The risk of simple febrile seizures after immunisation with a new group B meningococcal vaccine, New Zealand.

As part of safety monitoring during a group B meningococcal disease vaccination campaign in New Zealand, we examined the possible excess risk of vaccine-associated simple febrile seizures (SFS). We conducted a cohort analysis using data from active hospital-based surveillance in the South Auckland area and a national immunisation register. Based on analysis of approximately 63,000 doses, we found no statistically significant increase in SFS incidence within 1, 2, 4, or 7 days after vaccination for any/all doses administered to children aged 6 months through 4 years. We concluded that the vaccine is unlikely to induce a heightened risk of SFS.

The risk of bronchiolitis hospitalisation following administration of a group B meningococcal vaccine in New Zealand.

AIM: During the Phase II clinical trials for a new group B meningococcal vaccine in New Zealand, six study participants (including five children who had been vaccinated with this vaccine) were hospitalised due to acute bronchiolitis. We examined more closely the potential association between bronchiolitis hospitalisation and this vaccine. METHODS: We used descriptive comparisons, a cohort analysis, and a matched case-control study to examine the potential association of bronchiolitis hospitalisation with the vaccine using New Zealand Health Information Service hospital discharge data and vaccination data from the National Immunisation Register. RESULTS: The distribution of hospitalised bronchiolitis cases throughout New Zealand immediately following the introduction of the vaccine was consistent with historical (pre-vaccine) patterns. Similarly, all point estimates for relative risk (cohort analysis) and odds ratio (case-control study) for assessing the potential association between bronchiolitis hospitalisation and the vaccine were less than 1.00. CONCLUSIONS: We concluded that this vaccine is not associated with an increased risk of hospitalisation for bronchiolitis.

Post-marketing safety monitoring of a new group B meningococcal vaccine in New Zealand, 2004-2006.

New Zealand introduced a new outer membrane vesicle vaccine in 2004 to combat an epidemic of group B meningococcal disease. An Independent Safety Monitoring Board oversaw intensive safety monitoring, which included hospital surveillance, health professional reporting (passive and active) and mortality monitoring. With over three million doses administered to individuals aged under 20 years, the monitoring results provide consistent evidence supporting the vaccine's safety.

The global distribution of risk factors by poverty level.

OBJECTIVE: To estimate the individual-level association of income poverty with being underweight, using tobacco, drinking alcohol, having access only to unsafe water and sanitation, being exposed to indoor air pollution and being obese. METHODS: Using survey data for as many countries as possible, we estimated the relative risk association between income or assets and risk factors at the individual level within 11 medium- and low-income subregions of WHO. WHO and The World Bank data on the prevalence of risk factors and income poverty (defined as living on < US$ 1.00 per day, US$ 1-2.00 per day and > US$ 2.00 per day) were analysed to impute the association between poverty and risk factors for each subregion. The possible effect of poverty reduction on the prevalence of risk factors was estimated using population-attributable risk percentages. FINDINGS: There were strong associations between poverty and malnutrition among children, having access only to unsafe water and sanitation, and being exposed to indoor air pollution within each subregion (relative risks were twofold to threefold greater for those living on < US$ 1.00 per day compared with those living on > US$ 2.00 per day). Associations between poverty and obesity, tobacco use and alcohol use varied across subregions. If everyone living on < US$ 2.00 per day had the risk factor profile of those living on > US$ 2.00 per day, 51% of exposures to unimproved water and sanitation could be avoided as could 37% of malnutrition among children and 38% of exposure to indoor air pollution. The more realistic, but still challenging, Millennium Development Goal of halving the number of people living on < US$ 1.00 per day would achieve much smaller reductions. CONCLUSION: To achieve large gains in global health requires both poverty eradication and public health action. The methods used in this study may be useful for monitoring pro-equity progress towards Millennium Development Goals.