种率为99.11%和99.19%;快速调查接种率为97.85%和98.58%.快速调查发现不同居住形式、不同服苗场所目标儿童服苗率的差异有显著的统计学意义.     

Geospatial variation in measles vaccine coverage through routine and campaign strategies in Nigeria: Analysis of recent household surveys

Measles vaccination campaigns are conducted regularly in many low- and middle-income countries to boost measles control efforts and accelerate progress towards elimination. National and sometimes first-level administrative division campaign coverage may be estimated through post-campaign coverage surveys (PCCS). However, these large-area estimates mask significant geographic inequities in coverage at more granular levels. Here, we undertake a geospatial analysis of the Nigeria 2017–18 PCCS data to produce coverage estimates at 1 × 1 km resolution and the district level using binomial spatial regression models built on a suite of geospatial covariates and implemented in a Bayesian framework via the INLA-SPDE approach. We investigate the individual and combined performance of the campaign and routine immunization (RI) by mapping various indicators of coverage for children aged 9–59 months. Additionally, we compare estimated coverage before the campaign at 1 × 1 km and the district level with predicted coverage maps produced using other surveys conducted in 2013 and 2016–17. Coverage during the campaign was generally higher and more homogeneous than RI coverage but geospatial differences in the campaign’s reach of previously unvaccinated children are shown. Persistent areas of low coverage highlight the need for improved RI performance. The results can help to guide the conduct of future campaigns, improve vaccination monitoring and measles elimination efforts. Moreover, the approaches used here can be readily extended to other countries.     

Seroprevalence of anti-polio antibodies in a population 7 months to 39 years of age in Uruguay: Implications for future polio vaccination strategies

This study evaluated the seroprevalence of poliovirus types 1, 2 and 3 antibodies and vaccination coverage in 780 subjects aged between 7 months and 39 years in Montevideo, Uruguay, where oral polio vaccine (OPV) is used. Antibody titers were measured and seroprotection rates and geometric mean titers (GMTs) were compared among four age groups. Vaccination histories were recorded from documents and interviews. Seroprotection rates ranged from 72% to 95% in children aged 7–23 months, 31–77% in 2–9-year olds, 14–45% in 10–19-year olds and 20–59.5% in 20–39-year olds. Seroprotection decreased significantly with increasing age (p < 0.05). Polio vaccination coverage was >90% for the two youngest age groups. These results could help guide public policy decisions regarding polio vaccination, and support the use of inactivated polio vaccine following cessation of OPV.     

云南省1997/1998年度强化免疫活动服苗率快速评估结果分析

自１９９０年以来，云南省已连续开展了全省性和省内局部地区强化免疫活动１７轮次，累计口服脊髓灰质炎（脊灰）疫苗人数达３５９０．３１８万人。１９９７年１２月及１９９８年１月，按卫生部要求再次组织开展了２轮强化免疫活动。本地儿童和外地儿童报告服苗率均在９５％以上。两轮服苗工作结束后，云南省和日本国际协力事业团（ＪＩＣＡ）中国控制脊灰项目有关专家，应用服苗率快速评估的方法，对云南省昆明等７个地区（州、市）部分县的服苗率进行了评估，共调查９０９人。通过评估，调查服苗率与报告服苗率有较大差距，外地流动儿童服苗率比本地儿童低，在外地流动儿童中，“零”剂次免疫儿童仍占较大比例。     

广东省2009年麻疹疫苗强化免疫接种情况分析

[目的]对广东省2009年实施麻疹疫苗(MV)初始强化免疫的接种情况进行分析,为后续MV强化免疫提供经验。[方法]分析强化免疫期间的现场调查、评估报告和强化免疫前后的麻疹疫情资料。[结果]强化免疫共计接种目标儿童19952519人,报告接种率和快速评估接种率均﹥95%,快速评估接种率高于报告接种率(χ2=8.56,P﹤0.01)。各市报告接种率和快速评估接种率均﹥95%,其中深圳和中山快速评估接种率低于报告接种率,湛江、揭阳和云浮快速评估接种率高于报告接种率。用国家统计局的2008年末广东省人口资料估算接种率为90.19%;用广东统计年鉴2009公布的小学在校生数估算的小学生接种率为83.81%,第一批强化免疫的小学生估算接种率高于第二批,差异有统计学意义(χ2=263151.08,P﹤0.01)。强化免疫活动后的麻疹报告年发病率比强化免疫前下降了93.14%。[结论]本次麻疹疫苗强化免疫接种达到了预期目标,有效控制了广东省麻疹疫情。     

2007年四川省部分地区麻疹强化免疫接种分析

目的对2007年四川省部分地区实施麻疹疫苗（MV）强化免疫的接种率进行分析,为2008年17个市州开展麻疹强免提供经验,加速麻疹控制与消除的工作进展。方法综合分析强化免疫期间的现场调查和各地上报的项目总结和报表等资料。结果强化免疫共计接种目标儿童3980978人,报告接种率和快速评估接种率均〉95％,2者无统计学差异（X^2=3．75,P〉0．05）;接种目标儿童数〉摸底调查时统计的应种儿童数（3937372人）〉2006年四川省计免／冷链基本情况报表报告的儿童数（3610323人）。以疫苗使用情况进行估算,其接种率达到96．33％,与报告接种率比较D值=2．45％;以省统计局提供的人口数进行估算,接种率达到91．95％．与报告接种率比较D值=6．83％;以2006年四川省计免／冷链基本情况报表的人口数进行估算,其接种率达到110．27％,与报告接种率比较D值=11．49％。结论该次麻疹疫苗强化免疫达到了预期目标。     

Using oral polio vaccine beyond the cold chain: A feasibility study conducted during the national immunization campaign in Mali

We conducted the first systematic documentation of using oral polio vaccine (OPV) out of the cold chain during national immunization day (NID) campaigns in Mali. Using a crossover intervention design, vaccinators compared the transport of OPV in vaccine carriers with or without ice packs. Vaccine integrity was assured through monitoring vaccine vial monitor (VVM) status. Despite ambient temperatures up to 40 °C, none of the VVMs on any of the vials used (n = 956) reached their discard point. Over 90% of vaccinators and supervisors preferred conducting NIDs without ice packs. In addition, using OPV out of the cold chain reduced vaccine wastage resulting from melting ice packs causing labels to detach from the vial.     

我国四次脊髓灰质炎疫苗强化免疫活动接种率评价

１９９３年以来，我国在冬春季连续开展了４次８轮的全国强化免疫活动，据可供分析数据统计，全国４岁以下儿童累积接种５２亿人次，有效地提高了人群免疫水平。我国第４次局部范围的强化免疫活动（ＳＮＩＤｓ）分别有２６８２（第１轮）和２６５９（第２轮）个县（区、市、旗，下同）开展了强化免疫活动，分别占全国县数的９４５％和９３７％。据部分开展全省范围强化免疫省份的免疫儿童队列分析，每年强化免疫均有一定比例的漏种儿童，各出生队列的漏种率随年龄的增加而减少，同一出生队列脱漏率随经历强化免疫次数的增加而下降。因此，持续开展强化免疫活动可不断提高漏种儿童的免疫机会，降低脱漏率。     

Assessing the potency of oral polio vaccine kept outside of the cold chain during a national immunization campaign in Chad

This study is the first systematic documentation of the potency of monovalent oral polio vaccine type 3 (mOPV3) kept at ambient temperatures during a polio immunization campaign in Chad. During the study test vials were exposed to temperatures of up to 47.1 °C, and kept outside of the 2-8 °C range for a maximum of 86.9 hours. Post-campaign laboratory testing confirmed that the test vials were still potent, and in conformity with the defined release specifications. Further, the Vaccine Vial Monitors performed as expected, giving an early warning indication of when cumulative exposure to heat reached levels that may have negatively affected the vaccine's potency. This study provides proof-of-concept evidence that certain types of OPV remain potent and thus can be kept, for limited periods of time, as well as administered at ambient temperatures.     

中国近年含麻疹成分疫苗补充免疫活动前后麻疹发病情况分析

目的了解中国（未包括香港、澳门特别行政区和台湾地区,下同）近年含麻疹成分疫苗（Measles-containing Vaccine,MCV）补充免疫活动（Supplementary Immunization Activities,SIAs）的效果,为完善MCV免疫策略提供参考。方法采用描述性流行病学方法,对我国2004～2011年MCVSIAs资料与麻疹发病资料进行统计分析。结果MCVSIAs对降低麻疹发病总体效果明显,但各省（自治区、直辖市,下同）效果有一定差异。2004～2011年,开展MCVSIAs第二年与MCVSIAs当年相比,目标儿童麻疹发病数,初次实施MCVSIAs的省最高降幅为99．54％,最低降幅为73．38％,中位数为96．14％（P25=90．78％,P25=97．97％）;第二次实施MCVSIAs的省最高降幅为99．89％,最低降幅为16．67％,中位数为86．21％;第三次实施MCVSIAs的省最高降幅为91．89％,个别省不降反升,中位数为85．63％0（P25=67．95％,P75=96．00％）。MCVSIAs后,低麻疹发病率持续时间长短不一,最长的4年,最短的≤1年。结论MCVSIAs后,麻疹发病总体呈下降显著,但MCVSIAs后控制麻疹的效果取决于SIAs和常规免疫质量;消除麻疹的关键是保持高水平的常规免疫接种率（两剂次≥95％）,MCVSIAs是低接种率地区阻断麻疹流行、迅速建立免疫屏障的一种补充免疫的策略。     

Characterization and standardization of Sabin based inactivated polio vaccine: proposal for a new antigen unit for inactivated polio vaccines

GMP-batches of Sabin-IPV were characterized for their antigenic and immunogenic properties. Antigenic fingerprints of Sabin-IPV reveal that the D-antigen unit is not a fixed amount of antigen but depends on antibody and assay type. Instead of the D-antigen unit we propose standardization of IPV based on a combination of protein amount for dose and D-antigenicity for quality of the vaccine. Although Sabin-IPV type 2 is less immunogenic than regular wild type IPV type 2, the immunogenicity (virus neutralizing titers) per microgram antigen for Sabin-IPV type 2 is in the same order as for wild type serotypes 1 and 3. The latter observations are in line with data from human trials. This suggests that a higher dose of Sabin-IPV type 2 to compensate for the lower rat immunogenicity may not be necessary.     

Parental acceptance of inactivated polio vaccine in Southeast Nigeria: A qualitative cross-sectional interventional study

Background

The introduction of inactivated polio vaccines (IPV) is imminent. In view of the Polio Eradication and Endgame Strategic Plan 2013–2018, parental acceptance of IPV will be important for achieving universal coverage. In view of the imminent introduction of IPV, it is only reasonable to assess the awareness and acceptance of IPV, so that necessary socio-anthropological measures would be put in place. This study is aimed at determining the level of awareness and acceptance of IPV by parents.

Methods

A cross-sectional study involving 408 parents that brought their children for immunization. Structured-questionnaire was to collect data on the parent's demographic characteristics, awareness and acceptance of IPV. The independent factors that may affect parental acceptability of IPV were evaluated using linear regression analysis.

Results

About 53% of the parents had no knowledge of vaccine content and 84.1% had not heard of IPV, and 40.2% were willing to accept IPV. However, with post-intervention (IPV) health education, the level of acceptance of IPV increased to 95.6% and the difference was statistically significant (p = 0.0001). 35.3% expressed fear for IPV, and 61.8% cited fear for pain (61.8%). In the rating scale of 1 to 5, doctors (4.7), Nurses (4.0) and staff of the Ministry of Health (4.0) were rated high as reliable media to inform them about a new vaccine. The logistic regression revealed only educational level of mothers (p-value = 0.048) was the only significant factor associated with acceptability of IPV.

Conclusion

The parents’ knowledge on vaccine was poor, as well as IPV acceptability (pre health education). But the acceptability was improved with provision of extra information. Although most still preferred OPV, and with improvement in pain management, acceptability of IPV can be improved further. Clear policies and strategies should be immediately developed and implementation of pre-introduction awareness/sensitization on IPV should be commenced.     

口服脊髓灰质炎疫苗与相关病例发生危险性的流行病学分析

[目的]为探讨口服脊髓灰质炎活疫苗(OPV)与脊髓灰质炎疫苗相关病例(VAPP)的关系。[方法]对1991～1999年日照市报告的6例VAPP进行了分析。[结果]首次服苗者发生率为24.05/100万,0～4岁服苗总发生率为1.90/100万。发病者男、女性别之比为5:1;发病年龄在4～10月龄,均为第一次服苗后发病。服苗至发病平均潜伏期为20 d,60d后随访残留麻痹;有4名患者在发病前30 d内有肌肉注射史,其中3例口服OPV时与吸附百白破混合制剂(DPT)进行了联合免疫。病毒分型:Ⅰ型2株,Ⅱ型4株,Ⅲ型4株。[结论]VAPP主要发生在OPV的首次免疫;OPV首次免疫与DPT联合免疫VAPP发生率高于非联合免疫;VAPP发生以Ⅱ型、Ⅲ型病毒为主。     

2008、2010年保山市麻疹疫苗强化免疫效果评价

[目的]分析麻疹疫苗强化免疫接种情况,评价其效果。[方法]对保山市2008年11月和2010年9月两轮麻疹疫苗强化接种情况、人群麻疹IgG抗体水平检测进行分析与麻疹发病资料进行分析。[结果]2008年、2010年保山市麻疹疫苗强化免疫报告接种率分别为98.44%、98.35%,平均98.41%。2008年现场调查2600人,麻疹疫苗接种率为98.54%;2010年调查2418人,接种率为98.51%。麻疹IgG抗体阳性率,2009年903人为87.04%,2010年1 908人为95.02%(P<0.01)。麻疹发病率,2007年为6.66/10万,2008年为5.32/10万,2009年为1.08/10万,2010年为0.12/10万,2010年8月至2011年9月无发病。[结论]2轮麻疹疫苗强化免疫效果明显,人群麻疹IgG抗体水平提高,麻疹发病率下降。     

2005年大连市常规免疫接种率报告与监测评价

[目的]了解大连市常规免疫接种率监测情况.[方法]采用差值(D) 和比值(R)评价方法对大连市2005年常规免疫接种率进行统计分析.[结果]县(市、区,下同) 级报告的及时率和完整性分别96.97%、100.00%.2005年卡介苗、脊髓灰质炎疫苗、百白破联合疫苗、麻疹疫苗、乙型肝炎疫苗的常规免疫报告接种率均在99.00%以上,而估计接种率与报告接种率相差较大.口服脊髓灰质炎疫苗、百白破联合疫苗、麻疹疫苗D值不可信,卡介苗和乙型肝炎疫苗均为可疑.[结论]大连市常规免疫监测数据偏高.应加强技术培训,提高报告接种率的可信性.     

云南省2002年与四川省毗邻地区急性弛缓性麻痹病例主动搜索及口服脊髓灰质炎疫苗强化免疫结果分析

20 0 2年 6月 ,从四川省攀枝花市 2例急性弛缓性麻痹 (AFP)病例和 3名密切接触者粪便标本中分离到 5株疫苗重组脊髓灰质炎 (脊灰 )病毒 (VRPV) ,表明VRPV在该地区循环。 2 0 0 2年 8月 ,对云南省与四川省攀枝花市毗邻的 3个地区 (州、市 ,下同 )、5个县 (区、市 ,下同 )开展了AFP病例的主动搜索 ,未发现VRPV引起的病例。但发现AFP病例漏报率达 5 5 32 % ,一些地方常规免疫不落实。针对调查结果 ,2 0 0 2年 10、11月在楚雄、丽江、昭通 3个地区 2 5个县 ,开展了口服脊灰疫苗 (OPV)两轮强化免疫活动 ,报告接种率 >98% ,快速评估调查接种率常住儿童为 96 94 % ,流动儿童为 85 71%。     

Predictors of optional immunization uptake in an urban south Indian population

BackgroundIn Tamil Nadu, India, bacille Calmette–Guérin, diphtheria–tetanus–pertussis, oral poliomyelitis, hepatitis B, and measles vaccines are part of the routine immunization schedule and are available free from government health centers. All other vaccines are optional and available in the private sector at a cost to families. This study assesses immunization rates of routine and optional vaccines and examines parental attitudes toward vaccines in Pallavapuram, Tamil Nadu.MethodsThe cluster sampling method was used to estimate immunization coverage. Seven children 18 to 36 months old were selected from 30 clusters for a total sample of 210 children. Demographics and vaccination data were collected from interviews and immunization records. Predictors of vaccination status were identified with logistic regression models. In addition, 21 parents participated in semi-structured interviews regarding their attitudes toward vaccination. Interviews were analyzed qualitatively for themes.ResultsEighty one percent of children were fully immunized with routine vaccines. However, only 21% received all “major” optional vaccines, defined as 3 doses of Haemophilus influenzae type b vaccine, one dose of measles, mumps, rubella vaccine, and one dose of varicella zoster virus vaccine. Birth in a private hospital (OR 5.6, 95% CI 1.3 to 22.9, P < 0.01), higher income (P = 0.03), and maternal completion of high school (OR 6.4, 95% CI 1.5 to 27.6, P < 0.01) were significant predictors of receiving all major optional vaccines. Elucidated themes from interviews included (1) strong parental support for immunizations, (2) low concern for side effects, and (3) low uptake of optional vaccines due to high cost and lack of awareness.ConclusionsCoverage of optional vaccines is low despite positive attitudes toward immunizations. Efforts to reduce cost and increase awareness of these vaccines particularly among low-income families or to include these vaccines in the routine schedule may increase uptake and reduce morbidity and mortality from vaccine-preventable diseases.     

浙江省无脊髓灰质炎后两次群众性免疫活动实施结果分析

浙江省于1999年12月和2000年1月、2000年3月和4月,先后在部分地区开展了口服脊髓灰质炎(脊灰)疫苗(OPV)的强化免疫和"扫荡"式免疫活动,为了了解这两次群众性免疫活动的实施结果,对两次活动的接种率、实施过程递进性和出生队列的接种人数做了分析比较.结果显示2000年"扫荡"式免疫的报告接种率和调查接种率分别为99.1%、99.3%和98.1%、99.2%;而强化免疫则分别为95.9%、96.7%和88.1%、84.4%,前者高于后者,同时两轮活动之间的总体递进性也是"扫荡"式免疫优于强化免疫.对连续实施强化免疫和"扫荡"式免疫活动的地区进行出生队列的接种情况分析表明,"扫荡"式免疫活动中接种儿童数比强化免疫活动平均增长了84%,不同地区和年龄组之间接种人数变化情况不尽一致.这两次连续性的群众性免疫活动,尤其是"扫荡"式免疫活动对进一步提高薄弱地区的OPV接种率发挥了重要作用,但是要维持高水平的免疫接种率,尤其是保持无脊灰状态,仍应主要依靠高质量的常规免疫和监测.