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1.
Pan Afr Med J ; 33: 294, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692797

RESUMO

The number of children who survive to adolescence is increasing in Nigeria, significantly due to the success of child survival programs, with immunization as a major theme. However, the national immunization schedule in Nigeria is presently restricted to early childhood with no attention paid to immunization in adolescence. Presently, the vaccines that are readily available for adolescents include tetanus toxoid which is normally administered to pregnant women, so necessarily includes adolescent mothers; and a few research programs which offers hepatitis B vaccines. Also, there are few Nigerian adolescents who access immunization as a requirement for travelling outside the country or as a result of parental effort. Knowledge and awareness about adolescent immunization is generally poor. Nigerian adolescents have been shown to be poorly protected from tetanus, rubella and hepatitis B which are vaccine preventable. Neonatal, childhood and adult tetanus, congenital rubella syndrome, cervical cancer and hepatocellular carcinoma are just few of the diseases whose incidence can be reduced with an effective adolescent immunization program. This will also ensure that the gains of childhood immunization is concretized and socio-economic losses as a result of vaccine preventable diseases are eliminated to create a healthy and vibrant workforce. There is an urgent need to build a viable adolescent immunization program in Nigeria as adolescents represent a window of opportunity to prevent diseases which affect both the younger and older age group. This can be extended to other developing countries as well.


Assuntos
Programas de Imunização/organização & administração , Esquemas de Imunização , Imunização/métodos , Vacinas/administração & dosagem , Adolescente , Fatores Etários , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Humanos , Nigéria
2.
MMWR Morb Mortal Wkly Rep ; 68(45): 1029-1033, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31725710

RESUMO

Afghanistan and Pakistan are the only countries that continue to confirm ongoing wild poliovirus type 1 (WPV1) transmission (1). During January 2018-September 2019 the number of WPV1 cases in Pakistan increased, compared with the number during the previous 4 years. This report updates previous reports on Pakistan's polio eradication activities, progress, and challenges (2,3). In 2018, Pakistan reported 12 WPV1 cases, a 50% increase from eight cases in 2017, and a 31% increase in the proportion of WPV1-positive sites under environmental surveillance (i.e., sampling of sewage to detect poliovirus). As of November 7, 2019, 80 WPV1 cases had been reported, compared with eight cases by the same time in 2018. An intensive schedule of supplementary immunization activities (SIAs)* implemented by community health workers in the core reservoirs (i.e., Karachi, Peshawar, and Quetta) where WPV1 circulation has never been interrupted, and by mobile teams, has failed to interrupt WPV1 transmission in core reservoirs and prevent WPV1 resurgence in nonreservoir areas. Sewage samples have indicated wide WPV1 transmission in nonreservoir areas in other districts and provinces. Vaccine refusals, chronically missed children, community campaign fatigue, and poor vaccination management and implementation have exacerbated the situation. To overcome challenges to vaccinating children who are chronically missed in SIAs and to attain country and global polio eradication goals, substantial changes are needed in Pakistan's polio eradication program, including continuing cross-border coordination with Afghanistan, gaining community trust, conducting high-quality vaccination campaigns, improving oversight of field activities, and improving managerial processes to unify eradication efforts.


Assuntos
Erradicação de Doenças , Poliomielite/prevenção & controle , Vigilância da População , Criança , Pré-Escolar , Humanos , Programas de Imunização , Esquemas de Imunização , Lactente , Paquistão/epidemiologia , Poliomielite/epidemiologia , Poliovirus/isolamento & purificação , Vacina Antipólio Oral/administração & dosagem , Vacinação/estatística & dados numéricos
3.
Medicine (Baltimore) ; 98(47): e18035, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764822

RESUMO

Chronic obstructive pulmonary disease (COPD) patients are at a higher risk of development of lung cancer. Frequent exacerbations of COPD trigger the disease course to chronic inflammation which likely plays a role in the pathogenesis of lung cancer. Previous studies showed influenza virus infection is one of important causes for exacerbations of COPD. Therefore, the aim of this study was to know whether influenza vaccination could reduce the incidence of lung cancer in patients with COPD.This cohort study enrolled patients (≥55 years old) with a recorded diagnosis of COPD between January 1, 2000 and December 31, 2012 by using the Taiwan Health Insurance Database. A propensity score was calculated to reduce vaccine therapy selection bias. Cox proportional hazard regressions were used to investigate the association between the influenza vaccination and lung cancer incidence after adjusting for known confounding factors. Besides, we categorized the patients into 4 groups according to vaccination status (unvaccinated, total number of vaccinations: 1, 2-3, ≥4) to evaluate the dose-dependent effect on reducing lung cancer occurrence of lung cancer in COPD patients.Our study comprised of 28,752 eligible individuals from the COPD cohort database. Among them, 51% (14,630) received influenza vaccination; the rest (49%) of the COPD patients did not receive influenza vaccination. We observed that COPD patients receiving influenza vaccination had a lower risk of lung cancer (adjusted HR = 0.40, 95% CI (0.35-0.45), P < .001). We also founded comparable protective effect in both sexes and all age groups (55-64, 65-74, ≥75) regardless of influenza seasonality. Furthermore, dose-dependent protective effect could be seen after stratifying patients according to the total number vaccinations, the adjusted HRs for lung cancer risk were 0.48 (0.40-0.54) and 0.24 (0.20-0.29) for patients who received 2 to 3 and ≥4 vaccinations during the follow-up period.This population-based cohort study demonstrated that annual influenza vaccination administration could reduce incidence of lung cancer in COPD patients.


Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/complicações , Influenza Humana/prevenção & controle , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/complicações , Idoso , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Esquemas de Imunização , Incidência , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade
4.
MMWR Morb Mortal Wkly Rep ; 68(41): 905-912, 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31622283

RESUMO

State and local school vaccination requirements exist to ensure that students are protected against vaccine-preventable diseases (1). This report summarizes data collected by state and local immunization programs* on vaccination coverage among children in kindergarten in 49 states, exemptions for kindergartners in 50 states, and provisional enrollment and grace period status for kindergartners in 30 states. Nationally, vaccination coverage† was 94.9% for the state-required number of doses of diphtheria and tetanus toxoids, and acellular pertussis vaccine (DTaP); 94.7% for 2 doses of measles, mumps, and rubella vaccine (MMR); and 94.8% for the state-required doses of varicella vaccine. Whereas 2.5% of kindergartners had an exemption from at least one vaccine,§ 2.8% of kindergartners were not up to date for MMR and did not have a vaccine exemption. Nearly all states could achieve the recommended ≥95% MMR coverage if all nonexempt kindergartners were vaccinated in accordance with local and state vaccination policies.


Assuntos
Vacina contra Varicela/administração & dosagem , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Pré-Escolar , Humanos , Esquemas de Imunização , Instituições Acadêmicas , Estados Unidos
5.
MMWR Morb Mortal Wkly Rep ; 68(41): 913-918, 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31622284

RESUMO

The Advisory Committee on Immunization Practices (ACIP) recommends that children be vaccinated against 14 potentially serious illnesses during the first 24 months of life (1). CDC used data from the National Immunization Survey-Child (NIS-Child) to assess vaccination coverage with the recommended number of doses of each vaccine at the national, state, territorial, and selected local levels* among children born in 2015 and 2016. Coverage by age 24 months was at least 90% nationally for ≥3 doses of poliovirus vaccine, ≥1 dose of measles, mumps, and rubella vaccine (MMR), ≥3 doses of hepatitis B vaccine (HepB), and ≥1 dose of varicella vaccine, although MMR coverage was <90% in 20 states. Children were least likely to be up to date by age 24 months with ≥2 doses of influenza vaccine (56.6%). Only 1.3% of children born in 2015 and 2016 had received no vaccinations by the second birthday. Coverage was lower for uninsured children and for children insured by Medicaid than for those with private health insurance. Vaccination coverage can be increased by improving access to vaccine providers and eliminating missed opportunities to vaccinate children during health care visits. Increased use of local vaccination coverage data is needed to identify communities at higher risk for outbreaks of measles and other vaccine-preventable diseases.


Assuntos
Cobertura Vacinal/estatística & dados numéricos , Vacinas/administração & dosagem , Pré-Escolar , Pesquisas sobre Serviços de Saúde , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido , Estados Unidos
6.
Artigo em Inglês | MEDLINE | ID: mdl-31610771

RESUMO

Immunisation at the earliest appropriate age and high levels of vaccine coverage at milestone ages are important in preventing the spread of vaccine-preventable diseases. At the Central Coast Public Health Unit, the authors sought to determine if follow-up of children said by the Australian Childhood Immunisation Register (ACIR) to be overdue for vaccination improved both of these factors. In a quality improvement activity, monthly ACIR lists of overdue Central Coast children aged 9 to 10 months of age were examined. The study alternated three months of intervention with three months of no intervention. The intervention was designed to find evidence of vaccination, first from the last known provider, and then if this was unsuccessful, from the parent. If no information was available, a letter was sent to the parents. If the child was indeed vaccinated, the register was updated. If the child was missing any vaccinations, the parent(s) were encouraged to complete the schedule. On reviewing routinely-published quarterly ACIR data at three-monthly intervals for 24 months after the intervention (or non-intervention), timeliness of vaccination improved in the intervention cohort. Central Coast fully vaccinated rates diverged from NSW rates during the study. In addition, the ACIR quarters that contained two out of three months of intervention rather than one out of three months of intervention had the highest rates of fully vaccinated children. The authors concluded that the intervention improved both timeliness of vaccination and the proportion of fully vaccinated children.


Assuntos
Programas de Imunização/estatística & dados numéricos , Esquemas de Imunização , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem , Austrália , Confiabilidade dos Dados , Pesquisas sobre Serviços de Saúde , Humanos , Lactente , Pais , Sistema de Registros
7.
MMWR Morb Mortal Wkly Rep ; 68(42): 937-942, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31647786

RESUMO

Endorsed by the World Health Assembly in 2012, the Global Vaccine Action Plan 2011-2020 (GVAP) (1) calls on all countries to reach ≥90% national coverage with all vaccines in the country's national immunization schedule by 2020. Building on previous analyses (2) and using the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) global vaccination coverage estimates as of 2018, this report presents global, regional, and national vaccination coverage estimates and trends, including vaccination dropout rates. According to these estimates, global coverage with the first dose of diphtheria and tetanus toxoids and pertussis-containing vaccine (DTP1) remained relatively unchanged from 2010 (89%) to 2018 (90%). Global coverage with the third DTP dose (DTP3) followed a similar global trend to that of DTP1, remaining relatively consistent from 2010 (84%) to 2018 (86%) (3). Globally, 19.4 million children (14%) were not fully vaccinated in 2018, and among them, 13.5 million (70%) did not receive any DTP doses. Overall, dropout rates from DTP1 to DTP3 decreased globally from 6% in 2010 to 4% in 2018. Global coverage with the first dose of measles-containing vaccine (MCV1) remained between 84% and 86% during 2010-2018. Among countries that offer a second MCV dose (MCV2) during the second year of life, coverage increased from 19% in 2007 to 54% in 2018; among countries offering MCV2 to older age groups (children aged 3-14 years), coverage also increased, from 36% in 2007 to 69% in 2018 (3). Globally, the estimated difference in coverage with MCV1 and MCV2 in 2018 was 17%. However, among new and underused vaccines, global coverage increased from 2007 to 2018 for completed series of rotavirus vaccine, pneumococcal conjugate vaccine (PCV), rubella vaccine, Haemophilus influenzae type b vaccine (Hib), and hepatitis B vaccine (HepB). To reach global vaccination coverage goals for vaccines recommended during childhood, adolescence, and adulthood, tailored strategies that address local determinants for incomplete vaccination are needed, including targeting hard-to-reach and hard-to-vaccinate populations.


Assuntos
Saúde Global , Cobertura Vacinal/estatística & dados numéricos , Vacinas/administração & dosagem , Adolescente , Criança , Pré-Escolar , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Humanos , Programas de Imunização , Esquemas de Imunização , Lactente , Recém-Nascido , Organização Mundial da Saúde
8.
Rev Inst Med Trop Sao Paulo ; 61: e43, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31531621

RESUMO

In March 2014, the Quadrivalent human papilloma virus vaccine (4vHPV) was introduced in the female adolescents vaccination schedule of the National Immunization Program (PNI). A school-based vaccination program was implemented. We conducted a retrospective, descriptive study of the adverse events that took place after HPV vaccination, reported to the Adverse Events Following Immunization (AEFI) Information System in Sao Paulo State, from March 2014 to December 2016. All reports that fit the definitions of the 2014 National Manual on AEFI surveillance were included. AEFI risk was estimated by dividing the number of reports by the number of vaccine doses administered in the period. In the three-year period, 3,390,376 HPV vaccine doses were administered and 465 AEFI reports were registered, with 1,378 signs and symptoms. The reporting rate was 13.72 per 100,000 vaccine doses administered. The reports peaked in the first year of the program. The most frequent AEFI was syncope, with 5.7 reports per 100,000 doses administered, followed by dizziness, malaise, headache and nausea. Overall, 39 AEFI cases (8.4%) were classified as severe , with a reporting rate of 1.15 per 100,000 vaccine doses administered. Most cases were classified as severe because of hospitalization. Among them, there were cases of Guillain-Barré Syndrome, deep vein thrombosis, seizures and miscarriage. All young women recovered without sequelae. We identified five clusters of AEFI reports in four cities; the larger AEFI cluster occurred in the city of Bertioga, in September 2014, involving 13 female adolescents. Our data are in accordance with those from other countries and corroborate the safety of HPV vaccines.


Assuntos
Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18/efeitos adversos , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Brasil/epidemiologia , Criança , Feminino , Vacina Quadrivalente Recombinante contra HPV tipos 6, 11, 16, 18/administração & dosagem , Humanos , Esquemas de Imunização , Infecções por Papillomavirus/prevenção & controle , Vigilância da População , Estudos Retrospectivos , Adulto Jovem
10.
Pan Afr Med J ; 33: 96, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489074

RESUMO

Introduction: Hepatitis B vaccination among healthcare workers (HCWs) in Ghana has not been actively pursued despite the endemicity of the infection. This study measures the hepatitis B vaccine uptake among HCWs at the University of Ghana Hospital, Legon (UGHL) and identifies the factors associated with vaccination. Methods: An analytical cross-sectional study involving all staff who have direct contact with patients was conducted. Self-administered questionnaires were used to collect data on vaccination status, age, sex, type of staff, duration of work in the facility, exposure to blood or blood products, blood stained linens/waste, sharp instruments and performance of invasive procedures. Data was analysed using STATA 14. Continuous variables were described using median values and interquartile ranges (IQR) and categorical variables as proportions. Bivariate and multivariate analysis were conducted to identify the factors associated with hepatitis B vaccination status. Results: Of the 161 participants interviewed, 63.4% were females with median age 35 years (IQR: 27-45). Eighty-six (53.4%) of the respondents had taken the hepatitis B vaccine with 79.1% of them having completed the vaccination schedule. Factors associated with vaccination were working for more than 16 years (OR: 3.8, CI: 1.02-12.72), daily exposure to blood/blood products (OR: 4.1, CI: 1.43-11.81) and sharp instruments (OR: 4.45, CI: 1.39- 14.24), performing invasive procedures daily (OR: 3.0, CI: 1.07-8.45) and frequent exposure to blood stained linens/waste (OR: 6.1, CI: 1.41-26.51). Conclusion: The lack of hepatitis B vaccination among some HCWs at UGHL puts them at risk of contracting hepatitis B infection.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/prevenção & controle , Recursos Humanos em Hospital/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Gana , Hepatite B/transmissão , Humanos , Esquemas de Imunização , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Doenças Profissionais/prevenção & controle , Doenças Profissionais/virologia , Exposição Ocupacional/estatística & dados numéricos , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-31522666

RESUMO

This tenth annual immunisation coverage report shows data for the calendar year 2016 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. After a decade of being largely stable at around 90%, 'fully immunised' coverage at the 12-month assessment age increased in 2016 to reach 93.7% for the age assessment quarterly data point in December 2016, similar to the 93.4% for the age assessment quarterly data point in December 2016 for 60 months of age. Implementation of the 'No Jab No Pay' policy may have contributed to these increases. While 'fully immunised' coverage at the 24-month age assessment milestone decreased marginally from 90.8%, in December 2015, to 89.6% for the age assessment quarterly data point in December 2016, this was likely due to the assessment algorithm being amended in December 2016 to include four doses of DTPa vaccine instead of three, following reintroduction of the 18-month booster dose. Among Indigenous children, the gap in coverage assessed at 12 months of age decreased fourfold, from 6.7 percentage points in March 2013 to only 1.7 percentage points lower than non-Indigenous children in December 2016. Since late 2012, 'fully immunised' coverage among Indigenous children at 60 months of age has been higher than for non-Indigenous children. Vaccine coverage for the nationally funded seasonal influenza vaccine program for Indigenous children aged 6 months to <5 years, which commenced in 2015, remained suboptimal nationally in 2016 at 11.6%. Changes in MMR coverage in adolescents were evaluated for the first time. Of the 411,157 ten- to nineteen-year-olds who were not recorded as receiving a second dose of MMR vaccine by 31 December 2015, 43,103 (10.5%) of them had received it by the end of 2016. Many of these catch-up doses are likely to have been administered as a result of the introduction on 1 January 2016 of the Australian Government's 'No Jab No Pay' policy. In 2016, 78.6% of girls aged 15 years had three documented doses of HPV vaccine (jurisdictional range 67.8-82.9%), whereas 72.9% of boys (up from 67.1 % in 2015) had received three doses.


Assuntos
Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal , Adolescente , Adulto , Idoso , Austrália , Criança , Pré-Escolar , Feminino , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Rev Med Suisse ; 15(660): 1521-1525, 2019 Aug 28.
Artigo em Francês | MEDLINE | ID: mdl-31496178

RESUMO

The Swiss 2019 immunization schedule published includes 7 news clauses: 1) DTPa-IPV-Hib-HBV vaccination in newborns with the simplified dosing schedule "2+1"; 2) recommendation for vaccination against measles, mumps and rubella administered at 9 and 12 months of age; 3) pneumococcal immunization in children under 5 years of age as a basic recommendation; 4) replacement of the monovalent capsular group C meningococcal conjugate vaccine by the quadrivalent ACWY conjugate vaccine (Menveo); 5) extension of vaccination against tick-borne encephalitis virus to the entire Swiss territory - with the exception of the cantons of Geneva and Tessin - in people with risk factors for contagion; 6) replacement of Gardasil® with Gardasil 9® since January 2019; 7) recommendation for vaccination against hepatitis B in newborns.


Assuntos
Esquemas de Imunização , Vacinas/administração & dosagem , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Vacinação/normas
13.
Pan Afr Med J ; 33: 67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448029

RESUMO

Introduction: in 2014, Tanzania introduced the combined measles-rubella vaccine in the routine immunization schedule. Two doses of measles-rubella vaccine (MR1 and MR2) are recommended at 9 and 18 months, respectively. In 2015, MR2 coverage among eligible 18-month-old children in Tanzania was only 57%, lower than the WHO-recommended coverage (95%). During the same period Mtwara District Council (MDC) reported a coverage of 52% which is lower than the nation average. We determined factors associated with non-uptake of MR2 among children in MDC Tanzania. Methods: we conducted a community-based cross-sectional survey using cluster sampling during January - April 2017 in MDC. Caretakers of children born during January 2014 - January 2015 and residing in MDC for the past three years were recruited. We interviewed participants and reviewed vaccination cards. Logistic regression modeling was employed to identify independent factors associated with uptake of MR2. Results: of 1,000 children assessed, 558 (55.8%) were unvaccinated with MR2. Factors independently associated with non-uptake of MR2 included the caretaker being unaware of the ages for MR1 and MR2 administration [aOR=3.50; 95%CI 1.98-6.21; p<0.001], having MR2 vaccination services offered at the local vaccination station fewer than three days per week [aOR=1.50; 95%CI 1.42-5.59; p<0.001], not having the vaccine available during vaccination days [aOR=3.38; 95%CI 1.08-10.61; p<0.01], unwillingness of health workers to open multi-dose vaccine vials for a single child [aOR=3.80; 95% CI 2.12-6.79; p<0.001], and long waiting times for vaccination services [aOR=1.80; 95% CI 1.08-3.00; p<0.01]. Conclusion: more than half the children under five years in MDC were not vaccinated with MR2. Lack of caretaker knowledge about appropriate vaccination age, unavailability of vaccine, having insufficient numbers of children waiting to warrant multidose vial use, and long clinic waiting times were associated with MR2 non-uptake. The community should receive education about MR vaccine; we recommend thorough screening of children?s vaccination status at each clinic visit and provision of vaccine whenever possible. Vaccine distribution should be improved in MDC.


Assuntos
Vacina contra Sarampo/administração & dosagem , Vacina contra Rubéola/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Cuidadores/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Esquemas de Imunização , Modelos Logísticos , Masculino , Inquéritos e Questionários , Tanzânia , Listas de Espera , Adulto Jovem
14.
Arq Gastroenterol ; 56(2): 124-130, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31460574

RESUMO

BACKGROUND: Treatment for inflammatory bowel disease (IBD) includes a variety of immunosuppressants and biological agents, which increase the risk of infections due to altered cellular and humoral immunity. Prevention of these infections can be done through vaccination, however, patients with IBD are usually under-immunized. OBJECTIVE: Analyze the immunization status of patients with IBD and confront it with the current recommendations to verify if the immunization guidelines are being followed correctly. METHODS: Analytical cross-sectional study including 239 IBD patients being regularly followed in the Gastroenterology Service from Hospital de Clínicas da Universidade Federal do Paraná, which were subjected to a survey about their relevant demographic data and immunization status. RESULTS: The amount of patients that declared being unaware of their immunization status is high - between 34.3% (Tdap) and 52% (meningococcal) - excepting IIV, hepatitis B and HPV. The vaccines with the largest rates of patients declaring to have taken it are inactivated influenza vaccine (72.4%), BCG (55.3%), hepatitis B (48.3%), measles, mumps and rubella vaccine (43.8%) and DTaP (43%). The vaccines with the lowest rates of patients declaring to have taken it are Haemophilus influenza type b (0.8%), herpes zoster (2.1%) and HPV (3.4%). Patients that are being treated or have been treated with biological therapy have the largest immunization coverage for inactivated influenza vaccine (81%) and PPSV23 (25.9%), also they have the largest awareness rates for those vaccines. CONCLUSION: Although being a specialized service linked to a university hospital, vaccination coverage and patients' awareness rates proved to be below the desirable level. Vaccination and recovery of the immunization history is recommended immediately after the diagnosis of IBD, regardless of the use of biological agents. Those findings support the need of implementing hospital guidelines and constantly verifying its application by the multidisciplinary team in specialized services in IBD.


Assuntos
Esquemas de Imunização , Doenças Inflamatórias Intestinais/imunologia , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários
15.
J Microbiol ; 57(9): 821-827, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31452045

RESUMO

Most commercialized virus-like particle (VLP) vaccines use aluminum salt as adjuvant, even though VLPs provoke adequate antibody responses without adjuvant. We do not have detailed knowledge of how adjuvant affects the profile of anti-VLP antibodies. Meanwhile, there is evidence that differences between vaccination protocols influence the glycosylation of antibodies, which may alter their effector functions. In the present study a murine model was used to investigate the effects of dosing schedule and adjuvant on the antibody profiles and glycosylation levels of antigen-specific antibody responses to human papillomavirus type 16 L1 (HPV16 L1) VLPs. Mice received subcutaneously 2,000 ng of antigen divided into 4 or 7 doses. The HPV16 L1 VLPs elicited > 4 log10 anti-HPV16 L1 IgG titers without adjuvant, and aluminum hydroxide as adjuvant increased IgG titers 1.3- to 4-fold and reduced the anti-HPV16 L1 IgG2a / anti-HPV16 L1 IgG1 ratio value (use of aluminum hydroxide reduced the ratio of the IgG2a). Immunization with HPV16 L1 VLPs in combination with Freund's adjuvant enhanced IgG titers 5- to 12-fold. Seven-dose immunization markedly increased anti-HPV16 L1 IgM titers compared to four-dose immunization, as well as increasing the proportion of glycosylated antibodies. Our results suggest that antibody glycosylation can be controlled immunologically, and IgG and IgM profiles and glycosylation profiles of the vaccine-induced antibodies can be used as indicators reflecting the vaccine characteristics. These results indicate that the HPV16 L1 VLP dosing schedule can affect the quality of antigen-specific antibody responses. We suggest that dosing schedules should be noted in vaccination protocols for VLP-based vaccines.


Assuntos
Papillomavirus Humano 16/imunologia , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/administração & dosagem , Vacinas de Partículas Semelhantes a Vírus/administração & dosagem , Adjuvantes Imunológicos/administração & dosagem , Animais , Anticorpos Antivirais/imunologia , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Papillomavirus Humano 16/genética , Humanos , Esquemas de Imunização , Camundongos , Infecções por Papillomavirus/imunologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/imunologia , Vacinas de Partículas Semelhantes a Vírus/imunologia
16.
MMWR Morb Mortal Wkly Rep ; 68(32): 698-702, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31415491

RESUMO

Vaccination against human papillomavirus (HPV) is recommended to prevent new HPV infections and HPV-associated diseases, including some cancers. The Advisory Committee on Immunization Practices (ACIP)* routinely recommends HPV vaccination at age 11 or 12 years; vaccination can be given starting at age 9 years. Catch-up vaccination has been recommended since 2006 for females through age 26 years, and since 2011 for males through age 21 years and certain special populations through age 26 years. This report updates ACIP catch-up HPV vaccination recommendations and guidance published in 2014, 2015, and 2016 (1-3). Routine recommendations for vaccination of adolescents have not changed. In June 2019, ACIP recommended catch-up HPV vaccination for all persons through age 26 years. ACIP did not recommend catch-up vaccination for all adults aged 27 through 45 years, but recognized that some persons who are not adequately vaccinated might be at risk for new HPV infection and might benefit from vaccination in this age range; therefore, ACIP recommended shared clinical decision-making regarding potential HPV vaccination for these persons.


Assuntos
Vacinas contra Papillomavirus/administração & dosagem , Vacinação/normas , Adulto , Comitês Consultivos , Centers for Disease Control and Prevention (U.S.) , Feminino , Humanos , Esquemas de Imunização , Masculino , Infecções por Papillomavirus/prevenção & controle , Estados Unidos
17.
MMWR Morb Mortal Wkly Rep ; 68(33): 718-723, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31437143

RESUMO

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11-12 years to protect against certain diseases, including human papillomavirus (HPV)-associated cancers, meningococcal disease, and pertussis (1). A booster dose of quadrivalent meningococcal conjugate vaccine (MenACWY) is recommended at age 16 years, and serogroup B meningococcal vaccine (MenB) may be administered to persons aged 16-23 years (1). To estimate vaccination coverage among adolescents in the United States, CDC analyzed data from the 2018 National Immunization Survey-Teen (NIS-Teen) which included 18,700 adolescents aged 13-17 years.* During 2017-2018, coverage with ≥1 dose of HPV vaccine increased from 65.5% to 68.1%, and the percentage of adolescents up-to-date† with the HPV vaccine series increased from 48.6% to 51.1%, although the increases were only observed among males. Vaccination coverage increases were also observed for ≥1 MenACWY dose (from 85.1% to 86.6%) and ≥2 MenACWY doses (from 44.3% to 50.8%). Coverage with tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap) remained stable at 89%. Disparities in coverage by metropolitan statistical area (MSA)§ and health insurance status identified in previous years persisted (2). Coverage with ≥1 dose of HPV vaccine was higher among adolescents whose parents reported receiving a provider recommendation; however, prevalence of parents reporting receiving a recommendation for adolescent HPV vaccination varied by state (range = 60%-91%). Supporting providers to give strong recommendations and effectively address parental concerns remains a priority, especially in states and rural areas where provider recommendations were less commonly reported.


Assuntos
Cobertura Vacinal/estatística & dados numéricos , Vacinas/administração & dosagem , Adolescente , Comitês Consultivos , Centers for Disease Control and Prevention (U.S.) , Vacina contra Varicela/administração & dosagem , District of Columbia , Feminino , Pesquisas sobre Serviços de Saúde , Vacinas contra Hepatite B/administração & dosagem , Humanos , Esquemas de Imunização , Masculino , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacinas Meningocócicas/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Guias de Prática Clínica como Assunto , Estados Unidos , Vacinação/normas , Vacinas Conjugadas/administração & dosagem
18.
MMWR Morb Mortal Wkly Rep ; 68(33): 729-733, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31437144

RESUMO

Since October 2016, Afghanistan and Pakistan have been the only countries with reported cases of wild poliovirus type 1 (WPV1) (1). In Afghanistan, although the number of cases had declined during 2013-2016, the polio eradication program experienced challenges during 2017-2019. This report describes polio eradication activities and progress in Afghanistan during January 2018-May 2019 and updates previous reports (2,3). During May-December 2018, insurgent groups (antigovernment elements) banned house-to-house vaccination in most southern and southeastern provinces, leaving approximately 1 million children inaccessible to oral poliovirus vaccine (OPV) administration. During January-April 2019, vaccination targeting children at designated community sites (site-to-site vaccination) was permitted; however, at the end of April 2019, vaccination campaigns were banned nationally. During 2018, a total of 21 WPV1 cases were reported in Afghanistan, compared with 14 during 2017. During January-May 2019, 10 WPV1 cases were reported (as of May 31), compared with eight during January-May 2018. Sewage sample-testing takes place at 20 sites in the highest-risk areas for poliovirus circulation; 17 have detected WPV1 since January 2017, primarily in the southern and eastern provinces. Continued discussion with antigovernment elements to resume house-to-house campaigns is important to achieving polio eradication in Afghanistan. To increase community support for vaccination, collaboration among humanitarian service agencies to address other urgent health and basic needs is critical.


Assuntos
Erradicação de Doenças , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vigilância da População , Afeganistão/epidemiologia , Pré-Escolar , Humanos , Programas de Imunização/legislação & jurisprudência , Esquemas de Imunização , Lactente , Poliovirus/isolamento & purificação , Vacina Antipólio Oral/administração & dosagem , Vacinação/estatística & dados numéricos
19.
BMC Health Serv Res ; 19(1): 474, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291959

RESUMO

BACKGROUND: Despite the high burden of pneumococcal disease, pneumococcal vaccine coverage continues to fall short of Healthy People 2020 goals. A quasi-experimental design was used to investigate the impact of pneumococcal-specific best-practice alerts (BPAs) with and without workflow redesign compared to health maintenance notifications only, on pneumococcal vaccination rates in at-risk and high-risk adults, and on series completion in immunocompetent adults aged 65+ years. METHODS: This retrospective study used electronic health record and administrative data to identify pneumococcal vaccinations using cross sectional and historical cohorts of adults age 19+ years from 2013 to 2017 who attended clinics associated with the University of Utah Health. Difference-in-differences (DD) analyses was used to assess the impact of interventions across three observation periods (Baseline, Interim, and Follow Up). Adherence to the 2-dose vaccination schedule in older adults was measured through a longitudinal analysis. RESULTS: In DD analyses, implementing both workflow redesign and the BPA raised the vaccination rate by 8 percentage points (pp) (P < 0.001) and implementing the BPA only raised the rate by 7 pp. (P < 0.001) among at-risk adults age 19-64 years, relative to implementing health maintenance notifications (i.e., usual care) only in comparison clinics. In high-risk adults age 19-64 years, the BPA with or without workflow redesign did not significantly affect vaccination rates from baseline to follow up relative to health maintenance notifications. Per DD analyses, the effect of the BPA was mixed in immunocompetent and immunocompromised adults age 65+ years. However, immunocompetent older adults attending a clinic that implemented the BPA plus health maintenance notifications and workflow redesign (all 3 interventions) had 1.94 times higher odds (Odds ratio (OR) 1.94; P = 0.0003, 95% CI 1.24, 3.01) to receive the second pneumococcal dose than patients attending a usual practice clinic (i.e., no intervention). CONCLUSIONS: A pneumococcal BPA tool that reflects current guidelines implemented with and without workflow redesign improved vaccination rates for at-risk adults age 19-64 years and increased the likelihood of adults aged 65+ to complete the recommended 2-dose series. However, in other adult patient groups, the BPA was not consistently associated with improvements in pneumococcal vaccination rates.


Assuntos
Vacinas Pneumocócicas/administração & dosagem , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde , Sistemas de Alerta , Vacinação/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Registros Eletrônicos de Saúde , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Esquemas de Imunização , Masculino , Pessoa de Meia-Idade , Infecções Pneumocócicas/prevenção & controle , Estudos Retrospectivos , Medição de Risco , Adulto Jovem
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