Survey of coverage, strategy and cost of hepatitis B vaccination in rural and urban areas of China

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Measles transmission following the tsunami in a population with a high one-dose vaccination coverage, Tamil Nadu, India 2004–2005

Background  

On 26 December 2004, a tsunami struck the coast of the state of Tamil Nadu, India, where one-dose measles coverage exceeded 95%. On 29 December, supplemental measles immunization activities targeted children 6 to 60 months of age in affected villages. On 30 December, Cuddalore, a tsunami-affected district in Tamil Nadu reported a cluster of measles cases. We investigated this cluster to estimate the magnitude of the problem and to propose recommendations for control.     

Measles vaccination coverage during poliomyelitis national immunization days in Burkina Faso, 1999

In 1999, Burkina Faso added measles vaccine during the second round of its poliomyelitis national immunization days (NIDs). A cluster survey was conducted in each of the country's 53 health districts to assess vaccination coverage achieved by the campaign. Forty-four percent of children aged 9-59 months had a documented prior measles vaccination, and 88% were vaccinated during NIDs. Eighty-five percent of children not previously vaccinated received measles vaccine during the campaign. Although routine vaccination coverage varied substantially among children from various socioeconomic groups, the campaign appeared to almost equally reach all groups of children surveyed. Poliovirus vaccine coverage was 90% when measles vaccine was added to the campaign, compared with 88% during the first round. In Burkina Faso, the addition of measles vaccine to poliomyelitis NIDs achieved greater equity in measles vaccination coverage according to a number of socioeconomic factors without compromising the coverage of poliovirus vaccination.     

Measles incidence before and after mass vaccination campaigns in Burkina Faso

Burkina Faso conducted mass measles vaccination campaigns among children aged 9 months to 4 years during December 1998 and December 1999. The 1998 campaign was limited to six cities and towns, while the 1999 campaign was nationwide. The last year of explosive measles activity in Burkina Faso was 1996. Measles surveillance data suggest that the 1998 urban campaigns did not significantly impact measles incidence. After the 1999 national campaign, the total case count decreased during 2000 and 2001. However, 68% of measles cases occurred among children aged 5 years or older who were not included in the mass vaccination strategy. During 2000 and 2001, areas with high measles incidence were characterized by low population density and presence of mobile and poor populations. Measles control strategies in Sahelian Africa must balance incomplete impact on virus circulation with cost of more aggressive strategies that include older age groups.     

Tuberculin reactivity in a pediatric population with high BCG vaccination coverage.

SETTING: The tuberculin skin test (TST) is often included in diagnostic algorithms for tuberculosis (TB) in children. TST interpretation, however, may be complicated by prior Bacillus Calmette-Guerin (BCG) vaccination. We assessed the prevalence of and risk factors for positive TST reactions in children 3 to 60 months of age in Botswana, a country with high TB rates and BCG coverage of over 90%. METHODS: A multi-stage cluster survey was conducted in one rural and three urban districts. Data collected included demographic characteristics, nutritional indices, vaccination status, and prior TB exposure. Mantoux TSTs were administered and induration measured at 48-72 hours. RESULTS: Of 821 children identified, 783 had TSTs placed and read. Of the 759 children with vaccination cards, 755 (99.5%) had received BCG vaccine. Seventy-nine per cent of children had 0 mm induration, 7% had > or =10 mm induration ('positive' TST), and 2% had > or =15 mm. A positive TST was associated with reported contact with any person with active TB (odds ratio [OR] 1.9; 95% confidence interval [CI] 1.02-3.6), or a mother (OR 5.1; 95% CI 2.1-12.4) or aunt (OR 5.3; 95% CI 2.0-14.0) with active TB. TSTs > or =5 mm (but not > or =10 mm) were associated with presence of a BCG scar. Positive reactions were not associated with age, time since BCG vaccination, clinical signs or symptoms of TB, nutritional status, crowding, or recent measles or polio immunization. CONCLUSION: The TST remains useful in identifying children with tuberculous infection in this setting of high TB prevalence and extensive BCG coverage.     

Italy s new vaccination schedule reduced coverage of poliomyelitis vaccine in Naples

Italy s health ministry introduced changes to the immunisation schedules for children on 7 April 1999, including immunisation against poliomyelitis. The changes included the replacement of the first two childhood doses of oral poliomyelitis vaccine (OPV)     

The Caribbean experience in maintaining high measles vaccine coverage

The Caribbean subregion was the first area of the world to eliminate measles. From 1991 through 2010, the 21 countries of the subregion were remarkably successful in maintaining their measles-free status despite importations of the virus from areas where it continues to circulate. This task has been accomplished by ensuring that each country in the subregion maintains measles vaccine coverage of ≥95%. The absence of measles is the result of a collaboration between the various national authorities and the Pan American Health Organization in ensuring vaccination campaigns to deliver the second dose of a measles-containing vaccine, estimating and validating vaccine coverage for both the first and second doses of measles vaccine for all local populations; developing detailed plans of action to improve coverage in those populations where coverage is <95%; providing technical assistance for the implementation of the plan; and performing follow-up to confirm that all aspects of the plans were in fact implemented and that the target vaccination level was achieved. These efforts have been extremely successful in maintaining high vaccine coverage and, therefore, in keeping the virus from circulating on those occasions when it has been reintroduced into the subregion. Although sophisticated statistical methods have been used to identify weaknesses in national vaccine programs, the program is basically quite simple and can be systematically implemented in any country that has the desire to eliminate measles from its population.     

Cumulative vaccination coverage of measles- and oral polio vaccine obtained by the nationwide survey

In 2002 we estimated the measles cumulative vaccination coverage (CVC) in Japan by randomly selecting a total of 5,000 3-year-old children from the total Japanese population and examining the age in months when they were vaccinated against measles. This survey revealed that in Japan measles CVC at ages 18, 24, and 36 months were 61.7 +/- 1.6%, 79.6 +/- 1.3%, and 86.9 +/- 1.1%, respectively. The results obtained in 2003 revealed that the measles CVC among 3-year-old children in 2003 was higher than that obtained in 2002, with especially noticeable improvement in their period of 12 to 23 months of age. It is estimated that this improvement was attributed to the effort made by many persons concerning vaccination to raise the vaccination rate. In 2003 oral polio vaccine (OPV) CVC was investigated for the first time, in addition to measles CVC. OPV CVC of the first dose at 6, 12, and 36 months of age were 44.2 +/- 1.5%, 85.5 +/- 1.1%, and 94.7 +/- 0.8%, respectively. The results of the second dose at 12, 18, and 36 months of age were 42.3 +/- 1.5%, 73.5 +/- 1.3%, and 90.7 +/- 0.9%, respectively. Even at 36 months of age the CVC level of the second dose of OPV was found to be slightly lower than that of the first dose.     

A coverage evaluation survey of JE vaccination in two districts of Karnataka

A coverage evaluation survey was conducted in Mandya and Koppal districts of Karnataka state following the Japanese Encephalitis (JE) vaccination campaign. The purposes of the survey were to assess coverage of children in target age group by JE vaccination and to assess adverse events following immunisation against JE, the knowledge of health care providers and community about JE & mass vaccination for JE. The study design consisted of both quantitative and qualitative methods. The quantitative data was used to know the coverage levels for children. The qualitative data collected through interviews of head of the family in the sample households, selected health care workers using a structured pretested questionnaire. The standard cluster sampling method was used for selecting the sample of children to be evaluated. In Mandya district the evaluation showed 92% coverage in the selected sample of 313 children against the reported 83.85%. In Koppal district the evaluation showed 70% coverage, among the selected sample of 251 children, against the reported coverage of 69.8%. The incidence of adverse events was 4% in Mandya sample and 6.37% in Koppal sample. In Mandya district, about 42% of households had knowledge of JE. About 68% of households had prior knowledge of the immunization day. In Koppal district, the survey has revealed that only 19.85% of the heads of household had the knowledge of JE and 48.53% had the knowledge of JE vaccination before the day of vaccination campaign.     

Mumps epidemic in Portugal despite high vaccine coverage - preliminary report

A measles, mumps, and rubella (MMR) trivalent vaccine was added to Portugal's National Immunisation Programme (NIP) in 1987. All vaccines are given at health centres, free of charge, but an epidemic of mumps began in 1995, firstly in northern Portugal and     

Continuing rotavirus circulation in children and adults despite high coverage rotavirus vaccination in Finland

ObjectivesTo determine occurrence of residual rotavirus (RV) disease in different age groups in Finland after five to nine years of high coverage (≥90%) mass-vaccination with RotaTeq^Ⓡ vaccine, and to examine the vaccine effect on circulating genotypes.MethodsSince 2013 all clinical laboratories in the country were obliged to send RV positive stool samples for typing. RVs were genotyped by RT-PCR for VP7 and VP4 proteins, sequenced and compared to reference strains.ResultsRV continued to circulate throughout the study period at low level with a small increase in 2017–2018. There were three age-related clusters: young children representing primary or secondary vaccine failures, school-age children who may not have been vaccinated, and the elderly. Genotype distribution differed from the pre-vaccination period with a steady decline of G1P[8], emergence of G9P[8] and especially more recently G12P[8]. In the elderly, G2P[4] was predominant but was also replaced by G12P[8] in 2017–18.ConclusionsRV vaccination with a high coverage keeps RV disease at low level but does not prevent RV circulation. New RV genotypes have emerged replacing largely the previously predominant G1P[8]. Increase of overall RV activity with emergence of G12P[8] in the latest follow-up season 2017–18 might be a potential alarm sign.