Self-assessment of immediate post-vaccination pain after two different MMR vaccines administered as a second dose in 4- to 6-year-old children

The aim of this study was to compare self-reported immediate post-vaccination pain and safety of Priorix versus RORVax in 4- to 6-year-old children receiving their second dose of MMR vaccine, using the Faces Pain Scale-Revised (FPS-R), a validated self-report pain scale recommended by the French National Accreditation Agency and Health Evaluation. A total of 620 children from 28 French pediatricians completed all study procedures. Immediate post-vaccination pain was reported by 17.8% of the subjects in Priorix group (N=309) and by 44.7% of the subjects in RORVax group (N=311) [OR=3.7; P<0.001]. Parents' pain scores correlated significantly with children's scores. The reduction of immediate pain incidence in Priorix group persisted over the 4 post-vaccination days. This study, using a validated self-assessment pain scale, confirmed previous data showing a significantly lower incidence of immediate post-vaccination pain with Priorix as compared to RORVax.     

Immunogenicity and safety of a combined DTaP-IPV vaccine compared with separate DTaP and IPV vaccines when administered as pre-school booster doses with a second dose of MMR vaccine to healthy children aged 4-6 years

Combination vaccines represent one solution to the problem of increased numbers of injections during single clinic visits. A combined DTaP-IPV (Infanrix-IPV) vaccine has been developed for use as a pre-school booster. Four hundred healthy children aged 4-6 years previously primed with 4 doses of DTaP vaccine (Infanrix), 3 doses of poliovirus vaccine and 1 dose of MMR vaccine were randomized to receive single doses of either the combined DTaP-IPV vaccine or separate DTaP and IPV vaccines in a Phase II trial (DTaP-IPV-047). All children also received a second dose of MMR vaccine. Immunogenicity was assessed in serum samples taken before and 1 month after booster administration. Safety was actively assessed for 42 days post-vaccination. Non-inferiority of the DTaP-IPV vaccine to separate DTaP and IPV vaccines was demonstrated for all DTaP antigen booster response rates and poliovirus geometric mean titers of antibody ratios. Post-vaccination, > or =99.4% of children in both groups had seroprotective levels of anti-diphtheria and anti-tetanus antibodies (> or =0.1IU/mL) and seroprotective anti-poliovirus antibody titers (> or =1:8). All children in both groups were seropositive for measles, mumps and rubella antibodies, with similar post-vaccination geometric mean concentrations/titers. No significant differences were observed in the incidence of solicited local or general symptoms, unsolicited symptoms and serious adverse events between the two groups. This combined DTaP-IPV appeared safe and immunogenic when given as a booster dose at 4-6 years of age. The DTaP-IPV vaccine had no negative effect on the response to co-administered MMR vaccine, making it well-suited for use as a pre-school booster.     

The experience of hospital-related fears of 4- to 6-year-old children

Background There is little information available on a 4‐ to 6‐year‐old child's subjective experience of hospital‐related fears, even though the data collected from parents and hospital staff indicate that hospitalization is an anxiety‐producing experience for young children. Methods A qualitative method was chosen using a purposive sample of 90 children. The data were gathered via semi‐structured interview from 2004 to 2006. The data were analysed using the structure of Colaizzi's Method of Phenomenological Analysis. Results The essential fears were fears related to nursing interventions and pain, to the separation from parents and being left alone, to the lack of information, and to instruments and equipment. Children expressed their fears verbally or through their actions. The meaning of hospital‐related fear formed four main clusters: insecurity, injury, helplessness, and rejection. Conclusions For young children, an experience of hospital‐related might be so traumatic that it influences the well‐being of the child. The fear may damage the sense of security felt by the children, and weaken the child's willingness to trust health‐care professionals. The children often expressed their fear in a contradictory manner or denied it. Children need the help of adults to express their hospital‐related fears, including the objects of these fears.     

Persistence of antibodies in 4-8 year old Austrian children after vaccination with hexavalent DTaP-HBV-IPV/Hib and MMR vaccines

To determine the proficiency of the Austrian childhood vaccination schedule to induce long lasting seroprotection against vaccine preventable diseases a seroepidemiological study in 348 children between four and eight years of age was conducted. Antibodies against diphtheria, tetanus, pertussis, hepatitis B, measles, mumps and rubella antigens were assessed in children, who had been vaccinated with hexavalent DTaP-HBV-IPV/Hib vaccines at three, four, five months and in the second year of life and/or MMR vaccines in the second year of life at least once, but mostly twice.High seroprotection rates (SPRs) were detected for tetanus (96%) and measles (90%). SPRs regarding diphtheria and mumps were 81% and 72%, respectively. Rubella-SPRs were 68% in females and 58% in males. Hepatitis B-antibody levels ≥10 mIU/mL were present in 52%; antibodies against pertussis were detected in 27% of the children. SPRs for measles and rubella depended on the interval since last vaccination; mumps-antibodies were significantly lower after one MMR-vaccination only. Antibodies against diphtheria, tetanus and pertussis depended on the interval since last vaccination while HBs-antibodies did not. The low levels of antibodies 1-7 years after vaccination against pertussis, rubella and mumps after only one vaccination should be considered when recommending new vaccination schedules.     

沈阳市4~6岁儿童行为问题及其影响因素分析

目的 了解沈阳市4~6岁学龄前儿童行为问题现状并分析其影响因素,为儿童心理行为问题的预防提供依据。方法 选取沈阳市9区18所幼儿园36个班级4~6岁儿童作为研究对象,发放基本情况调查表、困难问卷(QCD)。根据QCD问卷调查结果,将儿童分为功能受损组(QCD得分＜30分)和非功能受损组(QCD得分≥30分),针对个人和家庭因素进行单因素分析,对有差异的因素进行多因素Logistic回归分析。结果 共发放问卷900份,回收877份,合格问卷834份。总体功能受损率为13.3%,其中男童功能受损率为15.1%(67/443),女童功能受损率为11.3%(44/391),男女功能受损率之比为1.34∶1。4、5、6岁功能受损率分别为17.9%、12.6%、10.7%。多因素分析显示,哀求式沟通(OR=5.878, 95%CI:1.626~21.253)、做作业时间30~60 min (OR=2.372, 95%CI:1.146~4.908)为行为问题的危险因素,年龄为5岁(OR=0.261, 95%CI: 0.137~0.497)、6岁(OR=0.522, 95%CI:0.295~0.923)、溺爱型教育(OR=0.231, 95%CI:0.068~0.783)为儿童行为问题的保护因素(P<0.05)。结论 沈阳市4~6岁儿童行为问题较为严重,影响因素复杂,可提前规避相应危险因素,早期预防儿童心理行为疾病的发生。     

Comparative immunogenicity under field conditions of two recombinant hepatitis B vaccines in 8-10-year-old children

The immunogenicity of two hepatitis B vaccines was compared in 8-10-year-old children immunized in a school program. One year apart, 1129 children received Engerix-B 10 microg vaccine (EB), and 1126 received Recombivax-HB 2.5 microg (RB), following the 0, 1, 6 schedule. Blood samples were collected one month after the third dose. Anti-Hbs were measured by commercial radioimmunoassay. In the EB group, 99.1% of the children seroconverted (>/=2 IU/l) compared to 99.7% in the RHB group (p=0.09). The seroprotection rate (>/=10 IU/l) was similar for both groups: 98.9% in the EB group and 99.2% in the RB group (p=0.66). However, GMCs of anti-HBs were higher in children given EB compared to those given RB (7307 vs. 3800 mIU/ml, p<0.0001). This study showed that both vaccines were highly immunogenic, in the course of a regular field immunization program. However, the difference observed in the antibody levels attained according to the vaccine may play a role in the long-term protection of these children.     

Spontaneously reported adverse reactions after diphtheria-tetanus revaccination at 4-6 years of age--a comparison of two vaccines with different amounts of diphtheria toxoid

On 1 January 1996, diphtheria-tetanus revaccination at the age of 5 years was implemented in the Danish Childhood Vaccination Programme. Initially, a combined DT vaccine containing 25 Lf diphtheria toxoid was used. Due to a high frequency of spontaneously reported adverse reactions, however, concerns were raised that the diphtheria dose was too high, and it was reduced to 6.25 Lf. This survey presents the rates of spontaneously reported adverse reactions following diphtheria-tetanus revaccinations of 4-6-year-old from 1996 to 2002. The change to the lower dose of diphtheria toxoid resulted in a remarkable reduction in the yearly rates of injection site reactions: in 1996, the rate was 180 injection site reactions per 100,000 vaccinations; from 1998 to 2002, this changed to between 12 and 24 reactions per 100,000 vaccinations. Furthermore, the rates of systemic reactions such as fever were reduced.     

Levels of bactericidal antibodies against meningococcus C after vaccination in 2- to 6-year-old children in Andalusia

BACKGROUND: In 1997, 18.5% of the cases of Meningococcal Disease caused b serogroup C in Andalusia were children between 2 and 4 years of age; ages where the initial immune response and the duration of the capsular A + C meningococcal polysaccharide vaccine is less than in older age groups. Research was designed in order to measure the immune response produced by this vaccine in children from 2 to 6 years of age and to compare it with the natural immunity present in unvaccinated children. METHODS: I. Dual monitoring study: a) groups of children vaccinated previously and control groups, b) groups of children who were going to be vaccinated, for pre and post-vaccination (1, 6 and 12 months) analysis and a control group. II. The bactericidal activity was measured according to the standardised protocol of the CDC with regard to the strain of N. meningitidis C-11. The sera with bactericidal activity (TAB) > 1:8 were considered to be protective. RESULTS: 1 and 2 months following vaccination, the proportion of TAB > 1:8 was significantly higher than that of the control group (65.6% and 73% in comparison to 2.2% and 12%). In the pre-vaccine and post-vaccine (after 6, 7, 12 and 13 months) verification, no significant difference between vaccinated individuals and controls was observed. CONCLUSIONS: The differences between vaccinated and unvaccinated individuals 1 and 2 months following vaccination indicate seroconversion in the vaccinated individuals. For the age group of between 2 to 6 years of age, the bactericidal activity acquired decline quickly, as, after 6 months, differences between this group and the control group are no longer observed.     

Objectively measured physical activity in a representative sample of 3- to 4-year-old children

OBJECTIVE: This study aimed to describe levels of physical activity in a representative sample of preschool children and to quantify tracking of activity over 1 year. RESEARCH METHODS AND PROCEDURES: Physical activity (mean accelerometry counts/minute) was assessed over 3 days using the Computer Science and Applications accelerometer in 3- to 4-year-old children (n = 104; 52 boys; mean age, 3.7 +/- 0.4 years). In 60 children (30 boys), measurements were repeated 1 year later. RESULTS: Mean total activity at baseline was 777 +/- 207 counts/minute in boys and 657 +/- 172 counts/minute for girls; this gender difference was significant (p < 0.001). In the cross-sectional analysis, total activity was significantly positively related to age (r = 0.37, p = 0.007). In the sample followed up for 1 year, mean total activity was 849 +/- 252. The longitudinal analysis confirmed that total physical activity increased over the 1-year period (paired Student's t test, p < 0.001). The tracking rank order correlation coefficient of total activity count over 1 year was r = 0.40 (p < 0.001). DISCUSSION: This study suggests that total activity increases during the preschool period in Scottish children and that gender differences in total activity are present early in life. Tracking of total activity was only modest, but adequate assessment of tracking requires methodological research aimed at elucidating the biological meaning of accelerometer output.     

深圳市6～16岁儿童青春期性发育现况调查

目的 对深圳市6~16岁中小学生青春期性发育现况进行横断面调查, 为儿童卫生保健、青春期健康教育提供基础数据。方法 2017年9月-2018年9月期间,按整群抽样的方法,在深圳东、中、西三个行政区中随机分别抽取中、小学各2所。采用现况法获取第二性征发育(男童睾丸和阴毛发育,女童乳房发育和阴毛发育)数据,询问女童本人月经初潮年龄,共纳入10 674名6~16岁儿童。采用概率比回归模型进行统计分析,结果以中位年龄及对应的95％CI间表示。结果 男童睾丸容积达4ml和出现阴毛的年龄分别为10.1岁(10.0~10.2)和12.2岁(11.9~12.6)。女童乳房发育和出现阴毛的年龄分别为8.5岁(7.4~9.4)和10.6岁(10.5~10.7),初潮年龄为12.1岁(11.8~12.4)。与2005年全国流调数据相比,男、女青春期启动年龄分别提前0.4岁及0.7岁,女童初潮年龄提前0.1岁。结论 深圳地区6~16岁中小学生青春期启动年龄、女童初潮年龄与2005年全国九大城市儿童性征发育调查研究结论相似。     

Comparison of the immunogenicity and reactogenicity of two commercially available hexavalent vaccines administered as a primary vaccination course at 2, 4 and 6 months of age

Infants (N = 459) were randomly assigned to receive either Infanrix hexa or Hexavac vaccines at 2, 4 and 6 months of age as a primary vaccination schedule. The immunogenicity of the hepatitis B component was statistically significantly higher for Infanrix hexa compared to Hexavac in terms of both seroprotection (98.6% versus 94.7%, p = 0.0302) and GMCs (905.6 versus 226.4, p < 0.0001). Significantly (p < or =0.0001) higher antibody levels against diphtheria and the 3 polio components were also induced by Infanrix hexa. The responses to tetanus, Hib and pertussis components were similar. The incidences of clinically relevant solicited symptoms, unsolicited symptoms or serious adverse events were low in both groups.     

西安市4~6岁儿童行为问题现况调查11年前后变化研究

目的 观察4~6岁儿童11年前后行为问题的变化情况,为促进儿童行为的健康发展提供指导依据。方法 分别于2007年10月和2018年10月采取随机整群抽样的方法从西安市东、西、南、北郊区及城中区各选择1所幼儿园,对在园的所有4~6岁儿童采用《Achenlach 4~16岁儿童行为量表》(家长用)(CBCL)进行问卷调查。对选取的幼儿园分别于2007年10月、2018年10月各进行了1次调查,两次调查的幼儿园相同。问卷由儿童家长知情同意后匿名填写。所有数据使用SPSS 21.0统计软件进行分析。结果 2007年和2018年调查结果显示:1)4~5岁男童幼稚不成熟(2.36% vs. 0.23%)、性问题因子异常率(7.26% vs. 18.85%)2018年均高于2007年(χ²=8.041,28.429,P＜0.05);其他因子异常率差异均无统计学意义(P＞0.05)。行为问题总异常率2018年(24.1%)高于2007年(18.8%),差异有统计学意义(χ²=4.092,P＜0.05)。2)4~5岁女童抑郁因子异常率2018年高于2007年,分裂样、社交退缩、性问题3个因子异常率2018年均低于2007年;行为问题总异常率2018年(30.3%)显著低于2007年(37.5%)(χ²=4.739,P=0.029)。3)6岁男童交往不良异常率2018年(1.96%)显著低于2007年(14.29%)(χ²=5.158,P＜0.05);6岁女童的所有行为因子异常率差异均无统计学意义(P＞0.05),6岁儿童行为问题总异常率11年前后差异无统计学意义(P＞0.05)。结论 4~6岁儿童各年龄段行为问题异常率变化11年前后有所不同。行为异常率4~5岁男童11年后增高,女童降低;6岁儿童的行为异常率变化不大。提示家长及幼教工作者,应根据儿童年龄、性别的行为特点,在教养过程中给予积极干预,促进儿童行为的健康发展。     

A phase III,open-label,randomised multicentre study to evaluate the immunogenicity and safety of a booster dose of two different reduced antigen diphtheria-tetanus-acellular pertussis-polio vaccines,when co-administered with measles-mumps-rubella vaccine in 3 and 4-year-old healthy children in the UK

AimTo evaluate the immunogenicity and safety of a reduced antigen diphtheria-tetanus-acellular pertussis-inactivated poliovirus (dTap-IPV_B) vaccine (Boostrix-IPV, GSK) as a pre-school booster in 3–4 year old children as compared to dTap-IPV_R (Repevax, Sanofi Pasteur), when co-administered with mumps-measles-rubella vaccine (MMRV).MethodsThis phase III, open label, randomised study was conducted in the UK between April 2011 and April 2012. Children due their pre-school dTap-IPV booster vaccination were randomised 2:1 to receive one of two different dTap-IPV vaccines (dTap-IPV_B or dTap-IPV_R) with blood sample for immunogenicity assessment just prior and one month after vaccination. Immune responses to diphtheria, tetanus and polio antigens were compared between the study vaccines (inferential comparison). In the absence of an accepted pertussis correlate of protection, the immunogenicity of dTap-IPV_B vaccine against pertussis was compared with historical pertussis efficacy data (inferential comparison). Safety and reactogenicity of both study vaccines were evaluated.Results387 children were randomised and 385 vaccinated: 255 in the dTap-IPV_B group and 130 in the dTap-IPV_R group. Prior to vaccination, ≥76.8% of children had anti-diphtheria and ≥65.5% had anti-tetanus titres above the protection threshold; for pertussis, the pre-vaccination seropositivity rate ranged between 18.1 and 70.6%. Both vaccines were immunogenic with 99.2–100% of children achieving titres above the pre-specified seroprotection/seropositivity thresholds. One serious adverse event not considered as causally related to the study vaccination by the study investigator was reported in the dTap-IPV_B group.ConclusionNon-inferiority of dTap-IPV_B to dTap-IPV_R was demonstrated. Both vaccines had a clinically acceptable safety and reactogenicity profile when co-administered with MMRV to children 3–4 years old.Trial registration: NCT01245049 (ClinicalTrials.gov)     

Sun exposure and number of nevi in 5- to 6-year-old European children

The occurrence and number of melanocytic nevi are among the most important known risk factors for the development of malignant melanoma. Studying the causes of nevi should lead to successful strategies in the prevention of melanoma. Among 11,478 white German children of preschool age the association between benign melanocytic nevi and a number of risk factors for skin cancer was examined. We found that subjects with a reported history of increased sun exposure, for example, painful sunburns, and an increased number of holidays in foreign countries with a sunny climate had significantly higher nevus counts than individuals without these characteristics. Our results provide further evidence that nevus counts may not only be part of a genetic predisposition but also a result of increased exposure to ultraviolet radiation. Together with the fact that a high nevus count is the most relevant risk factor for malignant melanoma, the results strongly indicate a connection between UV-radiation and the development of melanocytic skin cancer. In conclusion, strategies to reduce the incidence of melanoma should begin with young children.     

聊城市农村0～5岁儿童营养状况调查

目的了解农村地区0～5岁儿童营养状况,为改善儿童营养状况提供依据。方法分层随机抽取聊城市东昌府区3个乡(镇),按不同年龄段以接近1∶1的年龄别比例随机抽取0～5岁儿童303名,使用中国疾病预防控制中心营养与食品安全所制定的统一问卷,由经过培训的调查员以入户访问和测量的方式进行调查。结果 0～5岁儿童低体重率、生长迟缓率分别为3.3%和3.0%,营养不良率为9.6%,消瘦率为3.3%;儿童贫血率为24.1%,其中男童为22.6%,女童为26.5%。结论聊城市农村0～5岁儿童营养状况较好,但个别年龄组的贫血率较高。     

Phenylalanine intakes of 1- to 6-year-old children with phenylketonuria undergoing therapy

Mean of median phenylalanine intakes of 1- to 6-yr-old treated phenylketonuria patients who were growing normally were evaluated by age, sex, and treatment group assignment. Total daily means of median phenylalanine intakes of subjects in treatment group 1 were significantly different from those of subjects in treatment group 2 except at the median age of 69 months. Total daily phenylalanine intakes varied from 285 +/- 10 to 453 +/- 30 mg (mean +/- SEM) by subjects in treatment group 1. Total daily phenylalanine intakes of subjects in treatment group 2 varied from 349 +/- 12 to 530 +/- 42 mg (mean +/- SEM). Mean, median phenylalanine intakes by males ranged from 30 mg/kg of body weight by the younger to 23 mg/kg of body weight by the older subjects. Means of median phenylalanine intakes of females varied from 32 mg/kg of body weight by the younger to 21 mg/kg of body weight by the older subjects. No child had a median phenylalanine intake below 10 mg/kg of body weight.     

Eruption of first permanent molars in 4- to 8-year-old children in Plovdiv

INTRODUCTION: The eruption age of the first permanent molars is one of the milestones by which the normal physical development of the child is evaluated. AIM: The need of current data about M1 eruption in 4- to 8-year-old children determines the aim of the present study. MATERIAL AND METHODS: The study includes 928 children from 4 to 8 years of age, from randomly selected kindergartens and schools in Plovdiv. The initial, mean and the latest age of eruption were determined. RESULTS: The data show that there is no statistically significant difference in the eruption age of first permanent molars between the two genders, as well as between the upper and lower jaw. Statistically significantly higher percentage of 4-5 and 5-6 year-old children have had first permanent molars in 1985 compared to their pairs in 2001. CONCLUSIONS: In 4- to 8-year-old children from Plovdiv the initial eruption age of first permanent molars is 5-6 years, the mean age--6-7 years, and the latest age--7-8 years.