RESUMO
Crowded immunization schedules can result in missed or delayed dosing. Combination vaccines help immunize children on time, limit the required number of injections, and allow new vaccines to be added to the schedule. In the United States, a pentavalent vaccine combining diphtheria, tetanus toxoids, and acellular pertussis (DTaP), recombinant hepatitis B (HepB), and inactivated poliovirus vaccine (IPV) is available. Here, we describe the findings of informal surveys among providers, nurse managers, business managers, and parents on their attitudes toward and experiences with the DTaP-HepB-IPV vaccine. Combination vaccine use is expected to increase as more become available and awareness of their benefits grows.
Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Vacinas Combinadas , Pré-Escolar , Análise Custo-Benefício , Estudos Transversais , Vacina contra Difteria, Tétano e Coqueluche , Previsões , Administradores de Instituições de Saúde/psicologia , Diretrizes para o Planejamento em Saúde , Vacinas contra Hepatite B , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido , Enfermeiras e Enfermeiros/psicologia , Pesquisa Metodológica em Enfermagem , Pais/psicologia , Vacina Antipólio de Vírus Inativado , Segurança , Inquéritos e Questionários , Avaliação da Tecnologia Biomédica , Estados Unidos , Vacinas Combinadas/efeitos adversos , Vacinas Combinadas/economia , Vacinas Combinadas/provisão & distribuiçãoRESUMO
Hepatitis A can be a serious disease and represents a substantial health and economic burden. In recent years, a decline in the number of cases of hepatitis A has been observed, which has been attributed in part to the implementation of vaccination policies in states with high disease incidence. In May 2006, the Advisory Committee on Immunization Practices published updated recommendations to include routine hepatitis A vaccination for all children beginning at 12 to 23 months of age. In this review, information on hepatitis A disease burden is presented with a discussion on the new recommendations and implementation of hepatitis A vaccination.
Assuntos
Efeitos Psicossociais da Doença , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Vacinação , Idoso , Criança , Pré-Escolar , Aprovação de Drogas , Diretrizes para o Planejamento em Saúde , Política de Saúde , Hepatite A/complicações , Hepatite A/transmissão , Vacinas contra Hepatite A/provisão & distribuição , Humanos , Programas de Imunização/organização & administração , Esquemas de Imunização , Incidência , Lactente , Vacinação em Massa/organização & administração , Morbidade , Vigilância da População , Saúde Pública , Fatores de Risco , Índice de Gravidade de Doença , Fatores Socioeconômicos , Estados Unidos/epidemiologia , United States Food and Drug Administration , Vacinação/métodos , Vacinação/estatística & dados numéricosRESUMO
OBJECTIVES: Pertussis is one of the few vaccine-preventable diseases on the rise in the United States, particularly among adolescents. We analyzed the epidemiology of pertussis, focusing on disease burden in public health, and examined methods for controlling pertussis and reducing its incidence. DESIGN, SAMPLE, AND MEASUREMENTS: We evaluated current knowledge about pertussis, reported cases of pertussis in the United States, and the changing recognition, diagnosis, and management of the disease. The development of a pertussis vaccine, now licensed and recommended for use in adolescents and adults, was reviewed. RESULTS: Of reported cases in 2004, 38% occurred in adolescents. The increased incidence of pertussis may be the result of better diagnosis, better reporting, and increased awareness of the disease. The burden of adolescent and adult pertussis is significant and includes medical visits, laboratory tests, treatment for cases and contacts, time lost from school and work, disruption of schools experiencing outbreaks, and public health and media turmoil. At current disease rates, the financial cost of adolescent pertussis in this decade is projected at $3.2 billion. CONCLUSIONS: Efforts are needed to increase health care providers' knowledge of pertussis disease and vaccines, improve on-time infant immunization rates, promote immunization registries and public health surveillance, and ensure adequate compensation for vaccine purchase and administration. Universal recommendations for and widespread use of acellular pertussis vaccines in adolescents are the most effective measures in controlling the disease.