Safety of concomitant administration of inactivated hepatitis A vaccine with other vaccines in children under 16 years old in post-marketing surveillance.

BACKGROUND: Concomitant administration refers to the receipt of two or more vaccines during a single healthcare encounter, which is an efficient way to increase vaccination coverage in children. However, the post-marketing safety studies of concomitant administration are scarce. Inactivated hepatitis A vaccine (Healive®) has been used widely in China and other countries for more than a decade. We aimed to explore the safety of Healive® co-administered with other vaccines compared to Healive® alone in children under 16 years old. METHODS: We retrieved Adverse Events Following Immunization (AEFI) cases and vaccination doses of Healive® during 2020-2021 in Shanghai, China. The AEFI cases were divided into concomitant administration group and Healive® alone group. We used administrative data on vaccine doses as denominators to calculate and compare crude reporting rates between groups. We also compared baseline gender and age distribution, clinical diagnoses, and time interval from vaccination to onset of symptoms between groups. RESULTS: A total 319,247 doses of inactivated hepatitis A vaccine (Healive®) were used and 1,020 AEFI cases (319.50 per million doses) associated with Healive® were reported during 2020-2021 in Shanghai. There were 259,346 doses concomitantly administered with other vaccines and 830 AEFI cases (320.04 per million doses) were reported. There were 59,901 doses of Healive® that vaccinated alone, with 190 AEFI cases (317.19 per million doses). There was only one case with serious AEFI in concomitant administration group, with a rate of 0.39 per million doses. Reported rates of AEFI cases were similar between groups in general (p > 0.05). CONCLUSION: Concomitant administration of inactivated hepatitis A vaccine (Healive®) with other vaccines has a similar safe profile as Healive® alone.

Cost-Effectiveness of Three Poliovirus Immunization Schedules in Shanghai, China.

In Shanghai, China, a polio immunization schedule of four inactivated polio vaccines (IPV) has been implemented since 2020, replacing the schedules of a combination of two IPVs and two bivalent live attenuated oral polio vaccines (bOPV), and four trivalent live attenuated oral polio vaccines (tOPV). This study aimed to assess the cost-effectiveness of these three schedules in infants born in 2016, in preventing vaccine-associated paralytic poliomyelitis (VAPP). We performed a decision tree model and estimated incremental cost-effectiveness ratio (ICER). Compared to the four-tOPV schedule, the two-IPV-two-bOPV schedule averted 1.2 VAPP cases and 16.83 disability-adjusted life years (DALY) annually; while the four-IPV schedule averted 1.35 VAPP cases and 18.96 DALY annually. Consequently, ICERVAPP and ICERDALY were substantially high for two-IPV-two-bOPV (CNY 12.96 million and 0.93 million), and four-IPV (CNY 21.24 million and 1.52 million). Moreover, net monetary benefit of the two-IPV-two-bOPV and four-IPV schedules was highest when the cost of IPV was hypothesized to be less than CNY 23.75 or CNY 9.11, respectively, and willingness-to-pay was hypothesized as CNY 0.6 million in averting one VAPP-induced DALY. IPV-containing schedules are currently cost-ineffective in Shanghai. They may be cost-effective by reducing the prices of IPV, which may accelerate polio eradication in Chinese settings.

[Case-control study of risk factors for community acquired pneumonia among old persons in Shanghai City].

OBJECTIVE: To explore the risk factors of community acquired pneumonia (CAP) among persons at the age of equal to or older than 65 years old in Shanghai City. METHODS: A case-control study was carried out to study the risk factors of CAP. Some of the CAP cases were recruited from the survey in Xinhua Community and Bansongyuan Community, others were from a hospital's outpatients. The controls were taken sample from the two communities. All the cases and controls were 65 years old or above. The cases and controls were interviewed with a structured questionnaire. Multivariate non-conditional logistic regression and chi-square test were used to analyze the data. RESULTS: 128 cases and 306 controls were enrolled for the case-control study. Through the multivariate logistic regression, it was found that the risk of CAP was increased with regard to age (OR = 1.049, 95% CI 1.007-1.093), smoking (OR = 2.317, 95% CI 1.224-4.386), ADL score (OR = 0.599, 95% CI 0.474-0.755), chronic respiratory system diseases (OR = 6.295, 95% CI 3.738-10.604) and non lung cancer (OR = 4.332, 95% CI 1.340-14.005). CONCLUSION: Old age, smoking, lower ADL score, chronic respiratory system diseases and cancer may be the risk factors of CAP. The effective measures should be taken to prevent community acquired pneumonia of old persons with these characteristics.

[Inspection on the one-month attack rate of community acquired pneumonia among old persons in Shanghai, China].

OBJECTIVE: To investigate the one-month attack rate of community acquired pneumonia (CAP) among persons at the age of 65 year old and above in Shanghai, China. METHODS: Through pertinently sampling we selected Xinhua community and Bansongyuan community were selected as our study field. All the persons in the two communities of 65 years and above, which were 16000 residents, which were the subjects for the survey of investigating the one-month attack rate of CAP between February and March in 2004. RESULTS: The one-month attack rate of the ascertained CAP cases was 0.21% (95% CI 0.14%-0.29%), of the suspected cases was 0.1% (95% CI 0.06%-0.16%), of the total was 0.31% (95% CI 0.23%-0.41%). The one-month attack rate of CAP in males and females were 0.32% (95% CI 0.21%-0.48%) and 0.29% (95% CI 0.19%-0.43%) respectively. The one-month attack rate increased with the age and it was statistically significant through trend chi-square test. CONCLUSION: Among of equal or more than 65 years old in Shanghai, the total one-month attack rate of CAP was 0.31%, which was lower than the rate that reported in the American, and the one-month attack rate of CAP increased with the age.