The National Vaccine Injury Compensation Program

The National Childhood Vaccine Injury Act of 1986 established the National Vaccine Injury Compensation Program to compensate people thought to be injured by certain vaccines. The act's goals are to ensure an adequate supply of vaccines, to stabilize vaccine costs, and to establish and maintain an accessible and efficient setting for providing compensation to people found to have been injured by certain childhood vaccines. In addition, the legislation called for the reporting of adverse events after vaccination, the creation of vaccine-information materials that detail vaccine benefits and risks, and Institute of Medicine studies of possible vaccine-related injuries and encouraged research and development of new and safer vaccines. Over its 22-year history, the National Vaccine Injury Compensation Program has been a key component in stabilizing the US vaccine market through liability protection to both vaccine companies and health care providers and by providing a forum for people, no matter what age, to seek compensation.     

儿童伤害的危险因素研究现状

伤害是导致儿童死亡和健康损害的重要原因,社会经济水平高,对伤害重视,增加对伤害防治的预算投入、立法、媒体宣传等可减少儿童伤害的发生。而家庭社会经济地位低下、家庭规模大、多同胞、父母年龄及受教育程度低、失业、不良婚姻状况等是儿童发生伤害的危险因素。学校中体育运动及同侪欺凌引起的伤害较常见。儿童性别、年龄、性格、行为、精神疾病等与伤害相关,但肥胖、睡眠、遗传等因素在儿童伤害发生中的作用尚待明确。规范伤害的诊断和分类标准,加强低收入和中等收入国家儿童伤害危险因素的研究是未来相关研究的重要方向。     

Recent improvements in the Turkish Childhood National Immunization Program

The Childhood National Immunization Program (NIP) is a key element of the primary healthcare and plays a major role in the national health status. The Turkish NIP, which is run by the Ministry of Health, included mainly the basic vaccines (Bacillus Calmette-Guerin [BCG], diphtheria-pertussis-tetanus [DPT], polio, measles) until 2005. However, a change in the governmental policies in 2002 and a close collaboration with the Advisory Board of Immunization have improved the Turkish NIP not only in terms of the quality of the vaccines and vaccination rates but also the number of pathogens covered. Currently, Turkey has a NIP that is equivalent to or better than that of the other European countries. However, making vaccination a constant part and priority of the state health policies is necessary for sustainability. Political commitment and efficient multi-sectorial collaboration and awareness are crucial.     

Association Between Grandparental Co-Residence and Early Childhood Injury in the UK

In contemporary Western societies, accidents and injuries are the most common cause of death in early childhood. This makes them a major social and health policy issue and an important child well-being indicator. Here we compared the risk of home injuries between children who co-reside in three-generational households with grandparents and children who do not co-reside with grandparents. Moreover, we investigate whether grandparental presence is associated with decreased injuries in different risk situations, measured by family- and child-related factors. Using the British Millennium Cohort Study (n?=?12,319 children between the ages of 9 months and 3 years), we found that children who co-reside with grandparents had a lower probability of home injuries than children who do not co-reside with grandparents. In addition, grandparental co-residence was associated with a decreased risk of injuries more strongly in boys than girls. The results are discussed with reference to older adults’ beneficial role of supporting their offspring.     

Impact of Childhood Vaccine Discussion Format Over Time on Immunization Status

Objective

Presumptive formats to initiate childhood vaccine discussions (eg, “Well, we have to do some shots”) have been associated with increased vaccine acceptance after one visit compared to participatory formats (eg, “How do you feel about vaccines?”). We characterize discussion format patterns over time and the impact of their repeated use on vaccine acceptance.

Parental COVID-19 Vaccine Hesitancy in Diverse Communities: A National Survey

ObjectiveWe surveyed a diverse group of US participants to understand parental coronavirus disease 2019 (COVID-19) vaccine hesitancy.MethodsWe administered a telephone and online survey from May 7 to June 7, 2021 using stratified sampling to ensure robust sample sizes of racial and ethnic minorities. Of the 20,280 contacted, 12,288 respondents completed the survey (response rate 61%). We used chi-square tests and adjusted risk ratios to compare results by racial/ethnic group.ResultsOverall, 23% of parents stated that they plan to (or have) vaccinated their children; 30% said that they would not vaccinate their children, and 25% were unsure. Latino/a, Native American, and Asian American-Pacific Islander (AAPI) parents were generally more likely to vaccinate their children than Black or White parents. After adjusting for demographic factors, AAPI parents were significantly more likely to vaccinate their children than were others. Of parents who said that they would not vaccinate their child, 55% stated it was due to insufficient research. However, over half of parents stated that they would follow their child's health care provider's recommendations. After adjusting for demographic factors, trust in their primary care doctor was significantly lower among AAPI, Black, and Native American parents than White parents.ConclusionsParental vaccine hesitancy was similar overall, but drivers of hesitancy varied by racial/ethnic groups. While the perception that vaccines had been “insufficiently researched” was a major concern among all groups, we found that parents are generally inclined to follow health providers’ recommendations. Health professionals can play an important role in COVID-19 vaccine education and should provide access to vaccines.     

Childhood Obesity in Secondary Care: National Prospective Audit of Australian Pediatric Practice

ObjectiveIn many countries, pediatricians offer skilled secondary care for children with conditions more challenging than can readily be managed in the primary care sector, but the extent to which this sector engages with the detection and management of obesity remains largely unexplored. This study aimed to audit the prevalence, diagnosis, patient, and consultation characteristics of obesity in Australian pediatric practices.MethodsThis was a national prospective patient audit in Australia. During the course of 2 weeks, members of the Australian Paediatric Research Network prospectively recorded consecutive outpatient consultations by using a brief standardized data collection form. Measures included height, weight, demographics, child and parent health ratings, diagnoses, referrals, investigations, and consultation characteristics. We compared the prevalence of pediatrician-diagnosed and measured obesity (body mass index ≥95th percentile) and top-ranked diagnoses, patient, and consultation characteristics in (a) obese and nonobese children, and (b) obese children with and without a diagnosis.ResultsA total of 198 pediatricians recorded 5466 consultations with 2–17 year olds, with body mass index z-scores calculated for 3436 (62.9%). Of the 12.6% obese children, only one-third received an “overweight/obese” diagnosis. Obese children diagnosed as overweight/obese were heavier, older, and in poorer health than those not diagnosed and incurred more Medicare (government-funded health system) cost and referrals.ConclusionsObesity is infrequently clinically diagnosed by Australian pediatricians and measurement practices vary widely. Further research could focus on supporting and normalizing clinical obesity activities from which pediatricians and parents could see clear benefits.     

Perceived Persuasiveness of Evidence About Adverse Childhood Experiences: Results From a National Survey

ObjectiveAdvocates must make decisions about the types of evidence they emphasize when communicating to cultivate support for adverse childhood experience (ACE) prevention policies. This study sought to characterize public perceptions of the persuasiveness of 12 ACE evidence statements and assess differences by ideology in the strength of these evidence messages as rationales for ACE prevention policies.MethodsA web-based survey of a nationally representative sample of US adults was conducted using the KnowledgePanel (N = 503, completion rate = 60.5%). Respondents read ACE evidence statements and answered questions about the extent to which each was perceived as persuasive. Data were collected and analyzed in 2019.ResultsThe evidence statements perceived as most persuasive (scoring range 3–17) were those about ACEs as risk factors for mental health and substance use conditions (mean = 12.39) and suicide (mean = 12.14); ACEs generating financial costs for society (mean = 12.03); and the consequences of ACEs being preventable by a supportive adult (mean = 11.97). The evidence statements perceived as least persuasive were about ACEs generating health care costs for individuals (mean = 9.42) and ACEs as risk factors for physical health conditions (mean = 9.47). A larger proportion of liberals than conservatives rated every statement as providing a “strong reason” for ACE prevention policies. These differences were largest for evidence about ACEs generating financial costs for society (84.6% vs 42.8%, P < .0001) and socioeconomic disparities in ACEs (65.1% vs 32.9%, P < .0001).ConclusionsMany ACE evidence statements commonly used in policy advocacy differ from those perceived as most persuasive among a nationally representative sample of US adults.