Acute adverse events following immunization with DTP-HB-Hib pentavalent vaccine in the first year of life

Background: Since November 2014, the pentavalent (Diptheria+Tetanus+Pertussis and Hepatitis B and Hib or DTP-HBHib) vaccine has been integrated into the Iranian national vaccination programme. Aims: We conducted a prospective study in Zahedan in the southeast of the Islamic Republic of Iran to determine the incidence of adverse events following immunization (AEFI) with the pentavalent vaccine in children aged under one year. Methods: Using cluster sampling, 1119 children aged 2–10 months at 15 public health clinics were invited, through their parents, to participate in the study. The parents were trained to register and report any AEFIs in a questionnaire. They were instructed to return the child to the clinic for further examination by a physician if they observed any complications within 3 days of vaccination. Results: The most commonly reported AEFIs were fever (50.94%), mild (41.46%) and severe (1.70%) injection site complications, persistent crying for 3 hours or more (1.88%), hypotonic hyporesponsive episode (0.36%), vomiting (1.88%), diarrhoea (2.95%), and sterile abscess (0.62%). There were no cases of convulsion, purulent abscess or rash. The work experience of vaccinators (OR = 1.85; 95% CI: 1.4–2.46) showed a significant statistical association with the incidence of mild local complications at the injection site. Those with a history of Bacillus Calmette–Guérin (BCG) lymphadenitis (OR = 3.89; 95% CI:1.04–14.49) had a higher risk of severe local complications at the injection site. Conclusions: The observed incidence of serious AEFIs following pentavalent vaccine injection in the study population was within the expected range. However, some of the relationships observed in this study require further research.

Childhood very severe pneumonia and meningitisrelated hospitalization and death in Yemen, before and after introduction of H. influenzae type b (Hib)vaccine

لقد أدرج لقاح المستدمية المنزلية من النمط "بي" في البرنامج اليمني للتمنيع في عام 2005 . وتقارن هذه الدراسة بين معدلات الإدخال في المستشفيات والوفيات ذات الصلة بالالتهاب الرئوي الشديد جدا والالتهاب السحائي الناجم عن جميع الأسباب قبل وبعد إدخال لقاح المستدمية النزلية المتقارن من النمط "بي"، وتعرض نتائج الترصد لالتهاب السحايا الجرثومي في عام 2010 . وهي دراسة استعادية أجريت على البيانات التي جمعت في الفترة 2000 - 2010 وشملت جميع الأطفال الذين تراوحت أعمارهم بين شهرين و 60 شهرا في المستشفى الرئيسي لطب الأطفال في صنعاء. وقد اتضح وجود انخفاضات يعتد بها إحصائيا ومثيرة للاهتمام في معدلات الإدخال إلى المستشفى والموت الناجم عن جميع أسباب التهابات السحايا في الفترة التي سبقت إدخال اللقاح مقارنة بالفترة التي تلت إدخال اللقاح. إلا أن معدل الإدخال إلى المستشفى والوفيات بسبب الالتهاب الرئوي الشديد جدا لم يتحسن إلا قليلا، وكانت هناك بينات على تناقص، ولكن دون أن يكون له ميل يعتد به إحصائيا، مما يدل على أن الالتهاب الرئوي الشديد جدا كان بمثابة نقطة نهائية غير نوعية تترافق بأسباب متعددة للأمراض [منها جرثومي ومنها فيروسي]. ولايزال الالتهاب الرئوي الشديد جدا هو السبب الأكثر انتشارا للأمراض الشديدة وللموت بين صغار الأطفال، ولاسيما من يقل عمره عن 12 شهرا

ABSTRACT Haemophilus influenzae type b (Hib) vaccine was included in the Yemen immunization programme in 2005. Thisstudy compared the rates of very severe pneumonia and all-cause meningitis hospitalization and death, before and afterintroduction of conjugate Hib vaccine, and reports the results of the 2010 bacterial meningitis surveillance. A retrospectiveanalysis was made of data collected for 2000–2010 for all children aged 2–60 months in the main children’s hospital inSana’a. Compared with the pre-Hib vaccination period, the post-Hib period showed significant and impressive reductionsin the rates of hospitalization and death for all-cause meningitis. However, hospitalization and death for very severepneumonia improved only modestly, and there was evidence of a decreasing but non-significant trend indicting that verysevere pneumonia was a non-specific endpoint with multi-etiologies (both viral and bacterial). Very severe pneumoniaremains the leading cause of severe morbidity and death for young children, particularly those aged < 12 months.

RÉSUMÉ Le vaccin contre Haemophilus influenzae type b (Hib) a été inclus dans le programme de vaccination duYémen en 2005. La présente étude a comparé les taux d'hospitalisation et de décès dus à une pneumonie trèssévère et à une méningite toutes causes confondues, avant et après l'introduction du vaccin Hib conjugué ; elle apar ailleurs présenté les résultats de la surveillance de la méningite bactérienne de 2010. Une analyse rétrospectivea été menée afin de recueillir des données sur la période de 2000 à 2010 pour tous les enfants âgés de 2 à 60 moisdans le grand hôpital pour enfants de Sanaa. Par rapport à la période précédant la vaccination par le Hib, la périodesuivant cette dernière a présenté des réductions significatives et remarquables dans les taux d'hospitalisation et dedécès pour méningite toutes causes confondues. Toutefois, les taux d'hospitalisation et de décès pour pneumonietrès sévère n'ont diminué que modestement. Des éléments montrent certes une tendance à la baisse, mais nonsignificative, et indiquent que la pneumonie très sévère n'était pas un critère d'évaluation spécifique lorsque lesétiologies étaient multiples (à la fois virale et bactérienne). La pneumonie très sévère reste la cause principale demorbidité sévère et de décès chez le jeune enfant, notamment chez l'enfant de moins de 12 mois.

Burden of Haemophilus influenzae type B disease in Pakistani children

Estimates of the burden of Haemophilus influenzae type b [Hib] in children in Pakistan are limited. A prospective surveillance was set up in 8 sentinel sites in Karachi and Hyderabad in January 2004. A total of 1481 children aged < 5 years underwent lumbar puncture for suspected acute bacterial meningitis. Specimens from 237 [16.0%] children met the criteria for probable bacterial meningitis, and Hib was detected in 45 of them [19.0%]. The minimum detected incidence of Hib meningitis in the Hyderabad area was 7.6 per 100 000 in children < 5 years of age, and 38.1 per 100 000 children < 1 year. Hib vaccination is justified for inclusion in Pakistan's expanded programme of immunization

Prevalence of oropharyngeal colonization by Haemophilus influenzae type b in Iranian children

Healthy carriers of Haemophilus influenzae type b [Hib] play an important role in the spread of invasive disease. The aim of this study was to assess the need for Hib vaccination in Iranian children by estimating the prevalence of Hib oropharyngeal colonization among children in Tehran. Cultures were prepared from oropharyngeal swabs of 1000 children in 25 day-care centres in Tehran from October 2005 to March 2006. The prevalence of Hib carriers was 7.6%, similar to other developing countries prior to inoculation with the conjugate Hib vaccine. We recommend Hib vaccination be included in the Iranian national programme of immunization

Sub-regional meeting of national immunization programme managers (Central and Eastern Europe, Turkey and NIS) : report on a WHO meeting, Vienna, Austria 26-28 February 2002

The purpose of the meeting was to brief national immunization programme managers on immunization activities in the WHO European Region and to introduce the plan of action for 2002-2003. Participants received information on global, regional and selected national immunization programmes; measles surveillance and supplementary immunization activities; the introduction of new vaccines and the Global Alliance for Vaccines and Immunization (GAVI); and activities leading up to the declaration of the Region as poliomyelitis-free. The participants formulated recommendations to European countries and WHO on future strengthening of immunization systems, including the surveillance of vaccine-preventable diseases; vaccine management and safety of immunization; measles elimination; and the prevention of congenital rubella infection. They also asked WHO to continue the development of immunization policy; to be an advocate with the governments of participating Member States to provide appropriate financial support to immunization programmes as a priority within primary health care delivery; to promote and provide technical support towards the development and implementation of policies for ensuring safety of injections related to immunization, use of quality vaccines and cold chain management; and to finalize the Strategic plan for measles and congenital rubella infection in the European Region of WHO, 2002-2007, including technical supporting documents