Vaccination in emergencies

Nongovernmental organisations (NGOs) are the main actors of vaccine delivery during complex humanitarian emergencies such as large population displacements. This paper discusses the use of vaccinations against measles, cholera and meningitis in this context. The role of NGOs in the advocacy for making new and more effective vaccines available to the most vulnerable populations is also emphasised.     

Vaccination in conservation medicine

Unprecedented human population growth and anthropogenic environmental changes have resulted in increased numbers of people living in closer contact with more animals (wild, domestic, and peridomestic) than at any other time in history. Intimate linkage of human and animal health is not a new phenomenon. However, the global scope of contemporary zoonoses has no historical precedent. Indeed, most human infectious diseases classed as emerging are zoonotic, and many of these have spilled over from natural wildlife reservoirs into humans either directly or via domestic or peridomestic animals. Conservation medicine has recently emerged as a meaningful discipline to address the intersection of animal, human, and ecosystem health. Interest in the development of novel vaccines for wildlife encounters important challenges that may prevent progress beyond the conceptual phase. Although notable examples of successful wildlife immunisation programmes exist, depending upon key considerations, vaccination may or may not prove to be effective in the field. When implemented, wildlife vaccination requires a combination of novel zoonosis pathogen management strategies and public education to balance conservation, economic, and public health issues.     

Vaccination antivariolique

Ohne Zusammenfassung     

Vaccination strategies

By nature of their long-term deployment in challenging areas of the world, expatriate employees and their dependents are at increased risk for a number of infectious diseases. Targeted immunization strategies may decrease this risk. Expatriate employees and their dependents should be immunized before deployment, and programs should be established to provide booster immunizations if the risk is ongoing. When considering work-force productivity, work-force infectivity, and the common good, careful consideration should be given to establishing at least a basic immunization program for in-country nationals and their dependents.     

Influenza Vaccination

Influenza places a heavy burden on society. Distress of the community resulting from the disease translates into difficulties in family management as well as absence from work, school and social work. Moreover, there is still uncertainty in the current knowledge of anti-influenza immunity, even though, thanks to advances in molecular biology, the structure, chemistry and genetics of the virus are by now almost completely known. The greatest difficulty of the vaccine lies in the great variability of the influenza virus. The A and influenza viruses are the most important ones. The A viruses include several subtypes, H3N2 and H1N1 being presently the most important ones. The present vaccine, therefore, must be updated every year with strains that have the greatest probability of spreading in the human population during the influenza season. New influenza vaccines based on molecular biotechnology, such as DNA-recombinant or naked DNA vaccines, are currently widely studied and represent the vaccines that, hopefully, will bring about important improvements in the near future.     

Vaccination for Group B Streptococcus during pregnancy: attitudes and concerns of women and health care providers

Group B Streptococcus (GBS) is the leading infectious cause of neonatal morbidity and mortality. Although intrapartum antibiotic prophylaxis (IAP) strategies are effective in preventing GBS transmission from mothers to newborns, there are growing concerns about adverse effects, and the development of antibiotic resistance. GBS vaccines targeting the most virulent neonatal disease serotypes are currently under development and may be used during pregnancy. The objective of this study was to explore the key issues and concerns that would be associated with GBS vaccination during pregnancy from the perspectives of pregnant women and health care providers. Twenty-two women and 25 health care professionals in Alberta, Canada participated in 10 focus groups, each group ranging from 2 to 20 participants. Valuable information emerged from the focus groups about the factors that would affect acceptance of a maternal GBS vaccine. This information will be essential for health systems to consider in the introduction, promotion and delivery of such a vaccine. The data may help optimize education about GBS and a putative vaccine to pregnant women.     

Vaccination strategies in developing countries

By 1990 it is hoped that all of the world's infants will have access to immunization services and that these services will then continue indefinitely. The link between people and health services, including immunization, can only be forged and maintained by an effective system of delivery and support to all health workers. A careful choice of strategies for this delivery system and an understanding of local cultural attitudes and behaviour is vital if this link is to be effective. Health workers will have to be trained and then supported in the field by regular contact with their supervisors. They will also need continuous, reliable, predictable and adequate supplies of equipment, drugs, vaccines, fuel and money, including salaries. Immunization is cost effective as a health intervention, but an effective programme of immunization can contribute much more than just vaccines, if it is developed in the context of primary health care (PHC) as originally proposed in 1978 at the conference in Alma Ata.     

Vaccination of children in Japan

The coverage rates of six vaccines (BCG, polio, DPT, measles, mumps and varicella) and the prevalence of these diseases in Japan were investigated. It was found that 82.2% of children had been inoculated with BCG before their first birthday, and 85.4% were given two doses of polio vaccine before their second birthday. The high acceptance rates of these vaccines seem to be attributable to mass inoculations at health centers. On the other hand, the median age when the first dose of DPT vaccine was given was as late as 22 months. Mass administration of this vaccine during infancy should be performed since about one-quarter of the patients with diphtheria, pertussis or tetanus were less than one year old. The cumulative percentage for measles inoculation failed to reach 60% by the second birthday. Considering that the incidence of measles has not yet been satisfactory lowered and that infants under 23 months of age account for about one-half of this incidence, more children less than 18 months old should be immunized. The ineffective rate of varicella vaccine was found to be 18.2%, although reestimation of its effectiveness may be necessary.     

健康教育在乡镇预防接种工作中的作用

针对乡镇集中定点接种工作存在的利弊 ,莱州市城港路街道朱由卫生院在预防接种中实施健康教育使辖区内的计划免疫工作几年来一直在全市名列前茅。1 领导重视　宣传到位　农村的预防接种工作一直由乡村医生承担 ,适龄儿童不用出村即可接种疫苗。实行定点接种后 ,许多家长认为这种接种形式不方便 ,从经济上也造成一些损失等。为消除家长的这种片面认识 ,认识实行乡镇集中定点接种的重要意义 ,城港路街道健康教育工作领导小组决定利用电视、广播、宣传栏、黑板报、展板、卫生咨询及发放宣传单等多种形式进行健康教育 ,对实施乡镇集中定点接种…     

Vaccination against rabies in Poland

The data on anti-rabies vaccination in Poland in the last fifteen years are presented. In general, 89,019 people were vaccinated against rabies in Poland in the years 1986-2000, among them 580 after deep bite by rabid animal and 4814 after deep bite by an animal suspected of having rabies (III category of risk according to WHO). Among the patients with the III category exposition only a fraction were administered anti-rabies serum (12% of patients with deep bite by rabid animal), but this practice was becoming more frequent in recent years. 73% of patients were given vaccine after contact with domestic animals (dogs or cats), 9% after contact with wild foxes, which are the main reservoir of rabies in Poland. No cases of uneffective vaccination were observed. The preventive vaccination was sporadic and limited to persons with high professional risk of infection.