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1.
Objectives
We surveyed the vaccination status of family physicians (FP) in the Loire district (France) in 2010.Subjects and methods
A self-administered questionnaire was proposed to a panel of 460 FP; 288 (64%) answered.Results
The vaccination coverage for Diphtheria-Tetanus-Polio in the previous 10 years, BCG, pertussis, seasonal influenza, A/H1N1 2009 influenza, and hepatitis B was 81, 74, 59, 73, 65, and 87% respectively. Sixty-four percent of FP reported they were vaccinated against measles and 49% against chicken pox; 76% were aware of vaccination recommendations for healthcare professionals but 41% wanted more information on the subject. The younger physicians were better vaccinated for Diphtheria-Tetanus-Polio, measles, hepatitis B, and influenza according to a multivariate analysis.Conclusions
The vaccinations of FP (knowledge, practice) must be improved, especially by yearly updates, continuous medical education, and medical follow-up of healthcare professionals. 相似文献2.
Aims
The purpose of this study was to assess the standpoint of family physicians in the Southern French region Provence-Alpes-Cote d’Azur concerning human Papillomavirus vaccination and to evaluate the factors associated with a favorable standpoint.Methodology
A questionnaire was sent to a random sample of 1,000 family physicians. The survey focused on their profile, their views on vaccination generally and on HPV vaccination, their knowledge of HPV, their standpoint concerning STD prevention and cervical cancer screening. Multivariable linear regression system was used to study the variations associated with a favorable response to HPV vaccination.Outcome
Response was 36.6%. The responses were analyzed taking into account gender of the family physicians, location and size of their practice. There was reasonable similarity amongst those questioned. Around 89.6% of family physicians answers were in favor of HPV. The ideal age for vaccination was between 11 and 13 years of age for 34.4% and between 14 and 15 for 53.9%. The family physicians most in favor of vaccination were those involved in screening for STDs, those who did not think that the vaccine would have a negative effect on the image of sexuality and on screening for cervical cancer, and those who were confident about the vaccine safety.Conclusion
The study identified the negative elements concerning HPV in order to optimize information strategies among family physicians. 相似文献3.
A. Mayet F. Berger R. Haus-Cheymol V. Pommier de Santi C. Verret L. Ollivier S. Duron A. Spiegel X. Deparis R. Migliani 《Médecine et maladies infectieuses》2010
Objectives
Pertussis surveillance in the French general population was stopped in 1986. Pertussis was added to the list of illnesses surveyed by the military epidemiological surveillance network ecause of outbreaks having occurred among French servicepersons and in military high schools. This study had for aim to report the results of the first year of surveillance.Design
Pertussis declaration criteria were those recommended in 2006 by the French council for public hygiene. The data concerning active military servicepersons was collected by physicians of all military medical units. An anonymous declaration form was used for data collection.Results
In 2007, 66 cases of pertussis were reported in the military forces, 10 of which were excluded after a negative biological test. The classification of the 56 included cases was: 46% biologically confirmed cases, 20% clinically confirmed cases, 14% suspected cases, and 6% epidemiologically confirmed cases. The incidence density rate was 16.3 cases for 100,000 servicepersons-years. Age under 20 was associated with a 4.6 fold higher risk to develop pertussis.Conclusions
The high incidence rate observed in individuals under 20 years of age could reflect a shift of pertussis reservoir to young adults, as observed in industrialized countries after generalization of vaccination programs. However, several years of surveillance will be needed to confirm this hypothesis. Meanwhile, the military epidemiological network could constitute an important surveillance marker of pertussis among adults in France. 相似文献4.
Objective
This study had for aim to assess pneumococcal vaccination rates in hospitalized patients.Design
A prospective study was carried out in two medical wards of the Nice University Hospital, France. Patients were included from December 31, 2007 to February 12, 2008.Results
Hundred and thirty-seven patients, aged 62 ± 20 years, were included. Pneumococcal vaccination was indicated for 62 patients (45 %). Among these 62 patients, 53 (85 %) had not been vaccinated in the previous 5 years, for the following reasons: no medical advice on vaccination (36 cases), no medical consultation in the past years (nine cases), patient opposed to vaccination (two cases), physician opposed to vaccination (one case), miscellaneous (five cases). Among the 53 patients, seven were vaccinated during their hospital stay and 13 were advised to be vaccinated by their general practitioner.Conclusions
This study highlights a low rate of pneumococcal vaccination in hospitalized patients, mainly due to insufficient counseling from physicians, both in community or in hospital practice. 相似文献5.
P. Pina A.L. Moreau A. Duran O. Sadeg B. Mandelbaum A. Teixeira 《Médecine et maladies infectieuses》2008
Introduction
Seasonal influenza is a viral transmissible infectious disease causing increased morbidity or mortality in frail subjects, especially those living in institutions. Measures to prevent the impact of infectious diseases were proposed based on the use of influenza vaccination among health-care professionals. We wanted to evaluate the acceptance of our institutional vaccination procedure initiated in 2005 and possible improvement.Methods
A questionnaire was sent in May 2007 to all health-care professionals (n = 730) to identify their current vaccine status in 2006 and their opinion concerning vaccination against influenza in 2007.Results
Subsequently, 369 (50.2%) responses were obtained. Amongst those responding, 31.7% were vaccinated in 2006, 77.8% using the institutional procedure. Also, 221 (87.7%) nonvaccinated health-care professionals indicated their position concerning influenza vaccination: 37% of them would accept the vaccination in 2007 (on the condition that our current institutional procedure be improved), 63% of them would refuse influenza vaccines in spite of any improvement.Conclusion
Our study emphasizes that the use of an adapted procedure for influenza vaccination among health-care professionals could improve vaccine coverage. It also emphasizes that a margin of those professionals are still reluctant to vaccination. 相似文献6.
Objective
This literature review addresses the following question: what elements point to an impact of routine chicken pox vaccination of children on the incidence of shingles?Design
The search strategy involved an electronic search (Medline database via PubMed) and crossed references. Articles were selected by reading their abstracts.Results
There were few published studies dealing with the question. A total of 13 publications reported seven longitudinal studies on the incidence of shingles and six mathematical models. The population studies were all American, and reported discordant results, four reporting an increase, and three, stability in the incidence of shingles. Four of the six mathematical models concerned the impact of routine chicken pox vaccination on shingles epidemiology. All showed a transitory short-term increase in the incidence of shingles (on condition that vaccine was effective and coverage high) and a long-term incidence of shingles lower than the current rate.Conclusions
The currently available data is insufficient for any conclusion to be drawn as to the impact of routine pediatric chicken pox vaccination on the incidence of shingles. Monitoring the incidence of shingles in countries either recommending or not such vaccination should be maintained. 相似文献7.
Objectives
Influenza vaccination is recommended to all health care professionals (HCPs). However, vaccination rate among HCPs is low and may be due to uncertainty about the effectiveness of the vaccine and fear of its adverse effects. Therefore, this study aimed to investigate the awareness, knowledge, and attitude of HCPs towards influenza vaccination and we ascertain reasons for not getting vaccinated.Method
A cross-sectional conducted in 6 major hospitals in Saudi Arabia. 245 anonymous questionnaires were distributed to a convenient sample of staff during the 2012–2013 influenza season. The validated questionnaire consists of five sections that collect information about: demographics, attitude towards influenza vaccination, knowledge about influenza virus and vaccination, current practice and awareness of published guidelines.Results
242 completed questionnaires were received, a response rate of 98%. 38% of HCPs reported getting vaccinated. The most common reasons given by HCPs for not getting vaccinated were: fear of contracting illness (16%), belief that they are not at risk from influenza because they are young and healthy (13%) and being unaware of vaccine availability (13%). Non-availability of vaccine (43%) was the highest barrier for not providing vaccine for patients and HCPs followed by safety concerns for the patients (35%) and the respondents (33%). Almost 75% of HCPs were not aware of the influenza immunization guidelines published by the Advisory Committee on Immunization Practices and Centre for Disease Control.Conclusion
Despite the recommendations, only low percentage of HCPs in Saudi Arabian hospitals is vaccinated against influenza. The attention of health policy makers is needed to improve compliance of HCPs with guidelines on influenza vaccination. 相似文献8.
F. Dutheil P. Delaire G. Boudet K. Rouffiac K. Djeriri B. Souweine A. Chamoux 《Médecine et maladies infectieuses》2008
Objective
The aim of this study was to compare the cost of vaccination for the Clermont-Ferrand University hospital (CHU) personnel and the cost of sick leave among vaccinated and non-vaccinated employees in 2003, 2004, and 2005.Design
The study included 7256 CHU staff (medical and non-medical personnel). The cost of sick leave was calculated on the basis of short-term disease (four to nine days) over the three months of the epidemic season in 2004, 2005, and 2006.Results
In 2005, the overall cost of vaccination was 4.02 € per vaccinated employee. Over the three years, the total sick leave reached 804 days for employees vaccinated against 5670 for non-vaccinated employees. In 2003, 2004, and 2005, the vaccinal coverage was 13, 20.5, and 30.1%, the mean duration of sick leave was 0.16, 0.17, and 0.18 day among vaccinated staff, and 0.26, 0.39, and 0.34 day among non-vaccinated staff corresponding to a benefit per vaccinated employee of 5, 26, and 20 €, respectively for each year. The total benefit for the institution was 86,458 € (4630 + 38,168 + 43,660). If the vaccinated rate of 75% recommended by the Haute Autorité de santé (HAS) had been reached, the additional benefit would have been 250,193 € (33,157 + 152,256 + 65,180).Conclusions
The number of sick leave days and the related cost were approximately twice less important for vaccinated employees, economically justifying this vaccination including a period of weak epidemic, as checked over three consecutive years. 相似文献9.
Iván Martínez-Baz Marcela Guevara Fernando Elía Carmen Ezpeleta Mirian Fernández Alonso Jesús Castilla 《Gaceta sanitaria / S.E.S.P.A.S》2014
Objective
To estimate the effectiveness of the influenza vaccine under different criteria for selecting patients for swabbing.Method
A case-control study was performed of laboratory-confirmed cases (n = 909) and negative controls for influenza (n = 732) in the 2010-2011 to 2012-2013 seasons in Navarre (Spain). The adjusted vaccine effectiveness was estimated by including all swabs from patients with influenza-like-illness and selecting only the first two cases per physician and week.Results
The first two patients per physician and week were less frequently vaccinated against influenza (7.9% vs. 12.5%, p = 0.021) and less often received confirmation of influenza (53.6% vs. 66.4%, p <0.001) than subsequent patients. These differences decreased after adjustment for covariates. The effectiveness of the influenza vaccine was 49% (95% CI: 23-66%) when all swabs were included and was 55% (95% CI: 27-72%) when we selected the first two swabs per week and physician.Conclusion
The selection of the first two patients per physician and week may bias assessment of the effectiveness of the influenza vaccine, although this bias was small in the seasons analyzed. 相似文献10.
Aiden Kennedy Varan Alejandra Esteves-Jaramillo Vesta Richardson Marcelino Esparza-Aguilar Patricia Cervantes-Powell Saad B. Omer 《Vaccine》2014
Objective
Adult booster vaccination against pertussis can help prevent severe infections in young infants. We examined influences on intention to accept pertussis booster vaccination among pregnant women in Mexico City.Methods
We conducted a cross-sectional survey, recruiting convenience samples of pregnant women receiving prenatal care from three public healthcare centers between March and May 2012. Our primary outcome was intention to accept pertussis vaccination during pregnancy. We examined socio-demographic factors, vaccination history, pertussis knowledge, perceptions of vaccine information sources, and other potential influences on vaccine decision-making.Results
A total of 402 pregnant women agreed to participate, of which 387 (96%) provided their intention to accept or decline pertussis vaccination. Among respondents, 57% intended to accept a pertussis booster vaccine if offered, but only 16% had ever heard of pertussis, and only 2% knew someone who had contracted this disease. Over 80% of respondents would accept pertussis vaccination if recommended by an obstetrician-gynecologist. The most frequently selected reasons to refuse pertussis vaccination were concerns that the vaccine might harm the unborn baby or pregnant woman. In multivariate analysis, rating doctors and nurses as good sources of vaccine information, and having ever heard of pertussis, were independently associated with intention to accept pertussis vaccination.Conclusions
Promoting patient awareness about pertussis disease and vaccine safety, and encouraging general practitioners, nurses and obstetricians to recommend pertussis booster vaccine, may increase vaccine uptake among pregnant women. 相似文献11.
Introduction
Post-partum vaccination of new mothers is currently recommended in Australia to reduce pertussis infection in infants. Internationally, vaccination recommendations now include pregnant women in some countries. Understanding the awareness of pertussis vaccination recommendations among pregnant women, and their willingness to have the vaccine while pregnant is important for informing vaccine program implementation.Objective
To determine awareness and intentions toward current recommendations for post-partum pertussis vaccination among Australian pregnant women, and their willingness to accept pertussis vaccine during pregnancy, should it be recommended in Australia in the future.Design
Quantitative self-administered survey, using a non-random stratified sampling plan based on representative proportions by age, parity and region of residence.Participants and setting
Pregnant women receiving antenatal care through three large, demographically diverse referral hospitals in metropolitan, urban and rural New South Wales, Australia.Results
The response rate was 815/939 (87%). Most women (80%) reported willingness to have the pertussis vaccine during pregnancy, should it be recommended. Thirty four per cent of women intended to receive a pertussis vaccine post-partum, 17% had received it previously, while 45% had never heard of pertussis vaccine, had not thought about it, or were undecided about having it. Compared with those who had not received a recommendation to have the vaccine post-partum, women who had received a recommendation were 7 times more likely (95% CI 4–14) to report intention to have the vaccine.Conclusions
Health care provider recommendation is paramount to raising awareness of pertussis vaccination recommendations among pregnant women. Women's willingness to have the vaccine while pregnant is encouraging, and indicates the potential for high pertussis vaccine coverage among pregnant women, should it be recommended in Australia. 相似文献12.
B Thierry-Carstensen K Jordan HH Uhlving T Dalby C Sørensen AM Jensen C Heilmann 《Vaccine》2012,30(37):5464-5471
Background
Increasing incidence of pertussis in adolescents and adults has stimulated the development of safe and immunogenic acellular pertussis vaccines for booster vaccination of adolescents and adults.Purpose
To obtain clinical documentation of the safety and immunogenicity of a tetanus, diphtheria and monocomponent acellular pertussis combination vaccine (TdaP), when given as a booster vaccination to adults.Methods
The trial was double-blind, controlled and randomised. 802 healthy adults, aged 18–55 years who had completed childhood vaccination with diphtheria, tetanus and whole cell pertussis vaccine (DTwP), were booster vaccinated with TdaP or Td. Blood samples were taken before and one month after the vaccination for serological analysis and adverse events were recorded during the one-month-follow-up period.Results
The monocomponent acellular pertussis vaccine (aP) in the TdaP vaccine was immunogenic in adults with 92.0% of TdaP vaccinated subjects obtaining an anti-pertussis toxin (anti-PT) antibody booster response. TdaP was non-inferior to Td in eliciting seroprotective anti-tetanus and diphtheria antibody concentrations with more than 98% of subjects obtaining post-vaccination seroprotective concentrations (≥0.1 IU/mL). T and d booster response rates were 93.0% and 97.5%, respectively.The frequencies of solicited local adverse reactions were low and comparable between TdaP and Td vaccinees. In the TdaP group, 30.7% reported pain, 4.2% swelling and 2.0% erythema at the injection site. The most frequent solicited general symptoms were headache (20.4%), fatigue (17.0%) and myalgia (10.0%). In the Td group, 35.7% reported pain, 2.5% swelling and 3.2% erythema at the injection site, whereas headache, fatigue and myalgia were reported by 15.7%, 14.5% and 12.5%, respectively.In conclusion, TdaP Vaccine SSI was safe and immunogenic when given as a booster vaccination to adults. ClinicalTrials.gov registration number: NCT01033877. 相似文献13.
M. Mohseni-Zadeh D. Rey M.-L. Batard G. Beck Wirth M.-L. Partisani J.-M. Lang Y. Hansmann D. Christmann M. Martinot 《Médecine et maladies infectieuses》2010
Introduction
HIV patients have a high rate of infectious complications. Vaccination, though less efficient in case of severe immunosuppression, can prevent some of these infections. Since 2006, new vaccine recommendations have been elaborated in France. We studied the vaccine status of HIV+ patients for influenza, Streptococcus pneumoniae, tetanus, and hepatitis A and B among an alsatian HIV+ population.Patients and methods
From August 20, 2007 to September 15, 2007, HIV patients of the Alsace HIV center (COREVIH) were included in a prospective study, screening demographic, medical, immunovirologic, and vaccination data.Results
Three hundred and thirty-one patients were included, 49% of whom were asymptomatic, 29% symptomatic without AIDS, 18% at AIDS stage, and no documentation for 4%. Seventy-one patients (21.4%) were vaccinated against influenza, 11 (3.3%) against Streptococcus pneumoniae, 34 against HAV (only 16.3% of patients with a negative test before), 120 against HBV (60% of patients with no serological markers before), and 186 (56.2%) against tetanus. The most frequent reasons for non-vaccination were non-proposal by physicians, lack of expected effectiveness, and fear of an immunovirological adverse effect.Conclusion
Vaccination coverage for recommended vaccines of HIV infected people remains at a low level and appears sometimes inferior to the rates reached among the general French population. It is necessary to inform prescribers and HIV positive patients about the interest of vaccination. 相似文献14.
Introduction
In the United States, Federally Qualified Health Centers (FQHCs) are safety-net clinics that provide cervical cancer screening and human papillomavirus (HPV) vaccination to medically underserved women, some of whom may be at risk for developing cervical cancer. National guidelines recommend against using screening test results or sexual history to determine vaccine eligibility. Documenting HPV vaccine recommendations and beliefs of primary care providers in FQHCs may aid in promoting evidence-based practices and prioritizing health interventions for vulnerable populations.Methods
Between 2009 and 2010, we collected data from 98 primary care providers in 15 FQHC clinics in IL, USA using a cross-sectional survey. Questions assessed provider and practice characteristics, HPV vaccine recommendations, and provider's belief about whether their screening and management procedures would change for women who were vaccinated.Results
93% of providers recommended the HPV vaccine, most frequently for females aged 13–26 years (98%). Some providers reported sometimes to always using HPV test results (12%), Pap test results (7%), and number of sexual partners (33%) to determine vaccine eligibility. More than half of providers (55%) reported they will not change their screening and management practices for vaccinated females, yet believe vaccination will yield fewer abnormal Pap tests (71%) and referrals for colposcopy (74%).Conclusion
Study providers routinely recommended the HPV vaccine for their patients. However, providers made fewer recommendations to vaccinate females ages 9–12 years (which includes the target age for vaccination) compared to older females, and used pre-vaccination assessments not recommended by U.S. guidelines, such as screening test results and number of sexual partners. In order to maximize the public health benefit of the HPV vaccine to prevent cervical cancer, adherence to guidelines is necessary, especially in settings that provide care to medically underserved women. 相似文献15.
Background
Pertussis can cause significant morbidity in elderly patients, who can also transmit this disease to infants and young children. There is little data available on the use of acellular pertussis vaccines in recipients ≥65 years of age.Methods
Two studies examined the safety and immunogenicity of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine (Boostrix®) in healthy ≥65 year olds. In Study A subjects received single doses of Tdap and seasonal influenza vaccine either co-administered or given one month apart. In Study B subjects received either Tdap or tetanus-diphtheria (Td) vaccine. Antibodies were measured before and one month after vaccination. Reactogenicity and safety were actively assessed using diary cards.Results
A total of 1104 subjects 65 years of age and older received a Tdap vaccination in the two studies. In study A, no differences in immune responses to Tdap or influenza vaccine were observed between co-administered or sequentially administered vaccines. In study B, Tdap was non-inferior to Td with respect to diphtheria and tetanus seroprotection, and anti-pertussis GMCs were non-inferior to those observed in infants following a 3-dose diphtheria, tetanus and acellular pertussis (DTaP) primary vaccination series, in whom efficacy against pertussis was demonstrated. Reports of adverse events were similar between Tdap and Td groups.Conclusions
Tdap was found to be immunogenic in subjects ≥65 years, with a safety profile comparable to US-licensed Td vaccine. Tdap and influenza vaccine may be co-administered without compromise of either the reactogenicity or immunogenicity profiles of the two vaccines. 相似文献16.
Objectives
Shortly after pertussis vaccination was reintroduced in Sweden in 1996, an intensified pertussis disease surveillance programme was set up. In this study, we report on in-depth analyses of age–dose–number-specific incidences and the rate of pertussis hospitalisation for children with no, 1 or 2 doses of an acellular pertussis vaccine before pertussis disease. Vaccine coverage, the timeliness of childhood vaccination and the effect of later than scheduled pertussis vaccination(s) are also examined.Study design
Children with notified laboratory-confirmed (culture or PCR) pertussis disease were evaluated among the surveillance population of about 1 million infants, born between 1996 and 2007 and followed for pertussis disease from October 1997 to December 2007, for nearly 6 million person-years. Birth and vaccination dates of the diseased children are known from the surveillance programme. To estimate denominators of the age–dose–number-specific pertussis incidences, we used birth and vaccination dates from a vaccine trial with more than 72,000 infants combined with national pertussis vaccine coverage data for children in the surveillance population.Results
For infants from 3 to <5 months of age, the incidence of pertussis disease with at least 14 days of cough decreased from 264/100,000 for unvaccinated infants to 155/100,000 for infants with one dose of a pertussis vaccine prior to onset of the disease. In the age range 5 to <12 months, the age–dose specific incidences were 526, 95, and 24/100,000 for infants with no, 1 and 2 doses, respectively. The rate of hospitalisation for infants with 1 dose of a pertussis vaccine prior to onset of the disease was significantly lower than for unvaccinated infants of the same age.For many infants, there is a delay in administration of the vaccine doses according to the regular 3–5–12 month schedule (which has been the case for many years). Hypothetically, if all infants had been vaccinated exactly on schedule, we would expect about 28% fewer pertussis cases with at least 14 days of cough and 38% fewer hospitalisations due to pertussis, of cases possible to influence by vaccinations on schedule.Conclusion
Pertussis vaccination had a significant effect among infants already after the first dose. This is particularly important for premature infants and infants with severe respiratory and cardiac diseases. A moderate decrease in the incidence of pertussis disease in infants and rate of hospitalisation could be expected if primary vaccinations were carried out closer to the scheduled time than is currently the practice in Sweden. 相似文献17.
Rajan Guha Shantanabha Das June Ghosh Kshudiram Naskar Ashok Mandala Shyam Sundar Jean Claude Dujardin Syamal Roy 《Vaccine》2013
Background
Emergence of resistance against commonly available drugs poses a major threat in the treatment of visceral leishmaniasis (VL), particularly in the Indian subcontinent. Absence of any licensed vaccine against VL emphasizes the urgent need to develop an effective alternative vaccination strategy.Methodology
We developed a novel heterologous prime boost immunization strategy using kinetoplastid membrane protein-11 (KMP-11) DNA priming followed by boosting with recombinant vaccinia virus (rVV) expressing the same antigen. The efficacy of this vaccination regimen in a murine and hamster model of visceral leishmaniasis caused by both antimony resistant (Sb-R) and sensitive (Sb-S) Leishmania (L.) donovani is examined.Result
Heterologous prime-boost (KMP-11 DNA/rVV) vaccination was able to protect mice and hamsters from experimental VL induced by both Sb-S and Sb-R-L. (L.) donovani isolates. Parasite burden is kept significantly low in the vaccinated groups even after 60 days post-infection in hamsters, which are extremely susceptible to VL. Protection in mice is correlated with strong cellular and humoral immune responses. Generation of polyfunctional CD8+ T cell was observed in vaccinated groups, which is one of the most important prerequisite for successful vaccination against VL. Protection was accompanied with generation of antigen specific CD4+ and CD8+ cells that produced effector cytokines such as IFN-γ, IL-2 and TNF-α. KMP-11-DNA/rVV vaccination also developed strong cytotoxic response and reversed T-cell impairment to induce antigen specific T cell proliferation.Conclusion
KMP-11 is a unique antigen with high epitope density. Heterologous prime boost vaccination activates CD4+ and CD8+ T-cell mediated immunity to confer resistance to VL. This immunization method also produces high quality T-cells secreting multiple effector cytokines thus enhancing durability of the immune response. Thus the vaccination regime as described in the present study could provide a potent strategy for future anti-leishmanial vaccine development. 相似文献18.
Background
Between July 1997 and April 1998, Canadian public health agencies switched from the whole cell vaccine to the acellular vaccine for pertussis immunization. The acellular vaccine provided better efficacy and fewer adverse events than the whole cell vaccine did.Objective
To determine the economic impact of replacing the whole cell vaccine with an acellular vaccine in Canada.Methods
A decision analytic model was developed comparing costs and outcomes of pertussis vaccination for Canadian children born in the years 1991–2004. Effectiveness was measured as number of avoided pertussis cases as well as the number of avoided hospital admissions. Incremental costs per avoided pertussis case and per avoided hospital admission were calculated for Ministry of Health (MoH) and societal (SOC) perspectives. Various one-way sensitivity analyses as well as a Monte Carlo simulation were performed by varying key model parameters.Results
The switch in immunization programs resulted in an incremental cost to the MoH of CAD $108 per pertussis case avoided (CAD $0.96 per child-year). From the SOC perspective, there was a savings of CAD $184 per pertussis case avoided (CAD $0.13 per child-year). The one-way sensitivity analyses provided incremental cost-effective ratios (ICERs) ranging from an incremental cost of CAD $1034 per avoided pertussis case from the MoH perspective to a saving of CAD $1583 per avoided case from the SOC perspective. The Monte Carlo simulation confirmed the robustness of these results.Conclusions
Pertussis vaccination with AcE was cost-saving from the societal perspective and cost-effective from the Ministry of Health perspective. 相似文献19.
F. Blaizeau A. Lasserre L. Rossignol T. Blanchon S. Kernéis T. Hanslik D. Levy-Bruhl 《Médecine et maladies infectieuses》2012
Objectives
The authors assessed the knowledge and practices of French family physicians concerning the application of the new 2007 varicella vaccination guidelines for non-immune teenagers, 12 to 18 years of age. They also estimated the vaccination coverage in this population.Method
A questionnaire link was sent by to 1008 family physicians of the French Inserm Sentinel network. Each family physician had to include the last teenager aged 12 to 18 years seen in consultation, with no or uncertain history of clinical varicella.Results
One hundred and forty-one family physicians agreed to participate and included one patient (participation rate = 14%) between 4th November 2010 and 4th January 2011. One hundred and thirty-three questionnaires out of 141 (94%) were analyzed. Three patients were vaccinated and 127 were not, giving a weak vaccination coverage in the investigated population at 2%. Eighty-nine family physicians (70%) did not know about the recommendation, and 90 (71%) declared that they had no intention to vaccinate their patient against varicella.Conclusion
Guidelines on varicella vaccination of non-immune teenagers are poorly followed and accepted by family physicians. Vaccination coverage is very low, and efforts should be made to improve application of recommendations. 相似文献20.
F. Renou L. RaffrayA. Gerber M.P. MoitonD. Ferrandiz J.L. Yvin 《Médecine et maladies infectieuses》2010