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1.
Reprod Health ; 18(1): 47, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622376

RESUMO

BACKGROUND: Integrating family planning into child immunization services may address unmet need for contraception by offering family planning information and services to postpartum women during routine child immunization visits. However, policies and programs promoting integration are often based on insubstantial or conflicting evidence about its effects on service delivery and health outcomes. While integration models vary, many studies measure integration as binary (a facility is integrated or not) rather than a multidimensional and varying continuum. It is thus challenging to ascertain the determinants and effects of integrated service delivery. This study creates Facility and Provider Integration Indexes, which measure capacity to support integrated family planning and child immunization services and applies them to analyze the extent of integration across 400 health facilities. METHODS: This study utilizes cross-sectional health facility (N = 400; 58% hospitals, 42% primary healthcare centers) and healthcare provider (N = 1479) survey data that were collected in six urban areas of Nigeria for the impact evaluation of the Nigerian Urban Reproductive Health Initiative. Principal Component Analysis was used to develop Provider and Facility Integration Indexes that estimate the extent of integration in these health facilities. The Provider Integration Index measures provider skills and practices that support integrated service delivery while the Facility Integration Index measures facility norms that support integrated service delivery. Index scores range from zero (low) to ten (high). RESULTS: Mean Provider Integration Index score is 5.42 (SD 3.10), and mean Facility Integration Index score is 6.22 (SD 2.72). Twenty-three percent of facilities were classified as having low Provider Integration scores, 32% as medium, and 45% as high. Fourteen percent of facilities were classified as having low Facility Integration scores, 38% as medium, and 48% as high. CONCLUSION: Many facilities in our sample have achieved high levels of integration, while many others have not. Results suggest that using more nuanced measures of integration may (a) more accurately reflect true variation in integration within and across health facilities, (b) enable more precise measurement of the determinants or effects of integration, and (c) provide more tailored, actionable information about how best to improve integration. Overall, results reinforce the importance of utilizing more nuanced measures of facility-level integration.


Assuntos
Prestação Integrada de Cuidados de Saúde , Serviços de Planejamento Familiar , Administração de Instituições de Saúde , Programas de Imunização , Serviços de Saúde Reprodutiva , Adulto , Criança , Pré-Escolar , Estudos Transversais , Prestação Integrada de Cuidados de Saúde/organização & administração , Prestação Integrada de Cuidados de Saúde/normas , Serviços de Planejamento Familiar/organização & administração , Serviços de Planejamento Familiar/normas , Serviços de Planejamento Familiar/provisão & distribução , Feminino , Instalações de Saúde/normas , Administração de Instituições de Saúde/métodos , Administração de Instituições de Saúde/normas , Indicadores Básicos de Saúde , Humanos , Programas de Imunização/organização & administração , Programas de Imunização/normas , Programas de Imunização/provisão & distribução , Lactente , Recém-Nascido , Masculino , Nigéria/epidemiologia , Gravidez , Saúde Reprodutiva/normas , Serviços de Saúde Reprodutiva/organização & administração , Serviços de Saúde Reprodutiva/normas , Serviços de Saúde Reprodutiva/provisão & distribução , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Vacinação/métodos , Vacinação/estatística & dados numéricos
2.
Med Sci (Paris) ; 36(11): 1034-1037, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33151866

RESUMO

Coronavirus disease (COVID)-19 is an emerging pandemic infection whose significant ability to spread in a naïve population is well established. The first response of states to the COVID-19 outbreak was to impose lock-down and social barrier measures, such as wearing a surgical mask or social distancing. One of the consequences of this pandemic in terms of public health was the suspension or slowdown of infant vaccination campaigns, in almost all countries. The indirect effects of COVID-19 may therefore weigh on mortality from measles and polio in developing countries. In this pandemic chaos, the only hope lies in the rapid development of an effective vaccine against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). However, acceptance of this vaccine has not yet been won, as beyond the many unknowns that will inevitably weigh around such rapid development, skepticism among vaccine hesitants is growing.


Assuntos
Infecções por Coronavirus/epidemiologia , Programas de Imunização/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Saúde Pública/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Betacoronavirus/fisiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Programas de Imunização/organização & administração , Programas de Imunização/normas , Programas de Imunização/tendências , Sarampo/epidemiologia , Sarampo/prevenção & controle , Pandemias/prevenção & controle , Participação do Paciente/estatística & dados numéricos , Participação do Paciente/tendências , Pneumonia Viral/imunologia , Pneumonia Viral/prevenção & controle , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Saúde Pública/normas , Saúde Pública/tendências , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Vacinas Virais/uso terapêutico
3.
Obstet Gynecol ; 136(5): 1006-1015, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030866

RESUMO

OBJECTIVE: To evaluate the result of an inpatient postpartum human papillomavirus (HPV) immunization pilot program in a diverse, low-income patient population from an urban, hospital-based obstetrics and gynecology clinic. METHODS: In this cohort study, we present results from the first 2 years of the inpatient postpartum HPV immunization program, in which vaccine-eligible postpartum women were identified and immunized during their hospital stays. The program was implemented after educational outreach with prenatal and postpartum clinicians and nurses. Associations between receipt of the HPV vaccine as an inpatient and the characteristics of patients, and the likelihood of and missed opportunities for receiving a subsequent dose of the HPV vaccine as an outpatient were determined using logistic regression, time-to-event analyses, chi-squared tests and t-tests. RESULTS: From April 11, 2017, to April 10, 2019, 394 (59.2%) of 666 postpartum women were eligible for the inpatient postpartum HPV immunization program. The majority (265/394, 67.3%) received the immunization pilot program HPV dose; 36 of those 265 (13.6%) completed the series with that dose. Among women due for additional doses after hospital discharge, those who received the inpatient dose were more likely to receive a subsequent outpatient dose (138/229) than were those who did not receive an inpatient dose (39/129; hazard ratio 2.51, 95% CI 1.76-3.58). On average, there were 30.7 fewer (95% CI 5.8-55.6, P<.02) missed opportunities for subsequent outpatient doses for every 100 eligible visits among women who received the inpatient dose, compared with women who did not. By the end of the study, the proportion of women who had completed the vaccine series was higher among women who received the inpatient dose (95/265, 35.8%) than in those who did not (12 out 129, 9.3%; odds ratio 5.45, 95% CI 2.86-10.38). CONCLUSION: The inpatient postpartum HPV immunization program was associated with increased rates of immunization and addressed a previously missed opportunity. Inpatient immunization programs can serve as a critical way to address gaps in vaccine uptake.


Assuntos
Programas de Imunização/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Cuidado Pós-Natal/estatística & dados numéricos , Adulto , Distribuição de Qui-Quadrado , Feminino , Hospitais Urbanos , Humanos , Programas de Imunização/métodos , Programas de Imunização/normas , Modelos Logísticos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cuidado Pós-Natal/métodos , Cuidado Pós-Natal/normas , Pobreza/estatística & dados numéricos , Gravidez , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade , Adulto Jovem
4.
PLoS One ; 15(8): e0237913, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817630

RESUMO

BACKGROUND: In November 2016, the Kenya National Vaccines and Immunization Programme conducted an assessment of missed opportunities for vaccination (MOV) using the World Health Organization (WHO) MOV methodology. A MOV includes any contact with health services during which an eligible individual does not receive all the vaccine doses for which he or she is eligible. METHODS: The MOV assessment in Kenya was conducted in 10 geographically diverse counties, comprising exit interviews with caregivers and knowledge, attitudes, and practices (KAP) surveys with health workers. On the survey dates, which covered a 4-day period in November 2016, all health workers and caregivers visiting the selected health facilities with children <24 months of age were eligible to participate. Health facilities (n = 4 per county) were purposively selected by size, location, ownership, and performance. We calculated the proportion of MOV among children eligible for vaccination and with documented vaccination histories (i.e., from a home-based record or health facility register), and stratified MOV by age and reason for visit. Timeliness of vaccine doses was also calculated. RESULTS: We conducted 677 age-eligible children exit interviews and 376 health worker KAP surveys. Of the 558 children with documented vaccination histories, 33% were visiting the health facility for a vaccination visit and 67% were for other reasons. A MOV was seen in 75% (244/324) of children eligible for vaccination with documented vaccination histories, with 57% (186/324) receiving no vaccinations. This included 55% of children visiting for a vaccination visit and 93% visiting for non-vaccination visits. Timeliness for multi-dose vaccine series doses decreased with subsequent doses. Among health workers, 25% (74/291) were unable to correctly identify the national vaccination schedule for vaccines administered during the first year of life. Among health workers who reported administering vaccines as part of their daily work, 39% (55/142) reported that they did not always have the materials they needed for patients seeking immunization services, such as vaccines, syringes, and vaccination recording documents. CONCLUSIONS: The MOV assessment in Kenya highlighted areas of improvement that could reduce MOV. The results suggest several interventions including standardizing health worker practices, implementing an orientation package for all health workers, and developing a stock management module to reduce stock-outs of vaccines and vaccination-related supplies. To improve vaccination coverage and equity in all counties in Kenya, interventions to reduce MOV should be considered as part of an overall immunization service improvement plan.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde , Vacinação/normas , Vacinas/uso terapêutico , Cuidadores/psicologia , Criança , Pré-Escolar , Agentes Comunitários de Saúde , Feminino , Instalações de Saúde , Pessoal de Saúde/psicologia , Humanos , Programas de Imunização/normas , Esquemas de Imunização , Lactente , Entrevistas como Assunto , Quênia/epidemiologia , Masculino , Inquéritos e Questionários , Cobertura Vacinal/normas , Organização Mundial da Saúde
5.
Euro Surveill ; 25(25)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32613939

RESUMO

Sentinel surveillance of acute hospitalisations in response to infectious disease emergencies such as the 2009 influenza A(H1N1)pdm09 pandemic is well described, but recognition of its potential to supplement routine public health surveillance and provide scalability for emergency responses has been limited. We summarise the achievements of two national paediatric hospital surveillance networks relevant to vaccine programmes and emerging infectious diseases in Canada (Canadian Immunization Monitoring Program Active; IMPACT from 1991) and Australia (Paediatric Active Enhanced Disease Surveillance; PAEDS from 2007) and discuss opportunities and challenges in applying their model to other contexts. Both networks were established to enhance capacity to measure vaccine preventable disease burden, vaccine programme impact, and safety, with their scope occasionally being increased with emerging infectious diseases' surveillance. Their active surveillance has increased data accuracy and utility for syndromic conditions (e.g. encephalitis), pathogen-specific diseases (e.g. pertussis, rotavirus, influenza), and adverse events following immunisation (e.g. febrile seizure), enabled correlation of biological specimens with clinical context and supported responses to emerging infections (e.g. pandemic influenza, parechovirus, COVID-19). The demonstrated long-term value of continuous, rather than incident-related, operation of these networks in strengthening routine surveillance, bridging research gaps, and providing scalable public health response, supports their applicability to other countries.


Assuntos
Hospitais Pediátricos/estatística & dados numéricos , Programas de Imunização/normas , Admissão do Paciente/estatística & dados numéricos , Vigilância da População/métodos , Vacinação/efeitos adversos , Vacinas/administração & dosagem , Austrália/epidemiologia , Canadá/epidemiologia , Criança , Pré-Escolar , Confiabilidade dos Dados , Política de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Programas Nacionais de Saúde/normas , Vigilância em Saúde Pública , Vacinação/estatística & dados numéricos
6.
BMC Public Health ; 20(1): 999, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32586316

RESUMO

Tuberculosis is the deadliest infection of our time. In contrast, about 11,000 people died of Ebola between 2014 and 2016. Despite this manifest difference in mortality, there is now a vaccine licensed in the United States and by the European Medicines Agency, with up to 100% efficacy against Ebola. The developments that led to the trialing of the Ebola vaccine were historic and unprecedented. The single licensed TB vaccine (BCG) has limited efficacy. There is a dire need for a more efficacious TB vaccine. To deploy such vaccines, trials are needed in sites that combine high disease incidence and research infrastructure. We describe our twelve-year experience building a TB vaccine trial site in contrast to the process in the recent Ebola outbreak. There are additional differences. Relative to the Ebola pipeline, TB vaccines have fewer trials and a paucity of government and industry led trials. While pathogens have varying levels of difficulty in the development of new vaccine candidates, there yet appears to be greater interest in funding and coordinating Ebola interventions. TB is a global threat that requires similar concerted effort for elimination.


Assuntos
Vacina BCG/uso terapêutico , Ensaios Clínicos como Assunto/normas , Surtos de Doenças/prevenção & controle , Programas de Imunização/normas , Tuberculose/prevenção & controle , África , Surtos de Doenças/estatística & dados numéricos , Vacinas contra Ebola , Doença pelo Vírus Ebola/epidemiologia , Humanos , Tuberculose/epidemiologia
7.
Pan Afr Med J ; 35(Suppl 1): 1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373252

RESUMO

Substantial progress has been achieved in the last two decades with the implementation of measles control strategies in the African Region. Elimination of measles is defined as the absence of endemic transmission in a defined geographical region or country for at least 12 months, as documented by a well-performing surveillance system. The framework for documenting elimination outlines five lines of evidence that should be utilized in documenting and assessing progress towards measles elimination. In March 2017, the WHO regional office for Africa developed and disseminated regional guidelines for the verification of measles elimination. As of May 2019, fourteen countries in the African Region have established national verification committees and 8 of these have begun to document progress toward measles elimination. Inadequate awareness, concerns about multiple technical committees for immunization work, inadequate funding and human resources, as well as gaps in data quality and in the implementation of measles elimination strategies have been challenges that hindered the establishment and documentation of progress by national verification committees. We recommend continuous capacity building and advocacy, technical assistance and networking to improve the work around the documentation of country progress towards measles elimination in the African Region.


Assuntos
Erradicação de Doenças/organização & administração , Eficiência Organizacional , Programas de Imunização/organização & administração , Vacina contra Sarampo/uso terapêutico , Sarampo/prevenção & controle , Vigilância da População/métodos , África , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/normas , Confiabilidade dos Dados , Erradicação de Doenças/métodos , Erradicação de Doenças/normas , Humanos , Programas de Imunização/normas , Sarampo/epidemiologia , Organização Mundial da Saúde/organização & administração
8.
Pan Afr Med J ; 35(Suppl 1): 4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373255

RESUMO

Introduction: Immunization program monitoring includes numerous activities, some of which include monitoring of vaccination coverage, surveillance performance and epidemiological patterns. The provision of timely, high quality and actionable feedback is an essential component of strengthening health systems. Within the African region of the WHO, various bulletins are produced and disseminated regularly to provide feedback on the performance of immunization programs and vaccine preventable disease control initiatives. Methods: The 2019 annual national immunization program managers' meeting for countries in the eastern and southern African subregion was held in Asmara from 18 - 20 March 2019. A survey questionnaire was administered to the participants representing the national programs and in-country partners across the 20 countries. Results: On average, the 75 respondents receive 1.8 e-mailed feedback bulletins monthly. Twenty-three (31%) respondents receive 3 or more written feedback bulletins per month, and 72% receive the bulletins regularly. On a scale of 1 - 5 (from lowest to highest), 87% participants rated the relevance of the bulletins they receive at 4 - 5. Only 19% of the respondents responded that the results are discussed within the national immunization program, and 14% stated that action points are generated based on the feedback received. Fifty-nine (79%) respondents want to receive more frequent feedback on routine immunization performance. Among the EPI program managers and the EPI program data managers, the access to these feedback bulletins was quite limited. Even though the primary objective of the bulletins is to initiate discussions and action based on the provided feedback, such discussions do not happen regularly at country level. The programmatic use and advocacy value of the bulletins is not optimal. Conclusion: We recommend integrating program feedback, regularly updating the distribution lists, the additional use of instant messaging platforms for distribution, as well as online posting of the bulletins for wider availability.


Assuntos
Retroalimentação , Programas de Imunização/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Inquéritos e Questionários , Cobertura Vacinal , África Oriental/epidemiologia , África Austral/epidemiologia , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Países em Desenvolvimento , Humanos , Programas de Imunização/normas , Disseminação de Informação/métodos , Vigilância da População/métodos , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/normas , Atenção Primária à Saúde/estatística & dados numéricos , Inquéritos e Questionários/normas , Nações Unidas , Vacinação/estatística & dados numéricos , Cobertura Vacinal/métodos , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Organização Mundial da Saúde
9.
Pan Afr Med J ; 35(Suppl 1): 5, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373256

RESUMO

Introduction: Malawi's National Immunization Program introduced a second routine dose of measles containing vaccine (MCV2) in 2015 but found coverage lagging. We assessed data quality and gaps in service delivery. Methods: Investigators used a modified data quality audit in 6 low performing districts accompanied by questionnaires for health facilities (HF) and households with children with >1 vaccination. Results: MCV2 doses administered according to source were: 733 in registers, 2364 in reports, 1655 in district reports, 2761 in the electronic database. There was 77% agreement regarding status for MCV2 between the register and the home-based record (HBR). Drop-out differences were found between HF according to the practice of waiting for a minimum number of children to open an MCV vial, canceling sessions due to stock-out and requesting payment for a home-based record. Eighty one percent (81%) of children whose caregivers knew 2 doses were needed had received MCV2 vs fifty eight (58%) of children whose caregivers didn't know. Sixty two (62%) of children who were charged for HBR received MCV2 vs 78% reporting no charge. Conclusion: The drop-out between the first and second doses of MCV was high and inconsistent with elimination goals. The quality of administrative data in these 6 districts was found to be poor. This investigation found that session cancelation, charging for HBR and lack of caregiver knowledge affected completion of the vaccination series. The authors recommend program improvements in these areas to increase uptake of MCV2 and improved reporting practices at all levels of the system.


Assuntos
Barreiras de Comunicação , Vacina contra Sarampo/administração & dosagem , Sarampo/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Participação do Paciente/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Criança , Pré-Escolar , Confiabilidade dos Dados , Erradicação de Doenças/métodos , Erradicação de Doenças/organização & administração , Erradicação de Doenças/normas , Erradicação de Doenças/estatística & dados numéricos , Relação Dose-Resposta Imunológica , Humanos , Programas de Imunização/métodos , Programas de Imunização/organização & administração , Programas de Imunização/normas , Programas de Imunização/estatística & dados numéricos , Esquemas de Imunização , Lactente , Recém-Nascido , Malaui/epidemiologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Vigilância da População/métodos , Melhoria de Qualidade/organização & administração , Melhoria de Qualidade/normas , Projetos de Pesquisa , Inquéritos e Questionários/normas , Inquéritos e Questionários/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Cobertura Vacinal/métodos , Cobertura Vacinal/organização & administração
10.
Pan Afr Med J ; 35(Suppl 1): 8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373259

RESUMO

Introduction: Guinea, Sierra Leone and Liberia have attained significant reduction in measles incidence between 2004 and 2013. The Ebola outbreak in 2014-2015 in West Africa caused significant disruption of the health service delivery in the three worst affected countries. The magnitude of the impact on the immunization program has not been well documented. Methods: We reviewed national routine immunization administrative coverage data as well as measles surveillance performance and measles epidemiology in the years before, during and after the EVD outbreak in Guinea, Liberia, Sierra Leone. Results: Both Liberia and Guinea experienced a sharp decline of more than 25% in the monthly number of children vaccinated against measles in 2014 and 2015 as compared to the previous years, while there was no reported decline in Sierra Leone. Guinea and Liberia experienced a decline in measles surveillance activity and performance indicators in 2014 and 2015. During this period, there was an increase in measles incidence and a decline in the mean age of measles cases reported in Liberia and Sierra Leone. Guinea started reporting high measles incidence in 2016. All three countries organized measles supplemental immunization activities by June 2015. Liberia achieved 99% administrative coverage, while Guinea and Sierra Leone attained 90.6% and 97.2% coverage respectively. There were no severe adverse events reported during these mass vaccination activities. The disruptive effect of the Ebola outbreak on immunization services was especially evident in Guinea and Liberia. Our review of the reported administrative vaccination coverage at national level does not show significant decline in measles first dose vaccination coverage in Sierra Leone as compared to other reports. This may be due to inaccuracies in coverage monitoring and data quality problems. The increases in measles transmission and incidence in these three countries can be explained by the rapid accumulation of susceptible children. Despite the organization of mass vaccination activities, measles incidence through 2017 has remained higher than the pre-Ebola period in all three countries. Conclusion: The Ebola outbreak in West Africa significantly affected measles vaccination coverage rates in two of the three worst affected countries, and led to persistent gaps in coverage, along with high measles incidence that was documented until two years after the end of the Ebola outbreak. Liberia and Sierra Leone have demonstrated coverage improvements after the end of the Ebola outbreak.


Assuntos
Erradicação de Doenças/organização & administração , Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , Programas de Imunização/organização & administração , Sarampo/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Criança , Pré-Escolar , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Erradicação de Doenças/métodos , Erradicação de Doenças/normas , Guiné/epidemiologia , Humanos , Programas de Imunização/normas , Programas de Imunização/estatística & dados numéricos , Lactente , Libéria/epidemiologia , Vacinação em Massa/organização & administração , Vacinação em Massa/normas , Vacinação em Massa/estatística & dados numéricos , Sarampo/epidemiologia , Vigilância da População , Estudos Retrospectivos , Serra Leoa/epidemiologia , Cobertura Vacinal/organização & administração , Cobertura Vacinal/normas
12.
J Public Health Manag Pract ; 26(2): 148-152, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995547

RESUMO

OBJECTIVE: To determine the impact of using a person locator service to reduce undeliverable addresses for an immunization information system (IIS)-based reminder project. DESIGN: Return mail was compared at address-difference levels between original IIS addresses and updated addresses. SETTING: Minnesota residents were targeted for an immunization reminder postcard based on address. PARTICIPANTS: Both 11- and 12-year-olds with a Minnesota address in Minnesota's IIS. INTERVENTION: An immunization reminder postcard was mailed to households of participants. MAIN OUTCOME MEASURE(S): Reminder postcard return rates were tracked for address-difference levels between original IIS addresses and updated addresses. Return mail rates were track at the ZIP Code Tabulation Area (ZCTA) level and analyzed for demographic characteristic associations. RESULTS: Postcards had significantly lower odds of return when an address was confirmed (odds ratio [OR] = 0.09; 95% confidence interval [CI], 0.08-0.1; P < .001) or had major updates (OR = 0.47; 95% CI, 0.44-0.49; P < .001) than when no new address information was obtained. Significant, positive associations were found between return rate and both ZCTA-level poverty rate (γ = 0.235, P < .001) and ZCTA-level percentage of nonwhite residents (γ = 0.301, P < .001). CONCLUSIONS: Use of a person locator service is a promising method for reducing the barrier incorrect address information poses to successful reminder/recall notification. Implementation of person locator services could improve the data quality of address information in the IIS and success of outreach attempts by IIS users.


Assuntos
Programas de Imunização/normas , Imunização/psicologia , Sistemas de Alerta/normas , Criança , Estudos de Coortes , Feminino , Humanos , Imunização/normas , Imunização/estatística & dados numéricos , Programas de Imunização/métodos , Programas de Imunização/estatística & dados numéricos , Masculino , Minnesota , Sistemas de Alerta/estatística & dados numéricos
13.
An. pediatr. (2003. Ed. impr.) ; 92(1): 52.e1-52.e10, ene. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-186820

RESUMO

El CAV-AEP publica anualmente el calendario de vacunaciones que estima idóneo para los niños residentes en España, teniendo en cuenta la evidencia científica disponible. Se mantiene el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente. Se aconseja un refuerzo a los 6 años, preferentemente con DTPa (si está disponible), junto a una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, preferentemente entre las 27 y las 32 semanas. La vacuna del rotavirus debería ser sistemática para todos los lactantes. Se sigue proponiendo la incorporación en el calendario de la vacuna antimeningocócica B, con esquema 2 + 1 en lactantes. Además de la inclusión de la vacuna antimeningocócica conjugada tetravalente (MenACWY) a los 12 años con rescate hasta los 18 años, inclusive, el CAV recomienda que esta vacuna sea introducida también a los 12 meses de edad, sustituyendo a MenC. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos. Se emplearán esquemas de 2 dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica. Se recomienda la vacunación sistemática universal frente al VPH, tanto a chicas como a chicos, preferentemente a los 12 años, debiendo realizar un mayor esfuerzo para mejorar las coberturas. La de 9 genotipos amplía la cobertura para ambos sexos


The CAV-AEP annually publishes the immunisation schedule considered optimal for all children resident in Spain, taking into account the available evidence. The 2 + 1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate. A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2 + 1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, both for girls and boys, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Programas de Imunização/normas , Consórcios de Saúde , Programas de Imunização/métodos , Imunização Secundária/tendências , Vacinas/imunologia , Espanha
14.
Arch Argent Pediatr ; 117(2): S37-S119, 2019 04.
Artigo em Espanhol | MEDLINE | ID: mdl-31833342

RESUMO

Beginning in 1974, the date on which the Expanded Program on Immunization was established in the Americas, the number of deaths and disabilities due to certain infectious diseases decreased considerably thanks to universally applied vaccines. A program that initially included four vaccines that protected against six diseases (tuberculosis, diphtheria, pertussis, tetanus, polio and measles) was consolidated, over the years, by incorporating new vaccines and significantly raising coverage rates. The Sociedad Argentina de Pediatría (Argentine Society of Pediatrics), as a leader of opinion, played a leading role in the incorporation of new vaccines, currently reaching one of the most complete vaccination calendars in the world, which improves the levels of inequality and inequity in public health. Taking into account the significant role of the pediatrician in decision-making, the National Committee of Infectious Diseases, together with the Subsidiary Committees, prepared a document on updates and recommendations for 2018 on Polio, Rotavirus, Pneumococcus, Meningococcus, Human Papillomavirus, Chickenpox, Flu, Dengue vaccines and Whooping Cough.


Assuntos
Programas de Imunização/normas , Esquemas de Imunização , Vacina contra Coqueluche/administração & dosagem , Vacinas Estreptocócicas/administração & dosagem , Vacinas Virais/administração & dosagem , Adolescente , Argentina/epidemiologia , Varicela/epidemiologia , Varicela/prevenção & controle , Criança , Pré-Escolar , Tomada de Decisão Clínica , Contraindicações , Dengue/epidemiologia , Dengue/prevenção & controle , Diagnóstico Diferencial , Armazenamento de Medicamentos/métodos , Feminino , Saúde Global , Humanos , Lactente , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , América Latina/epidemiologia , Masculino , Infecções Meningocócicas/epidemiologia , Infecções Meningocócicas/prevenção & controle , Infecções Meningocócicas/transmissão , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Pediatria , Vacina contra Coqueluche/efeitos adversos , Vacina contra Coqueluche/imunologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Poliomielite/diagnóstico , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Poliomielite/transmissão , Vacinas contra Poliovirus/administração & dosagem , Vacinas contra Poliovirus/efeitos adversos , Vacinas contra Poliovirus/imunologia , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/prevenção & controle , Sociedades Médicas , Vacinas Estreptocócicas/efeitos adversos , Vacinas Estreptocócicas/imunologia , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/efeitos adversos , Vacinas Conjugadas/imunologia , Vacinas Virais/efeitos adversos , Vacinas Virais/imunologia , Coqueluche/epidemiologia , Coqueluche/prevenção & controle
15.
Aust N Z J Public Health ; 43(6): 558-562, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31617660

RESUMO

OBJECTIVES: To describe and compare vaccination coverage for Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) adults in 2004-05 and 2012-13, including the impact of national vaccination funding initiatives. METHODS: National Aboriginal and Torres Strait Islander Health cross-sectional surveys - 2004-05 (n=5,757) and 2012-13 (n=5,482) - were compared. Self-reported influenza and pneumococcal vaccination coverage among Indigenous adults was analysed by age, remoteness, gender and risk factor status. RESULTS: Influenza vaccination coverage among Indigenous adults in 2004-05 and 2012-13 remained low. While coverage increased for those aged 18-49 years from 23% to 29%, it declined for those aged ≥65 years from 84% to 74%. For remote areas, influenza coverage among those aged 50-64 years declined from 76% to 66%. Pneumococcal vaccination coverage remained very low and declined across all age groups in 2004-05 and 2012-13 (50-64 years: 30% to 23%). For remote areas, pneumococcal coverage declined among those aged 50-64 years from 52% to 32%. CONCLUSIONS: Indigenous adult vaccination coverage for influenza and pneumococcal disease remains unacceptably low. Between 2004-05 and 2012-13, declines occurred in pneumococcal vaccination coverage across all age groups ≥18 years. Despite national funding of influenza vaccine in 2010, there was no increase in influenza coverage, except for the 18-49-year age group. Implications for public health: Current approaches to promote, deliver and monitor vaccination of Indigenous adults are inadequate.


Assuntos
Serviços de Saúde do Indígena/estatística & dados numéricos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Humanos , Programas de Imunização/normas , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Grupo com Ancestrais Oceânicos , Cobertura Vacinal/tendências , Adulto Jovem
16.
J Pediatric Infect Dis Soc ; 8(6): 495-500, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31589289

RESUMO

The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts, meets 3 times per year to develop recommendations for vaccine use in the United States. There usually are 15 voting members, but at the June 2019 meeting, only 14 were present; each member's term is 4 years. ACIP members and Centers for Disease Control and Prevention (CDC) staff discuss the epidemiology of vaccine-preventable diseases and vaccine research, effectiveness, safety data, and clinical trial results. Representatives from the American Academy of Pediatrics (AAP) (Y. A. M. and D. W. K.) and the Pediatric Infectious Diseases Society (S. T. O.) are present as liaisons to the ACIP. The ACIP met on June 26 to 27, 2019, to discuss the use of human papillomavirus (HPV) vaccine in adults, pneumococcal vaccines in adults, measles updates, zoster vaccine, influenza vaccines, hepatitis A virus (HAV) vaccines, meningococcal vaccines, and dengue vaccine.


Assuntos
Comitês Consultivos , Programas de Imunização/normas , Vacinação/normas , Adolescente , Adulto , Comitês Consultivos/organização & administração , Idoso , Idoso de 80 Anos ou mais , Centers for Disease Control and Prevention, U.S. , Criança , Pré-Escolar , Vacinas contra Dengue/administração & dosagem , Vacinas contra Hepatite A , Vacina contra Herpes Zoster/administração & dosagem , Humanos , Esquemas de Imunização , Lactente , Vacinas contra Influenza/administração & dosagem , Sarampo , Vacina contra Sarampo/administração & dosagem , Vacinas Meningocócicas/administração & dosagem , Pessoa de Meia-Idade , Vacinas contra Papillomavirus , Pediatria , Vacina contra Coqueluche/administração & dosagem , Vacinas Pneumocócicas , Estados Unidos , Vacinas Combinadas/administração & dosagem , Adulto Jovem
17.
Viruses ; 11(9)2019 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-31480472

RESUMO

Licensure of a vaccine to protect against aerosolized Venezuelan equine encephalitis virus (VEEV) requires use of the U.S. Food and Drug Administration (FDA) Animal Rule to assess vaccine efficacy as human studies are not feasible or ethical. An approach to selecting VEEV challenge strains for use under the Animal Rule was developed, taking into account Department of Defense (DOD) vaccine requirements, FDA Animal Rule guidelines, strain availability, and lessons learned from the generation of filovirus challenge agents within the Filovirus Animal Nonclinical Group (FANG). Initial down-selection to VEEV IAB and IC epizootic varieties was based on the DOD objective for vaccine protection in a bioterrorism event. The subsequent down-selection of VEEV IAB and IC isolates was based on isolate availability, origin, virulence, culture and animal passage history, known disease progression in animal models, relevancy to human disease, and ability to generate sufficient challenge material. Methods for the propagation of viral stocks (use of uncloned (wild-type), plaque-cloned, versus cDNA-cloned virus) to minimize variability in the potency of the resulting challenge materials were also reviewed. The presented processes for VEEV strain selection and the propagation of viral stocks may serve as a template for animal model development product testing under the Animal Rule to other viral vaccine programs. This manuscript is based on the culmination of work presented at the "Alphavirus Workshop" organized and hosted by the Joint Vaccine Acquisition Program (JVAP) on 15 December 2014 at Fort Detrick, Maryland, USA.


Assuntos
Modelos Animais de Doenças , Vírus da Encefalite Equina Venezuelana/imunologia , Encefalomielite Equina Venezuelana/prevenção & controle , Vacinas Virais/uso terapêutico , Animais , Vírus da Encefalite Equina Venezuelana/genética , Vírus da Encefalite Equina Venezuelana/patogenicidade , Encefalomielite Equina Venezuelana/virologia , Guias como Assunto , Humanos , Programas de Imunização/métodos , Programas de Imunização/normas , Virologia/métodos
18.
Bioethics ; 33(9): 1042-1049, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31389050

RESUMO

Political communities across the world have recently sought to tackle rising rates of vaccine hesitancy and refusal, by implementing coercive immunization programs, or by making existing immunization programs more coercive. Many academics and advocates of public health have applauded these policy developments, and they have invoked ethical reasons for implementing or strengthening vaccine mandates. Others have criticized these policies on ethical grounds, for undermining liberty, and as symptoms of broader government overreach. But such arguments often obscure or abstract away from the diverse values that are relevant to the ethical justifications of particular political communities' vaccine-mandate policies. We argue for an expansive conception of the normative issues relevant to deciding whether and how to establish or reform vaccine mandates, and we propose a schema by which to organize our thoughts about the ways in which different kinds of vaccine-mandate policies implicate various values.


Assuntos
Surtos de Doenças/prevenção & controle , Programas de Imunização/ética , Programas de Imunização/normas , Recusa do Paciente ao Tratamento/ética , Vacinação/ética , Vacinação/normas , Vacinas/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Política de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública
19.
Nurs Forum ; 54(4): 553-556, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31389612

RESUMO

The State of Connecticut mandates that prekindergarten children be vaccinated against the influenza virus each year by December 31st. Annually, prekindergarten students in urban schools in Connecticut are not compliant with this statute due to many factors such as parents' lack of education. The purpose of an educational intervention project (EIP) is to provide urban prekindergarten parents/caregivers with education about the influenza virus, influenza vaccine, the community resources, and Connecticut mandates. An influenza vaccine educational intervention was provided to parents and caregivers of prekindergarten students in one urban elementary school in Connecticut. Parents were educated during an open house at the school and then 4 weeks later at a Meet and Greet with prekindergarten parents. Information regarding influenza virus, vaccine, and state regulations was provided along with Pre- and post-questionnaires to assess the level of knowledge. The goal of this EIP is increased knowledge of the influenza virus, the vaccine, community resources, and state regulations. The success of this educational intervention can be shared and implemented in other licensed prekindergarten programs to increase parents' knowledge and it would lead to increased rates of district-wide compliance and decreased student absences. Most importantly, implications point to the potential protection of the public from an illness stemming from the influenza virus.


Assuntos
Programas de Imunização/normas , Vacinas contra Influenza/uso terapêutico , Connecticut , Humanos , Programas de Imunização/métodos , Programas de Imunização/tendências , Vacinas contra Influenza/administração & dosagem , Influenza Humana/tratamento farmacológico , Influenza Humana/prevenção & controle , Avaliação de Programas e Projetos de Saúde/métodos , Vacinação/métodos , Vacinação/psicologia , Vacinação/normas
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