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2.
PLoS One ; 15(3): e0230359, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32203527

RESUMEN

INTRODUCTION: The clinical and economic impact of cervical cancer consistently become a serious burden for all countries, including Indonesia. The implementation of HPV vaccination policy for a big country such as Indonesia requires a strong commitment from several decision-makers. The aim of this study was to provide a comprehensive description on cost-effectiveness and the budget-impact of HPV vaccination policy in Indonesia. METHOD: A cohort Markov model was used to evaluate the cost and the clinical impact of HPV vaccination for 10 years old girls in Indonesia. The researchers consider two doses of all three available HPV vaccines adjusted with the HPV infection profilewith 95% vaccination coverage to estimate the national cervical cancer incidence and mortality. The Budget impact analysis explores three different scenarios covering (1) Two districts per year expansion, (2) oneprovince per year expansion and (3) achieving the National Immunization Program in 2024. RESULTS: Upon fully vaccinating almost 2.3 million 10-year-old girls, 34,723; 43,414; and 51,522 cervical cancer cases were prevented by Quadrivalent, Bivalent and Nonavalent vaccines, consecutively. Furthermore, the highest (591 cases) and lowest (399 cases) mortality were prevented by Nonavalent and Quadrivalent vaccines, respectively. Most of the vaccines were considerably cost-effective and only the Bivalent vaccine with the GAVI/UNICEF price which will be considered a cost-saving strategy.To provide national coverage of HPV vaccination in Indonesia, the government has to provide an annual budget of about US$49 million and US$22 million using the government contract price and GAVI/UNICEF price, respectively. CONCLUSION: HPV vaccination shows a cost-effective strategy and the budget required to provide this policy is considerably affordable for Indonesia.


Asunto(s)
Análisis Costo-Beneficio , Vacunación Masiva/economía , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Neoplasias del Cuello Uterino/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Presupuestos/estadística & datos numéricos , Niño , Simulación por Computador , Ahorro de Costo/estadística & datos numéricos , Femenino , Humanos , Incidencia , Indonesia/epidemiología , Cadenas de Markov , Vacunación Masiva/organización & administración , Vacunación Masiva/estadística & datos numéricos , Persona de Mediana Edad , Modelos Económicos , Mortalidad , Infecciones por Papillomavirus/economía , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Vacunas contra Papillomavirus/economía , Políticas , Dinámica Poblacional , Años de Vida Ajustados por Calidad de Vida , Neoplasias del Cuello Uterino/economía , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/virología , Cobertura de Vacunación/economía , Cobertura de Vacunación/organización & administración , Cobertura de Vacunación/estadística & datos numéricos , Adulto Joven
3.
PLoS One ; 15(3): e0230329, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32208432

RESUMEN

Given the complicated history of Japan's National Immunization Program, a significant proportion of Japanese people including healthcare workers (HCWs) still lack adequate immunity against measles, mumps, and rubella (MMR), resulting in occasional outbreaks. In 2014, the Japanese Society of Infection Prevention and Control (JSIPC) published vaccination guidelines for HCWs. We evaluated antibody titers before and after MMR vaccination in HCWs at the Nara Medical University Hospital, the attainment rate of the target antibody titers defined by the JSIPC guidelines, and the safety of vaccines. We measured MMR antibody titers in HCWs, followed by inoculation with the respective monovalent vaccines and/or trivalent MMR (tMMR) vaccine according to the JSIPC guidelines. Among 467 HCWs evaluated, antibody titers against measles and mumps measured using the IgG-enzyme immunoassay increased from 11.0 [interquartile range (IQR): 8.0-13.6] to 13.7 (IQR: 11.3-16.9; P < 0.001) and from 2.8 (IQR: 2.1-3.5) to 4.8 (IQR: 3.7-5.7; P < 0.001), respectively. By evaluating a logarithmic value of log2(X + 1) converted from an antibody titer X, antibody titers against rubella measured using the hemagglutination assay increased from 3.2 (IQR: 0-4.1) to 6.0 (IQR: 4.6-8.0; P < 0.001). Antibody titer elevated following tMMR vaccination was lower than that following monovalent vaccination in a single dose of the measles-containing, a single dose of the mumps-containing, and two doses of rubella-containing vaccine groups (P = 0.01, 0.01, and <0.001, respectively). After vaccination, 20.0%, 61.5%, and 46.2% of HCWs attained target antibody titers specified by the JSIPC guidelines for measles, rubella, and mumps, respectively. The systemic response in female HCWs who underwent monovalent mumps vaccination was statistically higher than that in others. Although the vaccination program for HCWs according to the JSIPC guidelines caused increased MMR antibody titers, the rates of attaining the target criteria were low.


Asunto(s)
Anticuerpos Antivirales/sangre , Brotes de Enfermedades/prevención & control , Personal de Salud/estadística & datos numéricos , Vacunación Masiva/organización & administración , Vacuna contra el Sarampión-Parotiditis-Rubéola/administración & dosificación , Adulto , Anticuerpos Antivirales/inmunología , Femenino , Implementación de Plan de Salud , Humanos , Esquemas de Inmunización , Japón , Masculino , Vacunación Masiva/normas , Vacunación Masiva/estadística & datos numéricos , Sarampión/inmunología , Sarampión/prevención & control , Sarampión/virología , Persona de Mediana Edad , Paperas , Guías de Práctica Clínica como Asunto , Rubéola (Sarampión Alemán)/inmunología , Rubéola (Sarampión Alemán)/prevención & control , Rubéola (Sarampión Alemán)/virología , Virus de la Rubéola/inmunología
5.
Mayo Clin Proc ; 95(1): 169-183, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31902413

RESUMEN

In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.


Asunto(s)
Vacunación Masiva , Infecciones Neumocócicas/prevención & control , Virosis/prevención & control , Adulto , Humanos , Vacunación Masiva/métodos , Vacunación Masiva/organización & administración , Infecciones Neumocócicas/epidemiología , Servicios Preventivos de Salud/normas , Estados Unidos , Cobertura de Vacunación/métodos , Cobertura de Vacunación/estadística & datos numéricos , Virosis/epidemiología
6.
Epidemiol Health ; 41: e2019044, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31623421

RESUMEN

OBJECTIVES: The aim of this study was to estimate the medical surge capacity required for mass prophylaxis based on a hypothetical outbreak of smallpox. METHODS: We performed a simulation using the Bioterrorism and Epidemic Outbreak Response Model and varied some important parameters, such as the number of core medical personnel and the number of dispensing clinics. RESULTS: Gaps were identified in the medical surge capacity of the Korean government, especially in the number of medical personnel who could respond to the need for mass prophylaxis against smallpox. CONCLUSIONS: The Korean government will need to train 1,000 or more medical personnel for such an event, and will need to prepare many more dispensing centers than are currently available.


Asunto(s)
Brotes de Enfermedades/prevención & control , Vacunación Masiva/organización & administración , Vacuna contra Viruela/administración & dosificación , Viruela/prevención & control , Competencia Clínica , Simulación por Computador , Instituciones de Salud/provisión & distribución , Fuerza Laboral en Salud/estadística & datos numéricos , Humanos , República de Corea/epidemiología , Viruela/epidemiología
7.
BMC Public Health ; 19(1): 925, 2019 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-31291922

RESUMEN

BACKGROUND: Gavi, the Vaccine Alliance, supported a mass vaccination Measles-Rubella Campaign (MRC) in Bangladesh during January-February 2014. METHODS: We conducted a mixed-method process evaluation to understand the successes and challenges in implementation of the MRC. We reviewed documents for the MRC and the immunization programme in Bangladesh; observed meetings, vaccination sessions, and health facilities; and conducted 58 key informant interviews, 574 exit interviews with caregivers and 156 brief surveys with stakeholders involved in immunization. Our theory of Change for vaccination delivery guided our assessment of ideal implementation milestones and indicators to compare with the actual implementation processes. RESULTS: We identified challenges relating to country-wide political unrest, administrative and budgetary delays, shortage of transportation, problems in registration of target populations, and fears about safety of the vaccine. Despite these issues, a number of elements contributed to the successful launch of the MRC. These included: the comprehensive design of the campaign; strong partnerships between immunization authorities in the government system, Alliance partners, and civil society actors; and motivated and skilled health workers at different levels of the health system. CONCLUSIONS: The successful implementation of the MRC in spite of numerous contextual and operational challenges demonstrated the adaptive capacity of the national immunization programme and its partners that has positive implications for future introductions of Gavi-supported vaccines.


Asunto(s)
Vacunación Masiva/organización & administración , Vacuna Antisarampión/administración & dosificación , Evaluación de Procesos, Atención de Salud , Vacuna contra la Rubéola/administración & dosificación , Adolescente , Bangladesh , Niño , Preescolar , Humanos , Lactante , Sarampión/prevención & control , Rubéola (Sarampión Alemán)/prevención & control
8.
Sante Publique ; Vol. 31(1): 177-186, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31210512

RESUMEN

OBJECTIVE: The objective of this study is to analyze the effect of a technical support aiming to improve vaccine program performance in the 10 health districts (HDs) of Côte d'Ivoire, in which the largest numbers of children not vaccinated against measles were registered. METHOD: These HDs benefited between June 2016 and May 2017, from four quarterly supportive supervisions along with technical support in health logistics and data management and quality. We had followed the evolution of the key indicators in each targeted HD and compared them to the other HDs. RESULTS: The measles containing vaccine coverage (MCVC) had increased and exceeded 80% in 8 out of 10 the targeted HDs. The increase of this MCVC was higher in the targeted HDs (12 points versus 3 points). The number of children not vaccinated against measles had been reduced by 66% and in 8 out of 10 HDs. The global drop-out rate decreased by 13 points in the targeted HDs, whereas it increased by 1 point in the other HDs.The timeliness increased and was more than 80% in 9 of the 10 targeted HDs. The increase of this timeliness was better in the targeted HDs (35 points versus 25 points). The overall quality index was higher in the targeted HDs (90% versus 82%) and the score per component for targeted HDs was better. CONCLUSION: This technical support has have an positive effect on the vaccine performance of targeted HDs. The current challenge is to scale up this type of intervention to all districts in the country.


Asunto(s)
Programas de Inmunización/organización & administración , Vacunación Masiva/organización & administración , Vacuna Antisarampión/administración & dosificación , Sarampión/prevención & control , Niño , Costa de Marfil/epidemiología , Humanos , Programas de Inmunización/métodos , Vacunación Masiva/métodos , Vacunación Masiva/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud
9.
Bosn J Basic Med Sci ; 19(3): 210-212, 2019 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-31064166

RESUMEN

Measles is a highly contagious and communicable viral disease which may be prevented by a sustained vaccination program. Due to missed vaccination, two major epidemics of measles (1997-1999 and 2014-2015) have been recorded after the war in Bosnia and Herzegovina (BH) with over 10,000 patients registered. According to the World Health Organization, BH is categorized as a country with endemic transmission of measles. The last measles epidemic was between 2014 and 2015, with 5,083 documented patients in the Federation of BH. In the first four months of 2019, more than 700 measles cases were registered in the same region. Significant transmission rate has been observed in Sarajevo Canton (SC) with 570 documented measles cases. Out of 570 measles cases in SC, 92.5% were unvaccinated. The most affected were children up to 6 years of age (62.8%), with one documented case of death (7-month old infant). In addition to this report, we discussed key stakeholders and possible circumstances responsible for the epidemic. The measles epidemic is still ongoing.


Asunto(s)
Epidemias/estadística & datos numéricos , Programas de Inmunización/organización & administración , Vacunación Masiva/organización & administración , Sarampión/epidemiología , Sarampión/prevención & control , Adolescente , Bosnia y Herzegovina/epidemiología , Niño , Preescolar , Humanos , Lactante
10.
Nat Commun ; 10(1): 1633, 2019 04 09.
Artículo en Inglés | MEDLINE | ID: mdl-30967543

RESUMEN

The success of vaccination programs depends largely on the mechanisms used in vaccine delivery. National immunization programs offer childhood vaccines through fixed and outreach services within the health system and often, additional supplementary immunization activities (SIAs) are undertaken to fill gaps and boost coverage. Here, we map predicted coverage at 1 × 1 km spatial resolution in five low- and middle-income countries to identify areas that are under-vaccinated via each delivery method using Demographic and Health Surveys data. We compare estimates of the coverage of the third dose of diphtheria-tetanus-pertussis-containing vaccine (DTP3), which is typically delivered through routine immunization (RI), with those of measles-containing vaccine (MCV) for which SIAs are also undertaken. We find that SIAs have boosted MCV coverage in some places, but not in others, particularly where RI had been deficient, as depicted by DTP coverage. The modelling approaches outlined here can help to guide geographical prioritization and strategy design.


Asunto(s)
Demografía/estadística & datos numéricos , Salud Global/estadística & datos numéricos , Vacunación Masiva/estadística & datos numéricos , Cobertura de Vacunación/estadística & datos numéricos , Cambodia , Preescolar , Conjuntos de Datos como Asunto , República Democrática del Congo , Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Etiopía , Humanos , Renta , Lactante , Recién Nacido , Vacunación Masiva/métodos , Vacunación Masiva/organización & administración , Vacuna Antisarampión/administración & dosificación , Modelos Estadísticos , Mozambique , Análisis Multivariante , Nigeria , Planificación Estratégica
11.
Am J Prev Med ; 56(4): e135-e141, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30772149

RESUMEN

INTRODUCTION: Tradeoffs exist between efforts to increase influenza vaccine uptake, including early season vaccination, and potential decreased vaccine effectiveness if protection wanes during influenza season. U.S. older adults increasingly receive vaccination before October. Influenza illness peaks vary from December to April. METHODS: A Markov model compared influenza likelihood in older adults with (1) status quo vaccination (August-May) to maximize vaccine uptake or (2) vaccination compressed to October-May (to decrease waning vaccine effectiveness impact). The Centers for Disease Control and Prevention data were used for influenza incidence and vaccination parameters. Prior analyses showed that absolute vaccine effectiveness decreased by 6%-11% per month, favoring later season vaccination. However, compressed vaccination could decrease overall vaccine uptake. Influenza incidence was based on average monthly incidence with earlier and later peaks also examined. Influenza strain distributions from two seasons were modeled in separate scenarios. Sensitivity analyses were performed to test result robustness. Data were collected and analyzed in 2018. RESULTS: Compressed vaccination would avert ≥11,400 influenza cases in older adults during a typical season if it does not decrease vaccine uptake. However, if compressed vaccination decreases vaccine uptake or there is an early season influenza peak, more influenza can result. In probabilistic sensitivity analyses, compressed vaccination was never favored if it decreased absolute vaccine uptake by >5.5% in any scenario; when influenza peaked early, status quo vaccination was favored. CONCLUSIONS: Compressed vaccination could decrease waning vaccine effectiveness and decrease influenza cases in older adults. However, this positive effect is negated when early season influenza peaks occur and diminished by decreased vaccine uptake that could occur with shortening the vaccination season.


Asunto(s)
Técnicas de Apoyo para la Decisión , Esquemas de Inmunización , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Vacunación Masiva/organización & administración , Anciano , Centers for Disease Control and Prevention, U.S./normas , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Gripe Humana/epidemiología , Masculino , Cadenas de Markov , Vacunación Masiva/normas , Vacunación Masiva/estadística & datos numéricos , Medición de Riesgo , Estaciones del Año , Factores de Tiempo , Resultado del Tratamiento , Estados Unidos/epidemiología
12.
Public Health Rep ; 134(2): 118-125, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30763141

RESUMEN

The modern era of vaccination was heralded with the licensure of the first 2 measles vaccines in 1963. This new era was distinct from the preceding era of vaccination for 4 main reasons. First, federal leadership in support of immunization at the local level grew. Second, immunization proponents championed the required vaccination of children as the best means of ensuring a protected population. Third, immunization proponents championed the idea that mass vaccination would not only help manage infectious diseases but also eradicate them. Fourth, the focus of local and federally supported immunization initiatives began to extend to the "mild" and "moderate" diseases of childhood (eg, measles), so-called because they were seen as less severe than previous targets of mass vaccination, such as smallpox, polio, and diphtheria. This article follows the history of measles to explore immunization successes and challenges in this modern era, because measles was the first of the mild and moderate diseases to become the target of a federally supported eradication-through-vaccination campaign, one that relied heavily on the preemptive, required vaccination of children. Its story thus epitomizes the range of political, epidemiological, cultural, and communications challenges to mass immunization in the modern era of vaccination.


Asunto(s)
Vacuna Antisarampión/historia , Sarampión/historia , Características Culturales , Erradicación de la Enfermedad/historia , Erradicación de la Enfermedad/organización & administración , Gobierno Federal , Comunicación en Salud , Historia del Siglo XX , Humanos , Vacunación Masiva/historia , Vacunación Masiva/organización & administración , Sarampión/epidemiología , Vacuna Antisarampión/administración & dosificación , Política
13.
Am J Prev Med ; 56(4): 591-602, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30773231

RESUMEN

CONTEXT: Despite current recommendations, human papillomavirus vaccine uptake remains low. A systematic review and meta-analysis assessed the effectiveness of interventions targeting human papillomavirus vaccine initiation and completion among children, adolescents, and young adults aged 9-26 years. EVIDENCE ACQUISITION: Three electronic databases (CINAHL, OVID, and Web of Science) were searched for articles published in English peer-reviewed journals between January 2006 and January 2017 of U.S. studies that evaluated intervention strategies and reported post-intervention human papillomavirus vaccine initiation or completion rates among individuals aged 9-26 years. Study characteristics and outcomes were extracted. Data were collected in 2016 and analyzed in 2017. EVIDENCE SYNTHESIS: Reviewers screened 983 unique titles and abstracts, read 241 full-text articles, and extracted data from 30 articles meeting the inclusion criteria (12 behavioral, ten environmental, four informational, and four combination strategies). Published EQUATOR (Enhancing the Quality and Transparency of Health Research) guidelines were used to assess study quality. Random effects meta-analyses were conducted. The meta-analyses included 17 RCTs and quasi-experiments involving 68,623 children, adolescents, and young adults. The pooled relative incidence estimates were 1.84 (95% CI=1.36, 2.48) for human papillomavirus vaccine initiation and 1.50 (95% CI=1.23, 1.83) for completion. Behavioral and informational interventions doubled human papillomavirus vaccine initiation (relative incidence estimate=2.04, 95% CI=1.36, 3.06 and relative incidence estimate=1.92, 95% CI=1.27, 2.91, respectively). Behavioral interventions increased completion by 68% (relative incidence estimate=1.68, 95% CI=1.25, 2.27). CONCLUSIONS: Evidence supports behavioral interventions for increasing human papillomavirus vaccine initiation and completion. Future studies are needed to assess the effectiveness of interventions in reaching diverse populations and reducing missed opportunities for human papillomavirus vaccination.


Asunto(s)
Vacunación Masiva/organización & administración , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Aceptación de la Atención de Salud/estadística & datos numéricos , Adolescente , Adulto , Niño , Humanos , Vacunación Masiva/estadística & datos numéricos , Vacunación Masiva/tendencias , Estados Unidos , Adulto Joven
14.
J Pediatr Nurs ; 44: 31-41, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30683279

RESUMEN

PROBLEM: The updated Advisory Committee on Immunization Practices (ACIP) 2016 guidelines recommends vaccination for the human papillomavirus (HPV) for all adolescents starting at ages 11-12 years. The United States continues to fall short of the benchmarks set by Healthy People 2020. The national vaccination rates hover at 49.5%, creating much room for improvement in health care systems. The purpose of this literature review was to identify evidence-based interventions to implement for improved outcomes. ELIGIBILITY CRITERIA: An integrative literature review was conducted using the CINAHL, EBSCO, Academic Search Complete, ProQuest and Medline databases. The search was limited to studies published in peer reviewed journals in the last 10 years. SAMPLE: Of the available studies, 201 met inclusion criteria with 46 studies meriting further review. RESULTS: Barriers to vaccination included missed opportunities due to lack of provider recommendation and awareness of current guidelines, and parental vaccination hesitancy. Effective strategies included reminder systems and strong provider recommendations. CONCLUSIONS: No one method has been effective in maintaining increases in vaccination rates. Multi-method strategies demonstrate the highest rates of maintaining increases in HPV vaccination. Strong provider recommendations are a cornerstone to any multi-method intervention. IMPLICATIONS: Providers and nurses need to shift conversations to strong recommendations for the HPV vaccination and include additional reminder systems, including protocols to meet Healthy People 2020 goals for HPV vaccination.


Asunto(s)
Vacunación Masiva/organización & administración , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Enfermedades de Transmisión Sexual/prevención & control , Adolescente , Comités Consultivos , Niño , Femenino , Humanos , Esquemas de Inmunización , Masculino , Infecciones por Papillomavirus/epidemiología , Vacunas contra Papillomavirus/inmunología , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Estados Unidos
15.
Hum Vaccin Immunother ; 15(6): 1302-1309, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30261152

RESUMEN

Background: Cholera is a considerable health burden in developing country settings including Bangladesh. The oral cholera vaccine (OCV) is a preventative tool to control the disease. The objective of this study was to describe whether the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), could provide the OCV to rural communities using existing government infrastructure. Methods: The study was conducted in rural sub-district Keraniganj, 20 km from the capital city Dhaka. All listed participants one year and above in age (excluding pregnant women) were offered two doses of OCV at a 14 day interval. Existing government facilities were used to deliver and also maintain the cold chain required for the vaccine. All events related to vaccination were recorded at the 17 vaccination sites to evaluate the coverage and feasibility of OCV program. Results: A total of 29,029 individuals received the 1st dose (90% of target) and 26,611 individuals received the 2nd dose (83% of target and 92% of 1st dose individuals) of OCV. The highest vaccination coverage was in younger children (1-9 years) and the lowest was amongst 18-29-year age group. Somewhat better coverage was seen amongst the female participants than males (92% vs. 88% for the 1st dose and 93% vs. 90% for the 2nd dose). The cost of vaccine cost was calculated as US$1.00 per dose plus freight, insurance, and transportation and the total vaccine delivery cost was US$70,957. Conclusion: This was a project undertaken using existing public health program resources to collect empirical evidence on the use of a mass OCV campaign in the rural setting. Mass vaccination with the OCV is feasible in the rural setting using existing governmental vaccine delivery systems in Bangladesh.


Asunto(s)
Vacunas contra el Cólera/economía , Cólera/prevención & control , Vacunación Masiva/economía , Vacunación Masiva/organización & administración , Cobertura de Vacunación/organización & administración , Administración Oral , Adolescente , Adulto , Bangladesh , Niño , Preescolar , Vacunas contra el Cólera/administración & dosificación , Costos y Análisis de Costo , Estudios de Factibilidad , Femenino , Humanos , Esquemas de Inmunización , Lactante , Masculino , Vacunación Masiva/estadística & datos numéricos , Persona de Mediana Edad , Mujeres Embarazadas , Refrigeración , Población Rural , Cobertura de Vacunación/economía , Cobertura de Vacunación/estadística & datos numéricos , Adulto Joven
17.
Rev. esp. salud pública ; 93: 0-0, 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-189545

RESUMEN

Fundamentos: La efectividad de la vacuna de la gripe ha hecho que sea una medida recomendada para personas de alto riesgo, entre ellos los adultos de 65 y más años. En este trabajo se planteó analizar la evolución de las tasas anuales de vacunación, e identificar subgrupos en la población que tuviese un riesgo significativo de no vacunarse. Métodos: Para el primer objetivo, la fuente de información fueron los datos que informa el Ministerio de Sanidad, Consumo y Bienestar Social. Para analizar las tendencias se llevó a cabo un análisis de series temporales interrumpidas. La fuentede información para el segundo objetivo fue la Encuesta Nacional de Salud de España de 2017. Se llevó a cabo un análisis de regresión logística multivariable. Resultados: La tasa de vacunación de la gripe mostró desde latemporada 2006-07 una disminución absoluta anual de 1,2 puntos (95% IC: 0,8%, 1,6%). La prevalencia de vacunación en 2017 era de 54,9%. Las variables independientemente asociadas con la mayor vacunación de la gripe eran ser hombre, la mayor edad, haber nacido en España, tener más visitas al médico, tener una prescripción de medicamentos, tener una enfermedad crónica, no ser fumador, y el menor consumo de frutas. Conclusiones: La cobertura de la vacuna de la gripe en población de 65 y más años no solo está por debajo de lo recomendado por la Organización Mundial de la Salud e indicado por el Consejo Interterritorial del Sistema Nacional de Salud sino que está disminuyendo significativamente cada año. Los subgrupos con menores tasas de vacunación (mujeres, menores de 75 años, no nacidos en España, con menos visitas al médico,sin prescripción de medicamentos, sin enfermedades crónicas, fumadores y con más consumo de frutas) deben ser identificados para desarrollar campañas y programas destinados a incrementar su vacunación de la gripe de forma que pueda aportar todo su beneficio potencial a la población específica


Background: The effectiveness of the influenza vaccine has made it a recommended intervention for people at high risk, including adults over 65. This work aimed to analyse the trends of annual vaccination rates, and identify subgroups in the population that have a significant risk of not receiving the vaccine. Methods: For the first objective, the source of information was the data reported by the Ministry of Health. To determine the trends in vaccination an analysis of interrupted time series was conducted. A multivariable logistic regression analysis was carried out with the National Health Survey (ENSE) of 2017 for the second objective. Results: The rate of influenza vaccination showed an absolute annual decrease of 1,2 points since the 2006-07 season (95% CI: 0,8%, 1,6%). The prevalence of vaccination in 2017 was 54,9%. The variables independently associated with a higher probability of the influenza vaccine were males, older age, born in Spain, having more visits to the doctor, with prescription of medications, having a chronic illness, being non-smoker, and the lower consumption of fruits. Conclusions: The coverage of the flu vaccine in the population aged 65 and over is not only below the recommendation of the World Health Organization and indicated by the Interterritorial Council of the National Health System, but is significantly decreasing every year. Sub-groups with lover vaccination rates (women, younger than 75 years , foreign born, with less visits to primary care, no prescription of medicines, no chronic diseases, smokers and with higher intake of fruit) should be targets to develop campaigns and programs to increase their uptake of influenza vaccination so it could provide its potential population benefit


Asunto(s)
Humanos , Anciano , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Cobertura de Vacunación/estadística & datos numéricos , Vacunación Masiva/organización & administración , Programas de Inmunización/organización & administración , Encuestas Epidemiológicas/estadística & datos numéricos , Indicadores de Morbimortalidad , Modelos Logísticos , Afecciones Crónicas Múltiples/epidemiología , Factores Epidemiológicos
18.
Dtsch Arztebl Int ; 115(43): 723-730, 2018 10 26.
Artículo en Inglés | MEDLINE | ID: mdl-30518471

RESUMEN

BACKGROUND: The World Health Organization (WHO) set the year 2020 as a target date for the eradication of measles in Europe, yet Germany is still far away from this goal. In this article, we provide an overview of current vaccination gaps and barriers to vaccination among children and adults in Germany, as well as potential strategies for overcoming them. METHODS: This review is based on pertinent publications identified by a selective literature search in PubMed (Medline). RESULTS: Measles vaccinations are not carried out in the appropriate timely fashion in Germany. Moreover, current vaccination rates among both children and adults are too low to achieve the goal of measles eradication. For example, among children born in 2014, the recommended vaccination rate of more than 95% was only reached when these children were 24 months old. Primary care physicians bear the responsibility for this situation, as they have the greatest influence on the decision to vaccinate. The main causes of vaccination gaps are safety worries and complacen- cy on the patients' part, and partial skepticism regarding vaccination on the part of the caregivers. We identified promising strategies for overcoming these problems: an instructive talk to provide evidence-based information to patients in an atmos- phere of mutual trust, reminder systems, multifactorial interventions, and facilitated access to vaccination, or, as a last resort, the reintroduction of compulsory vacci- nation. CONCLUSION: Primary care physicians play a key role in vaccination. The focus of further strategies should lie above all in improved patient education and in targeted reminders for patients who neglect to vaccinate themselves and/or their children.


Asunto(s)
Programas de Inmunización/estadística & datos numéricos , Vacunación Masiva/estadística & datos numéricos , Vacuna Antisarampión/uso terapéutico , Sarampión/prevención & control , Niño , Brotes de Enfermedades/prevención & control , Europa (Continente) , Alemania , Humanos , Programas de Inmunización/organización & administración , Vacunación Masiva/organización & administración , Sarampión/epidemiología , Organización Mundial de la Salud
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