Timeliness of routine immunization in non-preterm children less than 2 years old using electronic data capture in an ambulatory setting in France in the context of vaccine hesitancy

Objectives

The vaccine schedule was changed in 2013 in France, which resulted in fewer vaccinations. However, to maintain disease protection, both vaccine timeliness and high coverage should be respected. In the context of growing vaccine hesitancy, we aimed to describe compliance with the immunization program according to the age recommended for each dose for non-preterm children less than 2 years old.

Accuracy of the National Polio Surveillance Project data in Rajasthan

According to the National Polio Surveillance Project (NPSP) there were 15 polio cases in Rajasthan during 2000. Close scrutiny of the Line List of AFP cases shows that there were atleast 58 polio cases, many cases had been wrongly classified. Cases of vaccine associated paralytic poliomyelitis (VAPP) and vaccine failure had been missed.     

Vaccines for travelling minors: The ��shot�� heard around the world

The number of adults, children and adolescents who travel from the industrialized world to less industrialized countries for work or pleasure is steadily increasing. Travel immunizations for children are a critical element of pretrip planning. Occasionally, one of the most daunting aspects of an exotic trip or a foreign posting can be the logistics (and recriminations) associated with getting the family to a travel medicine clinic with sufficient lead time to ensure that all of the necessary immunizations are given before departure. The present paper reviews pertinent immunization information from three points of view: the travel clinic, the parent and (with license) the child.     

Potency of oral polio vaccine stored at distribution centers in madras

This study was done with the objective to measure, monitor, and document the potency of oral polio vaccine and the storage conditions in the city of Madras for a period of one year from May 88. The Corporation of Madras which takes care of indenting and supplying the vaccine has 87 centers for storage and distribution. We took 12 samples a month from these centers by stratified random sampling technique adopting proportionate sampling. The samples were coded and sent to the laboratory. The investigator noted the storage conditions in a specially designed data card. Results were notified to the managers concerned. 122 samples were tested out of which 28 (23%) showed loss of potency (< log 10584). The loss of potency is statistically significant in centers not having dial thermometer and where inappropriate carrier was used for transport of vaccine. It was least in Maternity and Child Health Centers probably due to the orientation of the personnel. The frequency of loss of potency was more in the beginning of the study and decreased as the study progressed. Monitoring of storage conditions and potency of vaccine along with periodic training and reorientation of health personnel are stressed.     

Awareness of pulse polio immunisation

Mass polio immunisation campaign was launched in the national capital territory of Delhi with 2 doses of polio vaccine to be administered to children upto 3 years of age on October and December 4, 1994 respectively. Massive information, education & communication (IEC) efforts through mass media and interpersonal communication preceded the dates of the campaign. A study to assess the awareness of general population was carried out by interviewing 225 adult residents of Delhi using a structured questionnaire. These were drawn by two stage stratified random sampling. Zonewise assembly segments in the first stage and census enumeration blocks in the second stage formed the sampling frame. The study, carried out 3 days prior to date of administration of first dose of oral polio, revealed that 60.4% of population was aware of the programme being launched and 31.6% about aim of the programe. None of the respondents were aware of all the specific parameters put together correctlyviz., objective, immunisation days, age group & immunisation status of children. The higher level of awareness was directly proportional to the level of education. The overwhelming success of the programme was indicated by immunisation of >90% children upto 3 years of age all over Delhi in the first phase of the programme. The key to success of the programme despite low awareness is explained on the basis of unflinching efforts put in by vaccine centre level committees, integrated child development scheme (ICDS) and urban basic service (UBS) functionaries in mobilising people to reach various vaccination centres. Other states planning to launch such mass campaigns should pay attention to social mobilisation in addition to IEC efforts for successful completion of the programme.     

儿童轮状病毒疫苗临床研究进展

轮状病毒是导致婴幼儿腹泻的重要病原体,目前尚无特异治疗方法,因此有效的疫苗预防尤为重要.疫苗的安全性、疗效、持续表达的外源抗原可能产生的后果及疫苗诱发机体免疫应答等因素均是疫苗研究的关键.该文对国外轮状病毒疫苗特点,疫苗发展历程及免疫实施咨询委员会和美国儿科学会轮状病毒疫苗使用指南作一概述,以期指导我国轮状病毒疫苗的研...     

Immunization for meningococcal serogroup B: What does the practitioner need to know?

Most invasive meningococcal disease in Canada is now caused by serogroup B organisms. A vaccine directed against this serogroup (4CMenB) is newly licensed in Canada. A decision will need to be made by all provinces and territories regarding whether a routine infant immunization program is warranted. This decision will need to take into account factors such as uncertain estimates for the effectiveness of the vaccine, the high incidence of fever from the vaccine and the burden of introducing more injections into the current immunization schedule, and consider them against the potentially preventable mortality and morbidity that result from a rare but very serious disease.     

Measles in a hilly hamlet of northern India

Objective : To ascertain the epidemiological links and risk factors responsible for the epidemic of measles in the village Astani in Himachal Pradesh.Methods : All the children less than twelve years who were present on 27th July 1997 were evaluated. A questionnaire requesting data on vaccination history and symptoms of measles was administered and complete physical examination including anthropometry was recorded in each child by the authors. The data also included complications (including that of death) secondary to measles infection.Results : A total of 48 children less than 12 years, present in the hamlet on 27th July 1997, were examined, out of which 28 (58%) were affected and 20 (42%) were unaffected. The immunization coverage in the affected children was 33% in contrast to 70% coverage in the unaffected group. Vaccine efficacy in the present epidemic was 51 %. The complication rate was 59%, which included one death. The anthropometric data showed that 92% of the affected children were malnourished. All the children were given age appropriate dose of Vitamin A and children of the nearby villages were vaccinated against measles as a part of outbreak control.Conclusion : This study clearly highlights the need to achieve and sustain high immunization coverage along with strengthening of the routine surveillance systems in remote village of India.     

Measles in a hilly hamlet of northern India

OBJECTIVE: To ascertain the epidemiological links and risk factors responsible for the epidemic of measles in the village Astani in Himachal Pradesh. METHODS: All the children less than twelve years who were present on 27th July 1997 were evaluated. A questionnaire requesting data on vaccination history and symptoms of measles was administered and complete physical examination including anthropometry was recorded in each child by the authors. The data also included complications (including that of death) secondary to measles infection. RESULTS: A total of 48 children less than 12 years, present in the hamlet on 27th July 1997, were examined, out of which 28 (58%) were affected and 20 (42%) were unaffected. The immunization coverage in the affected children was 33% in contrast to 70% coverage in the unaffected group. Vaccine efficacy in the present epidemic was 51%. The complication rate was 59%, which included one death. The anthropometric data showed that 92% of the affected children were malnourished. All the children were given age appropriate dose of Vitamin A and children of the nearby villages were vaccinated against measles as a part of outbreak control. CONCLUSION: This study clearly highlights the need to achieve and sustain high immunization coverage along with strengthening of the routine surveillance systems in remote village of India.     

Vaccine-preventable meningitis in French children with incorrect vaccination status from 2011 to 2013

The objective of this study was to determine the number of cases of pediatric meningitis or purpura fulminans associated with an incorrect vaccination status from 2011 to 2013 in France. A total of 48 children with vaccine-preventable meningitis or purpura fulminans, including three deaths, had an incorrect vaccination status: 26 cases were due to Neisseria meningitidis group C (54.2%), 19 to Streptococcus pneumoniae (39.6%), and three to Haemophilus influenzae type b (6.3%). The majority of patients (n = 35, 72.9%) had received no injection of the vaccine concerned. Over a 3-year period, 48 cases of bacterial meningitis or purpura fulminans in children could have been avoided if the French immunization schedule had been followed.     

Epidemiological evaluation of oral polio vaccine efficacy in Delhi

Forty seven cases of poliomyelitis and 94 controls were studied for immunization status. Unmatched analysis with one control per case and two controls per case was done to find out the ratio of the odds of immunization in diseased individuals as compared with the nondiseased (odds ratio). This ratio (OR) was used further to calculate oral polio vaccine efficacy. OPV efficacy was found to be 93% with 95% confidence limits of 75–98%.     

Epidemiology of hospital admissions for chickenpox in children: an Italian multicentre study in the pre-vaccine era

AIM: To describe the chickenpox complications in children in Italy. METHODS: Hospital discharge data from 1 January 2002 to 15 June 2006 were queried for patients less than 18 years of age in three Italian paediatric university hospitals. RESULTS: During the study period, 349 children (189 males, 160 females) were admitted. Thirteen out of 349 (3.7%) of them had serious underlying diseases. Two hundred and sixty-one (74.8%) children (median age: 41 months, range: 6 days -to 200 months) had complicated chickenpox. Among complications, neurological disorders were the most common (100/261 = 38.3%), followed by skin and soft tissue infections (63/261 = 24.1%), lower respiratory tract infections (57/261 = 21.8%) and haematological disorders (24/261 = 9.2%). Children with neurological complications were significantly older and had a longer hospital stay than those with other complications. Three children with encephalitis and cerebellitis had developed long-term sequelae by the 6-month follow-up. The mortality rate was 0.4% (1/261 children with complicated chickenpox). CONCLUSION: Chickenpox is a disease that can provoke serious complications and long hospital stays, even in healthy children. Our findings may be useful as background to evaluate the impact of a tetravalent measles-mumps-rubella-varicella vaccine (MMRV) which is going to be introduced in Italy.     

Immunity after (re)vaccination of paediatric patients following haematopoietic stem cell transplantation

Aims: Loss of specific immunity follows allogeneic haematopoietic stem cell transplantation (HSCT) in the majority of cases. Responses to (re)vaccinations can be used as indicators of a functional immunological recovery. Methods: Twenty‐three paediatric recipients of HSCT were enrolled in a single centre setting and responses to scheduled immunizations analysed. Results: Immunity to vaccine‐preventable diseases was impaired post HSCT, but (re)vaccinations induced protective responses in 59–100%, depending on the vaccine, regardless of prior graft‐versus‐host disease (GVHD) history. Conclusion: Despite the marked impact of moderate to severe chronic prior GVHD on both the qualitative and quantitative T‐cell recovery post allogenic HSCT, most paediatric recipients of allogeneic stem cell grafts appear to attain protective antibody levels after immunization.     

北京上海广州深圳4家儿童医院肺炎住院患儿肺炎链球菌分离株的血清型分布

目的了解目前从中国住院治疗肺炎患儿分离到的肺炎链球菌的血清型分布，及几种蛋白多糖结合疫苗的覆盖率，评估应用蛋白多糖结合疫苗预防肺炎链球菌感染的价值。方法选择2006年2月16日至2007年2月16日在首都医科大学附属北京儿童医院、复旦大学附属儿科医院、广州市儿童医院和深圳市儿童医院呼吸科住院治疗的肺炎患儿为研究对象，采用一次性吸痰管收集全部病例的呼吸道分泌物标本分离肺炎链球菌，部分患儿进行脑脊液、血液和胸腔积液中肺炎链球菌的分离。采用荚膜肿胀实验进行血清型分析。对4家儿童医院肺炎链球菌分离率和血清型进行分析，率的比较采用χ2检验或Fisher精确概率法。结果 研究期间共纳入2 865例肺炎患儿，2 865例呼吸道吸取物标本中分离到肺炎链球菌279株，其中有2株不同血清型菌株分离自同一病例，分离阳性率为9.7％（278/2 865）。3/8例胸腔积液中分离到肺炎链球菌，其中2例同时从呼吸道分泌物分离到肺炎链球菌，取其一进行血清分型，另1株从胸腔积液中分离的肺炎链球菌复苏失败，未进行血清分型。脑脊液和血液标本中未分离到肺炎链球菌。共有279株肺炎链球菌进行了血清型分析，以19F型最常见（60.6％，169/279），其次为19A（9.7％，27/279）、23F（9.3％，26/279）和6B（5.4％，15/279），上述4种血清型占全部菌株的84.9％（237/279）。肺炎链球菌7价结合疫苗（PCV7）覆盖率为81.0％，但在北京仅为46.0％，明显低于上海（80.0%）、广州(98.4%)和深圳（94.4%）。9价、10价和11价疫苗的覆盖率与PCV7相比并没有明显增加。13价疫苗的覆盖率（92.8％）较PCV7明显升高。结论4家儿童医院肺炎住院患儿分离的肺炎链球菌以19F、19A、23F和6B型常见。PCV7覆盖率为87％