Introduction of human papillomavirus (HPV) vaccination into national immunisation schedules in Europe: Results of the VENICE 2007 survey.

PubMed

King, L A; Lévy-Bruhl, D; O'Flanagan, D; Bacci, S; Lopalco, P L; Kudjawu, Y; Salmaso, S

2008-08-14

The European Union Member States are simultaneously considering introducing HPV vaccination into their national immunisation schedules. The Vaccine European New Integrated Collaboration Effort (VENICE) project aims to develop a collaborative European vaccination network. A survey was undertaken to describe the decision status and the decision-making process regarding the potential introduction of human papillomavirus (HPV) vaccination in to their national immunisation schedules. A web-based questionnaire was developed and completed online in 2007 by 28 countries participating in VENICE. As of 31 October 2007,five countries had decided to introduce HPV vaccination into the national immunisation schedule, while another seven had started the decision-making process with a recommendation favouring introduction. Varying target populations were selected by the five countries which had introduced the vaccination. Half of the surveyed countries had undertaken at least one ad hoc study to support the decision-making process. According to an update of the decision-status from January 2008, the number of countries which had made a decision or recommendation changed to 10 and 5 respectively. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe and the existence of expertise and experience among EU Member States. The VENICE network is capable of following this process and supporting countries in making vaccine introduction decisions. A VENICE collaborative web-space is being developed as a European resource for the decision-making process for vaccine introduction.

Immunisation coverage, 2012.

PubMed

Hull, Brynley P; Dey, Aditi; Menzies, Rob I; Brotherton, Julia M; McIntyre, Peter B

2014-09-30

This, the 6th annual immunisation coverage report, documents trends during 2012 for a range of standard measures derived from Australian Childhood Immunisation Register (ACIR) data, and National Human Papillomavirus (HPV) Vaccination Program Register data. These include coverage at standard age milestones and for individual vaccines included on the National Immunisation Program (NIP) and coverage in adolescents and adults. The proportion of Australian children 'fully vaccinated' at 12, 24 and 60 months of age was 91.7%, 92.5% and 91.2%, respectively. For vaccines available on the NIP but not assessed during 2012 for 'fully vaccinated' status or for eligibility for incentive payments (rotavirus and pneumococcal at 12 months and meningococcal C and varicella at 24 months) coverage varied. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.6%) and varicella at 24 months (84.4%). Although 'fully vaccinated' coverage at 12 months of age was lower among Indigenous children than non-Indigenous children in all jurisdictions, the extent of the difference varied, reaching a 15 percentage point differential in South Australia but only a 0.4 percentage point differential in the Northern Territory. Overall, Indigenous coverage at 24 months of age exceeded that at 12 months of age nationally and for all jurisdictions, but as receipt of varicella vaccine at 18 months is excluded from calculations, this represents delayed immunisation, with some contribution from immunisation incentives. The 'fully vaccinated' coverage estimates for vaccinations due by 60 months of age for Indigenous children exceeded 90% at 91% in 2012. Unlike in 2011, at 60 months of age, there was no dramatic variation in coverage between Indigenous and non-Indigenous children for individual jurisdictions. As previously documented, vaccines recommended for Indigenous children only, hepatitis A and pneumococcal vaccine, had

Estimating vaccination coverage in the absence of immunisation registers--the German experience.

PubMed

Siedler, A; Rieck, T; Reuss, A; Walter, D; Poggensee, G; Poethko-Muller, C; Reiter, S

2012-04-26

Immunisation registers are regarded as an appropriate solution to measure vaccination coverage on a population level. In Germany, a decentralised healthcare system and data protection regulations constrain such an approach. Moreover, shared responsibilities in the process of immunisation and multiple providers form the framework for public health interventions on vaccination issues. On the national level, those interventions consist mainly of conceptualising immunisation strategies, establishing vaccination programmes, and issuing recommendations. This paper provides an overview on sources and methods for collecting appropriate coverage data at national level and their public health relevance in Germany. Methods of data collection and available information on immunisations are described for three approaches: school entrance health examination, population surveys and insurance refund claim data. School entrance health examinations allow regional comparisons and estimation of trends for a specific cohort of children and for all recommended childhood vaccinations. Surveys deliver population based data on completeness and timeliness of selected vaccinations in populations defined by age or socio-demographic parameters and on knowledge and attitudes towards vaccination. Insurance refund claim data inform continuously on immunisation status (e.g. of children aged two years) or on vaccination incidence promptly after new or modified recommendations. In a complex healthcare system, the German National Public Health Institute (Robert Koch Institute, RKI) successfully compiles coverage data from different sources, which complement and validate one another. With the German approach of combining different data sources in the absence of immunisation registers, it is possible to gain solid and reliable data on the acceptance of vaccination programmes and target groups for immunisation. This approach might be of value for other countries with decentralised healthcare systems.

Maternal immunisation: ethical issues.

PubMed

Verweij, Marcel; Lambach, Philipp; Ortiz, Justin R; Reis, Andreas

2016-12-01

There has been increased interest in the potential of maternal immunisation to protect maternal, fetal, and infant health. Maternal tetanus vaccination is part of routine antenatal care and immunisation campaigns in many countries, and it has played an important part in the reduction of maternal and neonatal tetanus. Additional vaccines that have been recommended for routine maternal immunisation include those for influenza and pertussis, and other vaccines are being developed. Maternal immunisation is controversial since regulators, professionals, and the public are often reluctant to accept pharmaceutical interventions during pregnancy. So far, little attention has been given to the ethics of vaccination during pregnancy. In this Personal View we argue that maternal immunisation should be offered in response to concrete, severe risks of disease for mother and child, and we explain how this requirement of serious risk can be used to guide ethical decision-making about maternal immunisation. Copyright © 2016 World Health Organization. Published by Elsevier Ltd. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Immunisation of chickens with live Salmonella vaccines - Role of booster vaccination.

PubMed

Methner, U

2018-05-17

It is accepted that booster vaccinations of chickens with live Salmonella vaccines are essential part of vaccinations schemes to induce an effective adaptive immune response. As manufacturer of registered live Salmonella vaccines recommend different times of booster the question raises whether the duration between the first and second immunisation might influence the protective effect against Salmonella exposure. Chickens were immunised with a live Salmonella Enteritidis vaccine on day 1 of age followed by a booster vaccination at different intervals (day 28, 35 or 42 of age) to study the effects on the colonisation and invasion of the Salmonella vaccine strain, the humoral immune response and the efficacy against infection with Salmonella Enteritidis on day 56 of age. Immunisation of all groups resulted in a very effective adaptive immune response and a high degree of protection against severe Salmonella exposure, however, the time of booster had only an unverifiable influence on either the colonisation of the vaccine strain, the development of the humoral immune response or the colonisation of the Salmonella challenge strain. Therefore, the first oral immunisation of the chicks on day 1 of age seems to be of special importance and prerequisite for the development of the effective immune response. A booster immunisation should be carried out, however, the time of booster may vary between week 3 and week 7 of age of the chickens without adversely impact on the efficacy of the adaptive immune response or the protective effects. Copyright © 2018 Elsevier Ltd. All rights reserved.

Barriers to childhood immunisation: Findings from the Longitudinal Study of Australian Children.

PubMed

Pearce, Anna; Marshall, Helen; Bedford, Helen; Lynch, John

2015-06-26

To examine barriers to childhood immunisation experienced by parents in Australia. Cross-sectional analysis of secondary data. Nationally representative Longitudinal Study of Australian Children (LSAC). Five thousand one hundred seven infants aged 3-19 months in 2004. Maternal report of immunisation status: incompletely or fully immunised. Overall, 9.3% (473) of infants were incompletely immunised; of these just 16% had mothers who disagreed with immunisation. Remaining analyses focussed on infants whose mother did not disagree with immunisation (N=4994) (of whom 8% [398] were incompletely immunised). Fifteen variables representing potential immunisation barriers and facilitators were available in LSAC; these were entered into a latent class model to identify distinct clusters (or 'classes') of barriers experienced by families. Five classes were identified: (1) 'minimal barriers', (2) 'lone parent, mobile families with good support', (3) 'low social contact and service information; psychological distress', (4) 'larger families, not using formal childcare', (5) 'child health issues/concerns'. Compared to infants from families experiencing minimal barriers, all other barrier classes had a higher risk of incomplete immunisation. For example, the adjusted risk ratio (RR) for incomplete immunisation was 1.51 (95% confidence interval: 1.08-2.10) among those characterised by 'low social contact and service information; psychological distress', and 2.47 (1.87-3.25) among 'larger families, not using formal childcare'. Using the most recent data available for examining these issues in Australia, we found that the majority of incompletely immunised infants (in 2004) did not have a mother who disagreed with immunisation. Barriers to immunisation are heterogeneous, suggesting a need for tailored interventions. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Frequency of respiratory deterioration after immunisation in preterm infants.

PubMed

Hacking, Douglas F; Davis, Peter G; Wong, Ester; Wheeler, Kevin; McVernon, Jodie

2010-12-01

To determine the relationship between the initiation of respiratory support and the first routine immunisation of neonates at 2 months of age during primary hospitalisation. An historical cohort study design was used to study the neonatal factors associated with the initiation of respiratory support within 7 days of immunisation in a cohort of 7629 preterm and term infants admitted to the Neonatal Unit of the Royal Women's Hospital between 2001 and 2008. The 411 infants who received their first immunisations in hospital were both very preterm and of extremely low birth weight (ELBW, below 1000 g). Twenty-two infants experienced post-immunisation apnoea of sufficient severity to warrant the initiation of either intermittent positive pressure ventilation (two cases) or continuous positive airway pressure (20 cases). Infants exhibiting a respiratory deterioration following immunisation had a higher incidence of previous septicaemia (Odds ratio 2.5, 95% confidence interval 1.0, 6.1; P = 0.04) and received CPAP for a longer period prior to vaccination (P = 0.03). Apnoea following immunisation may be an aetiological factor in the requirement of respiratory support in a small number of preterm, ELBW infants particularly those with significant lung disease and those who have previously experienced septicaemia. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Association between sudden infant death syndrome and diphtheria-tetanus-pertussis immunisation: an ecological study.

PubMed

Müller-Nordhorn, Jacqueline; Hettler-Chen, Chih-Mei; Keil, Thomas; Muckelbauer, Rebecca

2015-01-28

Sudden infant death syndrome (SIDS) continues to be one of the main causes of infant mortality in the United States. The objective of this study was to analyse the association between diphtheria-tetanus-pertussis (DTP) immunisation and SIDS over time. The Centers for Disease Control and Prevention provided the number of cases of SIDS and live births per year (1968-2009), allowing the calculation of SIDS mortality rates. Immunisation coverage was based on (1) the United States Immunization Survey (1968-1985), (2) the National Health Interview Survey (1991-1993), and (3) the National Immunization Survey (1994-2009). We used sleep position data from the National Infant Sleep Position Survey. To determine the time points at which significant changes occurred and to estimate the annual percentage change in mortality rates, we performed joinpoint regression analyses. We fitted a Poisson regression model to determine the association between SIDS mortality rates and DTP immunisation coverage (1975-2009). SIDS mortality rates increased significantly from 1968 to 1971 (+27% annually), from 1971 to 1974 (+47%), and from 1974 to 1979 (+3%). They decreased from 1979 to 1991 (-1%) and from 1991 to 2001 (-8%). After 2001, mortality rates remained constant. DTP immunisation coverage was inversely associated with SIDS mortality rates. We observed an incidence rate ratio of 0.92 (95% confidence interval: 0.87 to 0.97) per 10% increase in DTP immunisation coverage after adjusting for infant sleep position. Increased DTP immunisation coverage is associated with decreased SIDS mortality. Current recommendations on timely DTP immunisation should be emphasised to prevent not only specific infectious diseases but also potentially SIDS.

Immunisation registers in Italy: a patchwork of computerisation.

PubMed

Alfonsi, V; D'Ancona, F; Rota, M C; Giambi, C; Ranghiasci, A; Iannazzo, S

2012-04-26

In Italy, the 21 regional health authorities are in charge of organising and implementing their own vaccination strategy, based on the national vaccine plan. Immunisation coverage varies greatly among the regions for certain vaccines. Efforts to increase childhood immunisation coverage have included initiatives to develop and implement computerised immunisation registers in as many regions as possible. We undertook a cross-sectional online survey in July 2011 to provide an updated picture of the use, heterogeneity and main functions of different computerised immunisation registers used in the Italian regions and to understand the flow of information from local health units to the regional authorities and to the Ministry of Health. Comparing current data with those obtained in 2007, a substantial improvement is evident. A total of 15 regions are fully computerised (previously nine), with 83% of local health units equipped with a computerised register (previously 70%). Eight of the 15 fully computerised regions use the same software, simplifying data sharing. Only four regions are able to obtain data in real time from local health units. Despite the progress made, the capacity to monitor vaccination coverage and to exchange data appears still limited.

IMMUNISATION TRAINING NEEDS IN MALAWI.

PubMed

Tsega, A Y; Hausi, H T; Steinglass, R; Chirwa, G Z

2014-09-01

The Malawi Ministry of Health (MOH) and its immunisation partners conducted a training needs assessment in May 2013 to assess the current status of immunisation training programmemes in health training institutions, to identify unmet training needs, and to recommend possible solutions for training of health workers on a regular basis. A cross-sectional, descriptive study. Health training institutions in Malawi, a developing country that does not regularly update its curricula to include new vaccines and management tools, nor train healthcare workers on a regular basis. Researchers interviewed Malawi's central immunisation manager, three zonal immunisation officers, six district officers, 12 health facility immunisation coordinators, and eight principals of training institutions. All health training institutions in Malawi include immunisation in their preservice training curricula. However, the curriculum is not regularly updated; thus, the graduates are not well equipped to provide quality services. In addition, the duration of the training curriculum is inadequate, and in-service training sessions for managers and service providers are conducted only on an ad hoc basis. All levels of Malawi's health system have not met sufficient training needs for providing immunisations, and the health training institutions teach their students with outdated materials. It is recommended that the training institutions update their training curricula regularly and the service providers are trained on a regular basis.

Has decentralisation affected child immunisation status in Indonesia?

PubMed

Maharani, Asri; Tampubolon, Gindo

2014-01-01

The past two decades have seen many countries, including a number in Southeast Asia, decentralising their health system with the expectation that this reform will improve their citizens' health. However, the consequences of this reform remain largely unknown. This study analyses the effects of fiscal decentralisation on child immunisation status in Indonesia. We used multilevel logistic regression analysis to estimate these effects, and multilevel multiple imputation to manage missing data. The 2011 publication of Indonesia's national socio-economic survey (Susenas) is the source of household data, while the Podes village census survey from the same year provides village-level data. We supplement these with local government fiscal data from the Ministry of Finance. The findings show that decentralising the fiscal allocation of responsibilities to local governments has a lack of association with child immunisation status and the results are robust. The results also suggest that increasing the number of village health centres (posyandu) per 1,000 population improves probability of children to receive full immunisation significantly, while increasing that of hospitals and health centres (puskesmas) has no significant effect. These findings suggest that merely decentralising the health system does not guarantee improvement in a country's immunisation coverage. Any successful decentralisation demands good capacity and capability of local governments.

Has decentralisation affected child immunisation status in Indonesia?

PubMed Central

Maharani, Asri; Tampubolon, Gindo

2014-01-01

Background The past two decades have seen many countries, including a number in Southeast Asia, decentralising their health system with the expectation that this reform will improve their citizens’ health. However, the consequences of this reform remain largely unknown. Objective This study analyses the effects of fiscal decentralisation on child immunisation status in Indonesia. Design We used multilevel logistic regression analysis to estimate these effects, and multilevel multiple imputation to manage missing data. The 2011 publication of Indonesia's national socio-economic survey (Susenas) is the source of household data, while the Podes village census survey from the same year provides village-level data. We supplement these with local government fiscal data from the Ministry of Finance. Results The findings show that decentralising the fiscal allocation of responsibilities to local governments has a lack of association with child immunisation status and the results are robust. The results also suggest that increasing the number of village health centres (posyandu) per 1,000 population improves probability of children to receive full immunisation significantly, while increasing that of hospitals and health centres (puskesmas) has no significant effect. Conclusion These findings suggest that merely decentralising the health system does not guarantee improvement in a country's immunisation coverage. Any successful decentralisation demands good capacity and capability of local governments. PMID:25160515

The current state of introduction of HPV vaccination into national immunisation schedules in Europe: results of the VENICE 2008 survey.

PubMed

Lévy-Bruhl, D; Bousquet, V; King, L A; O'Flanagan, D; Bacci, S; Lopalco, P L; Salmaso, S

2009-10-01

Three surveys have been undertaken in European Union (EU) member states since January 2007, within the European Commission funded Vaccine European New Integrated Collaboration Effort (VENICE) project, to monitor the decision status regarding the introduction of human papillomavirus (HPV) vaccination into national immunisation schedules. A web-based questionnaire was developed and completed online by the 28 countries participating in VENICE. According to the last update (31st December 2008), 15 countries have decided to introduce HPV vaccination into their national immunisation schedule, while another six have started the decision-making process with a recommendation favouring introduction. Varying target populations have been selected by the countries which have introduced vaccination. The number of countries which have made a decision or recommendation has increased from 12 to 21 between October 2007 and December 2008. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe. A further update should be available in the second half of 2009.

Low immunisation uptake: Is the process the problem?

PubMed Central

Harrington, P.; Woodman, C.; Shannon, W.

2000-01-01

OBJECTIVE—To examine mothers' satisfaction with the process of immunisation and its possible contribution to suboptimal immunisation uptake.
DESIGN—In depth interviews with mothers.
SETTING—Two Community Care Areas, Dublin city, Ireland.
PARTICIPANTS—In depth interviews of 23 mothers of children 1-2 years old, recruited purposively from a birth cohort born in 1994.
MAIN RESULTS—Mothers preferred general practice to Health Centre immunisation (11:5) for predominantly emotional compared with practical reasons (4:1). Health Centre immunisation was seen, at times, as unacceptably rough and inhuman. Many mothers experienced severe emotional distress at the prospect of inflicting the pain of immunisation on their babies. The non-empathic stance of some immunising doctors was unacceptable to mothers. They valued attempts by health professionals to acknowledge the pain of immunisation and to engage with their baby. Adverse experiences contributed to deferral of future visits and to defaulting behaviour.
CONCLUSIONS—Low empathy mass immunisation in clinic type settings may be unacceptable to mothers in the 1990s, and may in part explain suboptimal uptake in health care systems that use such clinics.


Keywords: immunisation; health behaviour; immunisation uptake PMID:10814662

NSW Annual Immunisation Coverage Report, 2009.

PubMed

Hull, Brynley; Dey, Aditi; Mahajan, Deepika; Campbell-Lloyd, Sue; Menzies, Robert I; McIntyre, Peter B

2010-01-01

This is the first in a series of annual immunisation coverage reports that document trends in NSW for a range of standard measures derived from Australian Childhood Immunisation Register data, including overall coverage at standard age milestones and for individual vaccines. This report includes data up to and including 2009. Data from the Australian Childhood Immunisation Register, the NSW Health Survey and the NSW School Immunisation Program were used to calculate various measures of population coverage relating to childhood vaccines, adult influenza and pneumococcal vaccines and adolescent vaccination, respectively. Immunise Australia Program targets have been reached for children at 12 and 24 months of age but not for children at 5 years of age. Delayed receipt of vaccines is an issue for vaccines recommended for Aboriginal children. Pneumococcal vaccination in the elderly has been steadily rising, although it has remained lower than the influenza coverage estimates. For adolescents, there is better coverage for the first and second doses of human papillomavirus vaccine and the dose of dTpa than for varicella. This comprehensive analysis provides important baseline data for NSW against which future reports can be compared to monitor progress in improving immunisation coverage. Immunisation at the earliest appropriate age should be a public health goal for countries such as Australia where high levels of vaccine coverage at milestone ages have been achieved.

Non-specific effect of Bacille Calmette-Guérin vaccine on the immune response to routine immunisations.

PubMed

Ritz, Nicole; Mui, Milton; Balloch, Anne; Curtis, Nigel

2013-06-26

Bacille Calmette-Guérin (BCG) is one of the most commonly administered vaccines worldwide. In addition to protection against tuberculosis (TB), evidence suggests that BCG immunisation has a number of additional beneficial non-specific immunological effects. These include a reduction in overall infant and child mortality attributable to causes other than TB in high-mortality regions. The antibody response to immunisations provides an opportunity to investigate the influence of BCG on the immune response to unrelated antigens. This study compared the antibody response to routine immunisations in BCG-immunised and non-BCG-immunised infants. BCG-immunised infants were recruited from a related study in which BCG was given at birth and non-BCG-immunised infants were recruited from immunisation clinics. All infants received their routine immunisations according to the Australian National Immunisation Program. Concentrations of antibodies against pneumococcal (anti-Pn Ps), Haemophilus influenzae type B (anti-Hib), tetanus toxoid (anti-TT) and hepatitis B surface (anti-HBs) antigen were measured four weeks after the last (six month) set of infant immunisations. A total of 127 parents agreed for their infants to take part in the study of which 108 were included in the final analysis (56 BCG-immunised and 52 non-BCG-immunised). The geometric mean concentration (GMC) of anti-Pn Ps IgG for all serotypes, anti-Hib IgG and anti-TT IgG were higher in the BCG-immunised group than the non-BCG-immunised group. This difference reached statistical significance for serotype 9V (p<0.01) and 18C (p=0.04). The GMC of anti-HBs IgG was lower in the BCG-immunised group than the non-BCG-immunised group (p=0.03). The majority of participants in both groups had antibody levels above the protective threshold. BCG immunisation at birth influences the antibody response to routine immunisations administered later in infancy. This has important implications for the introduction of both pneumococcal

Cost analysis of immunisation against east coast fever on smallholder dairy farms in Kenya.

PubMed

Muraguri, G R; Mbogo, S K; McHardy, N; Kariuki, D P

1998-03-27

A spreadsheet model was developed and used to estimate the total cost of immunising cattle against East Coast fever (ECF) based on the infection-and-treatment method. Using data from an immunisation trial carried out on 102 calves and yearlings on 64 farms in the Githunguri division, Kiambu district, Kenya, a reference base scenario of a mean herd of five animals, a 10% rate of reaction to immunisation and a 2-day interval monitoring regimen (a total of 10 farm visits) was simulated. Under these conditions, the mean cost of immunisation per animal was US$16.48 (Ksh 955.78); this was equivalent to US$82.39 (Ksh 4778.90) per five-animal farm. A commonly reported reactor rate of 3% would decrease the cost of US$14.63 (Ksh 848.29) per animal. Reducing the number of farm monitoring visits from 10 to 7 would reduce the total cost by 10%, justified if farmers are trained to undertake some of the monitoring work. The fixed costs were 53% of the total cost of immunisation per farm. The cost of immunisation decreased with increasing number of animals per farm, showing economies of scale.

Determinants of partial or no primary immunisations.

PubMed

Jessop, L J; Kelleher, C C; Murrin, C; Lotya, J; Clarke, A T; O'Mahony, D; Fallon, U B; Johnson, H; Bury, G; Murphy, A W

2010-08-01

To determine if different factors affect children having full, partial or no primary immunisations. This was a crossgenerational cohort study with linkage to primary care and hospital records conducted in urban and rural settings in Ireland, recruiting in 2001-2003 with 5-year follow-up. A total of 749 children with immunisation information took part. The uptake of reported primary immunisations was 92.8% full, 4.9% partial and 2.3% no primary immunisations. Adjusted relative risk ratios for children receiving no primary immunisations were significant for: having a mother who had ever visited an alternative practitioner 3.69 (1.05 to 12.9), a mother with means tested full general medical services eligibility 8.11 (1.58 to 41.65), a mother who scored <50 for the World Health Organization Quality of Life (WHO-QOL) scale psychological domain 8.82 (1.79 to 43.6) or living in the west of Ireland (rural) 3.64 (1.0 to 13.2). Being born prematurely was associated with partial primary immunisation, adjusted OR 4.63 (1.24 to 17.3). Knowledge of these differences will help target campaigns to increase full uptake of primary immunisations.

Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand.

PubMed

Hayman, D T S; Marshall, J C; French, N P; Carpenter, T E; Roberts, M G; Kiedrzynski, T

2017-09-05

As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (R v , the number of secondary infections in a partially immunised population), based on the number of immunologically-naïve people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles R v often includes or exceeds one (0.18-3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target naïve individuals is economically beneficial even when childhood immunisation rates are high. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parents' difficulties with decisions about childhood immunisation.

PubMed

Austin, Helen; Campion-Smith, Charles; Thomas, Sarah; Ward, William

2008-10-01

Uptake of childhood immunisation fluctuates in the UK. Convenience, access and parents' relationships with professionals influence uptake. This study explores the decision-making by parents about their children's immunisation through focus groups with analysis to identify categories of concern. Issues raised in focus groups included fear, risk, anger, worry and guilt, confusion, difficulty of decision-making and trust of professionals. The parents of completely and incompletely immunised children shared areas of concern, but there were also significant differences. There was a subset of parents of incompletely immunised children who had decided that their children would not have full immunisation, and this group had little trust in information provided by healthcare professionals. Simply providing more information is unlikely to change their decision.

Immunising Children in Primary Care in the UK--What Are the Concerns of Principal Immunisers?

ERIC Educational Resources Information Center

Maconachie, Moira; Lewendon, Gill

2004-01-01

Objective: To determine the levels of concern about risks associated with childhood immunisations among principal immunisers in general practice. Design: Self-administered postal questionnaire survey. Setting: South & West Devon Health Authority. Participants: Eighty-eight/102 general practices: 78 practice nurses, 7 general practitioners, 3…

Medicare Benefits Schedule data to monitor influenza immunisation in Australian adults.

PubMed

Dyda, Amalie; MacIntyre, C Raina; Banks, Emily; Kaldor, John; Newall, Anthony T; McIntyre, Peter; Liu, Bette

2015-09-30

In Australia, adult immunisation coverage is primarily monitored via periodic telephone surveys that rely on self-reported immunisation status. All Australian residents are eligible for Medicare, so we examined the feasibility of using immunisation-specific Medicare Benefits Schedule (MBS) item numbers to monitor and estimate adult influenza immunisation coverage. Baseline questionnaire data from 267 129 participants from the 45 and Up Study, a prospective cohort study, were linked to data containing information on individual MBS immunisation-specific items from 2006 to 2011. Temporal trends in recording of these items were examined. Self-reported influenza immunisation status obtained from a follow-up questionnaire from 27 036 participants was then compared with the MBS immunisation records. From 2006 to 2011, the pattern of MBS immunisation claims was consistent with self-reported influenza immunisation trends, with annual peaks occurring from March to May. There was fair agreement between MBS immunisation records and self-reported influenza immunisation: 48.8% (95% CI 47.1, 50.4) of participants who self-reported influenza immunisation had a matching MBS record, and 79.6% (95% CI 78.8, 80.4) who reported never having influenza immunisation had no matching MBS record. However, compared with self-reported influenza vaccination for people aged ≥65 years from the 2009 Adult Immunisation Telephone Survey (74.6%), the proportion of participants aged >65 years with an MBS immunisation record was low, with an annual median of 39.3% (range 28.3%-62.1%). MBS immunisation item data are readily available and may be useful to monitor trends in adult influenza immunisation, but they are likely to substantially underestimate coverage. Other approaches, such as capture of general practitioner-delivered influenza vaccine doses or a whole-of-life immunisation register, are needed to comprehensively monitor and estimate adult immunisation coverage for influenza and other

NSW annual immunisation coverage report, 2011.

PubMed

Hull, Brynley; Dey, Aditi; Campbell-Lloyd, Sue; Menzies, Robert I; McIntyre, Peter B

2012-12-01

This annual report, the third in the series, documents trends in immunisation coverage in NSW for children, adolescents and the elderly, to the end of 2011. Data from the Australian Childhood Immunisation Register, the NSW School Immunisation Program and the NSW Population Health Survey were used to calculate various measures of population coverage. During 2011, greater than 90% coverage was maintained for children at 12 and 24 months of age. For children at 5 years of age the improvement seen in 2010 was sustained, with coverage at or near 90%. For adolescents, there was improved coverage for all doses of human papillomavirus vaccine, both doses of hepatitis B vaccine, varicella vaccine and the dose of diphtheria, tetanus and acellular pertussis given to school attendees in Years 7 and 10. Pneumococcal vaccination coverage in the elderly has been steadily rising, although it has remained lower than the influenza coverage estimates. This report provides trends in immunisation coverage in NSW across the age spectrum. The inclusion of coverage estimates for the pneumococcal conjugate, varicella and meningococcal C vaccines in the official coverage assessments for 'fully immunised' in 2013 is a welcome initiative.

Cost analysis of routine immunisation in Zambia.

PubMed

Schütte, Carl; Chansa, Collins; Marinda, Edmore; Guthrie, Teresa A; Banda, Stanley; Nombewu, Zipozihle; Motlogelwa, Katlego; Lervik, Marita; Brenzel, Logan; Kinghorn, Anthony

2015-05-07

This study aimed to inform planning and funding by providing updated, detailed information on total and unit costs of routine immunisation (RI) in Zambia, a GAVI-eligible lower middle-income country with a population of 13 million. The exercise was part of a multi-country study on costs and financing of routine immunisation (EPIC) that utilized a common, ingredients-based approach to costing. Data on inputs, prices and outputs were collected in a stratified, random sample of 51 facilities in nine districts between December 2012 and March 2013 using a pre-tested questionnaire. Shared inputs were allocated to RI costs on the basis of tracing factors developed for the study. A comprehensive set of costs were analysed to obtain total and unit costs, at facility and above-facility levels. The total annual economic cost of RI was $38.16 million, equivalent to approximately 10% of government health spending. Government contributed 83% of finances. Labour accounted for the lion's share (49%) of total costs followed by vaccines (16%) and travel allowances (12%). Analysis of specific activity costs showed that outreach and facility-based services accounted for half of total economic costs. Costs for managing the program at district, provincial and national levels (above-facility costs) represented 24% of total costs. Average unit costs were $7.18 per dose, $59.32 per infant and $65.89 per DPT3 immunised child, with markedly higher unit costs in rural facilities. Analyses suggest that greater efficiency is associated with higher utilisation levels and urban facility type. Total and unit costs, and government's contribution, were considerably higher than previous Zambian estimates and international benchmarks. These findings have substantial implications for planners, efficiency improvement and sustainable financing, particularly as new vaccines are introduced. Variations in immunisation costs at facility level warrant further statistical analyses. Copyright © 2015 Elsevier

Immunisation strategies for viral diseases in developing countries.

PubMed

Ruff, T A

1999-01-01

In just under a quarter of a century, the Expanded Programme on Immunisation has been associated with an increase in infant immunisation coverage from around 5% to 80%, and the prevention of at least 3 million deaths annually, at very low cost. The global target of poliomyelitis eradication by the year 2000 appears feasible. Measles is the next likely target for eradication via immunisation, through 'catch-up', 'keep up' and 'follow-up' strategies which have proven highly effective in the Americas. Yet much needs to be done in order to extend readily achievable immunisation benefits equitably to all the world's people and to realise the potential of existing and soon to be available vaccines for disease control and eradication, as experience with yellow fever and hepatitis B vaccines demonstrates. Unsafe injection practices are widespread, have received inadequate attention, and cause a substantial global burden of blood-borne infections. The risk of increasing global inequity in immunisation highlights the centrality of resource allocation priorities in determining the extent to which the benefits of immunisation will be realised, particularly for new vaccines which are significantly more costly than established EPI vaccines. WHO/UNICEF strategies to target more effectively immunisation support to the neediest countries, to prioritise new vaccines, and to target carefully vaccine procurement and encourage sharply tiered vaccine pricing support both equity and sustainability. However, increasing the resources available to immunisation is vital and requires powerful advocacy on public health, moral, cost-effectiveness and legal grounds. More appropriate resource allocation priorities could readily provide the means necessary to address both technical and operational immunisation challenges.

Improving immunisation timeliness in Aboriginal children through personalised calendars

PubMed Central

2013-01-01

Background Delayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children. Strategies to increase immunisation coverage and timeliness can be resource intensive. In a low cost initiative at the Aboriginal Medical Service Western Sydney (AMSWS) in 2008–2009, a trial of personalised calendars to prompt timely childhood immunisation was undertaken. Methods Calendars were generated during attendances for early childhood immunisations. They were designed for display in the home and included the due date of the next immunisation, a photo of the child and Aboriginal artwork. In a retrospective cohort design, Australian Childhood Immunisation Register data from AMSWS and non-AMSWS providers were used to determine the delay in immunisation and percentage of immunisations on time in those who received a calendar compared to those who did not. Interviews were undertaken with carers and staff. Results Data on 2142 immunisation doses given to 505 children were analysed, utilising pre-intervention (2005–2007) and intervention (2008–2009) periods and a 2 year post-intervention observation period. 113 calendars were distributed (30% of eligible immunisation attendances). Improvements in timeliness were seen at each schedule point for those children who received a calendar. The average delay in those who received a calendar at their previous visit was 0.6 months (95% CI -0.8 to 2.6) after the due date, compared to 3.3 months (95% CI −0.6 to 7.5) in those who did not. 80% of doses were on time in the group who received a calendar at the preceding immunisation, 66% were on time for those who received a calendar at an earlier point and 57% of doses were on time for those who did not receive a calendar (P<0.0001, Cochran-Armitage trend test). Interview data further supported the value and effectiveness of the calendars as both a prompt to timely immunisations and a community health education project without undue

Immunisation coverage in rural-urban migrant children in low and middle-income countries (LMICs): a systematic review and meta-analysis.

PubMed

Awoh, Abiyemi Benita; Plugge, Emma

2016-03-01

The majority of children who die from vaccine-preventable diseases (VPDs) live in low-income and-middle-income countries (LMICs). With the rapid urbanisation and rural-urban migration ongoing in LMICs, available research suggests that migration status might be a determinant of immunisation coverage in LMICs, with rural-urban migrant (RUM) children being less likely to be immunised. To examine and synthesise the data on immunisation coverage in RUM children in LMICs and to compare coverage in these children with non-migrant children. A multiple database search of published and unpublished literature on immunisation coverage for the routine Expanded Programme on Immunisation (EPI) vaccines in RUM children aged 5 years and below was conducted. Following a staged exclusion process, studies that met the inclusion criteria were assessed for quality and data extracted for meta-analysis. Eleven studies from three countries (China, India and Nigeria) were included in the review. There was substantial statistical heterogeneity between the studies, thus no summary estimate was reported for the meta-analysis. Data synthesis from the studies showed that the proportion of fully immunised RUM children was lower than the WHO bench-mark of 90% at the national level. RUMs were also less likely to be fully immunised than the urban-non-migrants and general population. For the individual EPI vaccines, all but two studies showed lower immunisation coverage in RUMs compared with the general population using national coverage estimates. This review indicates that there is an association between rural-urban migration and immunisation coverage in LMICs with RUMs being less likely to be fully immunised than the urban non-migrants and the general population. Specific efforts to improve immunisation coverage in this subpopulation of urban residents will not only reduce morbidity and mortality from VPDs in migrants but will also reduce health inequity and the risk of infectious disease

Immunisation coverage in rural–urban migrant children in low and middle-income countries (LMICs): a systematic review and meta-analysis

PubMed Central

Awoh, Abiyemi Benita; Plugge, Emma

2016-01-01

Background The majority of children who die from vaccine-preventable diseases (VPDs) live in low-income and-middle-income countries (LMICs). With the rapid urbanisation and rural–urban migration ongoing in LMICs, available research suggests that migration status might be a determinant of immunisation coverage in LMICs, with rural–urban migrant (RUM) children being less likely to be immunised. Objectives To examine and synthesise the data on immunisation coverage in RUM children in LMICs and to compare coverage in these children with non-migrant children. Methods A multiple database search of published and unpublished literature on immunisation coverage for the routine Expanded Programme on Immunisation (EPI) vaccines in RUM children aged 5 years and below was conducted. Following a staged exclusion process, studies that met the inclusion criteria were assessed for quality and data extracted for meta-analysis. Results Eleven studies from three countries (China, India and Nigeria) were included in the review. There was substantial statistical heterogeneity between the studies, thus no summary estimate was reported for the meta-analysis. Data synthesis from the studies showed that the proportion of fully immunised RUM children was lower than the WHO bench-mark of 90% at the national level. RUMs were also less likely to be fully immunised than the urban-non-migrants and general population. For the individual EPI vaccines, all but two studies showed lower immunisation coverage in RUMs compared with the general population using national coverage estimates. Conclusions This review indicates that there is an association between rural–urban migration and immunisation coverage in LMICs with RUMs being less likely to be fully immunised than the urban non-migrants and the general population. Specific efforts to improve immunisation coverage in this subpopulation of urban residents will not only reduce morbidity and mortality from VPDs in migrants but will also reduce

NSW annual immunisation coverage report, 2010.

PubMed

Hull, Brynley; Dey, Aditi; Campbell-Lloyd, Sue; Menzies, Robert I; McIntyre, Peter B

2011-11-01

This annual report, the second in the series, documents trends in immunisation coverage in NSW for children, adolescents and the elderly, to the end of 2010. Data from the Australian Childhood Immunisation Register, the NSW School Immunisation Program and the NSW Population Health Survey were used to calculate various measures of population coverage, coverage for Aboriginal children and vaccination timeliness for all children. Over 90% coverage has been reached for children at 12 and 24 months of age. For children at 5 years of age there was an improvement during 2010 in timeliness for vaccines due at 4 years and coverage almost reached 90%. Delayed receipt of vaccines is still an issue for Aboriginal children. For adolescents, there is good coverage for the first and second doses of human papillomavirus vaccine and the dose of diphtheria, tetanus and acellular pertussis. The pneumococcal vaccination rate in the elderly has been steadily rising, although it has remained lower than the influenza coverage estimates. Completion of the recommended immunisation schedule at the earliest appropriate age should be the next public health goal at both the state and local health district level. Official coverage assessments for 'fully immunised' should include the 7-valent pneumococcal conjugate and meningococcal C vaccines, and wider dissemination should be considered.

The introduction of the meningococcal B (MenB) vaccine (Bexsero®) into the national infant immunisation programme--New challenges for public health.

PubMed

Ladhani, Shamez N; Campbell, Helen; Parikh, Sydel R; Saliba, Vanessa; Borrow, Ray; Ramsay, Mary

2015-12-01

The United Kingdom is the first country to introduce Bexsero(®) (GSK Biologicals), a multicomponent, protein-based vaccine against meningococcal group B (MenB), into the national infant immunisation programme. This vaccine is like no other licensed vaccine and poses a number of implementation and surveillance challenges in England. From 01 September 2015, UK infants were offered a reduced two dose primary immunisation schedule at 2 and 4 months followed by a booster at 12 months. Because of high rates of fever post-vaccination, parents were advised to give their infants three doses of prophylactic paracetamol, with the first dose given as soon as possible after the primary MenB vaccination dose. Since the vaccine only protects against 73-88% of MenB strains causing invasive disease in England, clinical isolates and PCR-positive samples will require extensive characterisation by the Meningococcal Reference Unit (MRU) at Public Health England (PHE) in order to monitor vaccine effectiveness and identify potential vaccine failures. PHE is also conducting detailed clinical and epidemiological surveillance to assess the impact of the MenB immunisation programme on the morbidity and mortality associated with invasive meningococcal disease in infants and young children. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Providing opportunistic immunisations for at-risk inpatients in a tertiary paediatric hospital.

PubMed

Elia, Sonja; Perrett, Kirsten; Newall, Fiona

2017-01-01

Attaining high immunisation coverage rates for children with medical conditions is vital. The Royal Children's Hospital (RCH) Immunisation Service has the opportunity to check each inpatient's immunisation status and provide opportunistic vaccines and/or bring the Australian Childhood Immunisation Register (ACIR) up-to-date. This paper highlights that during admission, one quarter of children were not up-to-date with routine scheduled immunisations and 42% of those inpatients due or overdue for immunisation were vaccinated. The model of establishing routine checking of immunisation records and reminding hospital staff about immunisation can result in improvements in vaccination coverage. Healthcare providers have a responsibility to check immunisation status and offer vaccines when necessary; however, often there are missed opportunities to immunise. This paper demonstrates that having a dedicated Immunisation Service, a partnership with a relevant government agency, and effective collaboration with inpatient clinical teams, opportunistic immunisation can be achieved for inpatients. © 2017 Wiley Periodicals, Inc.

MMR immunisation status among Dublin paediatric A&E attenders.

PubMed

Murphy, A W; Power, R; Kinlen, D M; Johnson, Z

1994-01-01

The objectives of this study were to establish the need for opportunistic MMR immunisation among paediatric A&E attenders to the three Dublin paediatric hospitals and to examine the relationship between immunisation status and socioeconomic factors. Design was that of a two month cross sectional study. Survey data was then compared with information on the Eastern Health Board (EHB) records system. Small area and multiple regression analysis of socioeconomic factors derived from participants addresses was also performed. Subjects were 337 children who attended these departments and were aged between fifteen months and five years. For 66% of cases there was a history of MMR immunisation, 30% gave a negative history and 4% did not know. Of those giving a negative history, one third said immunisation had been omitted for no specific reason. EHB records suggested that 39% were immunised, 41% were not and 20% were not on file. Eligibility for the GMS was not associated with failure to immunise. Small area and multiple regression analysis showed little association between immunisation uptake and socioeconomic factors. An opportunistic MMR immunisation policy in A&E Departments would make an important contribution to increasing overall uptake figures. Parental knowledge of the implications of measles and the effectiveness of immunisation needs to be improved. Computerised child health systems must have high data quality standards and access to these systems should be made available in A&E departments.

"It's a complex mesh"- how large-scale health system reorganisation affected the delivery of the immunisation programme in England: a qualitative study.

PubMed

Chantler, Tracey; Lwembe, Saumu; Saliba, Vanessa; Raj, Thara; Mays, Nicholas; Ramsay, Mary; Mounier-Jack, Sandra

2016-09-15

The English health system experienced a large-scale reorganisation in April 2013. A national tri-partite delivery framework involving the Department of Health, NHS England and Public Health England was agreed and a new local operational model applied. Evidence about how health system re-organisations affect constituent public health programmes is sparse and focused on low and middle income countries. We conducted an in-depth analysis of how the English immunisation programme adapted to the April 2013 health system reorganisation, and what facilitated or hindered the delivery of immunisation services in this context. A qualitative case study methodology involving interviews and observations at national and local level was applied. Three sites were selected to represent different localities, varying levels of immunisation coverage and a range of changes in governance. Study participants included 19 national decision-makers and 56 local implementers. Two rounds of interviews and observations (immunisation board/committee meetings) occurred between December 2014 and June 2015, and September and December 2015. Interviews were audio recorded and transcribed verbatim and written accounts of observed events compiled. Data was imported into NVIVO 10 and analysed thematically. The new immunisation programme in the new health system was described as fragmented, and significant effort was expended to regroup. National tripartite arrangements required joint working and accountability; a shift from the simpler hierarchical pre-reform structure, typical of many public health programmes. New local inter-organisational arrangements resulted in ambiguity about organisational responsibilities and hindered data-sharing. Whilst making immunisation managers responsible for larger areas supported equitable resource distribution and strengthened service commissioning, it also reduced their ability to apply clinical expertise, support and evaluate immunisation providers' performance

[Immunisation schedule of the Spanish Association of Paediatrics: 2018 recommendations].

PubMed

Moreno-Pérez, David; Álvarez García, Francisco José; Álvarez Aldeán, Javier; Cilleruelo Ortega, María José; Garcés Sánchez, María; García Sánchez, Nuria; Hernández Merino, Ángel; Méndez Hernández, María; Merino Moína, Manuel; Montesdeoca Melián, Abián; Ruiz-Contreras, Jesús

2018-01-01

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines. Regarding funded immunisations, 2+1 strategy (2, 4, 11-12 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended. Administration of the 6-year booster dose with DTPa is recommended, and a poliomyelitis dose for children who had received the 2+1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy between 27 and 32 weeks' gestation. The two-dose scheme should be used for MMR (12 months and 2-4 years) and varicella (15 months and 2-4 years). MMRV vaccine could be applied as the second dose if available. Coverage of human papillomavirus vaccination in girls aged 12 with a two dose scheme (0, 6 months) should be improved. Information and recommendation for male adolescents about potential beneficial effects of this immunisation should be provided as well. The new 9 genotypes vaccine is now available, expanding the coverage for both gender. Regarding non-funded immunisations, Committee on Vaccines of the Spanish Association of Paediatrics recommends meningococcal B vaccination, with a 3+1 schedule, and requests to be included in the National Immunisation Program. Tetravalent meningococcal vaccine (MenACWY) is recommended to adolescents (14-18 years) who are going to live in countries with systematic vaccination against ACWY serogroups, and people >6 weeks of age with risk factors or travellers to countries with very high incidence. Vaccination against rotavirus is recommended in all infants. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Primary care practice and health professional determinants of immunisation coverage.

PubMed

Grant, Cameron C; Petousis-Harris, Helen; Turner, Nikki; Goodyear-Smith, Felicity; Kerse, Ngaire; Jones, Rhys; York, Deon; Desmond, Natalie; Stewart, Joanna

2011-08-01

To identify primary care factors associated with immunisation coverage. A survey during 2005-2006 of a random sample of New Zealand primary care practices, with over-sampling of practices serving indigenous children. An immunisation audit was conducted for children registered at each practice. Practice characteristics and the knowledge and attitudes of doctors, nurses and caregivers were measured. Practice immunisation coverage was defined as the percentage of registered children from 6 weeks to 23 months old at each practice who were fully immunised for age. Associations of practice, doctor, nurse and caregiver factors with practice immunisation coverage were determined using multiple regression analyses. One hundred and twenty-four (61%) of 205 eligible practices were recruited. A median (25th-75th centile) of 71% (57-77%) of registered children at each practice was fully immunised. In multivariate analyses, immunisation coverage was higher at practices with no staff shortages (median practice coverage 76% vs 67%, P = 0.004) and where doctors were confident in their immunisation knowledge (72% vs 67%, P= 0.005). Coverage was lower if the children's parents had received information antenatally, which discouraged immunisation (67% vs 73%, P = 0.008). Coverage decreased as socio-economic deprivation of the registered population increased (P < 0.001) and as the children's age (P = 0.001) and registration age (P = 0.02) increased. CONCLUSIONS Higher immunisation coverage is achieved by practices that establish an early relationship with the family and that are adequately resourced with stable and confident staff. Immunisation promotion should begin antenatally. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Primary health care and immunisation in Iran.

PubMed

Nasseri, K; Sadrizadeh, B; Malek-Afzali, H; Mohammad, K; Chamsa, M; Cheraghchi-Bashi, M T; Haghgoo, M; Azmoodeh, M

1991-05-01

The Primary Health Care (PHC) network of Iran consists of a rural and an urban branch. While the rural branch presently covers a sizeable portion of the rural population, the urban PHC project is in its early stages of implementation. The Expanded Programme on Immunisation (EPI) in Iran, which started as an independent and vertical project in early 1983, is being gradually integrated into the PHC network as the latter expands. Results of the second PHC programme review of Iran shows that immunisation coverage of children has improved appreciably since the first PHC review, especially for BCG which stands at 56.3%. Complete immunisation at first birthday in the rural areas with the PHC services is 44.1%, whereas for urban areas other than Teheran it is 28.1%. While the high coverage in the rural areas is attributed to the 'active' approach and vigilance of the providers of immunisation (i.e. the community health workers and the vaccinators of the mobile teams), the higher coverage in the capital city of Teheran is attributed to the involvement of private paediatricians and the generally higher social, economic, and educational status as well as higher interest of mothers. It is noticed that the results of cluster sampling for determination of immunisation coverage in large metropolitan areas of the developing world must be interpreted with much care. The reason is that in these areas extreme fluctuations in the crude birth rate are common and therefore results tend to over-represent the attributes of the segment of population with lower birth rate. It is also argued that complete immunisation might not be the best indicator for assessing the progress of the immunisation efforts. These and other findings are discussed in detail. are discussed in detail.

Adapting immunisation schedules for children undergoing chemotherapy.

PubMed

Fernández-Prada, María; Rodríguez-Martínez, María; García-García, Rebeca; García-Corte, María Dolores; Martínez-Ortega, Carmen

2018-02-01

Children undergoing chemotherapy for cancer have special vaccination needs after completion of the treatment. The aim of this study was to evaluate the adaptation of post-chemotherapy vaccination schedules. An observational study was performed on a retrospective cohort that included all children aged from 0 to 14 years, who completed chemotherapy in a tertiary hospital between 2009 and 2015. Inclusion and exclusion criteria were applied. Immunisation was administered in accordance with the guidelines of the Vaccine Advisory Committee of the Spanish Association of Paediatrics. Primary Care immunisation and clinical records of the Preventive Medicine and Public Health Department were reviewed. Of the 99 children who had received chemotherapy, 51 (70.6% males) were included in the study. As regards the type of tumour, 54.9% had a solid organ tumour, and 45.1% had a haematological tumour. Post-chemotherapy immunisation was administered to 70.6%. The most common vaccines received were: diphtheria-tetanus-pertussis or diphtheria-tetanus (54.9%), meningococcus C (41.2%), and seasonal influenza (39.2%). The rate of adaptation of the immunisation schedule after chemotherapy was 9.8%. The pneumococcal conjugate vaccine against 7v or 13v was administered to 21.6% of study subjects. However, only 17.6% received polysaccharide 23v. None received vaccination against hepatitis A. No statistically significant differences were observed between adherence to immunisation schedules and type of tumour (P=.066), gender (P=.304), or age (P=.342). Post-chemotherapy immunisation of children with cancer is poor. The participation of health professionals in training programs and referral of paediatric cancer patients to Vaccine Units could improve the rate of schedule adaptation and proper immunisation of this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Evaluation of protection induced by immunisation of domestic pigs with deletion mutant African swine fever virus BeninΔMGF by different doses and routes.

PubMed

Sánchez-Cordón, Pedro J; Jabbar, Tamara; Berrezaie, Margot; Chapman, Dave; Reis, Ana; Sastre, Patricia; Rueda, Paloma; Goatley, Lynnette; Dixon, Linda K

2018-01-29

A live attenuated African swine fever virus (ASFV) vaccine candidate, produced by deletion of several genes belonging to multi-gene families MGF360 and 505 from virulent Benin 97/1 strain (BeninΔMGF), induces protection in pigs against parental virulent strain. In order to better define the safety and efficacy of this attenuated vaccine candidate and to understand protective mechanisms, we extended previous studies by intramuscular immunisation of pigs with the deletion mutant BeninΔMFG at different doses (10 2 , 10 3 , 10 4 TCID 50 ), together with intranasal immunisation at the 10 3 dose. Results demonstrated a strong correlation between both doses and routes of immunisation of BeninΔMFG and the percentage of protection achieved, the onset of clinical signs, the viremia levels reached and the onset of death in non-protected pigs. The results show that the intramuscular route using high doses (10 4 TCID 50 ) is the best option for immunisation. Only transient increase in temperature associated with a peak of virus genome levels was observed in most pigs after immunisation. Then, virus genome levels progressively decreased throughout the experiment until reaching low or undetectable levels in those protected pigs that survived after challenge. The IgM antibody responses following immunisation were detected between day 7-10 post-immunisation and remained at elevated levels for 10-18 days in most pigs before dropping. IgG was detected from day 15 to 21 post-immunisation and maintained at increased levels for the remainder of the experiment in most pigs. Induction of IFNγ and IL-10 was detected by ELISA in sera from some pigs immunised with 10 3 TCID 50 by intramuscular or intranasal route at early times post-immunisation. IL-10 was also detected in serum from some non-protected pigs included in these groups after challenge. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Determinants of parents' decisions on childhood immunisations at Kumasi Metropolis in Ghana.

PubMed

Hagan, Doris; Phethlu, Deliwe R

2016-07-29

To describe factors that influence parents' decisions on childhood immunisations at Kumasi Metropolis in Ghana. Quantitative cross-sectional survey. A sample of 303 parents was obtained from a monthly accessible population of 1420 individuals from the five district hospitals through convenience sampling of respondents at immunisation sessions in Kumasi. Data obtained from the survey were analysed with SPSS version 21 software. Most parents were aware of child immunisations, but they had limited knowledge on vaccines and immunisation schedules. Antenatal nurses constituted the most accessible source of vaccine information. The study established a high percentage of complete immunisation, influenced by parents' fear of their children contracting vaccine-preventable diseases. Remarkably, some parents indicated that they immunised their children because they wanted to know the weight of their children. Forgetfulness and lack of personnel or vaccine at the centres were the reasons given by the few parents who could not complete immunisation schedules for their children, whereas the socio-demographic variables considered did not influence parents' decision on immunisation. Knowledge on immunisation could not influence immunisation decisions but parents' fear of vaccine-preventable diseases, awareness on the benefits of immunisations and sources of vaccine information were the main factors that influenced immunisation decision at Kumasi in Ghana.

Suboptimal MMR2 vaccine coverage in six counties in Norway detected through the national immunisation registry, April 2014 to April 2017

PubMed Central

Hagerup-Jenssen, Maria; Kongsrud, Sigrun; Riise, Øystein Rolandsen

2017-01-01

In 2014, Norway became aware of potential low vaccination coverage for the second dose of measles-mumps-rubella vaccine (MMR2) in six of 19 counties. This was detected by comparing the national coverage (NC) for 16-year-olds extracted from the national immunisation registry SYSVAK with the annual status update for elimination of measles and rubella (ASU) reported to the World Health Organization (WHO). The existing method for calculating NC in 2014 did not show MMR2 coverage. ASU reporting on MMR2 was significantly lower then the NC and below the WHO-recommended 95% coverage. SYSVAK is based on the Norwegian personal identification numbers, which allows monitoring of vaccinations at aggregateded as well as individual level. It is an important tool for active surveillance of the performance of the Norwegian Childhood Immunisation Programme (NCIP). The method for calculating NC was improved in 2015 to reflect MMR2 coverage for 16-year-olds. As a result, Norway has improved its real-time surveillance and monitoring of the actual MMR2 coverage also through SYSVAK (the annual publication of NC). Vaccinators receive feedback for follow-up if 15-year-olds are missing MMR2. In 2017, only three counties had an MMR2 coverage below 90%. PMID:28489000

Suboptimal MMR2 vaccine coverage in six counties in Norway detected through the national immunisation registry, April 2014 to April 2017.

PubMed

Hagerup-Jenssen, Maria; Kongsrud, Sigrun; Riise, Øystein Rolandsen

2017-04-27

In 2014, Norway became aware of potential low vaccination coverage for the second dose of measles-mumps-rubella vaccine (MMR2) in six of 19 counties. This was detected by comparing the national coverage (NC) for 16-year-olds extracted from the national immunisation registry SYSVAK with the annual status update for elimination of measles and rubella (ASU) reported to the World Health Organization (WHO). The existing method for calculating NC in 2014 did not show MMR2 coverage. ASU reporting on MMR2 was significantly lower then the NC and below the WHO-recommended 95% coverage. SYSVAK is based on the Norwegian personal identification numbers, which allows monitoring of vaccinations at aggregateded as well as individual level. It is an important tool for active surveillance of the performance of the Norwegian Childhood Immunisation Programme (NCIP). The method for calculating NC was improved in 2015 to reflect MMR2 coverage for 16-year-olds. As a result, Norway has improved its real-time surveillance and monitoring of the actual MMR2 coverage also through SYSVAK (the annual publication of NC). Vaccinators receive feedback for follow-up if 15-year-olds are missing MMR2. In 2017, only three counties had an MMR2 coverage below 90%. This article is copyright of The Authors, 2017.

Incidence of rhesus immunisation after genetic amniocentesis.

PubMed

Tabor, A; Jerne, D; Bock, J E

1986-08-30

Of 655 Rh negative women without anti-D antibody in their serum at genetic amniocentesis, 361 delivered a Rh positive infant. Prophylactic treatment with anti-D immunoglobulin was not given at amniocentesis. The women were followed prospectively, being given a screening test for antibody after amniocentesis, at delivery, and six months later. Five of these 361 women yielded a positive test result due to anti-D antibody. The immunisation rate after genetic amniocentesis was no higher than the spontaneous immunisation rate during pregnancy. Four women who had two amniocenteses in the same pregnancy and 34 women who had amniocentesis in two consecutive pregnancies with Rh positive fetuses were not immunised. Among six women with anti-D antibody in their serum before amniocentesis the titre of antibody increased in three. Amniocentesis may have worsened the outcome of these pregnancies. These results suggest that the risk of immunisation in Rh negative women is small.

Benefits and risks of childhood immunisations in developing countries.

PubMed Central

Holden, J D

1987-01-01

The ratio of benefit to harm from an imaginary, modest immunisation programme in a developing country and the numbers of lives likely to be saved and severe handicaps prevented have been estimated. Immunisation is much more likely to benefit children than to harm them, and health workers can be confidently encouraged not to withhold the benefits of immunisation from most children. PMID:3109642

Adolescent values for immunisation programs in Australia: A discrete choice experiment.

PubMed

Wang, Bing; Chen, Gang; Ratcliffe, Julie; Afzali, Hossein Haji Ali; Giles, Lynne; Marshall, Helen

2017-01-01

The importance of adolescent engagement in health decisions and public health programs such as immunisation is becoming increasingly recognised. Understanding adolescent preferences and further identifying barriers and facilitators for immunisation acceptance is critical to the success of adolescent immunisation programs. This study applied a discrete choice experiment (DCE) to assess vaccination preferences in adolescents. This study was conducted as a cross-sectional, national online survey in Australian adolescents. The DCE survey evaluated adolescent vaccination preferences. Six attributes were assessed including disease severity, target for protection, price, location of vaccination provision, potential side effects and vaccine delivery method. A mixed logit model was used to analyse DCE data. This survey was conducted between December 2014 and January 2015. Of 800 adolescents aged 15 to 19 years, stronger preferences were observed overall for: vaccination in the case of a life threatening illness (p<0.001), lower price vaccinations (p<0.001), mild but common side effects (p = 0.004), delivery via a skin patch (p<0.001) and being administered by a family practitioner (p<0.001). Participants suggested that they and their families would be willing to pay AU$394.28 (95%CI: AU$348.40 to AU$446.92) more for a vaccine targeting a life threatening illness than a mild-moderate illness, AU$37.94 (95%CI: AU$19.22 to AU$57.39) more for being vaccinated at a family practitioner clinic than a council immunisation clinic, AU$23.01 (95%CI: AU$7.12 to AU$39.24) more for common but mild and resolving side effects compared to rare but serious side effects, and AU$51.80 (95%CI: AU$30.42 to AU$73.70) more for delivery via a skin patch than injection. Consideration of adolescent preferences may result in improved acceptance of, engagement in and uptake of immunisation programs targeted for this age group.

Evaluation of bacille Calmette-Guérin immunisation programs in Australia.

PubMed

Khandaker, Gulam; Beard, Frank H; Dey, Aditi; Coulter, Chris; Hendry, Alexandra J; Macartney, Kristine K

2017-03-31

bacille Calmette-Guérin (BCG) immunisation programs in Australia are funded and operated by the individual states and territories. In recent years BCG vaccine shortages have required use of unregistered products. We aimed to evaluate BCG immunisation programs in Australia, with particular reference to program implementation and national consistency.
 Methods: Between September and November 2015, 12 key stakeholders, representing Australian states and territories, completed surveys. We analysed BCG vaccination coverage data from the Australian Childhood Immunisation Register (ACIR), and data on adverse events following immunisation (AEFI) with BCG vaccine from the Therapeutic Goods Administration's Adverse Drug Reactions System, for 2001 to 2014.
 Results: Access to BCG vaccination varies between jurisdictions, with some states providing this only in major city locations. Analysis of ACIR data suggests significant differences in vaccine delivery between jurisdictions, but varying levels of under-reporting to the ACIR were also acknowledged. The rate of BCG AEFI appeared to increase between 2011 and 2014; however, these data need to be interpreted with caution due to small numbers, likely under-reporting of both numerator (AEFI) and denominator (vaccine doses administered), and the general increase in reporting of AEFI related to other vaccines in children over this period.
 Conclusions: BCG immunisation programs aim to prevent severe forms of tuberculosis in young children who live in or travel to high burden settings. A range of factors, particularly inconsistent vaccine supply are leading to low, variable and inequitable vaccine delivery across Australian jurisdictions. Improved BCG vaccination uptake and AEFI data quality are required for accurate monitoring of program delivery and vaccine safety - this is particularly important given the current need to use unregistered vaccines. Improved and consistent access to BCG vaccine is suggested to optimise

Active surveillance study of adverse events following immunisation of children in the Czech Republic.

PubMed

Danova, Jana; Kocourkova, Aneta; Celko, Alexander M

2017-02-06

Despite the undisputed public health benefits of routine vaccination, adverse events following immunisation (AEFI) remain a concern. As most adverse events are mild, they may be under-reported; this may underlie the wide range of AEFI rates reported in the literature. We investigated the rates of AEFI related to routine vaccination of children 0-10 years old in the Czech Republic. The study reviewed patients' records in a sample of 49 paediatric GP practices covering all 12 administrative regions of the Czech Republic between 2011 and 2013. Adverse events following routine immunisation of children aged 0-10 years were identified and recorded. The overall rate of AEFI was 209/100,000 doses; this was 6 times higher than the rate reported to the Czech State Institute for Drug Control (34/100,000 doses). Over two fifths (44%) of all AEFI occurred after the booster dose of the combined diphteria, tetanus and pertussis vaccine in 5-year old children. The vast majority of AEFI were non-serious local events (e.g. redness) and fever. Most AEFI occurred the second day after the immunisation, lasted 4 days on average, and were treated by cold therapy, antipyretics and analgesics. The rate of AEFI identified in this study was considerably higher than the officially reported rate. Although the vast majority of AEFI were non-serious, health care providers and the public should be educated and encouraged to report AEFI to address the issue of underreporting, to increase the safety profile of vaccines, and to improve public confidence in immunisation programmes.

Mapping financial flows for immunisation in Uganda 2009/10 and 2010/11: New insights for methodologies and policy.

PubMed

Guthrie, Teresa; Zikusooka, Charlotte; Kwesiga, Brendan; Abewe, Christabel; Lagony, Stephen; Schutte, Carl; Marinda, Edmore; Humphreys, Kerrin; Motlogelwa, Katlego; Nombewu, Zipozihle Chuma; Brenzel, Logan; Kinghorn, Anthony

2015-05-07

The Global Vaccine Action Plan highlights the need for immunisation programmes to have sustainable access to predictable funding. A good understanding of current and future funding needs, commitments, and gaps is required to enhance planning, improve resource allocation and mobilisation, and to avoid funding bottlenecks, as well as to ensure that co-funding arrangements are appropriate. This study aimed to map the resource envelope and flows for immunisation in Uganda in 2009/10 and 2010/11. To assess costs and financing of immunisation, the study applied a common methodology as part of the multi-country Expanded Program on Immunisation Costing (EPIC) study (Brenzel et al., 2015). The financial mapping developed a customised extension of the System of Health Accounts (SHA) codes to explore immunisation financing in detail. Data were collected from government and external sources. The mapping was able to assess financing more comprehensively than many studies, and the simultaneous costing of routine immunisation collected detailed data about human resources costs. The Ugandan government contributed 56% and 42% of routine immunisation funds in 2009/10 and 2010/11, respectively, higher than previously estimated, and managed up to 90% of funds. Direct delivery of services used 93% of the immunisation financial resources in 2010/11, while the above service delivery costs were small (7%). Vaccines and supplies (41%) and salaries (38%) absorbed most funding. There were differences in the key cost categories between actual resource flows and the estimates from the comprehensive multi-year plan (cMYP). Results highlight that governments and partners need to improve systems to routinely track immunisation financing flows for enhanced accountability, performance, and sustainability. The modified SHA coding allowed financing to be mapped to specific immunisation activities, and could be used for standardised, resource tracking compatible with National Health Accounts (NHA

Changing attitudes to childhood immunisation in English parents.

PubMed

Campbell, Helen; Edwards, Angela; Letley, Louise; Bedford, Helen; Ramsay, Mary; Yarwood, Joanne

2017-05-19

We undertook a national survey of parental attitudes to childhood vaccinations and compared results with those in earlier comparable surveys covering a 10year period. We randomly selected 275 nationally representative sampling locations in England. Interviewers identified eligible primary care givers (referred to as parents) of children aged from 2months to <5years and conducted home-based interviews between January and April 2015. We aimed to recruit 1000 parents of children aged 0-2years and 1000 of children aged 3-4years. The questionnaire covered all aspects of the immunisation process, vaccines administered in pregnancy and from infancy to pre-school with a maximum of 86 mixed questions. Interviews were completed with 1792 parents of whom 1130 had children aged 0-2years and 999 had children aged 3-4years; 337 had children of both ages. The findings showed that confidence in and acceptance of the vaccination programme was high. Only 2% of parents reported refusing vaccination whilst 90% reported vaccinating their children automatically when due. Almost all parents (97%) had access to the internet and 34% consulted web-based resources for information on vaccination. Parents who used chat rooms or discussion forums for this purpose were significantly more likely to say they had seen something that would make them doubt having their child(ren) immunised (31% compared to 8% amongst all parents). Health professionals and the NHS were seen as the most trusted source of advice on immunisation (90% agreed/strongly agreed with each). Very few parents did not trust these sources (4% and 3% disagreed, respectively). Health professionals remain extremely important in communicating information about vaccination and are highly trusted by parents; a trust that has increased in recent years. Despite most parents seeking information on the Internet, trust in and advice from health care professionals appeared to be key factors influencing parental decisions. Crown Copyright �

Pertussis and influenza immunisation during pregnancy: a landscape review.

PubMed

Abu Raya, Bahaa; Edwards, Kathryn M; Scheifele, David W; Halperin, Scott A

2017-07-01

Immunisation during pregnancy is a relatively new strategy, and is currently limited to tetanus, pertussis, and influenza vaccines. None of these vaccines were developed specifically for use in pregnancy, but they provide an effective method of protecting mothers and young infants. In response to increases in pertussis morbidity and mortality among young infants, several countries have recommended universal tetanus, diphtheria, and acellular pertussis immunisation during pregnancy. Similarly, many countries recommend influenza immunisation during pregnancy to reduce the risk of disease for mother and infant. Although scientific evidence to support maternal immunisation against pertussis and influenza is rapidly accumulating, important knowledge gaps remain that need to be addressed by future research, which we have highlighted in this Series paper. Copyright © 2017 Elsevier Ltd. All rights reserved.

The influence of performance-based payment on childhood immunisation coverage.

PubMed

Merilind, Eero; Salupere, Rauno; Västra, Katrin; Kalda, Ruth

2015-06-01

Pay-for-performance, also called the quality system (QS) in Estonia, was implemented in 2006 and one indicator for achievement is the childhood immunisation coverage rate. The WHO vaccination coverage in Europe for diphtheria, tetanus and pertussis, and measles in children aged around one year old should meet or exceed 90 per cent. The study was conducted using a database from the Estonian Health Insurance Fund. The study compared childhood immunisation coverage rates of all Estonian family physicians in two groups, joined and not joined to the quality system during the observation period 2006-2012. Immunisation coverage was calculated as the percentage of persons in the target age group who received a vaccine dose by a given age. The target level of immunisations in Estonia is set at 90 per cent and higher. Immunisation coverage rates of family doctors (FD) in Estonia showed significant differences between two groups of doctors: joined to the quality system and not joined. Doctors joined to the quality system met the 90 per cent vaccination criterion more frequently compared to doctors not joined to the quality system. Doctors not joined to the quality system were below the 90 per cent vaccination criterion in all vaccinations listed in the Estonian State Immunisation Schedule. Pay-for-performance as a financial incentive encourages higher levels of childhood immunisations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Status of cold chain in routine immunisation centres of the Expanded Programme on Immunisation in Quetta, Pakistan.

PubMed

Buledi, Rahim; Butt, Zahid Ahmad; Ahmed, Jamil; Alizai, Aamir Akram

2017-05-01

To determine the status of cold chain and knowledge and practices of health workers about cold chain maintenance in routine immunisation health centres. This cross-sectional study was conducted in Quetta, Pakistan, from May to July 2012, and comprised health facilities in the district. We interviewed the staff responsible for vaccine storage and cold chain maintenance and used a checklist to assess cold chain maintenance of routine expanded programme on immunisation vaccines. SPSS 16 was used for data analysis.. Of the 42 health facilities, staff of 13(30%) wrongly indicated that measles and Bacillus Calmette-Guérin were cold sensitive vaccines. Temperature of the ice-lined refrigerators was not maintained twice daily in 18(43%) centres. There were no voltage stabilisers and standby power generators in 31(74%) and 38(90%) centres, respectively. Vaccine arrangement was found to be inappropriate in ice-lined refrigerators of 38(90%) centres and ice packs were incorrectly used in carriers in 22(52%) centres. Vaccine stock was not charted in 39(93%) centres. Moreover, 4(10%) facilities did not have dedicated expanded programme on immunisation rooms whereas about 5(12%) and 33(79%) had no vaccinator and separate expanded programme on immunisation incharge appointed. Also, 32(76%) centres did not have a female vaccinator appointed. Although the majority of health staff had adequate knowledge, there were weaknesses in practice of maintaining the cold chain.

Immunisation coverage of children in the child welfare system: a systematic review protocol.

PubMed

Hermann, Jennifer S; Featherstone, Robin M; Russell, Margaret L; MacDonald, Shannon E

2017-04-27

Children may be placed in the care of the child welfare system when they require additional supports or intervention to ensure their safety and security. Transitions in living arrangements (eg, home to foster care and return to home) and other difficult circumstances for these children may result in interruptions in routine preventive healthcare, such as childhood immunisations. The purpose of this systematic literature review is to determine whether immunisation coverage is a problem among children in the child welfare system and identify any known supports and/or barriers to vaccine uptake in this population. This systematic review will encompass published and unpublished primary research studies that assess (A) immunisation coverage of children in the child welfare system, (B) how this coverage compares to the general population and/or children not in the child welfare system, and (C) supports and barriers affecting immunisation status of these children. Vaccines in the recommended childhood immunisation schedule for each study setting will be considered. Medline, Embase, Cochrane Library, CINAHL, SocINDEX and ERIC will be comprehensively searched. We will also search ProQuest dissertations and theses, the Conference Proceedings Citation Index for Science and Social Science & Humanities, and a sample of relevant provincial, national and international websites. References of included studies will be manually searched for relevant studies. English language primary studies from 2000 to current focused on immunisations of children (age 0-17 years) in the child welfare system, in a high-income country, will be included. A narrative analysis of key findings from included studies will be performed and presented. This protocol does not require ethics approval. Planned dissemination includes peer-reviewed publication, conference presentations and briefs for policy makers. This protocol is registered in the PROSPERO International Prospective Register of Systematic Reviews

Reduction in HPV 16/18 prevalence in sexually active young women following the introduction of HPV immunisation in England.

PubMed

Mesher, D; Soldan, K; Howell-Jones, R; Panwar, K; Manyenga, P; Jit, M; Beddows, S; Gill, O N

2013-12-17

Reduction in the prevalence of vaccine type HPV infection in young women is an early indication of the impact of the HPV immunisation programme and a necessary outcome if the subsequent impact on cervical cancer is to be realised. Residual vulva-vaginal swab (VVS) specimens from young women aged 16-24 years undergoing chlamydia screening in community sexual health services (formerly known as family planning clinics), general practice (GP), and youth clinics in 2010-2012 were submitted from 10 laboratories in seven regions around England. These specimens were linked to demographic and sexual behaviour data reported with the chlamydia test, anonymised, and tested for type-specific HPV DNA using a multiplex PCR and Luminex-based genotyping test. Estimated immunisation coverage was calculated and findings were compared to a baseline survey conducted prior to the introduction of HPV immunisation in 2008. A total of 4664 eligible specimens were collected and 4178 had a valid test result. The post-immunisation prevalence of HPV 16/18 infection was lowest in this youngest age group (16-18 years) and increased with age. This increase with age was a reversal of the pattern seen prior to immunisation and was inversely associated with estimates of age-specific immunisation coverage (65% for 16-18 year olds). The prevalence of HPV 16/18 infection in the post-immunisation survey was 6.5% amongst 16-18 year olds, compared to 19.1% in the similar survey conducted prior to the introduction of HPV immunisation. These findings are the first indication that the national HPV immunisation programme is successfully preventing HPV 16/18 infection in sexually active young women in England. The reductions seen suggest, for the estimated coverage, high vaccine effectiveness and some herd-protection benefits. Continued surveillance is needed to determine the effects of immunisation on non-vaccine HPV types. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Year-round influenza immunisation during pregnancy in Nepal: a phase 4, randomised, placebo-controlled trial.

PubMed

Steinhoff, Mark C; Katz, Joanne; Englund, Janet A; Khatry, Subarna K; Shrestha, Laxman; Kuypers, Jane; Stewart, Laveta; Mullany, Luke C; Chu, Helen Y; LeClerq, Steven C; Kozuki, Naoko; McNeal, Monica; Reedy, Adriana M; Tielsch, James M

2017-09-01

Influenza immunisation during pregnancy is recommended but not widely implemented in some low-income regions. We assessed the safety and efficacy in mothers and infants of year-round maternal influenza immunisation in Nepal, where influenza viruses circulate throughout the year. In this phase 4, randomised, placebo-controlled trial, we enrolled two consecutive sequential annual cohorts of pregnant women from the Sarlahi district in southern Nepal. We randomised mothers 1:1 to receive seasonally recommended trivalent inactivated influenza vaccine or saline placebo in blocks of eight, stratified by gestational age at enrolment (17-25 weeks vs 26-34 weeks). Women were eligible if they were married, 15-40 years of age, 17-34 weeks' gestation at enrolment, and had not previously received any influenza vaccine that season. We collected serum samples before and after immunisation, and cord blood from a subset of women and infants. Staff masked to allocation made home visits every week from enrolment to 6 months after delivery. Midnasal swabs for respiratory virus PCR testing were collected during maternal acute febrile respiratory infections, and from infants with any respiratory symptom. We assessed vaccine immunogenicity, safety, and three primary outcomes: the incidence of maternal influenza-like illness in pregnancy and 0-180 days postpartum, the incidence of low birthweight (<2500 g), and the incidence of laboratory-confirmed infant influenza disease from 0 to 180 days. This trial is registered with ClinicalTrials.gov, number NCT01034254. From April 25, 2011, to Sept 9, 2013, we enrolled 3693 women in two cohorts of 2090 (1041 assigned to placebo and 1049 to vaccine) and 1603 (805 assigned to placebo and 798 to vaccine), with 3646 liveborn infants (cohort 1, 999 in placebo group and 1010 in vaccine group; cohort 2, 805 in placebo group and 798 in vaccine group). Immunisation reduced maternal febrile influenza-like illness with an overall efficacy of 19% (95% CI 1 to

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study.

PubMed

Jackson, Cath; Dyson, Lisa; Bedford, Helen; Cheater, Francine M; Condon, Louise; Crocker, Annie; Emslie, Carol; Ireland, Lana; Kemsley, Philippa; Kerr, Susan; Lewis, Helen J; Mytton, Julie; Overend, Karen; Redsell, Sarah; Richardson, Zoe; Shepherd, Christine; Smith, Lesley

2016-09-01

the Bristol English Gypsy/Irish Traveller community. Language, literacy, discrimination, poor school attendance, poverty and housing were identified by Travellers and service providers as barriers for some. Trustful relationships with health professionals were important and continuity of care was valued. A few English-speaking Travellers described problems of booking and attending for immunisation. Service providers tailored their approach to Travellers, particularly the Roma. Funding cuts, NHS reforms and poor monitoring challenged their work. Five 'top-priority' interventions were agreed across communities and service providers to improve the immunisation among Travellers who are housed or settled on an authorised site: (1) cultural competence training for health professionals and frontline staff; (2) identification of Travellers in health records to tailor support and monitor uptake; (3) provision of a named frontline person in general practitioner practices to provide respectful and supportive service; (4) flexible and diverse systems for booking appointments, recall and reminders; and (5) protected funding for health visitors specialising in Traveller health, including immunisation. No Travellers living on the roadside or on unofficial encampments were interviewed. We should exert caution in generalising to these groups. To include development, implementation and evaluation of a national policy plan (and practice guidance plan) to promote the uptake of immunisation among Traveller communities. Current Controlled Trials ISRCTN20019630 and UK Clinical Research Network Portfolio number 15182. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 72. See the NIHR Journals Library website for further project information.

The challenges and opportunities of translating best practice immunisation strategies among low performing general practices to reduce equity gaps in childhood immunisation coverage in New Zealand.

PubMed

Turner, Nikki M; Charania, Nadia A; Chong, Angela; Stewart, Joanna; Taylor, Lynn

2017-01-01

Immunisation coverage rates vary considerably at the local level across New Zealand and challenges remain with effectively translating best available research evidence into public health practice. This study aimed to translate best practices from high performing general practices into strategies to improve childhood immunisation coverage among low performing practices. An intervention study was undertaken of general practices with low immunisation coverage rates and a high percentage of the enrolled population being of Māori ethnicity. Intervention groups received customised action plans and support for a 12 month period while control groups received 'business as usual' support. Structured interviews were conducted with key informants from all participating practices to understand current aspects related to childhood immunisation delivery and surveys were conducted to understand how the intervention worked. Collected data were thematically analysed. Ten sites were randomised to either intervention ( n  = 6) or control group ( n  = 4). Positive aspects of childhood immunisation delivery included high prioritisation at the practice and staff being pro-immunisation and knowledgeable. Key challenges experienced included inaccurate family contact information and discrepancies with referral processes to other providers. Other challenges noted were building rapport with families and vaccine hesitancy. The action plans included various strategies aimed to improve processes at the practice, contact and engagement with parents, and partnership development with local service providers. Creating customised action plans and providing support to providers were considered as helpful approaches when attempting to improve childhood immunisation coverage rates. Our study supports the notion that one strategy will not solely by itself improve childhood immunisation rates and highlights the importance of having a toolkit of strategies from which to draw from.

Kawasaki disease and immunisation: A systematic review.

PubMed

Phuong, Linny Kimly; Bonetto, Caterina; Buttery, Jim; Pernus, Yolanda Brauchli; Chandler, Rebecca; Felicetti, Patrizia; Goldenthal, Karen L; Kucuku, Merita; Monaco, Giuseppe; Pahud, Barbara; Shulman, Stanford T; Top, Karina A; Trotta, Francesco; Ulloa-Gutierrez, Rolando; Varricchio, Frederick; de Ferranti, Sarah; Newburger, Jane W; Dahdah, Nagib; Singh, Surjit; Bonhoeffer, Jan; Burgner, David

2017-03-27

Kawasaki disease is a complex and potentially serious condition. It has been observed in temporal relation to immunisation. We conducted a systematic literature review using various reference sources to review the available evidence published in the literature. We identified twenty seven publications reporting a temporal association between immunisation and Kawasaki disease. We present a systematic review of data drawn from randomised controlled trials, observational studies, case series and reports, and reviews. Overall there was a lack of standardised case definitions, making data interpretation and comparability challenging. Although a temporal relationship between immunisation and Kawasaki disease is suggested, evidence for an increased risk or a causal association is lacking. Implementation of a standardised Kawasaki disease case definition would increase confidence in the findings and add value to future studies of pre- or post-licensure vaccine safety studies. Copyright © 2016. Published by Elsevier Ltd.

Immunisation coverage annual report, 2011.

PubMed

Hull, Brynley P; Dey, Aditi; Menzies, Rob I; Brotherton, Julia M; McIntyre, Peter B

2013-12-31

This, the 5th annual immunisation coverage report, documents trends during 2011 for a range of standard measures derived from Australian Childhood Immunisation Register data, and National Human Papillomavirus (HPV) Vaccination Program Register data. The proportion of children 'fully vaccinated' at 12, 24 and 60 months of age was 91.4%, 92.2% and 89.5% respectively. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.8%) and varicella at 24 months (83.9%). By late 2011, the percentage of children who received the 1st dose of DTPa vaccine dose at less than 8 weeks of age was greater than 50% in 3 jurisdictions, the Australian Capital Territory, Victoria, and Queensland and at 70% for New South Wales and Tasmania. Although coverage at 12 months of age was lower among Indigenous children than non-Indigenous children in all jurisdictions, the extent of the difference varied. Overall, coverage at 24 months of age exceeded that at 12 months of age nationally. At 60 months of age, there was dramatic variation between individual jurisdictions, ranging from coverage 8% lower in Indigenous children in South Australia to 6% higher in the Northern Territory. As previously documented, vaccines recommended for Indigenous children only (hepatitis A and pneumococcal polysaccharide vaccine) had suboptimal coverage at 60% and 68%, respectively. On-time receipt (before 49 months of age) of vaccines by Indigenous children at the 60-month milestone age improved between 2010 (18%) and 2011 (19%) but the disparity in on-time vaccination between Indigenous and non-Indigenous children increased at all 3 age milestones. The percentage of vaccine objectors in 2011 (1.7%) has increased from 2007 when it was 1.1%. Coverage data for the 3rd dose of HPV from the national HPV register in the school catch up program was 71% but was substantially lower for the catch-up program for women outside school (39

The future of immunisation policy, implementation, and financing.

PubMed

Levine, Orin S; Bloom, David E; Cherian, Thomas; de Quadros, Ciro; Sow, Samba; Wecker, John; Duclos, Philippe; Greenwood, Brian

2011-07-30

Vaccines have already saved many lives and they have the potential to save many more as increasingly elaborate technologies deliver new and effective vaccines against both infectious diseases--for which there are currently no effective licensed vaccines--such as malaria, tuberculosis, and HIV and non-infectious diseases such as hypertension and diabetes. However, these new vaccines are likely to be more complex and expensive than those that have been used so effectively in the past, and they could have a multifaceted effect on the disease that they are designed to prevent, as has already been seen with pneumococcal conjugate vaccines. Deciding which new vaccines a country should invest in requires not only sound advice from international organisations such as WHO but also a well informed national immunisation advisory committee with access to appropriate data for local disease burden. Introduction of vaccines might need modification of immunisation schedules and delivery procedures. Novel methods are needed to finance the increasing number of new vaccines that have the potential to save lives in countries that are too poor to afford them. Here, we discuss some options. Copyright © 2011 Elsevier Ltd. All rights reserved.

Interventions for improving coverage of childhood immunisation in low- and middle-income countries.

PubMed

Oyo-Ita, Angela; Wiysonge, Charles S; Oringanje, Chioma; Nwachukwu, Chukwuemeka E; Oduwole, Olabisi; Meremikwu, Martin M

2016-07-10

Immunisation is a powerful public health strategy for improving child survival, not only by directly combating key diseases that kill children but also by providing a platform for other health services. However, each year millions of children worldwide, mostly from low- and middle-income countries (LMICs), do not receive the full series of vaccines on their national routine immunisation schedule. This is an update of the Cochrane review published in 2011 and focuses on interventions for improving childhood immunisation coverage in LMICs. To evaluate the effectiveness of intervention strategies to boost and sustain high childhood immunisation coverage in LMICs. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2016, Issue 4, part of The Cochrane Library. www.cochranelibrary.com, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (searched 12 May 2016); MEDLINE In-Process and Other Non-Indexed Citations, MEDLINE Daily and MEDLINE 1946 to Present, OvidSP (searched 12 May 2016); CINAHL 1981 to present, EbscoHost (searched 12 May 2016); Embase 1980 to 2014 Week 34, OvidSP (searched 2 September 2014); LILACS, VHL (searched 2 September 2014); Sociological Abstracts 1952 - current, ProQuest (searched 2 September 2014). We did a citation search for all included studies in Science Citation Index and Social Sciences Citation Index, 1975 to present; Emerging Sources Citation Index 2015 to present, ISI Web of Science (searched 2 July 2016). We also searched the two Trials Registries: ICTRP and ClinicalTrials.gov (searched 5 July 2016) SELECTION CRITERIA: Eligible studies were randomised controlled trials (RCT), non-RCTs, controlled before-after studies, and interrupted time series conducted in LMICs involving children aged from birth to four years, caregivers, and healthcare providers. We independently screened the search output, reviewed full texts of potentially eligible articles, assessed risk of bias

Improving preterm infants' immunisation status: a follow-up audit.

PubMed

Crawford, Nigel W; Barfield, Charles; Hunt, Rod W; Pitcher, Helen; Buttery, Jim P

2014-04-01

Preterm infants are at increased risk of vaccine preventable diseases. An audit in 2007 identified suboptimal immunisation status of preterm infants. The aim of this study was to complete the 'audit loop', reviewing preterm infants' immunisation status at a single tertiary paediatric hospital. A retrospective follow-up immunisation audit was conducted at The Royal Children's Hospital, Melbourne, neonatal unit. The 'audit loop' included a preterm infants' reminder sticker and feedback of the original audit findings to Royal Children's Hospital health-care professionals. Immunisation status was determined using the Australian Childhood Immunisation Register record for all admitted preterm infants born <32 weeks gestation (July 2008-June 2009). Conducted in March 2011, the median age of participants (n = 57) was 2.5 years (range 1.7-3.1 years). Forty-four per cent (25/57) had a history of chronic lung disease, 86% (49/57) were <1500 g and 42% (24/57) <28 weeks gestation. The majority (96% (55/57)) were up to date with routine immunisations at 12 months of age. There was a 2.4-fold increase, compared with the original audit, for receipt of the additional recommended hepatitis B vaccine at 12 months of age, as well as influenza vaccine in infants with chronic lung disease. This study showed that a simple reminder combined with education strategies can improve vaccine delivery in special risk groups such as preterm infants. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Immunisation hotline calls as five-in-one vaccine introduced.

PubMed

Fisher-Jeffes, Lisa; Finlay, Fiona

2006-04-01

Announcement of the introduction of the five-in-one vaccine (DTaP/IPV/Hib) into the primary immunisation schedule was made on 9 August 2004. In this study all calls to the immunisation hotline were recorded between 9 August 2004 and 19 November 2004, noting who called and the nature of their enquiry. A total of 208 calls were received during the study period, and of these 23 (11.1%) related to the new vaccine. Calls were from parents (10/23, 43%), health visitors (9/23, 39%) and practice nurses (3/23, 13%). A variety of themes were covered in calls including local availability of the five-in-one vaccine, vaccine safety, mercury content and efficacy. Calls not connected with the new vaccine concerned mostly adolescent MMR (17.3%) as there was a local mumps epidemic. Others related to clarification of a child's immunisation status (13.5%), primary MMR immunisation (13.5%), vaccination scheduling or administration difficulties (12%), other schedule (12.5%) and non-schedule vaccines (2.4%), vaccine reactions (2.4%), travel vaccines (6%), BCG (6%), and a few miscellaneous queries (3%). Overall questions about the new five-in-one vaccine accounted for an extra 23 calls to the immunisation hotline during the study period (11.1% of calls).

Vaccination for tomorrow: the need to improve immunisation rates.

PubMed

Kassianos, George

2010-01-01

Since the 1998 health scare about measles mumps and rubella (MMR) immunisation, vaccination rates for measles have suffered. Although these recovered for a brief period in 2004-05, they have stalled again and latest figures suggest that only 85% of children are now immunised against this disease. The UK has become one of the five countries in the European Union with the highest measles rates. Meanwhile the wider picture indicates that other vaccination rates, including for seasonal influenza, are not meeting targets. This is a potential sign that the MMR scare and myths around immunisation are setting a worrying trend of some people losing confidence in the practice of vaccination. The UK has expanded its childhood immunisation programme to include the human papilloma virus vaccine (HPV) which protects against some types of cervical cancer. New life-saving vaccines for diseases, including meningococcal B meningitis (a strain of meningitis not yet covered by the existing vaccination programme), shingles and hepatitis C will soon become available. It is therefore important that information is available to the general public about the excellent safety record and benefits of vaccination to ensure that as many people as possible can take advantage of these new vaccines. This article explores the current uptake of, and attitudes towards, vaccination programmes and discusses some myths about immunisation. It suggests that community health care teams with access to adults, including parents of children and young people who need vaccination, are well placed to help challenge some of these myths and promote the benefits of immunisation. Practical suggestions are included on how this can be achieved.

Fiscal consequences of changes in morbidity and mortality attributed to rotavirus immunisation.

PubMed

Kotsopoulos, Nikolaos; Connolly, Mark P; Postma, Maarten J; Hutubessy, Raymond C W

2013-11-04

Changes in population health status are known to influence government fiscal transfers both in terms of lost tax revenue and increased expenditure for health and social services. To estimate the fiscal impact of changes in morbidity and mortality attributed to rotavirus immunisation, we developed a government perspective model to estimate discounted net tax revenue for Ghana and Vietnam. The model derived the impact of rotavirus morbidity and mortality on lifetime productive capacity and related tax transfers, and demand for government transfers in relation to education and healthcare in immunised and non-immunised cohorts. The discounted age-specific net tax revenue was derived by deducting transfers from gross taxes and discounting for time preference. In Ghana, taking into account immunisation costs, tax and transfers, the estimated net discounted tax for the immunised cohort was estimated to generate $2.6 billion in net taxes up to age 65. In Vietnam, the net revenue attributed to the immunised cohort reached $55.17 billion suggesting an incremental benefit of approximately $29 million. We posit that the government perspective fiscal framework described here is a valid approach for estimating how governments benefit from investments in immunisation that can be considered supplementary to conventional cost-effectiveness approaches for defining value. Copyright © 2013 Elsevier Ltd. All rights reserved.

Boosting uptake of influenza immunisation: a randomised controlled trial of telephone appointing in general practice.

PubMed Central

Hull, Sally; Hagdrup, Nicola; Hart, Ben; Griffiths, Chris; Hennessy, Enid

2002-01-01

BACKGROUND: Immunisation against influenza is an effective intervention that reduces serologically confirmed cases by between 60% and 70%. Almost all influenza immunisation in the UK is done within general practice. Current evidence on the effectiveness of patient reminders for all types of immunisation programmes is largely based on North American studies. AIM: To determine whether telephone appointments offered bygeneral practice receptionists increase the uptake of irfluenza immunisation among the registered population aged over 65 years in east London practices. DESIGN OF STUDY: Randomised controlled trial. SETTING: Three research general practices within the East London and Essex network of researchers (ELENoR). METHOD: Participants were 1,820 low-risk patients aged 65 to 74 years who had not previously been in a recall system for influenza immunisation at their general practice. The intervention, during October 2000, was a telephone call from the practice receptionist to intervention group households, offering an appointment for influenza immunisation at a nurse-run. clinic Main outcome measures were the numbers of individuals in each group receiving immunisation, and practice costs of a telephone-appointing programme. RESULTS: intention to treat analysis showed an immunisation rate in the control group of 44%, compared with 50% in the intervention group (odds ratio = 1.29, 95% confidence interval = 1.03 to 1.63). Of the patients making a telephone appointment, 88% recieved immunisation, while 22% of those not wanting an appointment went on to be immunised. In the controlgroup, income generated was 11.35 pounds per immunisation, for each additional immunisation in the intervention group the income was 5.20 pounds. The 'number needed to telephone' was 17. CONCLUSION: Uptake of influenza immunisation among the low-risk older population in inner-city areas can be boosted by around 6% using a simple intervention by receptionists. Immunisation rates in this low

[Immunisation schedule of the Spanish Association of Paediatrics: 2014 recommendations].

PubMed

Moreno-Pérez, D; Alvarez García, F J; Arístegui Fernández, J; Cilleruelo Ortega, M J; Corretger Rauet, J M; García Sánchez, N; Hernández Merino, A; Hernández-Sampelayo Matos, T; Merino Moína, M; Ortigosa Del Castillo, L; Ruiz-Contreras, J

2014-01-01

prevention of this disease. In anticipation of upcoming national and international studies, the Committee recommends the vaccine for the control of disease outbreaks, and insists on the need to be available in pharmacies. Finally, it emphasises the need to bring incomplete vaccinations up to date following the catch-up immunisation schedule. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Socioeconomic disparities in coverage of full immunisation among children of adolescent mothers in India, 1990–2006: a repeated cross-sectional analysis

PubMed Central

Kumar, Chandan; Singh, Prashant Kumar; Singh, Lucky; Rai, Rajesh Kumar

2016-01-01

Objective Studies have highlighted that children of adolescent (aged 15–19 years) mothers are likely to receive relatively poor healthcare. With an unacceptably high adolescent birth rate, India houses the highest number of adolescent mothers globally, putting children at risk of inadequate vaccination. This paper assesses trends and extent of socioeconomic disparities in the coverage of full immunisation among children of adolescent mothers in India. Design Repeated cross-sectional analytical study. Data sources 3 consecutive rounds of the National Family Health Survey (NFHS) conducted during 1992–1993, 1998–1999 and 2005–2006 were used. Besides, the required information is also extracted from the 2011 Indian Census. Participants Children (aged 12–23 months) of adolescent (aged 15–19 years) mothers. Sample inclusion criteria involved the last child of the adolescent eligible to avail full immunisation. Setting Nationally representative sample. Data analysis The Cochran-Armitage test, χ2 test and binary logistic regression methods were applied to attain the study objective. Results Between 1990 and 2006, a non-significant increase of 4 percentage points in full immunisation of children of adolescent mothers was estimated. During the same period, a large difference between the probability of children of adolescent mothers receiving full immunisation belonging to the least (predicted probability (PP): 0.196 in 1990–1993, and PP: 0.213 in 2003–2006) and the most (PP: 0.589 in 1990–1993, and PP: 0.645 in 2003–2006) socioeconomically privileged group was estimated, and this disparity persisted over the survey period. Conclusions During 1990–2006, an insufficient improvement in provision of full immunisation to children born to adolescent mothers was recorded. The study underscored the suboptimum immunisation of rural, illiterate and poor children of adolescent women. The programme and policymakers could focus on district-wise concentration

Medication errors: immunisation.

PubMed

Bird, Sara

2006-09-01

Case histories are based on actual medical negligence claims or medicolegal referrals, however certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. This article outlines a medication error involving childhood immunisation and examines the underlying causes of the incident. Advice about how to deal with a patient and their family when things go wrong is provided.

Immunogenicity and safety of yellow fever vaccine among 115 HIV-infected patients after a preventive immunisation campaign in Mali.

PubMed

Sidibe, Mariam; Yactayo, Sergio; Kalle, Abdoulaye; Sall, Amadou A; Sow, Samba; Ndoutabe, Modjirom; Perea, William; Avokey, Fenella; Lewis, Rosamund F; Veit, Olivia

2012-07-01

The immune response to yellow fever (YF) vaccine and its safety among HIV-infected individuals living in YF endemic areas is not well understood. Following a national YF preventive immunisation campaign in Mali in April 2008, we assessed the immunogenicity and safety of 17D yellow fever vaccine (17DV) among HIV-infected patients in two HIV treatment centres in Bamako, Mali, by testing for neutralising antibodies and identifying serious adverse events following immunisation (AEFI). A YF neutralisation titre (NT) of 1:≥20 was considered to be adequate and protective. A serious AEFI included hospitalisation, any life-threatening condition, or death, occurring within 30 days following 17DV administration. Of 115 HIV-infected patients who reported having received 17DV, 110 (96%) were on combination antiretroviral therapy and 83 patients were tested for neutralising antibodies. Around the time of vaccination, median CD4 cell count was 389 cells/mm(3) (IQR 227-511cells/mm(3)); HIV-RNA was undetectable in 24 of 46 patients tested. Seventy-six (92%) of 83 participants had adequate immune titres 9 months after the immunisation campaign. Previous vaccination or flavivirus exposure could contribute to this finding. No serious AEFI was found in the 115 participants. In this small series, YF vaccine appeared to be immunogenic with a favourable safety profile in HIV-infected patients on antiretroviral therapy. Higher CD4 cell counts and suppressed HIV-RNA were associated with the presence of an adequate immune titre and higher NTs. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Differences in uptake of immunisations and health examinations among refugee children compared to Danish-born children: a cohort study.

PubMed

Moller, Sanne Pagh; Hjern, Anders; Andersen, Anne-Marie Nybo; Norredam, Marie

2016-04-01

Refugee children and their families constitute a vulnerable group regarding health and access to care. In a register-based cohort design, we examined differences in uptake of immunisations and child health examinations between refugee children and Danish-born children, including predictors of uptake among refugee children. Refugee children (n = 16,701) who, between January 1993 and December 2010, obtained residency permits in Denmark were included and matched in a 1:6 ratio on age and sex with Danish-born children (n = 100,206). Personal identification numbers were cross-linked to the National Danish Health Service Register, identifying all contacts for immunisation and child health examinations. We estimated hazard ratios (HR) of uptake. Refugee children had a lower uptake of all immunisations compared to Danish-born children. The lowest uptake was found for immunisation against diphtheria, tetanus, pertussis and polio (HR = 0.50; 95 % confidence interval (CI) 0.48-0.51). Participation in child health examinations was also lower among refugee children with the lowest at the last child health examination at age 5 (HR = 0.48; 95 % CI 0.47-0.50). Adjusting the analysis for parental income increased the HRs by 10-20 %. This Danish register-based study using nationwide data revealed a lower uptake of routine immunisations and child health examinations among refugee children compared to Danish-born children. •Uptake of immunisation and child health examination is associated with low household income, unemployment and low educational status among the parents. •Uptake may be even lower among refugee families as they constitute a vulnerable group regarding access to healthcare. What is New: •Refugee children had lower uptake of immunisations and child health examinations compared to Danish-born children. •Several predictors of uptake were identified including region of origin and duration of residence.

Shifts in global immunisation goals (1984-2004): unfinished agendas and mixed results.

PubMed

Hardon, Anita; Blume, Stuart

2005-01-01

The turn of the millennium has been marked by a large-scale mobilisation of resources for immunisation programmes in developing countries. The resources have been generated by public and private sector parties collaborating in the Global Alliance for Vaccines and Immunization (GAVI). GAVI was formed in response to deteriorating immunisation coverage rates occurring in the late 1990s. GAVI is the latest in a line of vaccine initiatives, which have operated over the past 20 years. This article reviews the five most important global immunisation initiatives that have taken place over those past 20 years. It analyses their origins, shifts in global immunisation goals, identifies key actors, assesses the initiatives' capacity to mobilise resources and increase immunisation coverage, and points to possible unintended effects of the initiatives. The study argues that shifts in global immunisation goals lead to fragmentation in the implementation of vaccine programmes at the local level in developing countries. It also suggests that global actors involved in the formulation of these initiatives appear to miss opportunities to build on past experiences and fail to learn from previous mistakes. This raises questions about the initiatives' sustainability and relevance to the overall objective of preventing vaccine-preventable deaths.

Socio Cultural and Geographical Determinants of Child Immunisation in Borno State, Nigeria

PubMed Central

2013-01-01

Immunisation has been an important strategy for disease prevention globally. Despite proven successes in other settings, child immunisation has continued to be problematic in developing countries including Nigeria. In addressing the problems, policy in Nigeria is largely directed at overcoming socio cultural issues surrounding parents’ rejection of vaccines. However, determinants of immunisation have geographical implications as well. A cross sectional survey was used to select 484 mothers/caregivers through a multi stage cluster sampling technique from the three senatorial districts of Borno State, Nigeria. Mothers or caregivers of children 12–23 months were interviewed using a structured questionnaire adapted from the Nigeria Demographic and Health Survey (2008). Socio cultural factors measured include mother’s education, religion, husband’s permission and sex of child while spatial variables include location i.e. whether rural or urban, and distance measured in terms of physical distance, cost and perception of physical distance. Descriptive statistics, univariate and multivariate logistic regressions were used to analyse the results. Data indicate that only 10.5% of children were fully immunised. Though immunisation uptake differed between the senatorial districts, this was not significant (P=0.1). In the bivariate analysis, mothers living in urban areas, <1 km to immunisation centre, their perception of travel distance and travel cost were the spatial predictors of immunisation while literacy and husband’s permission were the socio-cultural factors of significance. However, in the multivariate regression only two geographical factors i.e. living in an urban area [odds ratio (OR) 3.42, confidence interval (CI) 1.40–8.33] and mothers’ perception of distance (OR 4.52, CI 2.14–9.55) were protective against under immunisation while mother’s education was the only socio cultural variable of significance (OR 0.10, CI 0.03–0.41). It was concluded

More support for mothers: a qualitative study on factors affecting immunisation behaviour in Kampala, Uganda

PubMed Central

2011-01-01

Background The proportion of Ugandan children who are fully vaccinated has varied over the years. Understanding vaccination behaviour is important for the success of the immunisation programme. This study examined influences on immunisation behaviour using the attitude-social influence-self efficacy model. Methods We conducted nine focus group discussions (FGDs) with mothers and fathers. Eight key informant interviews (KIIs) were held with those in charge of community mobilisation for immunisation, fathers and mothers. Data was analysed using content analysis. Results Influences on the mother's immunisation behaviour ranged from the non-supportive role of male partners sometimes resulting into intimate partner violence, lack of presentable clothing which made mothers vulnerable to bullying, inconvenient schedules and time constraints, to suspicion against immunisation such as vaccines cause physical disability and/or death. Conclusions Immunisation programmes should position themselves to address social contexts. A community programme that empowers women economically and helps men recognise the role of women in decision making for child health is needed. Increasing male involvement and knowledge of immunisation concepts among caretakers could improve immunisation. PMID:21942999

Need for Optimisation of Immunisation Strategies Targeting Invasive Meningococcal Disease in the Netherlands.

PubMed

Bousema, Josefien Cornelie Minthe; Ruitenberg, Joost

2015-09-13

Invasive meningococcal disease (IMD) is a severe bacterial infectious disease with high mortality and morbidity rates worldwide. In recent years, industrialised countries have implemented vaccines targeting IMD in their National Immunisation Programmes (NIPs). In 2002, the Netherlands successfully implemented a single dose of meningococcal serogroup C conjugate vaccine at the age of 14 months and performed a single catch-up for children ≤18 years of age. Since then the disease disappeared in vaccinated individuals. Furthermore, herd protection was induced, leading to a significant IMD reduction in non-vaccinated individuals. However, previous studies revealed that the current programmatic immunisation strategy was insufficient to protect the population in the foreseeable future. In addition, vaccines that provide protection against additional serogroups are now available. This paper describes to what extent the current strategy to prevent IMD in the Netherlands is still sufficient, taking into account the burden of disease and the latest scientific knowledge related to IMD and its prevention. In particular, primary MenC immunisation seems not to provide long-term protection, indicating a risk for possible recurrence of the disease. This can be combatted by implementing a MenC or MenACWY adolescent booster vaccine. Additional health benefits can be achieved by replacing the primary MenC by a MenACWY vaccine. By implementation of a recently licensed MenB vaccine for infants in the NIP, the greatest burden of disease would be targeted. This paper shows that optimisation of the immunisation strategy targeting IMD in the Netherlands should be considered and contributes to create awareness concerning prevention optimisation in other countries. © 2015 by Kerman University of Medical Sciences.

Immunisation Information Systems - useful tools for monitoring vaccination programmes in EU/EEA countries, 2016.

PubMed

Derrough, Tarik; Olsson, Kate; Gianfredi, Vincenza; Simondon, Francois; Heijbel, Harald; Danielsson, Niklas; Kramarz, Piotr; Pastore-Celentano, Lucia

2017-04-27

Immunisation Information Systems (IIS) are computerised confidential population based-systems containing individual-level information on vaccines received in a given area. They benefit individuals directly by ensuring vaccination according to the schedule and they provide information to vaccine providers and public health authorities responsible for the delivery and monitoring of an immunisation programme. In 2016, the European Centre for Disease Prevention and Control (ECDC) conducted a survey on the level of implementation and functionalities of IIS in 30 European Union/European Economic Area (EU/EEA) countries. It explored the governance and financial support for the systems, IIS software, system characteristics in terms of population, identification of immunisation recipients, vaccinations received, and integration with other health record systems, the use of the systems for surveillance and programme management as well as the challenges involved with implementation. The survey was answered by 27 of the 30 EU/EEA countries having either a system in production at national or subnational levels (n = 16), or being piloted (n = 5) or with plans for setting up a system in the future (n = 6). The results demonstrate the added-value of IIS in a number of areas of vaccination programme monitoring such as monitoring vaccine coverage at local geographical levels, linking individual immunisation history with health outcome data for safety investigations, monitoring vaccine effectiveness and failures and as an educational tool for both vaccine providers and vaccine recipients. IIS represent a significant way forward for life-long vaccination programme monitoring. This article is copyright of The Authors, 2017.

Myocardial complications of immunisations.

PubMed

Helle, E P; Koskenvuo, K; Heikkilä, J; Pikkarainen, J; Weckström, P

1978-10-01

Immunisation may induce myocardial complications. In this pilot study clinical, electrocardiographic, chemical and immunological findings have been studied during a six weeks' follow-up after routine immunisation (mumps, polio, tetanus, smallpox, diphtheria and type A meningococcal disease) among 234 Finnish conscripts at the beginning of their military service. Serial pattern of ECG changes suggestive of myocarditis was recorded in eight of the 234 conscripts one to two weeks after vaccination against smallpox and diphtheria. Changes were mainly minor ST segment elevations and T wave inversions and usually they disappeared in a few weeks. The ECG positives more often had a history of atopy, and their mean body temperatures and heart rates after the vaccinations were higher than among the other subjects (p less than 0.01). However, clinical myocarditis was never noted, nor were immunological or enzymological changes different among the ECG positives. Thus in 3% of the study population, evidence of postvaccinal myocarditis was noted, based on serial ECG patterns, but without any other evidence of cardiac disease.

[Immunisation schedule of the Spanish Association of Paediatrics: 2017 recommendations].

PubMed

Moreno-Pérez, David; Álvarez García, Francisco José; Arístegui Fernández, Javier; Cilleruelo Ortega, María José; Corretger Rauet, José María; García Sánchez, Nuria; Hernández Merino, Ángel; Hernández-Sampelayo Matos, Teresa; Merino Moína, Manuel; Ortigosa Del Castillo, Luis; Ruiz-Contreras, Jesús

2017-02-01

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV- AEP) annually publishes the immunisation schedule which, in our opinion, is considered optimal for children resident in Spain, taking into account the evidence available on current vaccines. Pneumococcal and varicella immunisation in early childhood is already included in all funded vaccines present in the regional immunisation programmes. Furthermore, this committee establishes recommendations on vaccines not included in official calendars (non-funded immunisations), such as rotavirus, meningococcal B, and meningococcal ACWY. As regards funded immunisations, 2+1 strategy (2, 4, 11-12 months) with hexavalent (DTaP-IPV-Hib-HB) and 13-valent pneumococcal vaccines is recommended. Administration of the 6-year booster dose with DTaP is recommended, as well as a poliomyelitis dose for children who had received the 2+1 scheme, with the Tdap vaccine for adolescents and pregnant women between 27 and 32 weeks gestation. The two-dose scheme should be used for MMR (12 months and 2-4 years) and varicella (15 months and 2-4 years). Coverage of human papillomavirus vaccination in girls aged 12 with a two-dose scheme (0, 6 months) should be improved. Information and recommendations for male adolescents about potential beneficial effects of the tetravalent HPV vaccine should also be provided. ACWY meningococcal vaccine is the optimal choice in adolescents. For recommended unfunded immunisations, the CAV-AEP recommends the administration of meningococcal B vaccine, due to the current availability in Spanish community pharmacies, with a 3+1 scheme. CAV-AEP requests the incorporation of this vaccine in the funded unified schedule. Vaccination against rotavirus is recommended in all infants. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Identification of a target population for immunisation against East Coast fever in coastal Kenya.

PubMed

Maloo, S H; Ngumi, P; Mbogo, S; Williamson, S; Thorpe, W; Rowlands, G J; Perry, B D

2001-11-02

Two experiments were carried out to identify the target population of cattle for immunisation against East Coast fever (ECF) using the infection-and-treatment method. Firstly, a sentinel-calf study was used to determine the age window for ECF immunisation by determining ages at clinical detection of infection with Theileria parva. Six groups of five naive cross-bred (Bos taurus/Bos indicus) male calves, introduced at intervals of 2 months at a mean age of 26 days, were exposed to natural tick challenge on a high ECF-risk, small-holder farm in the coastal lowland, coconut-cassava agro-ecological zone of coastal Kenya. Secondly, a challenge study evaluated the relationship between the presence of T. parva antibodies and immunity. Ten indigenous adult Zebu cattle and nine Zebu young stock purchased from farmers in the same zone, and eight cross-bred calves (survivors of the sentinel-calf study) were challenged with 10 times the immunising dose of T. parva Marikebuni stock. Twenty-four of these 27 cattle had high antibody titres before challenge. Two cross-bred calves, obtained from an ECF-free area and seronegative to T. parva schizont antigen, also were challenged and used as susceptible controls. Twenty-five (83%) of the 30 sentinel calves contracted ECF over an age range of 36-116 days (mean 72 days). The remaining five calves died of other causes within 2 months of arrival on the farm. Fourteen of the 25 calves survived the infection and developed antibodies to T. parva. Despite tick control, seven of these 14 calves had a second episode of ECF and two died. In total, 13 of the 25 calves that contracted ECF died. Only one of 19 indigenous Zebu animals developed clinical ECF when challenged with T. parva Marikebuni (mild clinical signs with spontaneous recovery). Of the eight cross-bred survivors from the first experiment, only one succumbed to ECF when challenged and it died. Both susceptible cross-bred calves developed severe clinical signs of ECF and one died

Continuous active surveillance of adverse events following immunisation using SMS technology.

PubMed

Westphal, Darren W; Williams, Stephanie A; Leeb, Alan; Effler, Paul V

2016-06-17

On-going post-licensure surveillance of adverse events following immunisation (AEFI) is critical to detecting and responding to potentially serious adverse events in a timely manner. SmartVax is a vaccine safety monitoring tool that uses automated data extraction from existing practice management software and short message service (SMS) technology to follow-up vaccinees in real-time. We report on childhood vaccine safety surveillance using SmartVax at a medical practice in Perth, Western Australia. Parents of all children under age five years who were vaccinated according to the Australian National Immunisation Schedule between November 2011 and June 2015 were sent an SMS three days post administration to enquire whether the child had experienced a suspected vaccine reaction. Affirmative replies triggered a follow-up SMS requesting details of the reaction(s) via a link to a survey that could be completed using a smartphone or the web. Rates of reported AEFI including fever, headache, fatigue, rash, vomiting, diarrhoea, rigours, seizures, and local reactions were calculated by vaccination time point. Overall, 239 (8.2%; 95% CI 7.2-9.2%) possible vaccine reactions were reported for 2897 vaccination visits over the 44 month time period. The proportion of children experiencing a possible AEFI, mostly local reactions, was significantly greater following administration of diphtheria-tetanus-pertussis-poliomyelitis vaccine at 4 years of age (77/441; 17.5%; 95% CI 13.9-21.0%) compared to the vaccinations given at 2-18 months (p<0.001). Across all time points, local reactions and fatigue were the most frequently reported AEFI. Automated SMS-based reporting can facilitate sustainable, real-time, monitoring of adverse reactions and contribute to early identification of potential vaccine safety issues. Copyright © 2016 Elsevier Ltd. All rights reserved.

GAVI and hepatitis B immunisation in India.

PubMed

Kolås, A

2011-01-01

In cooperation with Indian health authorities, the GAVI Alliance (GAVI) is introducing Hepatitis B (HepB) vaccination into the immunisation programmes of 11 'better-performing' Indian states. This article describes the concerns and interests of major stakeholders in the programme, including GAVI partners and the Indian government, and summarises Indian debates that have emerged in response to the project, especially on the issue of selective vs. universal immunisation. The article suggests that programme planning should be based on a good knowledge of disease prevalence and the relative importance of perinatal HepB transmission, which would require a comprehensive cross-country study of the epidemiology of HepB among different populations, the relative importance of different transmission routes and the degree of geographical variation in India. Based on this research, further studies could address the feasibility and cost-effectiveness of routine birth-dose administration and selective birth-dose immunisation of infants born to mothers who are chronic HepB virus carriers. The GAVI 'formula' could be strengthened by supporting the basic epidemiological research that is essential to effective programme planning in recipient countries, which are by definition among the world's poorest countries.

Reports of sensorineural deafness after measles, mumps, and rubella immunisation.

PubMed Central

Stewart, B J; Prabhu, P U

1993-01-01

There have been nine reports of sensorineural hearing loss after measles, mumps, and rubella (MMR) immunisation. In three cases the deafness was unrelated to MMR immunisation. In six cases the cause was unknown and MMR remained a possible aetiology. Any risk associated with attenuated viruses must be weighed against the risks of the natural diseases. PMID:8024302

Every Day Is National Lab Day

ERIC Educational Resources Information Center

Bull, Glen

2010-01-01

President Barack Obama recently issued a call for increased hands-on learning in U.S. schools in an address at the National Academy of Sciences. Obama concluded that the future of the United States depends on one's ability to encourage young people to "create, and build, and invent." In this article, the author discusses National Lab Day (NLD)…

Advances in childhood immunisation in South Africa: where to now? Programme managers' views and evidence from systematic reviews.

PubMed

Wiysonge, Charles Shey; Ngcobo, Nthombenhle J; Jeena, Prakash M; Madhi, Shabir A; Schoub, Barry D; Hawkridge, Anthony; Shey, Muki S; Hussey, Gregory D

2012-07-31

The Expanded Programme on Immunisation (EPI) is one of the most powerful and cost-effective public health programmes to improve child survival. We assessed challenges and enablers for the programme in South Africa, as we approach the 2015 deadline for the Millennium Development Goals. Between September 2009 and September 2010 we requested national and provincial EPI managers in South Africa to identify key challenges facing EPI, and to propose appropriate solutions. We collated their responses and searched for systematic reviews on the effectiveness of the proposed solutions; in the Health Systems Evidence, Cochrane Library, and PubMed electronic databases. We screened the search outputs, selected systematic reviews, extracted data, and assessed the quality of included reviews (using AMSTAR) and the quality of the evidence (using GRADE) in duplicate; resolving disagreements by discussion and consensus. Challenges identified by EPI managers were linked to healthcare workers (insufficient knowledge of vaccines and immunisation), the public (anti-immunisation rumours and reluctance from parents), and health system (insufficient financial and human resources). Strategies proposed by managers to overcome the challenges include training, supervision, and audit and feedback; strengthening advocacy and social mobilisation; and sustainable EPI funding schemes, respectively. The findings from reliable systematic reviews indicate that interactive educational meetings, audit and feedback, and supportive supervision improve healthcare worker performance. Structured and interactive communication tools probably increase parents' understanding of immunisation; and reminders and recall, use of community health workers, conditional cash transfers, and mass media interventions probably increase immunisation coverage. Finally, a national social health insurance scheme is a potential EPI financing mechanism; however, given the absence of high-quality evidence of effects, its

Immunisation Information Systems – useful tools for monitoring vaccination programmes in EU/EEA countries, 2016

PubMed Central

Derrough, Tarik; Olsson, Kate; Gianfredi, Vincenza; Simondon, Francois; Heijbel, Harald; Danielsson, Niklas; Kramarz, Piotr; Pastore-Celentano, Lucia

2017-01-01

Immunisation Information Systems (IIS) are computerised confidential population based-systems containing individual-level information on vaccines received in a given area. They benefit individuals directly by ensuring vaccination according to the schedule and they provide information to vaccine providers and public health authorities responsible for the delivery and monitoring of an immunisation programme. In 2016, the European Centre for Disease Prevention and Control (ECDC) conducted a survey on the level of implementation and functionalities of IIS in 30 European Union/European Economic Area (EU/EEA) countries. It explored the governance and financial support for the systems, IIS software, system characteristics in terms of population, identification of immunisation recipients, vaccinations received, and integration with other health record systems, the use of the systems for surveillance and programme management as well as the challenges involved with implementation. The survey was answered by 27 of the 30 EU/EEA countries having either a system in production at national or subnational levels (n = 16), or being piloted (n = 5) or with plans for setting up a system in the future (n = 6). The results demonstrate the added-value of IIS in a number of areas of vaccination programme monitoring such as monitoring vaccine coverage at local geographical levels, linking individual immunisation history with health outcome data for safety investigations, monitoring vaccine effectiveness and failures and as an educational tool for both vaccine providers and vaccine recipients. IIS represent a significant way forward for life-long vaccination programme monitoring. PMID:28488999

Relationship between parent held child records for immunisations, parental recall and health service.

PubMed

Jessop, L; Lotya, J; Murrin, C; Fallon, U B; Kelleher, C C

2011-03-01

Parent held child records (PHCR) were introduced in Ireland in 2008. This study investigated the relationship between the PHCR, parental recall and regional Health Service Executive (HSE) records for immunisation uptake. It used the Lifeways cohort study of 1070 singleton children to compare immunisation data from PHCR at one year, parental recall at five years and information from the HSE. When compared to HSE records, full recording of primary immunisations in the PHCR was reported for 695 of 749 (92.8%) children. Parental recall was correct for 520 of 538 (96.7%) children. Of the 307 completed PHCRs, 207 (75.9%) agreed with the HSE records. Agreement between the three sources for primary immunisations was 74-93% but was not statistically significant. Agreement was 91% (p < 0.001) for measles, mumps and rubella (MMR) vaccines between parental recall and HSE records. PHCRs underestimated and parental recall overestimated immunisation status when compared with HSE records.

Characteristics and practices of National Immunisation Technical Advisory Groups in Europe and potential for collaboration, April 2014.

PubMed

Takla, A; Wichmann, O; Carrillo-Santisteve, P; Cotter, S; Levy-Bruhl, D; Paradowska-Stankiewicz, I; Valentiner-Branth, P; D'Ancona, F

2015-03-05

In many countries, national vaccination recommendations are developed by independent expert committees, so-called national immunisation technical advisory groups (NITAG). Since the evaluation of vaccines is complex and resource-demanding, collaboration between NITAGs that evaluate the same vaccines could be beneficial. We conducted a cross-sectional survey among 30 European countries in February 2014, to explore basic characteristics and current practices of European NITAGs and identify potential modes and barriers for collaboration. Of 28 responding countries, 26 reported to have a NITAG or an equivalent expert group. Of these, 20 apply a systematic approach in the vaccine decision-making process, e.g. by considering criteria such as country-specific disease epidemiology, vaccine efficacy/effectiveness/safety, health economics, programme implementation/logistics or country-specific values/preferences. However, applied frameworks and extent of evidence review differ widely. The use of systematic reviews is required for 15 of 26 NITAGs, while results from transmission modelling and health economic evaluations are routinely considered by 18 and 20 of 26 NITAGs, respectively. Twenty-five countries saw potential for NITAG-collaboration, but most often named structural concerns, e.g. different NITAG structures or countries’ healthcare systems. Our survey gathered information that can serve as an inventory on European NITAGs, allowing further exploration of options and structures for NITAG collaboration.

Is childhood immunisation associated with atopic disease from age 7 to 32 years?

PubMed Central

Nakajima, Kazunori; Dharmage, Shyamali C; Carlin, John B; Wharton, Cathryn L; Jenkins, Mark A; Giles, Graham G; Abramson, Michael J; Walters, E Haydn; Hopper, John L

2007-01-01

Background There is ongoing conjecture over whether childhood immunisation leads to an increased risk of developing atopic diseases. Objective To examine associations between childhood immunisation and the risk of atopic disease. Method Immunisation histories of 8443 Tasmanian children born in 1961 obtained from school medical records were linked to the Tasmanian Asthma Study. Associations between immunisation status and atopic diseases were examined while adjusting for possible confounders using multiple logistic regression. Results Diphtheria immunisation was weakly associated with an increased risk of asthma by age 7 years (odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1 to 1.7), but there was no evidence of any association for four other vaccinations studied. An increased risk of eczema by age 7 years was associated with immunisation against diphtheria (OR 1.5, 95% CI 1.1 to 2.1), tetanus (OR 1.5, 95% CI, 1.1 to 2.0), pertussis (OR 1.5, 95% CI 1.1 to 1.9) and polio (OR 1.4, 95% CI 1.0 to 1.9) but not small pox. Similar but slightly weaker patterns of association were observed between the risk of food allergies and immunisation against diphtheria (OR 1.5, 95% CI 1.0 to 2.1), pertussis (OR 1.4, 95% CI 1.1 to 1.9), polio (OR 1.4, 95% CI 1.00 to 2.1) and tetanus (OR 1.30 95% CI 0.99 to 1.70), but not with small pox. There was no evidence of associations between immunisation history and hay fever, or incidence of later‐onset atopic outcomes. Conclusions The few effects seen in this study are small and age‐dependent, and nearly all our findings support numerous previous studies of no effect of vaccines on asthma. Based on these findings, the fear of their child developing atopic disease should not deter parents from immunising their children, especially when weighed against the benefits. PMID:17090571

Variation in cost and performance of routine immunisation service delivery in India

PubMed Central

Chatterjee, Susmita; Das, Palash; Nigam, Aditi; Nandi, Arindam; Brenzel, Logan; Ray, Arindam; Haldar, Pradeep; Aggarwal, Mahesh Kumar; Laxminarayan, Ramanan

2018-01-01

A comprehensive understanding of the costs of routine vaccine delivery is essential for planning, budgeting and sustaining India’s Universal Immunisation Programme. India currently allocates approximately US$25 per child for vaccines and operational costs. This budget is prepared based on historical expenditure data as information on cost is not available. This study estimated the cost of routine immunisation services based on a stratified, random sample of 255 public health facilities from 24 districts across seven states—Bihar, Gujarat, Kerala, Meghalaya, Punjab, Uttar Pradesh and West Bengal. The economic cost for the fiscal year 2013–2014 was measured by adapting an internationally accepted approach for the Indian context. Programme costs included the value of personnel, vaccines, transport, maintenance, training, cold chain equipment, building and other recurrent costs. The weighted average national level cost per dose delivered was US$2.29 including vaccine costs, and the cost per child vaccinated with the third dose of diphtheria–pertussis–tetanus (DPT) vaccine (a proxy for full immunisation) was US$31.67 (at 2017 prices). There was wide variation in the weighted average state-level cost per dose delivered inclusive of vaccine costs (US$1.38 to US$2.93) and, for the cost per DTP3 vaccinated child (US$20.08 to US$34.81). Lower costs were incurred by facilities and districts that provided the largest number of doses of vaccine. Out of the total cost, the highest amount (57%) was spent on personnel. This costing study, the most comprehensive conducted to date in India, provides evidence, which should help improve planning and budgeting for the national programme. The budget generally considers financial costs, while this study focused on economic costs. For using this study’s results for planning and budgeting, the collected data can be used to extract the relevant financial costs. Variation in cost per dose and doses administered across facilities

The need for innovative strategies to improve immunisation services in rural Zimbabwe.

PubMed

Chadambuka, Addmore; Chimusoro, Anderson; Apollo, Tsitsilina; Tshimanga, Mufuta; Namusisi, Olivia; Luman, Elizabeth T

2012-01-01

Gokwe South, a rural district in Midlands Province, Zimbabwe, reported the lowest rate of immunisation coverage in the country in 2005: 55 per cent of children vaccinated with three doses of diphtheria/pertussis/tetanus vaccine (DPT3) and 35 per cent dropout between the first and third dose of DPT. In January 2007, the authors assessed local barriers to immunisation and proposed strategies to improve immunisation rates in the district, in the face of nationwide economic and political challenges. A situational analysis was performed to assess barriers to immunisation using focus-group discussions with health workers, key informant interviews with health management and community leaders, and desk reviews of records. Responses were categorised and solutions proposed. Health workers and key informants reported that immunisation service delivery was hampered by insufficient availability of gas for cold-chain equipment, limited transport and fuel to conduct basic activities, and inadequate staff and supervision. Improving coverage will require prioritising gas for vaccine cold-chain equipment, identifying reliable transportation or alternative transportation solutions, and increased staff, training and supervision. Local assessment is critical to pinpointing site-specific barriers, and innovative strategies are needed to overcome existing contextual challenges. © 2012 The Author(s). Disasters © Overseas Development Institute, 2012.

Closing the gap in Australian Aboriginal infant immunisation rates -- the development and review of a pre-call strategy.

PubMed

Cashman, Patrick M; Allan, Natalie A; Clark, Katrina K; Butler, Michelle T; Massey, Peter D; Durrheim, David N

2016-06-16

Improving timely immunisation is key to closing the inequitable gap in immunisation rates between Aboriginal children and non-Indigenous children. Aboriginal Immunisation Officers were employed in Hunter New England Local Health District (HNELHD), New South Wales (NSW), Australia, to telephone the families of all Aboriginal infants prior to the due date for their first scheduled vaccination. Aboriginal Immunisation Officers contacted the families of Aboriginal children born in the Hunter New England Local Health District (HNELHD) by telephone before their due immunisation date (pre-call) to provide the rationale for timely immunisation, and to facilitate contact with culturally safe local immunisation services if this was required. The impact of this strategy on immunisation coverage rates is reviewed. For the period March 2010 to September 2014 there was a significant increase in immunisation coverage rate for Aboriginal children at 12 months of age in HNELHD (p < 0.0001). The coverage in the rest of NSW Aboriginal children also increased but not significantly (p = 0.218). Over the full study period there was a significant decrease in the immunisation coverage gap between Aboriginal children and non-Indigenous children in HNELHD (p < 0.0001) and the rest of NSW (p = 0.004). The immunisation coverage gap between Aboriginal and non-Indigenous infants decreased at a significantly faster rate in HNELHD than the rest of NSW (p = 0.0001). By the end of the study period in 2014, immunisation coverage in HNELHD Aboriginal infants had surpassed that of non-Indigenous infants by 0.8 %. The employment of Aboriginal immunisation officers may be associated with closing of the gap between Aboriginal and non-Indigenous infants' immunisation coverage in HNELHD and NSW. The pre-call telephone strategy provided accelerated benefit in closing this gap in HNELHD.

Economic evaluation of routine infant rotavirus immunisation program in Japan.

PubMed

Hoshi, Shu-Ling; Kondo, Masahide; Okubo, Ichiro

2017-05-04

Two rotavirus vaccines are currently available in Japan. We estimated the incremental cost-effectiveness ratio (ICER) of routine infant rotavirus immunisation program without defining which vaccine to be evaluated, which reflects the current deliberation at the Health Science Council in charge of Immunisation and Vaccine established by the Ministry of Health, Labor and Welfare of Japan. Three ICERs were estimated, one from payers' perspective and 2 from societal perspective depending on the scenarios to uptake vaccines. The health statuses following the birth cohort were as follows: not infected by rotavirus, asymptomatic infection, outpatients after infection, hospitalised after infection, developing encephalitis/encephalopathy followed by recovery, sequelae, and death. Costs of per course of vaccination was ¥30,000 (US$283; US$1 = ¥106). The model runs for 60 months with one month cycle. From payers' perspective, estimated ICERs were ¥6,877,000 (US$64,877) per QALY. From societal perspective, immunisation program turns out to be cost-saving for 75% simultaneous vaccination scenario, while it is at ¥337,000 (US$3,179) per QALY gained with vaccine alone scenario. The probability of rotavirus immunisation program to be under ¥5,000,000 (US$47,170) per QALY was at 19.8%, 40.7%, and 75.6% when costs per course of vaccination were set at ¥30,000 (US$283), ¥25,000 (US$236), and ¥20,000 (US$189), respectively. Rotavirus immunisation program has a potential to be cost-effective from payers' perspective and even cost-saving from societal perspective in Japan, however, caution should be taken with regard to the interpretation of the results as cost-effectiveness is critically dependent on vaccination costs.

Assessing the economic impact of immunisation against East Coast fever: a case study in coast province, Kenya.

PubMed

Mukhebi, A W; Kariuki, D P; Mussukuya, E; Mullins, G; Ngumi, P N; Thorpe, W; Perry, B D

1995-07-01

The cost of immunising cattle against East Coast fever by the infection and treatment method has been calculated for a pilot scheme in Kaloleni Division of the Coast Province of Kenya by using a spreadsheet model. The cost was calculated to be KSh 544 (US$25) per animal (in 1990 values). If a farmer were to bear all this cost, immunisation would be financially profitable in grade cattle, but the benefits of immunisation would not be sufficient to justify the immunisation of zebu cattle. For these animals, the cost of immunisation would have to be in the range of KSh 230 to KSh 415 per animal, or the farm-gate price of milk would have to increase by at least 80 per cent from KSh 7.50 to 13.50/litre, or the government would have to subsidise the cost either partially or fully. The first two possibilities are realistic, because the costs of routine immunisation are likely to be lower than for the pilot scheme, and because the increasing demand for milk is likely to push up prices in the liberalised markets. If both the grade and zebu cattle in Kaloleni Division were targets for immunisation, it is estimated that there would be 14,500 head for immunisation annually, costing an estimated KSh 8 million. The spreadsheet model used to assess the economics of immunisation in the Kaloleni Division could be applied to determine the government or private veterinary service charges for immunisation that would be financially profitable to farmers in a defined cattle production system in any division, district or country. The model could also be used to estimate the annual total number of cattle for immunisation in a target cattle production system and thus help with the financial planning for the exercise.

The transfer of East Coast fever immunisation to veterinary paraprofessionals in Zambia.

PubMed

Marcotty, T; Chaka, G; Brandt, J; Berkvens, D; Thys, E; Mulumba, M; Mataa, L; Van den Bossche, P

2008-12-01

In eastern Zambia, immunisation by 'infection and treatment' is the main method used to control East Coast fever, an acute and lethal cattle disease. This service, which requires a stringent cold chain, used to be free of charge. When a minimal user fee was introduced, attendance dropped drastically. Consequently, this complex immunisation programme was transferred to veterinary paraprofessionals working on their own account, with the aim of boosting a more sustainable distribution of vaccine. Paraprofessionals were provided with a motorbike and the required specific equipment, but fuel and drugs were at their expenses. The paraprofessionals recovered their costs, with a profit margin, by charging the cattle owners for immunisation. The reasons for the successful transfer of immunisation to paraprofessionals (despite the maintenance of a fee) are attributed mainly to the absence of information asymmetry between the paraprofessional and the livestock owner, the appreciable level of effort of the paraprofessionals and the verifiable outcome of the service provided.

East Coast fever immunisation field trial in crossbred dairy cattle in Hanang and Handeni districts in northern Tanzania.

PubMed

Lynen, Godelieve; Yrjö-Koskinen, Alma E; Bakuname, Christine; Di Giulio, Giuseppe; Mlinga, Nevil; Khama, Isaac; Hanks, James; Taylor, Nick M; James, Andrew D; McKeever, Declan; Peters, Andy R; Rushton, Jonathan

2012-03-01

East Coast fever (ECF) causes considerable mortality and production losses in the Tanzania smallholder dairy sector and limits the introduction of improved dairy breeds in areas where the disease is present. The infection and treatment method (ITM) was adopted by smallholder dairy farms for ECF immunisation in Hanang and Handeni districts of Tanzania. This study recorded incidence rates for ECF and other tick-borne diseases (TBDs) for ECF-immunised and non-immunised cattle between 1997 and 2000. Approximately 80% of smallholder households from both sites (n = 167) participated in this longitudinal study, with immunisations carried out at the request of the livestock owners. Efficacy of ITM for preventing ECF cases in these crossbred dairy cattle was estimated at 97.6%, while that for preventing ECF deaths was 97.9%. One percent of the cattle developed clinical ECF as a result of immunisation. Since ECF immunisation permits a reduction in acaricide use, an increase in other TBDs is a potential concern. Sixty-three percent of farmers continued to use the same acaricide after immunisation, with 80% of these reducing the frequency of applications. Overall, 78% of farmers increased the acaricide application interval after immunisation beyond that recommended by the manufacturer, resulting in annual savings in the region of USD 4.77 per animal. No statistical difference was observed between the immunised and non-immunised animals in the incidence of non-ECF TBDs. However, immunised animals that succumbed to these diseases showed fewer case fatalities. ITM would therefore appear to be a suitable method for ECF control in Tanzania's smallholder dairy sector.

Interventions for improving coverage of childhood immunisation in low- and middle-income countries

PubMed Central

Oyo-Ita, Angela; Wiysonge, Charles S; Oringanje, Chioma; Nwachukwu, Chukwuemeka E; Oduwole, Olabisi; Meremikwu, Martin M

2016-01-01

Background Immunisation is a powerful public health strategy for improving child survival, not only by directly combating key diseases that kill children but also by providing a platform for other health services. However, each year millions of children worldwide, mostly from low- and middle-income countries (LMICs), do not receive the full series of vaccines on their national routine immunisation schedule. This is an update of the Cochrane review published in 2011 and focuses on interventions for improving childhood immunisation coverage in LMICs. Objectives To evaluate the effectiveness of intervention strategies to boost and sustain high childhood immunisation coverage in LMICs. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2016, Issue 4, part of The Cochrane Library. www.cochranelibrary.com, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (searched 12 May 2016); MEDLINE In-Process and Other Non-Indexed Citations, MEDLINE Daily and MEDLINE 1946 to Present, OvidSP (searched 12 May 2016); CINAHL 1981 to present, EbscoHost (searched 12 May 2016); Embase 1980 to 2014 Week 34, OvidSP (searched 2 September 2014); LILACS, VHL (searched 2 September 2014); Sociological Abstracts 1952 - current, ProQuest (searched 2 September 2014). We did a citation search for all included studies in Science Citation Index and Social Sciences Citation Index, 1975 to present; Emerging Sources Citation Index 2015 to present, ISI Web of Science (searched 2 July 2016). We also searched the two Trials Registries: ICTRP and ClinicalTrials.gov (searched 5 July 2016) Selection criteria Eligible studies were randomised controlled trials (RCT), non-RCTs, controlled before-after studies, and interrupted time series conducted in LMICs involving children aged from birth to four years, caregivers, and healthcare providers. Data collection and analysis We independently screened the search output, reviewed

[Immunisation schedule of the Spanish Association of Paediatrics: 2013 recommendations].

PubMed

Moreno-Pérez, D; Álvarez García, F J; Arístegui Fernández, J; Barrio Corrales, F; Cilleruelo Ortega, M J; Corretger Rauet, J M; González-Hachero, J; Hernández-Sampelayo Matos, T; Merino Moína, M; Ortigosa Del Castillo, L; Ruiz-Contreras, J

2013-01-01

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on the safety, effectiveness and efficiency of vaccines. The present schedule includes levels of recommendation. We have graded as routine vaccinations those that the CAV-AEP consider all children should receive; as recommended those that fit the profile for universal childhood immunisation and would ideally be given to all children, but that can be prioritised according to the resources available for their public funding; and as risk group vaccinations those that specifically target individuals in situations of risk. Immunisation schedules tend to be dynamic and adaptable to ongoing epidemiological changes. Nevertheless, the achievement of a unified immunisation schedule in all regions of Spain is a top priority for the CAV-AEP. Based on the latest epidemiological trends, CAV-AEP follows the innovations proposed in the last year's schedule, such as the administration of the first dose of the MMR and the varicella vaccines at age 12 months and the second dose at age 2-3 years, as well as the administration of the Tdap vaccine at age 4-6 years, always followed by another dose at 11-14 years of age, preferably at 11-12 years. The CAV-AEP believes that the coverage of vaccination against human papillomavirus in girls aged 11-14 years, preferably at 11-12 years, must increase. It reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule. Universal vaccination against varicella in the second year of life is an effective strategy and therefore a desirable objective. Vaccination against rotavirus is recommended in all infants due to the morbidity and elevated healthcare burden of the virus. The Committee stresses the need to vaccinate population groups considered at risk against influenza and hepatitis A. Finally, it

78 FR 56121 - National Grandparents Day, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-11

... Grandparents Day, 2013 Proclamation 9014--National Days of Prayer and Remembrance, 2013 #0; #0; #0..., 2013 National Grandparents Day, 2013 By the President of the United States of America A Proclamation In... future. On National Grandparents Day, America pauses to honor the bedrocks of our families and thank...

Social Transfer of Pathogenic Fungus Promotes Active Immunisation in Ant Colonies

PubMed Central

Konrad, Matthias; Vyleta, Meghan L.; Theis, Fabian J.; Stock, Miriam; Tragust, Simon; Klatt, Martina; Drescher, Verena; Marr, Carsten; Ugelvig, Line V.; Cremer, Sylvia

2012-01-01

Due to the omnipresent risk of epidemics, insect societies have evolved sophisticated disease defences at the individual and colony level. An intriguing yet little understood phenomenon is that social contact to pathogen-exposed individuals reduces susceptibility of previously naive nestmates to this pathogen. We tested whether such social immunisation in Lasius ants against the entomopathogenic fungus Metarhizium anisopliae is based on active upregulation of the immune system of nestmates following contact to an infectious individual or passive protection via transfer of immune effectors among group members—that is, active versus passive immunisation. We found no evidence for involvement of passive immunisation via transfer of antimicrobials among colony members. Instead, intensive allogrooming behaviour between naive and pathogen-exposed ants before fungal conidia firmly attached to their cuticle suggested passage of the pathogen from the exposed individuals to their nestmates. By tracing fluorescence-labelled conidia we indeed detected frequent pathogen transfer to the nestmates, where they caused low-level infections as revealed by growth of small numbers of fungal colony forming units from their dissected body content. These infections rarely led to death, but instead promoted an enhanced ability to inhibit fungal growth and an active upregulation of immune genes involved in antifungal defences (defensin and prophenoloxidase, PPO). Contrarily, there was no upregulation of the gene cathepsin L, which is associated with antibacterial and antiviral defences, and we found no increased antibacterial activity of nestmates of fungus-exposed ants. This indicates that social immunisation after fungal exposure is specific, similar to recent findings for individual-level immune priming in invertebrates. Epidemiological modeling further suggests that active social immunisation is adaptive, as it leads to faster elimination of the disease and lower death rates than

Immunisation practices in centres caring for children with perinatally acquired HIV: A call for harmonisation.

PubMed

Bamford, Alasdair; Manno, Emma C; Mellado, Maria Jose; Spoulou, Vana; Marques, Laura; Scherpbier, Henriette J; Niehues, Tim; Oldakowska, Agnieszka; Rossi, Paolo; Palma, Paolo

2016-11-04

Current national immunisation schedules differ between countries in terms of vaccine formulation, timing of vaccinations and immunisation programme funding and co-ordination. As a result, some HIV infected paediatric population may be left susceptible to vaccine preventable infections. Vaccines used in healthy population should be subjected to high quality ethical research and be explicitly validated for use in children with special vaccination needs such as those infected with HIV. This survey was completed to assess current vaccination practices and attitudes toward vaccination among pediatricians who care for vertically HIV infected children. An online questionnaire was completed by 46 experts in paediatric HIV-infection from the Paediatric European Network for Treatment of AIDS (PENTA). Data were collected between November 2013 and March 2014. 46units looking after 2465 patients completed the questionnaire. The majority of units (67%) reported that common childhood immunisation were administered by the family doctor or local health services rather than in the HIV specialist centre. Vaccination histories were mostly incomplete and difficult to obtain for 40% of the studied population. Concerns were reported regarding the use of live attenuated vaccines, such as varicella and rotavirus, and these were less frequently recommended (61% and 28% of the units respectively). Monitoring of vaccine responses was employed in a minority of centres (41%). A range of different assays were used resulting in diverse units of measurement and proposed correlates of protection. Vaccination practices for perinatally HIV-infected children vary a great deal between countries. Efforts should be made to improve communication and documentation of vaccinations in healthcare settings and to harmonise recommendations relating to additional vaccines for HIV infected children and the use of laboratory assays to guide immunisation. This will ultimately improve coverage and vaccine induced

Factors affecting the causality assessment of adverse events following immunisation in paediatric clinical trials: An online survey.

PubMed

Voysey, Merryn; Tavana, Rahele; Farooq, Yama; Heath, Paul T; Bonhoeffer, Jan; Snape, Matthew D

2015-12-16

Serious adverse events (SAEs) in clinical trials require reporting within 24h, including a judgment of whether the SAE was related to the investigational product(s). Such assessments are an important component of pharmacovigilance, however classification systems for assigning relatedness vary across study protocols. This on-line survey evaluated the consistency of SAE causality assessment among professionals with vaccine clinical trial experience. Members of the clinical advisory forum of experts (CAFÉ), a Brighton Collaboration online-forum, were emailed a survey containing SAEs from hypothetical vaccine trials which they were asked to classify. Participants were randomised to either two classification options (related/not related to study immunisation) or three options (possibly/probably/unrelated). The clinical scenarios, were (i) leukaemia diagnosed 5 months post-immunisation with a live RSV vaccine, (ii) juvenile idiopathic arthritis (JIA) 3 months post-immunisation with a group A streptococcal vaccine, (iii) developmental delay diagnosed at age 10 months after infant capsular group B meningococcal vaccine, (iv) developmental delay diagnosed at age 10 months after maternal immunisation with a group B streptococcal vaccine. There were 140 respondents (72 two options, 68 three options). Across all respondents, SAEs were considered related to study immunisation by 28% (leukaemia), 74% (JIA), 29% (developmental delay after infant immunisation) and 42% (developmental delay after maternal immunisation). Having only two options made respondents significantly less likely to classify the SAE as immunisation-related for two scenarios (JIA p=0.0075; and maternal immunisation p=0.045). Amongst study investigators (n=43) this phenomenon was observed for three of the four scenarios: (JIA p=0.0236; developmental delay following infant immunisation p=0.0266; and developmental delay after maternal immunisation p=0.0495). SAE causality assessment is inconsistent amongst study

A qualitative analysis of parental decision making for childhood immunisation.

PubMed

Marshall, S; Swerissen, H

1999-10-01

Achieving high rates of childhood immunisation is an important public health aim. Currently, however, immunisation uptake in Australia is disappointing. This qualitative study investigated the factors that influence parental decision making for childhood immunisation, and whether parents' experiences were better conceptualised in terms of static subjective expected utility models or in terms of a more dynamic process. Semi-structured in-depth interviews were conducted with 20 predominantly middle-class mothers--17 immunizers and three non-immunizers, in Melbourne, Victoria, in 1997. The data were then examined using thematic analysis. The results suggested that for these participants the decision regarding childhood immunization was better conceptualized as a dynamic process. The decision required initial consideration, implementation then maintenance. If a better understanding of immunization decision making is to be achieved, future studies must look beyond static frameworks. Clearer insight into the dynamic nature of immunization decision making should assist in the identification of more effective methods of promoting childhood immunization to groups at risk of non-compliance.

Growth enhancement of rainbow trout (Oncorhynchus mykiss) by passive immunisation against somatostatin-14

USDA-ARS?s Scientific Manuscript database

Juvenile rainbow trout (Oncorhynchus mykiss) were passively immunised against somatostatin-14 (SS-14) using an antibody originating from egg laying chicken (Gallus domesticus). Fish were immunised weekly (0, 7, 14, 21, 28, 35 d) with chicken egg yolk derived immunoglobulin (IgY) against SS-14 (1:25 ...

Rural-urban inequities in childhood immunisation in Nigeria: The role of community contexts

PubMed Central

2011-01-01

Abstract Context Childhood vaccinations are one of the most cost-effective means of reducing negative child health outcomes. Despite the benefits of immunisation, inequities persist both between and within rural-urban areas in Nigeria. Objectives To assess the role of community contexts on rural-urban inequities in full immunisation uptake amongst children 12 months of age and older. Methods Data from the 2003 Nigeria Demographic and Health Survey including 6029 live born children from 3725 women aged 15–49 years were examined using multilevel regression analysis. Results Rural children were disadvantaged both in the proportion receiving full immunisation and individual vaccines. Contextual or community-level factors such as community prenatal care by doctor, community hospital delivery, and region of residence accounted for significant rural-urban inequities in full immunisation. Conclusion This study stresses the need for community-level interventions aimed at closing rural-urban inequities in the provision of maternal and child health care services.

National Day of Service

NASA Image and Video Library

2013-01-19

Musician Ben Folds performs at the the National Day of Service on the National Mall, Saturday, January 19, 2013, in Washington. NASA along with other federal agencies set up along the Mall as part of events surrounding the inauguration of President Barack Obama. Photo Credit: (NASA/Carla Cioffi)

Rotavirus vaccination within the South African Expanded Programme on Immunisation.

PubMed

Seheri, L Mapaseka; Page, Nicola A; Mawela, Mothahadini P B; Mphahlele, M Jeffrey; Steele, A Duncan

2012-09-07

Diarrhoeal diseases are ranked the third major cause of childhood mortality in South African children less than 5 years, where the majority of deaths are among black children. Acute severe dehydrating rotavirus diarrhoea remains an important contributor towards childhood mortality and morbidity and has been well documented in South Africa. As the preventive strategy to control rotavirus diarrhoea, South Africa became the first country in the WHO African Region to adopt the rotavirus vaccine in the national childhood immunisation programme in August 2009. The rotavirus vaccine in use, Rotarix, GSK Biologicals, is given at 6 and 14 weeks of age, along with other vaccines as part of Expanded Programme on Immunisation (EPI). Studies which facilitated the introduction of rotavirus vaccine in South Africa included the burden of rotavirus disease and strain surveillance, economic burden of rotavirus infection and clinical trials to assess the safety and efficacy of vaccine candidates. This paper reviews the epidemiology of rotavirus in South Africa, outlines some of the steps followed to introduce rotavirus vaccine in the EPI, and highlights the early positive impact of vaccination in reducing the rotavirus burden of disease based on the post-marketing surveillance studies at Dr George Mukhari hospital, a sentinel site at University of Limpopo teaching hospital in Pretoria, South Africa, which has conducted rotavirus surveillance for >20 years. Copyright © 2012 Elsevier Ltd. All rights reserved.

Should professionals caring for children be vaccinated? Community perspectives on health care and child care worker immunisation.

PubMed

Tuckerman, Jane; Thomas, Natalie; Marshall, Helen S

2016-03-29

Several immunisations including influenza and pertussis are specifically recommended for healthcare workers (HCW) and childcare workers (CCW). This study aimed to assess community attitudes to HCW and CCW immunisation recommendations for pertussis and seasonal influenza. A cross-sectional study was conducted by Computer Assisted Telephone Interviewing (CATI) from April to May 2011. Statistical analyses used data weighted to the South Australian population by probability of selection, age, gender and geographical location using benchmarks derived from the 2009 Census population figures. Almost all respondents supported vaccination of HCWs and CCWs against pertussis and influenza. For pertussis, 95.3% agreed nurses, 94.9% agreed doctors and 94.7% agreed CCWs have an obligation to be vaccinated. For influenza, 91.4% agreed nurses, 90.7% agreed doctors and 89.9% agreed CCWs have an obligation to be vaccinated. We identified higher support for protection against pertussis compared to influenza for all three groups of workers (p<0.001). There were higher concerns if CCWs compared to HCWs were not vaccinated against pertussis (OR=2.78) and influenza (OR=1.99). Young (18-30 years) and older age (60+ years) and lower educational attainment were predictors of support for HCWs and CCWs to be vaccinated against influenza. For pertussis, lower educational attainment was a predictor of support for HCWs immunisation. Community support for CCW and HCW immunisation is strong with CCW immunisation was considered a priority. Pertussis immunisation was considered a higher priority than influenza immunisation for HCWs and CCWs. CCW immunisation should be considered for inclusion in public health immunisation programmes. Copyright © 2016 Elsevier Ltd. All rights reserved.

The effect of East Coast fever immunisation and different acaricidal treatments on the productivity of beef cattle.

PubMed

Morzaria, S P; Irvin, A D; Wathanga, J; D'Souza, D; Katende, J; Young, A S; Scott, J; Gettinby, G

1988-09-17

A trial was performed on a farm in the Coast Province of Kenya to study the effects of East Coast fever immunisation and different acaricidal treatments on the productivity of immunised and unimmunised beef cattle. Eighty cattle were immunised against Theileria parva parva (Marikebuni) by the infection and treatment method and a similar group was left as an unimmunised control. Immunisation had no deleterious effect on the cattle. After immunisation, the immunised and control groups were each subdivided into four groups of 20 and each subgroup was managed under a different tick control regimen. The tick control regimen were, acaricidal spraying twice a week or once every three weeks, the application of acaricide-impregnated ear-tags, and no tick control. During a nine-month exposure period there were 18 cases of East Coast fever among the 80 immunised cattle, three which were severe and the others mild. Among the 80 unimmunised cattle there were 57 cases of East Coast fever, 50 of which were severe. The highest morbidity and mortality occurred in the groups under limited tick control or without tick control. Overall weight gain in the immunised cattle, irrespective of the tick control regimen, was better than the weight gain in the unimmunised groups. Within the immunised groups, the weight gain of the cattle sprayed twice weekly was comparable to the weight gain of the animals with acaricidal ear-tags and was significantly higher than the weight gains in the groups sprayed once every three weeks or with tick control. Preliminary cost/benefit analysis showed that it was uneconomical to maintain unimmunised cattle under limited or no tick control.(ABSTRACT TRUNCATED AT 250 WORDS)

The pros and cons of immunisation -- Paper two: the importance of immunisation.

PubMed

Gust, Ian D

1995-05-01

Like other medicine, all vaccines have some side effects or complications; in general the incidence and severity of complications is lower than for pharmaceuticals. When considered on a population basis, the incidence of serious complications of vaccination is minute, when compared with the outcome of natural infection. Enlightened governments, which promote immunisation as a means of minimising the impact of infectious diseases in their communities, also accept the responsibility for any adverse events which can be demonstrated to be vaccine related, and provide compensation and care for people who are affected.

76 FR 56941 - National Grandparents Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... National Grandparents Day, 2011 By the President of the United States of America A Proclamation The support.... On National Grandparents Day, we honor the loving presence of these mentors who have contributed... 11, 2011, as National Grandparents Day. I call upon all Americans to take the time to honor their own...

Immunisation coverage and its associations in rural Tanzanian infants.

PubMed

Kruger, Carsten; Olsen, Oystein E; Mighay, Emanuel; Ali, Mohammed

2013-01-01

associated with low FVRs included interruption of scheduled monthly immunisation clinics (OR 9.8 (CI 2.1-45.5)) and lack of vaccines (OR 1.2-2.9, depending on vaccine). In multivariate analysis, predominant Datoga tribal affiliation and lack of vaccines retained their association with the risk of low rates of vaccination. Vaccination rates in this difficult-to-reach population are markedly lower than the national average for almost all years and clinics. Affiliation to the nomadic Datoga tribe and lack of vaccines determine VRs in this rural population. Improvements in immunisation service delivery, vaccine availability, stronger involvement of the nomadic communities and special outreach services for this population are required to improve VRs in these remote areas of Tanzania.

77 FR 65459 - United Nations Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... United Nations Day, 2012 By the President of the United States of America A Proclamation Sixty-seven... United Nations Day by celebrating the founding ideals laid down in its Charter and reaffirming the... proclaim October 24, 2012, as United Nations Day. I urge the Governors of the 50 States, and the officials...

Enteritis with pneumatosis intestinalis following rotavirus immunisation in an infant with short bowel syndrome.

PubMed

Lopez, Robert N; Krishnan, Usha; Ooi, Chee Y

2017-04-26

Rotavirus vaccines now form part of the national immunisation schedule in many countries. Contraindications to its use are few but do not currently include infants with short bowel syndrome (SBS). We present a nearly 3-month-old boy with SBS who developed enteritis with pneumatosis intestinalis following administration of the Rotarix vaccine. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Wāhine hauora: linking local hospital and national health information datasets to explore maternal risk factors and obstetric outcomes of New Zealand Māori and non-Māori women in relation to infant respiratory admissions and timely immunisations.

PubMed

Filoche, Sara; Garrett, Susan; Stanley, James; Rose, Sally; Robson, Bridget; Elley, C Raina; Lawton, Bev

2013-07-10

Significant health inequities exist around maternal and infant health for Māori, the indigenous people of New Zealand. The infants of Māori are more likely to die in their first year of life and also have higher rates of hospital admission for respiratory illnesses, with the greatest burden of morbidity being due to bronchiolitis in those under one year of age. Timely immunisations can prevent some respiratory related hospitalisations, although for Māori, the proportion of infants with age appropriate immunisations are lower than for non-Māori. This paper describes the protocol for a retrospective cohort study that linked local hospital and national health information datasets to explore maternal risk factors and obstetric outcomes in relation to respiratory admissions and timely immunisations for infants of Māori and non-Māori women. The study population included pregnant women who gave birth in hospital in one region of New Zealand between 1995 and 2009. Routinely collected local hospital data were linked via a unique identifier (National Health Index number) to national health information databases to assess rates of post-natal admissions and access to health services for Māori and non-Māori mothers and infants. The two primary outcomes for the study are: 1. The rates of respiratory hospitalisations of infants (≤ 1 yr of age) calculated for infants of both Māori and non-Māori women (for mothers under 20 years of age, and overall) accounting for relationship to parity, maternal age, socioeconomic deprivation index, maternal smoking status. 2. The proportion of infants with age appropriate immunisations at six and 12 months, calculated for both infants born to Māori women and infants born to non-Māori women, accounting for relationship to parity, maternal age, socioeconomic deprivation index, smoking status, and other risk factors. Analysis of a wide range of routinely collected health information in which maternal and infant data are linked will

Acceptability of financial incentives or quasi-mandatory schemes to increase uptake of immunisations in preschool children in the United Kingdom: Qualitative study with parents and service delivery staff.

PubMed

McNaughton, Rebekah Jayne; Adams, Jean; Shucksmith, Janet

2016-04-27

Since the 1990 s strenuous attempts have been made to rebuild trust in childhood immunisations. This study aimed to understand if financial incentives (FI) or quasi-mandatory schemes (QMS), e.g. mandating immunisations for entry to universal services such as day care or school, might be acceptable interventions to increase immunisations uptake for preschool children. Parents and carers of preschool children (n=91); health and other professionals (n=18); and those responsible for developing and commissioning immunisation services (n=6) took part in the study. Qualitative methods were employed to explore the acceptability of FI/QMS with stakeholders. Framework analysis was used to develop a coding framework that was applied to the whole dataset. Interpretations of the emergent themes were verified between researchers and presented to the project's Parent Reference Group to ensure coherence and relevance. (1) FI: parents and professionals felt introducing FI was inappropriate. It was acknowledged FI may encourage families living in disadvantage to prioritise immunisation, but unintended consequences could outweigh any advantage. FI essentially changes behaviour into a cash transaction which many equated to bribery that could inadvertently create inequalities. (2) QMS: parents and professionals highlighted the positives of introducing QMS, stating it felt natural, fair and less likely to create inequality. Despite QMS' potential to positively impact on uptake there were concerns about the implementation and workability of such schemes. FI for preschool immunisation may not be acceptable, within a UK context. Introducing FI could have detrimental effects on uptake if it were associated with bribery and coercion. Quasi-mandatory schemes, mandating immunisation for universal service entry, was the most acceptable option and could contribute to the normalising of immunisation. Future work would be needed to assess how this could be successfully implemented and if it did

National Day of Service

NASA Image and Video Library

2013-01-19

Actress Eva Longoria, Co-Chair of the Presidential Inaugural Committee, speaks at the National Day of Service on the National Mall, Saturday, January 19, 2013, in Washington. NASA along with other federal agencies set up along the Mall as part of events surrounding the inauguration of President Barack Obama. Photo Credit: (NASA/Carla Cioffi)

United Nations Day, 24 October.

ERIC Educational Resources Information Center

Osborne, Ken, Ed.

1993-01-01

Serving as the journal of the Manitoba Social Science Teachers' Association, this issue commemorates United Nations Day with the editorial, "Teaching about the United Nations" (Ken Osborne). Another article devoted to the international organization is "The United Nations and International Peace and Security" (Ken Osborne). The…

Fifty years of immunisation in Australia (1964-2014): the increasing opportunity to prevent diseases.

PubMed

Royle, Jenny; Lambert, Stephen B

2015-01-01

Medicine has seen dramatic changes in the last 50 years, and vaccinology is no different. Australia has made a significant contribution to world knowledge on vaccine-preventable diseases. Certain deadly diseases have disappeared or become rare in Australia following successful introduction of vaccines. As diseases become rarer, public knowledge about the diseases and their serious consequences has decreased, and concerns about potential vaccine side effects have increased. To maintain confidence in immunisations, sharing of detailed information about the vaccines and the diseases we are trying to prevent is integral to the continued success of our public health programme. Modern quality immunisation programmes need to communicate complex information to immunisation providers and also to the general community. Improving immunisation coverage rates and eliminating the gap in coverage and timeliness between Aboriginal and Torres Strait Islander peoples and non-Indigenous people has become a high priority. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Evaluation of 'SAEFVIC', A Pharmacovigilance Surveillance Scheme for the Spontaneous Reporting of Adverse Events Following Immunisation in Victoria, Australia.

PubMed

Clothier, Hazel J; Crawford, Nigel W; Russell, Melissa; Kelly, Heath; Buttery, Jim P

2017-06-01

Australia is traditionally an early adopter of vaccines, therefore comprehensive and effective post-licensure vaccine pharmacovigilance is critical to maintain confidence in immunisation, both nationally and internationally. With adverse event following immunisation (AEFI) surveillance the responsibility of Australian jurisdictions, Victoria operates an enhanced passive AEFI surveillance system integrated with clinical services, called 'SAEFVIC' (Surveillance of Adverse Events Following Vaccination In the Community). The aim of this study was to evaluate Victoria's current AEFI surveillance system 'SAEFVIC' and inform ongoing quality improvement of vaccine pharmacovigilance in Victoria and Australia. We conducted a retrospective structured desktop evaluation of AEFI reporting received by SAEFVIC from 2007 to 2014, to evaluate the system according to its stated objectives, i.e. to improve AEFI reporting; provide AEFI signal detection; and to maintain consumer confidence in vaccination. AEFI reporting has tripled since SAEFVIC commenced (incidence risk ratio [IRR] 3.04, 95% confidence interval [CI] 2.35-3.93), raising Victoria to be the lead jurisdiction by AEFI reporting volume and to rank third by population reporting rate nationally. The largest increase was observed in children. Data were utilised to investigate potential signal events and inform vaccine policy. Signal detection required clinical suspicion by surveillance nurses, or prior vaccine-specific concerns. Subsequent vaccination post-AEFI was documented for 56.2% (95% CI 54.1-58.4) of reports, and the proportion of children due or overdue for vaccination was 2.3% higher for those reporting AEFI compared with the general population. SAEFVIC has improved AEFI surveillance, facilitates signal investigation and validation, and supports consumer confidence in immunisation. Expansion of the system nationally has the potential to improve capacity and capability of vaccine pharmacovigilance, particularly

Passive immunisation, an old idea revisited: Basic principles and application to modern animal production systems.

PubMed

Hedegaard, Chris J; Heegaard, Peter M H

2016-06-01

Immunisation by administration of antibodies (immunoglobulins) has been known for more than one hundred years as a very efficient means of obtaining immediate, short-lived protection against infection and/or against the disease-causing effects of toxins from microbial pathogens and from other sources. Thus, due to its rapid action, passive immunisation is often used to treat disease caused by infection and/or toxin exposure. However immunoglobulins may also be administered prior to exposure to infection and/or toxin, although they will not provide long-lasting protection as is seen with active immunisation (vaccination) in which an immunological memory is established by controlled exposure of the host to the pathogen in question. With multi-factorial infectious diseases in production animals, especially those that have proven hard to control by vaccination, the potential of passive immunisation remains big. This review highlights a number of examples on the use of passive immunisation for the control of infectious disease in the modern production of a range of animals, including pigs, cattle, sheep, goat, poultry and fish. Special emphasis is given on the enablement of passive immunisation strategies in these production systems through low cost and ease of use as well as on the sources, composition and purity of immunoglobulin preparations used and their benefits as compared to current measures, including vaccination (also comprising maternal vaccination), antibiotics and feed additives such as spray-dried plasma. It is concluded that provided highly efficient, relatively low-price immunoglobulin products are available, passive immunisation has a clear role in the modern animal production sector as a means of controlling infectious diseases, importantly with a very low risk of causing development of bacterial resistance, thus constituting a real and widely applicable alternative to antibiotics. Copyright © 2016 Elsevier B.V. All rights reserved.

Immunisation of cattle with cysteine proteinases of Trypanosoma congolense: targetting the disease rather than the parasite.

PubMed

Authié, E; Boulangé, A; Muteti, D; Lalmanach, G; Gauthier, F; Musoke, A J

2001-11-01

In order to test the hypothesis that trypanosome cysteine proteinases (CPs) contribute to pathology of trypanosomosis, cattle were immunised with CP1 and/or CP2, the major CPs of Trypanosoma congolense, and subsequently challenged with T. congolense. Immunisation had no effect on the establishment of infection and the development of acute anaemia. However, immunised cattle, unlike control cattle, maintained or gained weight during infection. Their haematocrit and leukocyte counts showed a tendency to recovery after 2-3 months of infection. Cattle immunised with CP2 mounted early and prominent IgG responses to CPs and to the variable surface glycoprotein following challenge. Thus trypanosome CPs may play a role in anaemia and immunosuppression; conversely, anti-CP antibody may modulate the trypanosome-induced pathology.

Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks.

PubMed

Rimmer, J; Belk, C; Lund, V J; Swift, A; White, P

2014-07-01

There are no UK guidelines for the use of antibiotics and/or immunisations in patients with an active anterior skull base cerebrospinal fluid leak. This study aimed to define current UK practice in this area and inform appropriate guidelines for ENT surgeons. A web-based survey of all members of the British Rhinological Society was carried out and the literature in this area was reviewed. Of those who responded to the survey, 14 per cent routinely give prophylactic antibiotics to patients with cerebrospinal fluid leaks, and 34.9 per cent recommend immunisation against at least one organism, most commonly Streptococcus pneumoniae (86.7 per cent). There is no evidence to support the use of antibiotic prophylaxis in patients with a cerebrospinal fluid leak. We propose that all such patients are advised to seek immunisation against pneumococcus, meningococcus and haemophilus.

75 FR 56465 - National Grandparents Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... National Grandparents Day, 2010 By the President of the United States of America A Proclamation Throughout... traditions of our heritage are passed down through generations. On National Grandparents Day, we honor those... Day presents a chance to show our profound appreciation and respect for the central roles that family...

Fact or fallacy? Immunisation arguments in the New Zealand print media.

PubMed

Petousis-Harris, Helen A; Goodyear-Smith, Felicity A; Kameshwar, Kamya; Turner, Nikki

2010-10-01

To explore New Zealand's four major daily newspapers' coverage of immunisation with regards to errors of fact and fallacy in construction of immunisation-related arguments. All articles from 2002 to 2007 were assessed for errors of fact and logic. Fact was defined as that which was supported by the most current evidence-based medical literature. Errors of logic were assessed using a classical taxonomy broadly based in Aristotle's classifications. Numerous errors of both fact and logic were identified, predominantly used by anti-immunisation proponents, but occasionally by health authorities. The proportion of media articles reporting exclusively fact changes over time during the life of a vaccine where new vaccines incur little fallacious reporting and established vaccines generate inaccurate claims. Fallacious arguments can be deconstructed and classified into a classical taxonomy including non sequitur and argumentum ad Hominem. Most media 'balance' given to immunisation relies on 'he said, she said' arguments using quotes from opposing spokespersons with a failure to verify the scientific validity of both the material and the source. Health professionals and media need training so that recognising and critiquing public health arguments becomes accepted practice: stronger public relations strategies should challenge poor quality articles to journalists' code of ethics and the health sector needs to be proactive in predicting and pre-empting the expected responses to introduction of new public health initiatives such as a new vaccine. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study

PubMed Central

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Sharma, Saket; Allen, Elizabeth; Shankar, Anuraj H; Zodpey, Sanjay

2016-01-01

Objectives Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants. Setting Urban poor community in the Southeast district of Delhi, India. Participants We randomly sampled 1849 children aged 1–3.5 years from 13 451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria–pertussis–tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers’ recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation. Results Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32. Conclusions Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in

We strongly support childhood immunisation-statement from the European Academy of Paediatrics (EAP).

PubMed

Dornbusch, Hans Juergen; Hadjipanayis, Adamos; Del Torso, Stefano; Mercier, Jean-Christophe; Wyder, Corinne; Schrier, Lenneke; Ross-Russell, Robert; Stiris, Tom; Ludvigsson, Jonas F

2017-05-01

The eradication of smallpox and the elimination of several other infectious diseases from much of the world has provided convincing evidence that vaccines are among the most effective interventions for promoting health. The current scepticism about immunisation among members of the new US administration carries a risk of decreasing immunisation rates also in Europe. While only a small minority of the population are strongly anti-vaccine, their public activities have significantly influenced an uncertainty among the general population about both the safety of and the necessity for vaccination. Therefore, the EAP calls for greater publically available, scientifically supported information on vaccination, particularly targeted at health care providers, for the further development of electronically based immunisation information systems (IIS). We further call on all European countries to work together both in legislative and public health arenas in order to increase vaccination coverage among the paediatric population. In the interest of children and their parents, the EAP expresses its strong support for childhood immunisation and recommended vaccination schedules. We are prepared to work with governments and media and share the extensive evidence demonstrating the effectiveness and safety of vaccines.

Assessing the impact of East Coast Fever immunisation by the infection and treatment method in Tanzanian pastoralist systems.

PubMed

Martins, S Babo; Di Giulio, G; Lynen, G; Peters, A; Rushton, J

2010-12-01

A field trial was carried out in a Maasai homestead to assess the impact of East Coast Fever (ECF) immunisation by the infection and treatment method (ITM) with the Muguga Cocktail on the occurrence of this disease in Tanzanian pastoralist systems. These data were further used in partial budgeting and decision analysis to evaluate and compare the value of the control strategy. Overall, ITM was shown to be a cost-effective control option. While one ECF case was registered in the immunised group, 24 cases occurred amongst non-immunised calves. A significant negative association between immunisation and ECF cases occurrence was observed (p≤0.001). ECF mortality rate was also lower in the immunised group. However, as anti-theilerial treatment was given to all diseased calves, no significant negative association between immunisation and ECF mortality was found. Both groups showed an overall similar immunological pattern with high and increasing percentages of seropositive calves throughout the study. This, combined with the temporal distribution of cases in the non-immunised group, suggested the establishment of endemic stability. Furthermore, the economic analysis showed that ITM generated a profit estimated to be 7250 TZS (1 USD=1300 TZS) per vaccinated calf, and demonstrated that it was a better control measure than natural infection and subsequent treatment. Copyright © 2010 Elsevier B.V. All rights reserved.

An audit of the quality of online immunisation information available to Australian parents.

PubMed

Wiley, K E; Steffens, M; Berry, N; Leask, J

2017-01-13

The Internet is increasingly a source of health information for parents, who use the Internet alongside health care providers for immunisation information. Concerns have been raised about the reliability of online immunisation information, however to date there has been no audit of the quality or quantity of what is available to Australian parents. The objective of this study was to address this gap by simulating a general online search for immunisation information, and assessing the quality and quantity of the web sites returned by the search. We used Google trends to identify the most common immunisation search terms used in Australia. The ten most common terms were entered into five search engines and the first ten non-commercial results from each search collated. A quality assessment tool was developed using the World Health Organization Global Advisory Committee on Vaccine Safety (GACVS) criteria for assessing the quality of vaccine safety web sites, and used to assess and score the quality of the sites. Seven hundred web pages were identified, of which 514 were duplicates, leaving 186 pages from 115 web sites which were audited. Forty sites did not include human immunisation information, or presented personal opinion about individuals, and were not scored. Of the 75 sites quality scored, 65 (87%) were supportive of immunisation, while 10 (13%) were not supportive. The overall mean quality score was 57/100 (range 14/100 to 92/100). When stratified by pro and anti-vaccination stance, the average quality score for pro-vaccine sites was 61/100, while the average score for anti-vaccine sites was 30/100. Pro-vaccine information could be divided into three content groups: generalist overview with little detail; well-articulated and understandable detail; and lengthy and highly technical explanations. The main area found to be lacking in pro-vaccine sites was lack of transparent authorship. Our findings suggest a need for information which is easily found

Study of immunisation status of rural children (12-23 months age) of district Jaipur, Rajasthan and factors influencing it: a hospital based study.

PubMed

Masand, Rupesh; Dixit, A M; Gupta, R K

2012-11-01

To outline the immunisation status of rural children and factors influencing it, a cross-sectional study was undertaken in the paediatric OPD of a medical college hospital among children (n = 300) in the age group of 12-23 months belonging to rural areas of the district Jaipur, Rajasthan. Parents of 300 children were interviewed using a preformed schedule. Children were labelled as 'completely immunised', 'partially immunised' or 'non-immunised' according to working definitions. Various socioeconomic, demographic, cultural, logistic and behavioural factors found to influence the immunisation status were outlined. Chi-square test and logistic regression analysis was done for statistical analysis. There were 100 children (33.3%) who were 'completely' immunised, 144 (48%) were 'partially' immunised and the remaining 56 (18.7%) were 'non-immunised'. The immunisation status was significantly influenced by the visit of the health worker at home, social class, religion, place of delivery, distance from the vaccination centre to child's residence, caste and education. Sex of the child, birth order and type of the family had no impact. The most common reasons for partial immunisation (n = 144) were: Parents' 'forgetfulness' of the schedule, adverse effects observed and not recalled by the health worker. The most common reasons for non-immunisation (n = 56) were lack of knowledge regarding vaccines and schedule, fear of 'injection' and busy in profession. The various factors found to influence the immunisation status of rural children need to be addressed in order to achieve millennium development goal of reducing under-five child mortality.

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): protocol for an exploratory, qualitative study

PubMed Central

Jackson, Cath; Crocker, Annie; Emslie, Carol; Dyson, Lisa; Gallagher, Bridget; Schicker, Frieda; Shepherd, Christine; Smith, Lesley; Vousden, Linda

2015-01-01

Introduction Gypsies, Travellers and Roma (referred to here as Travellers) experience significantly poorer health and have shorter life expectancy than the general population. They are also less likely to access health services including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. This study has two aims: (1) Investigate the barriers and facilitators to acceptability and uptake of immunisations among six Traveller communities in the UK; (2) Identify potential interventions to increase uptake in these Traveller communities. Methods and analysis A three-phase qualitative study with six Traveller communities. PHASE 1: In each community, we will explore up to 45 Travellers’ views about the influences on their immunisation behaviours and ideas for improving uptake in their community. PHASE 2: In each community, we will investigate 6–8 service providers’ perspectives on barriers and facilitators to childhood and adult immunisations for Traveller communities with whom they work, and ideas to improve uptake. Interview data will be analysed using the Framework approach. PHASE 3: The findings will be discussed and interventions prioritised in six workshops, each with 10–12 phase 1 and 3–4 phase 2 participants. Ethics and dissemination This research received approval from NRES Committee Yorkshire and The Humber-Leeds East (Ref. 13/YH/02). It will produce (1) findings on the barriers and facilitators to uptake of immunisations in six Traveller communities; (2) a prioritised list of potentially feasible and acceptable interventions for increasing uptake in these communities; and (3) methodological development in undertaking research with diverse Traveller communities. The study has the potential to inform new ways of delivering services to ensure high immunisation uptake. Findings will be disseminated to participants, relevant UK organisations with responsibility

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): protocol for an exploratory, qualitative study.

PubMed

Jackson, Cath; Bedford, Helen; Condon, Louise; Crocker, Annie; Emslie, Carol; Dyson, Lisa; Gallagher, Bridget; Kerr, Susan; Lewis, Helen J; Mytton, Julie; Redsell, Sarah A; Schicker, Frieda; Shepherd, Christine; Smith, Lesley; Vousden, Linda; Cheater, Francine M

2015-06-08

Gypsies, Travellers and Roma (referred to here as Travellers) experience significantly poorer health and have shorter life expectancy than the general population. They are also less likely to access health services including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. This study has two aims: (1) Investigate the barriers and facilitators to acceptability and uptake of immunisations among six Traveller communities in the UK; (2) Identify potential interventions to increase uptake in these Traveller communities. A three-phase qualitative study with six Traveller communities. PHASE 1: In each community, we will explore up to 45 Travellers' views about the influences on their immunisation behaviours and ideas for improving uptake in their community. PHASE 2: In each community, we will investigate 6-8 service providers' perspectives on barriers and facilitators to childhood and adult immunisations for Traveller communities with whom they work, and ideas to improve uptake. Interview data will be analysed using the Framework approach. PHASE 3: The findings will be discussed and interventions prioritised in six workshops, each with 10-12 phase 1 and 3-4 phase 2 participants. This research received approval from NRES Committee Yorkshire and The Humber-Leeds East (Ref. 13/YH/02). It will produce (1) findings on the barriers and facilitators to uptake of immunisations in six Traveller communities; (2) a prioritised list of potentially feasible and acceptable interventions for increasing uptake in these communities; and (3) methodological development in undertaking research with diverse Traveller communities. The study has the potential to inform new ways of delivering services to ensure high immunisation uptake. Findings will be disseminated to participants, relevant UK organisations with responsibility for the implementation of immunisation policy and Traveller health

[Immunisation schedule of the Spanish Association of Paediatrics: 2016 recommendations].

PubMed

Moreno-Pérez, D; Álvarez García, F J; Arístegui Fernández, J; Cilleruelo Ortega, M J; Corretger Rauet, J M; García Sánchez, N; Hernández Merino, A; Hernández-Sampelayo Matos, T; Merino Moína, M; Ortigosa del Castillo, L; Ruiz-Contreras, J

2016-01-01

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) annually publishes the immunisation schedule which, in our opinion, estimates optimal for children resident in Spain, considering available evidence on current vaccines. We acknowledge the effort of the Ministry of Health during the last year in order to optimize the funded unified Spanish vaccination schedule, with the recent inclusion of pneumococcal and varicella vaccination in early infancy. Regarding the funded vaccines included in the official unified immunization schedule, taking into account available data, CAV-AEP recommends 2+1 strategy (2, 4 and 12 months) with hexavalent (DTPa-IPV-Hib-HB) vaccines and 13-valent pneumococcal conjugate vaccine. Administration of Tdap and poliomyelitis booster dose at the age of 6 is recommended, as well as Tdap vaccine for adolescents and pregnant women, between 27-36 weeks gestation. The two-dose scheme should be used for MMR (12 months and 2-4 years) and varicella (15 months and 2-4 years). Coverage of human papillomavirus vaccination in girls aged 11-12 with a two dose scheme (0, 6 months) should be improved. Information for male adolescents about potential beneficial effects of this immunisation should be provided as well. Regarding recommended unfunded immunisations, CAV-AEP recommends the administration of meningococcal B vaccine, due to the current availability in Spanish communitary pharmacies, with a 3+1 scheme (3, 5, 7 and 13-15 months). CAV-AEP requests the incorporation of this vaccine in the funded unified schedule. Vaccination against rotavirus is recommended in all infants. Annual influenza immunisation and vaccination against hepatitis A are indicated in population groups considered at risk. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Immunisation timeliness in a cohort of urban Aboriginal and Torres Strait Islander children.

PubMed

Lovie-Toon, Yolanda G; Hall, Kerry K; Chang, Anne B; Anderson, Jennie; O'Grady, Kerry-Ann F

2016-11-14

To evaluate immunisation coverage, timeliness and predictors of delayed receipt in urban Australian Indigenous children during the first 18 months of life. Cross-sectional retrospective analysis of data collected from 140 Australian Indigenous children aged < 5 years at the time of enrolment in a prospective cohort study on respiratory illness between 14 February 2013 and 28 January 2015. Children were recruited through an urban community primary health care centre in the Northern suburbs of Brisbane, Queensland. The proportion of children with completed immunisation schedules was 50 of 105 (47.6%) at 7 months, 30 of 85 (35.3%) at 13 months and 12 of 65 (18.5%) at 19 months. Timely receipt of diphtheria-tetanus-pertussis decreased from 78.4% at 2 months of age to 63.7 and 59.3% at 4 and 6 months respectively. Amongst the 105 parents/guardians with children ≥7 months at enrolment, 71 (67.6%) incorrectly reported their child's immunisation status. Delayed vaccine receipt was significantly associated (p ≤0.05) with having multiple children in the household, mother's unemployment and premature birth. Coverage and timeliness among this population is suboptimal and decreases as children age. Parent/guardian reporting of vaccination status was unreliable. Children of unemployed mothers and those with multiple siblings should be targeted to improve community immunisation timeliness due to a greater risk of vaccination delay. High quality trials, conducted in several settings to account for the diversity of Australian Indigenous communities are urgently needed to identify culturally appropriate, effective and sustainable strategies to improve immunisation targets in children.

Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study.

PubMed

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Sharma, Saket; Allen, Elizabeth; Shankar, Anuraj H; Zodpey, Sanjay

2016-08-26

Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants. Urban poor community in the Southeast district of Delhi, India. We randomly sampled 1849 children aged 1-3.5 years from 13 451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria-pertussis-tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers' recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation. Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32. Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in order to improve immunisation coverage in deprived urban

Immunisation against Theileria parva in eastern Zambia: influence of maternal antibodies and demonstration of the carrier status.

PubMed

Marcotty, T; Brandt, J; Billiouw, M; Chaka, G; Losson, B; Berkvens, D

2002-12-11

Immunisation of calves by the infection and treatment method (I & T) has been extensively used in the eastern province of Zambia to control East Coast fever (ECF), a protozoan tick-borne disease. This paper presents the results of a field longitudinal study, which included a total of 148 Angoni calves. After immunisation against ECF, they were monitored for a full rainy season, coinciding with the main peak of activity of the vector of Theileria parva, the tick Rhipicephalus appendiculatus. Dysimmunisation (acute reaction generated by I & T immunisation), seroconversion and mortality are among the parameters recorded. The effect of maternal antibodies on these parameters was analysed and also studied in experimental conditions on two calves. Before immunisation, young calves had a higher seroprevalence than older animals (maternal antibodies) but their post-immunisation seroprevalence was lower. There was no evidence that their immunoprotection was weaker but this indicates that the post-immunisation seroconversion is probably not a reliable tool to monitor the efficacy of calf immunisation. The carrier state of cattle after immunisation was investigated in experimental conditions on three bovines whereas in the field, the infection prevalence in the ticks was estimated using the relation between the tick burden and the T. parva contacts with the calves. The ability of larval and nymphal R. appendiculatus ticks to pick-up T. parva from carriers and to transmit it to naïve animals after moulting was assessed. It was found that both instars are able to transmit clinical and lethal ECF but that the prevalence of T. parva infection in nymphs is much lower than in adults, confirming the primary role of adults in the transmission of ECF in endemic conditions. Similar results were obtained from the field whereby the ECF peak corresponds with the peak of adult R. appendiculatus activity. The infection prevalence in the ticks was however much lower in the field than in

Immunisation coverage in the rural Eastern Cape — are we getting the basics of primary care right? Results from a longitudinal prospective cohort study

PubMed Central

le Roux, K; Akin-Olugbade, O; Katzen, L S; Laurenzi, C; Mercer, N; Tomlinson, M; Rotheram-Borus, M J

2017-01-01

BACKGROUND Immunisations are one of the most cost-effective public health interventions available and South Africa (SA) has implemented a comprehensive immunisation schedule. However, there is disagreement about the level of immunisation coverage in the country and few studies document the immunisation coverage in rural areas. OBJECTIVE To examine the successful and timely delivery of immunisations to children during the first 2 years of life in a deeply rural part of the Eastern Cape Province ot SA. METHODS From January to April 2013, a cohort of sequential births (N=470) in the area surrounding Zithulele Hospital in the OR Tambo District of the Eastern Cape was recruited and followed up at home at 3, 6, 9,12 and 24 months post birth, up to May 2015. Immunisation coverage was determined using Road-to-Health cards. RESULTS The percentages of children with all immunisations up to date at the time of interview were: 48.6% at 3 months, 73.3% at 6 months, 83.9% at 9 months, 73.3% at 12 months and 73.2% at 24 months. Incomplete immunisations were attributed to stock-outs (56%), lack of awareness of the immunisation schedule or of missed immunisations by the mother (16%) and lack of clinic attendance by the mother (19%). Of the mothers who had visited the clinic for baby immunisations, 49.8% had to make multiple visits because of stock-outs. Measles coverage (of at least one dose) was 85.2% at 1 year and 96.3% by 2 years, but 20.6% of babies had not received a second measles dose (due at 18 months) by 2 years. Immunisations were often given late, particularly the 14-week immunisations. CONCLUSIONS Immunisation rates in the rural Eastern Cape are well below government targets and indicate inadequate provision of basic primary care. Stock-outs of basic childhood immunisations are common and are, according to mothers, the main reason for their childrens immunisations not being up to date. There is still much work to be done to ensure that the basics of disease prevention

Pertussis immunisation and control in England and Wales, 1957 to 2012: a historical review.

PubMed

Amirthalingam, G; Gupta, S; Campbell, H

2013-09-19

This review summarises the epidemiology and control of pertussis in England and Wales since the introduction of routine immunisation and considers the implications for future control. Routine infant immunisation with a whole-cell pertussis (wP) vaccine was introduced in 1957 and had a marked impact on the overall disease burden. Following a fall in vaccine coverage during the 1970s and 80s linked to a safety scare with wP vaccine, there was an extended period of high coverage and pertussis incidence fell dramatically. Incidence continued to decrease with the introduction of an acellular pertussis vaccine in the pre-school booster in November 2001 and in the primary United Kingdom (UK) schedule in September 2004 but has increased since July 2011. In response to a high rate of pertussis in infants, a temporary vaccination programme for pregnant women was introduced in October 2012. The key aim of the programme is to protect vulnerable infants from birth in the first months of life, before they can be fully protected by routine infant immunisation. A review of the UK adolescent immunisation programme is currently ongoing and the inclusion of a pertussis booster is being considered.

Mucosal immunity and novel tuberculosis vaccine strategies: route of immunisation-determined T-cell homing to restricted lung mucosal compartments.

PubMed

Lai, Rocky; Afkhami, Sam; Haddadi, Siamak; Jeyanathan, Mangalakumari; Xing, Zhou

2015-06-01

Despite the use of bacille Calmette-Guérin (BCG) for almost a century, pulmonary tuberculosis (TB) continues to be a serious global health concern. Therefore, there has been a pressing need for the development of new booster vaccines to enhance existing BCG-induced immunity. Protection following mucosal intranasal immunisation with AdHu5Ag85A is associated with the localisation of antigen-specific T-cells to the lung airway. However, parenteral intramuscular immunisation is unable to provide protection despite the apparent presence of antigen-specific T-cells in the lung interstitium. Recent advances in intravascular staining have allowed us to reassess the previously established T-cell distribution profile and its relationship with the observed differential protection. Respiratory mucosal immunisation empowers T-cells to home to both the lung interstitium and the airway lumen, whereas intramuscular immunisation-activated T-cells are largely trapped within the pulmonary vasculature, unable to populate the lung interstitium and airway. Given the mounting evidence supporting the safety and enhanced efficacy of respiratory mucosal immunisation over the traditional parenteral immunisation route, a greater effort should be made to clinically develop respiratory mucosal-deliverable TB vaccines. Copyright ©ERS 2015.

Parental perceptions of school-based influenza immunisation in Ontario, Canada: a qualitative study

PubMed Central

MacDougall, Donna; Crowe, Lois; Pereira, Jennifer A; Kwong, Jeffrey C; Quach, Susan; Wormsbecker, Anne E; Ramsay, Hilary; Salvadori, Marina I; Russell, Margaret L

2014-01-01

Objective To understand the perspectives of Ontario parents regarding the advantages and disadvantages of adding influenza immunisation to the currently existing Ontario school-based immunisation programmes. Design Descriptive qualitative study. Participants Parents of school-age children in Ontario, Canada, who were recruited using a variety of electronic strategies (social media, emails and media releases), and identified as eligible (Ontario resident, parent of one or more school-age children, able to read/write English) on the basis of a screening questionnaire. We used stratified purposeful sampling to obtain maximum variation in two groups: parents who had ever immunised at least one child against influenza or who had never done so. We conducted focus groups (teleconference or internet forum) and individual interviews to collect data. Thematic analysis was used to analyse the data. Setting Ontario, Canada. Results Of the 55 participants, 16 took part in four teleconference focus groups, 35 in 6 internet forum focus groups and four in individual interviews conducted between October 2012 and February 2013. Participants who stated that a school-based influenza immunisation programme would be worthwhile for their child valued its convenience and its potential to reduce influenza transmission without interfering with the family routine. However, most thought that for a programme to be acceptable, it would need to be well designed and voluntary, with adequate parental control and transparent communication between the key stakeholder groups of public health, schools and parents. Conclusions These results will benefit decision-makers in the public health and education sectors as they consider the advantages and disadvantages of immunising children in schools as part of a system-wide influenza prevention approach. Further research is needed to assess the perceptions of school board and public health stakeholders. PMID:24902736

Parental perceptions of school-based influenza immunisation in Ontario, Canada: a qualitative study.

PubMed

MacDougall, Donna; Crowe, Lois; Pereira, Jennifer A; Kwong, Jeffrey C; Quach, Susan; Wormsbecker, Anne E; Ramsay, Hilary; Salvadori, Marina I; Russell, Margaret L

2014-06-05

To understand the perspectives of Ontario parents regarding the advantages and disadvantages of adding influenza immunisation to the currently existing Ontario school-based immunisation programmes. Descriptive qualitative study. Parents of school-age children in Ontario, Canada, who were recruited using a variety of electronic strategies (social media, emails and media releases), and identified as eligible (Ontario resident, parent of one or more school-age children, able to read/write English) on the basis of a screening questionnaire. We used stratified purposeful sampling to obtain maximum variation in two groups: parents who had ever immunised at least one child against influenza or who had never done so. We conducted focus groups (teleconference or internet forum) and individual interviews to collect data. Thematic analysis was used to analyse the data. Ontario, Canada. Of the 55 participants, 16 took part in four teleconference focus groups, 35 in 6 internet forum focus groups and four in individual interviews conducted between October 2012 and February 2013. Participants who stated that a school-based influenza immunisation programme would be worthwhile for their child valued its convenience and its potential to reduce influenza transmission without interfering with the family routine. However, most thought that for a programme to be acceptable, it would need to be well designed and voluntary, with adequate parental control and transparent communication between the key stakeholder groups of public health, schools and parents. These results will benefit decision-makers in the public health and education sectors as they consider the advantages and disadvantages of immunising children in schools as part of a system-wide influenza prevention approach. Further research is needed to assess the perceptions of school board and public health stakeholders. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

Urban settings do not ensure access to services: findings from the immunisation programme in Kampala Uganda.

PubMed

Babirye, Juliet N; Engebretsen, Ingunn M S; Rutebemberwa, Elizeus; Kiguli, Juliet; Nuwaha, Fred

2014-03-06

Previous studies on vaccination coverage in developing countries focus on individual- and community-level barriers to routine vaccination mostly in rural settings. This paper examines health system barriers to childhood immunisation in urban Kampala Uganda. Mixed methods were employed with a survey among child caretakers, 9 focus group discussions (FGDs), and 9 key informant interviews (KIIs). Survey data underwent descriptive statistical analysis. Latent content analysis was used for qualitative data. Of the 821 respondents in the survey, 96% (785/821) were mothers with a mean age of 26 years (95% CI 24-27). Poor geographical access to immunisation facilities was reported in this urban setting by FGDs, KIIs and survey respondents (24%, 95% CI 21-27). This coupled with reports of few health workers providing immunisation services led to long queues and long waiting times at facilities. Consumers reported waiting for 3-6 hours before receipt of services although this was more common at public facilities. Only 33% (95% CI 30-37) of survey respondents were willing to wait for three or more hours before receipt of services. Although private-for-profit facilities were engaged in immunisation service provision their participation was low as only 30% (95% CI 27-34) of the survey respondents utilised these facilities. The low participation could be due to lack of financial support for immunisation activities at these facilities. This in turn could explain the rampant informal charges for services in this setting. Charges ranged from US$ 0.2 to US$4 and these were more commonly reported at private (70%, 95% CI 65-76) than at public (58%, 95% CI 54-63) facilities. There were intermittent availability of vaccines and transport for immunisation services at both private and public facilities. Complex health system barriers to childhood immunisation still exist in this urban setting; emphasizing that even in urban areas with great physical access, there are hard to reach people

Infant Feeding among Women Attending an Immunisation Clinic at a Tertiary Health Institution in Ibadan, Nigeria

ERIC Educational Resources Information Center

Fatiregun, A. A.; Abegunde, V. O.

2009-01-01

Maternal characteristics can affect a mother's decision to breastfeed. This study used a cross-sectional design to assess maternal variables and infant feeding patterns among nursing mothers attending an immunisation clinic in Ibadan, Nigeria. A total of 264 mothers who consecutively attended the immunisation clinic and met certain inclusion…

Optimisation of intradermal DNA electrotransfer for immunisation.

PubMed

Vandermeulen, Gaëlle; Staes, Edith; Vanderhaeghen, Marie Lise; Bureau, Michel Francis; Scherman, Daniel; Préat, Véronique

2007-12-04

The development of DNA vaccines requires appropriate delivery technologies. Electrotransfer is one of the most efficient methods of non-viral gene transfer. In the present study, intradermal DNA electrotransfer was first optimised. Strong effects of the injection method and the dose of DNA on luciferase expression were demonstrated. Pre-treatments were evaluated to enhance DNA diffusion in the skin but neither hyaluronidase injection nor iontophoresis improved efficiency of intradermal DNA electrotransfer. Then, DNA immunisation with a weakly immunogenic model antigen, luciferase, was investigated. After intradermal injection of the plasmid encoding luciferase, electrotransfer (HV 700 V/cm 100 micros, LV 200 V/cm 400 ms) was required to induce immune response. The response was Th1-shifted compared to immunisation with the luciferase recombinant protein. Finally, DNA electrotransfer in the skin, the muscle or the ear pinna was compared. Muscle DNA electrotransfer resulted in the highest luciferase expression and the best IgG response. Nevertheless electrotransfer into the skin, the muscle and the ear pinna all resulted in IFN-gamma secretion by luciferase-stimulated splenocytes suggesting that an efficient Th1 response was induced in all case.

Duration of equine influenza virus shedding and infectivity in immunised horses after experimental infection with EIV A/eq2/Richmond/1/07.

PubMed

Paillot, R; Prowse, L; Montesso, F; Stewart, B; Jordon, L; Newton, J R; Gilkerson, J R

2013-09-27

Equine influenza (EI) is a major respiratory disease of horses. Recent outbreaks of EI have demonstrated the ease with which EI virus (EIV) can be transmitted internationally. This study aimed to improve our understanding of EIV shedding after infection of vaccinated horses, which would inform possible changes to current quarantine requirements. Our objectives were to compare commonly used diagnostic tests and to evaluate the relative merits of nasal and nasopharyngeal swabs for detection of EIV in vaccinated and unvaccinated ponies following EIV infection and to use these data to inform optimal quarantine procedures for the safe international movement of horses. Five ponies vaccinated against EI were infected experimentally with A/eq/Richmond/1/07 (Florida clade 2), 11 weeks after V2. Nasal and nasopharyngeal swabs were taken daily for 14 days and every 2 days for another 2 weeks. The 5 vaccinates were introduced sequentially for 48h to 3 groups of 2 naïve sentinel ponies each on days 2, 4 and 6 post-challenge respectively. Clinical signs of disease and EIV shedding were monitored for 14 days after co-mingling. EIV was detected by 3 different methods of detection (EIV nucleoprotein ELISA, EIV nucleoprotein qRT-PCR and isolation/titration in embryonated hens' eggs). Directigen™ EZ Flu A+B tests were also performed on samples from the vaccinated ponies for 6 days after infection. Results show that nasopharyngeal swabs were superior to nasal swabs, with increased frequency and amount of virus detected. The average mean duration of shedding was 6-8 days in naïve animals. All 3 sentinel groups were infected successfully with EIV after commingling with vaccinates, indicating up to 6 days of transmission. EI protection induced by vaccination is a dynamic process, naturally fluctuating and dependent on the time since last immunisation, with periods of high immunity (peak of immunity shortly after boost immunisation) and periods of susceptibility to EIV infection. This

75 FR 60277 - National Hunting and Fishing Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-29

... Part VII The President Proclamation 8567--National Hunting and Fishing Day, 2010 Proclamation 8568--National Public Lands Day, 2010 Proclamation 8569--Gold Star Mother's and Families' Day, 2010 #0; #0; #0... into the character of our Nation. From the rocky shoals of New England to the rugged mountains of the...

Chitosan microspheres as candidate plasmid vaccine carrier for oral immunisation of Japanese flounder (Paralichthys olivaceus).

PubMed

Tian, Jiyuan; Yu, Juan; Sun, Xiuqin

2008-12-15

Oral DNA-based immunotherapy is a new treatment option for fish immunisation in intensive culture. However, because of the existence of the nucleases and severe gastrointestinal conditions, DNA-based vaccines can be hydrolyzed or denatured. In our laboratory, a plasmid DNA (pDNA) containing major capsid protein (MCP) gene of lymphocystis disease virus (LCDV) was prepared, and then pDNA was encapsulated in chitosan microspheres through an emulsion-based methodology. The yield, loading percent and encapsulation efficiency of microspheres were 93.6%, 0.3% and 94.5%, respectively. Scanning electron microscopy (SEM) showed that pDNA-loaded microspheres yielded a spherical shape with smooth surfaces. The disproportion of super-coiled to open circle and linear pDNA suggested that high transfection efficiencies of pDNA in microspheres were retained. The cumulative release of pDNA showed that chitosan microspheres were resistant to degradation in simulated gastrointestinal tract environment. The release profile at PBS buffer (pH 7.4) displayed that pDNA-loaded chitosan microspheres had a release up to 42 days after intestinal imbibition. RT-PCR showed that RNA containing information of MCP gene existed in various tissues 10-90 days post-vaccination. SDS-PAGE and immunofluorescent images indicated that pDNA expressed MCP in tissues of fish 10-90 days after oral administration. In addition, indirect ELISA displayed that the immune responses of sera were positive (O.D.> or =0.3) from week 1 to week 16 for fish vaccinated with microspheres, in comparison with fish vaccinated with naked pDNA. Data obtained suggested that chitosan microspheres were promising carriers for oral pDNA vaccine. Because this encapsulation technique was easy to operate and immunisation efficacy of microspheres loaded with pDNA was significant, it had potential to be used in drug delivery applications.

Socioeconomic inequalities and vaccination coverage: results of an immunisation coverage survey in 27 Brazilian capitals, 2007-2008.

PubMed

Barata, Rita Barradas; Ribeiro, Manoel Carlos Sampaio de Almeida; de Moraes, José Cássio; Flannery, Brendan

2012-10-01

Since 1988, Brazil's Unified Health System has sought to provide universal and equal access to immunisations. Inequalities in immunisation may be examined by contrasting vaccination coverage among children in the highest versus the lowest socioeconomic strata. The authors examined coverage with routine infant immunisations from a survey of Brazilian children according to socioeconomic stratum of residence census tract. The authors conducted a household cluster survey in census tracts systematically selected from five socioeconomic strata, according to average household income and head of household education, in 26 Brazilian capitals and the federal district. The authors calculated coverage with recommended vaccinations among children until 18 months of age, according to socioeconomic quintile of residence census tract, and examined factors associated with incomplete vaccination. Among 17,295 children with immunisation cards, 14,538 (82.6%) had received all recommended vaccinations by 18 months of age. Among children residing in census tracts in the highest socioeconomic stratum, 77.2% were completely immunised by 18 months of age versus 81.2%-86.2% of children residing in the four census tract quintiles with lower socioeconomic indicators (p<0.01). Census tracts in the highest socioeconomic quintile had significantly lower coverage for bacille Calmette-Guérin, oral polio and hepatitis B vaccines than those with lower socioeconomic indicators. In multivariable analysis, higher birth order and residing in the highest socioeconomic quintile were associated with incomplete vaccination. After adjusting for interaction between socioeconomic strata of residence census tract and household wealth index, only birth order remained significant. Evidence from Brazilian capitals shows success in achieving high immunisation coverage among poorer children. Strategies are needed to reach children in wealthier areas.

Regression of devil facial tumour disease following immunotherapy in immunised Tasmanian devils

PubMed Central

Tovar, Cesar; Pye, Ruth J.; Kreiss, Alexandre; Cheng, Yuanyuan; Brown, Gabriella K.; Darby, Jocelyn; Malley, Roslyn C.; Siddle, Hannah V. T.; Skjødt, Karsten; Kaufman, Jim; Silva, Anabel; Baz Morelli, Adriana; Papenfuss, Anthony T.; Corcoran, Lynn M.; Murphy, James M.; Pearse, Martin J.; Belov, Katherine; Lyons, A. Bruce; Woods, Gregory M.

2017-01-01

Devil facial tumour disease (DFTD) is a transmissible cancer devastating the Tasmanian devil (Sarcophilus harrisii) population. The cancer cell is the ‘infectious’ agent transmitted as an allograft by biting. Animals usually die within a few months with no evidence of antibody or immune cell responses against the DFTD allograft. This lack of anti-tumour immunity is attributed to an absence of cell surface major histocompatibility complex (MHC)-I molecule expression. While the endangerment of the devil population precludes experimentation on large experimental groups, those examined in our study indicated that immunisation and immunotherapy with DFTD cells expressing surface MHC-I corresponded with effective anti-tumour responses. Tumour engraftment did not occur in one of the five immunised Tasmanian devils, and regression followed therapy of experimentally induced DFTD tumours in three Tasmanian devils. Regression correlated with immune cell infiltration and antibody responses against DFTD cells. These data support the concept that immunisation of devils with DFTD cancer cells can successfully induce humoral responses against DFTD and trigger immune-mediated regression of established tumours. Our findings support the feasibility of a protective DFTD vaccine and ultimately the preservation of the species. PMID:28276463

Ethnicity-specific factors influencing childhood immunisation decisions among Black and Asian Minority Ethnic groups in the UK: a systematic review of qualitative research

PubMed Central

Forster, Alice S; Rockliffe, Lauren; Chorley, Amanda J; Marlow, Laura A V; Bedford, Helen; Smith, Samuel G; Waller, Jo

2017-01-01

Background Uptake of some childhood immunisations in the UK is lower among those from some Black and Asian Minority Ethnic (BAME) backgrounds. This systematic review of qualitative research sought to understand the factors that are associated with ethnicity that influence the immunisation decisions of parents from BAME backgrounds living in the UK. Methods Databases were searched on 2 December 2014 for studies published at any time using the terms ‘UK’ and ‘vaccination’ and ‘qualitative methods’ (and variations of these). Included articles comprised participants who were parents from BAME backgrounds. Thematic synthesis methods were used to develop descriptive and higher order themes. Themes specific to ethnicity and associated factors are reported. Results Eight papers were included in the review. Most participants were from Black (n=62) or Asian (n=38) backgrounds. Two ethnicity-related factors affected immunisation decisions. First, factors that are related to ethnicity itself (namely religion, upbringing and migration, and language) affected parents' perceived importance of immunisations, whether immunisations were permitted or culturally acceptable and their understanding of immunisation/the immunisation schedule. Second, perceived biological differences affected decision-making and demand for information. Conclusions Factors related to ethnicity must be considered when seeking to understand immunisation decisions among parents from BAME backgrounds. Where appropriate and feasible, vaccination information should be targeted to address beliefs about ethnic differences held by some individuals from some BAME backgrounds. PMID:27531844

Clear and present danger: in childhood meningitis. The importance of Hib immunisation in infancy and high-risk groups.

PubMed

Paul, Siba Prosad; Lamont, Lilias Susan

2012-01-01

The incidence of Haemophilus influenzae type b (Hib) invasive disease has declined significantly in the United Kingdom since the introduction of routine Hib immunisation. However life-threatening Hib infections such as meningitis and epiglottitis may still occur, especially in the unimmunised and immigrant children. A case of Hib meningitis is a reminder that the threat of invasive Hib disease has not been totally eliminated. Early diagnosis and treatment of bacterial meningitis (including Hib meningitis) is essential to prevent death and serious neurological sequelae. Health visitors play a vital role in encouraging parents to have their children immunised without any avoidable delays and in providing reliable information as necessary to back up this advice. Enquiring about immunisation status of all children new to a practice and addressing any omissions, should be routine; immigrant children (and their parents) may be particularly vulnerable and more likely to be inadequately immunised.

A mild Theileria parva parasite with potential for immunisation against East Coast fever.

PubMed

Mbogo, S K; Kariuki, D P; Ngumi, P N; McHardy, N

1996-01-01

Twenty-three Friesian cattle were inoculated subcutaneously anterior to the left prescapular lymph node with 1 ml of a mild isolate of Theileria parva. The cattle developed low macroschizont parasitosis but no clinical reaction was observed. Thirty-five days later the cattle were grouped into five groups and challenged with five different Theileria parva isolates (four cattle-derived Theileria and one buffalo-derived Theileria). The cattle were all solidly immune to challenge with the cattle-derived Theileria isolates but three out of five of the cattle challenged with the buffalo-derived parasite died of theileriosis. All ten non-immunised control cattle developed severe theileriosis and were treated with buparvaquone (Butalex; Pitman-Moore).

Do selective immunisation against tuberculosis and hepatitis B reach the targeted populations? A nationwide register-based study evaluating the recommendations in the Norwegian Childhood Immunisation Programme.

PubMed

Feiring, Berit; Laake, Ida; Molden, Tor; Håberg, Siri E; Nøkleby, Hanne; Seterelv, Siri Schøyen; Magnus, Per; Trogstad, Lill

2016-04-12

Selective immunisation is an alternative to universal vaccination if children at increased risk of disease can be identified. Within the Norwegian Childhood Immunisation Programme, BCG vaccine against tuberculosis and vaccine against hepatitis B virus (HBV) are offered only to children with parents from countries with high burden of the respective disease. We wanted to study whether this selective immunisation policy reaches the targeted groups. The study population was identified through the Norwegian Central Population Registry and consisted of all children born in Norway 2007-2010 and residing in Norway until their second birthday, in total 240,484 children. Information on vaccinations from the Norwegian Immunisation Registry, and on parental country of birth from Statistics Norway, was linked to the population registry by personal identifiers. The coverage of BCG and HBV vaccine was compared with the coverage of vaccines in the universal programme. Among the study population, 16.1% and 15.9% belonged to the target groups for BCG and HBV vaccine, respectively. Among children in the BCG target group the BCG vaccine coverage was lower than the coverage of pertussis and measles vaccine (83.6% vs. 98.6% and 92.3%, respectively). Likewise, the HBV vaccine coverage was lower than the coverage of pertussis and measles vaccine in the HBV target group (90.0% vs. 98.6% and 92.3%, respectively). The coverage of the targeted vaccines was highest among children with parents from South Asia and Sub-Saharan Africa. The coverage of vaccines in the universal programme was similar in targeted and non-targeted groups. Children targeted by selective vaccination had lower coverage of the target vaccines than of vaccines in the universal programme, indicating that selective vaccination is challenging. Improved routines for identifying eligible children and delivering the target vaccines are needed. Universal vaccination of all children with these vaccines could be considered

75 FR 21155 - National Equal Pay Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... America A Proclamation Throughout our Nation's history, extraordinary women have broken barriers to... Equal Pay Day symbolizes the day when an average American woman's earnings finally match what an average... celebrate the strength and vibrancy women add to our economy. Our Nation's workforce includes more women...

A bibliometric analysis of systematic reviews on vaccines and immunisation.

PubMed

Fernandes, Silke; Jit, Mark; Bozzani, Fiammetta; Griffiths, Ulla K; Scott, J Anthony G; Burchett, Helen E D

2018-04-19

SYSVAC is an online bibliographic database of systematic reviews and systematic review protocols on vaccines and immunisation compiled by the London School of Hygiene & Tropical Medicine and hosted by the World Health Organization (WHO) through their National Immunization Technical Advisory Groups (NITAG) resource centre (www.nitag-resource.org). Here the development of the database and a bibliometric review of its content is presented, describing trends in the publication of policy-relevant systematic reviews on vaccines and immunisation from 2008 to 2016. Searches were conducted in seven scientific databases according to a standardized search protocol, initially in 2014 with the most recent update in January 2017. Abstracts and titles were screened according to specific inclusion criteria. All included publications were coded into relevant categories based on a standardized protocol and subsequently analysed to look at trends in time, topic, area of focus, population and geographic location. After screening for inclusion criteria, 1285 systematic reviews were included in the database. While in 2008 there were only 34 systematic reviews on a vaccine-related topic, this increased to 322 in 2016. The most frequent pathogens/diseases studied were influenza, human papillomavirus and pneumococcus. There were several areas of duplication and overlap. As more systematic reviews are published it becomes increasingly time-consuming for decision-makers to identify relevant information among the ever-increasing volume available. The risk of duplication also increases, particularly given the current lack of coordination of systematic reviews on vaccine-related questions, both in terms of their commissioning and their execution. The SYSVAC database offers an accessible catalogue of vaccine-relevant systematic reviews with, where possible access or a link to the full-text. SYSVAC provides a freely searchable platform to identify existing vaccine-policy-relevant systematic

NK cells influence both innate and adaptive immune responses after mucosal immunisation with antigen and mucosal adjuvant*

PubMed Central

Hall, Lindsay J; Clare, Simon; Dougan, Gordon

2012-01-01

NK cells were found to be recruited in a temporally controlled manner to the nasal-associated lymphoid tissue and the cervical lymph nodes of mice following intranasal immunisation with Ag85B-ESAT6 antigen from Mycobacterium tuberculosis mixed with Escherichia coli heat-labile toxin as adjuvant. These NK cells were activated and they secreted a diverse range of cytokines and other immunmodulators. Using antibody depletion targeting anti-asialo GM1, we found evidence for altered trafficking, impaired activation and cytokine secretion of dendritic cells, macrophages and neutrophils in immunised NK cell depleted mice compared to control animals. Analysis of antigen-specific immune responses revealed an attenuated antibody and cytokine response in immunised NK cell depleted animals. Systemic administration of rIL-6 but not rIFN-γ significantly restored immune responses in mice depleted of NK cells. In conclusion, cytokine production, particularly IL-6, via NK cells and NK cell activated immune populations, plays an important role in the establishment of local innate immune responses and the consequent development of adaptive immunity after mucosal immunisation. PMID:20220095

Why National Biomechanics Day?

PubMed

DeVita, Paul

2018-04-11

National Biomechanics Day (NBD) seeks to expand the influence and impact of Biomechanics on our society by expanding the awareness of Biomechanics among young people. NBD will manifest this goal through worldwide, synchronized and coordinated celebrations and demonstrations of all things Biomechanics with high school students. NBD invites all Biomechanists to participate in NBD 2018, http://nationalbiomechanicsday.asbweb.org/. Copyright © 2018 Elsevier Ltd. All rights reserved.

78 FR 31809 - National Maritime Day, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... Day, 2013 Executive Order 13644--Amendment to Executive Order 13639 #0; #0; #0; Presidential Documents... Maritime Day, 2013 By the President of the United States of America A Proclamation Through every chapter of... economic growth by shipping our products all around the world. On National Maritime Day, we honor the...

Australian National University Science Extension Day

ERIC Educational Resources Information Center

Fletcher, Sarah

2016-01-01

The first Australian National University (ANU) Science Extension Day was held on September 8, 2015. The ANU Science Extension Day is a project that was initiated by Theodore Primary School (ACT) and developed by Theodore Primary, Calwell High School, Science Educators Association of the ACT (SEA*ACT), and the ANU. The project was developed with a…

Opportunistic immunisation in the emergency department: a survey of staff knowledge, opinion and practices.

PubMed

Philips, Leanne; Young, Jeanine; Williams, Lesley A; Cooke, Marie; Rickard, Claire

2014-05-01

The aim of this study was to identify (a) emergency department staff knowledge, opinion and practices in relation to childhood vaccines and opportunistic immunisation in the emergency department and (b) differences between nursing and medical staff knowledge, opinion and self reported practices. A self-administered, cross-sectional survey was offered to a convenience sample of medical and nursing staff (n=86) working in a tertiary paediatric emergency department. Variables of interest were described using frequencies and odds ratios to report differences between medical and nursing staff responses. An 87% survey response was achieved. The majority of staff agreed that childhood vaccines were safe (96%), effective (99%) and necessary (97%). Less than half (45%) of the staff correctly identified that there is no association between measles, mumps and rubella (MMR) vaccine and autism. Medical staff were more likely than nurses to disagree that giving multiple vaccines overloads the immune system (p<0.01), or that complementary therapies reduced the need for a child to be vaccinated (p<0.006). These knowledge deficits exist despite a reported awareness of immunisation resources. The majority (96%) of those surveyed reported that the Australian Immunisation Handbook was as a useful resource. Overall, the majority of staff agreed vaccines are safe, effective and necessary. This study highlighted that staff knowledge deficits and misconceptions about vaccines and vaccine management may be barriers to promoting opportunistic immunisation practices in ED. Copyright © 2014 College of Emergency Nursing Australasia Ltd. All rights reserved.

Control of a community outbreak of measles which started in a poorly immunised high school population.

PubMed

Merianos, A; Miller, N C; Patel, M S

1993-09-01

An outbreak of measles occurred in Darwin from February to March 1991. The first case was in a 13-year-old high school student who had returned from a holiday overseas. She was symptomatic on the second day of the new school term. She infected an infant while both waited in a doctor's surgery. Outbreak control measures were instituted 18 days later when the Communicable Diseases Centre was first alerted of cases through the laboratory notification scheme. Through active surveillance, we identified 76 cases of measles, of whom 92 per cent (70 cases) were under 20 years of age. Of these, 46 were students at the index high school in which the attack rate was 39.2 per 1,000. They transmitted the disease to six unvaccinated siblings aged 11 to 18 years, resulting in a secondary attack rate of 113 per 1,000 in this age group (relative risk of disease in siblings 2.8, 95 per cent confidence interval 1.2 to 6.2). The outbreak affected one other high school, a number of primary schools, one tertiary institution, and nine children under five years. Only four of the cases had a verified history of previous immunisation against measles. The outbreak was arrested within two weeks of instituting community-wide control measures. Inadequate immunisation coverage among school-aged children and delays in notification contributed to the severity of the outbreak. Improved measles surveillance systems, including telephone notification of clinical cases are needed so that control measures can be instituted immediately within the household and in the community.

An increase in accident and emergency presentations for adverse events following immunisation after introduction of the group B meningococcal vaccine: an observational study.

PubMed

Nainani, Viveka; Galal, Ushma; Buttery, Jim; Snape, Matthew D

2017-08-09

To determine whether the introduction of the capsular group B meningococcal vaccine (4CMenB) in the UK has increased presentations of infants to emergency departments with adverse events following immunisation (AEFI). A retrospective review of hospital records of infants aged 1-6 months presenting to Oxford University Hospitals NHS Trust's emergency departments from September 2013 to August 2016 with discharge diagnoses of vaccine reactions or non-specific conditions. Immunisation history was checked by reference to centralised immunisation records. Presentation classifications were 'probable vaccine reaction' (ie, symptoms within 48 hours of immunisation; no alternative cause found), 'possible vaccine reaction' (symptoms within 48 hours of immunisation with a possible alternative cause) or 'not related' (clear alternative diagnosis or not immunised within previous 48 hours). Prior to 4CMenB introduction (2013-15), an annual average of 12 infants presented with probable or possible AEFIs, increasing to 38 infants in the year following 4CMenB introduction (2015/2016). Rates of AEFIs per 1000 immunisation episodes increased post-4CMenB introduction from 1.03 to 3.4 (p<0.001) at 2 months and from 0.14 to 1.13 (p=0.005) at 4 months. At 3 months, when 4CMenB is not given, no increase was seen (p=0.380). 4CMenB introduction was also associated with increased AEFI-related hospital admissions, invasive investigations and intravenous antibiotic use. The increase in emergency department attendances, investigations and antibiotic use for AEFIs following 4CMenB immunisation may influence the cost-effectiveness of the 4CMenB immunisation campaign. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ethnicity-specific factors influencing childhood immunisation decisions among Black and Asian Minority Ethnic groups in the UK: a systematic review of qualitative research.

PubMed

Forster, Alice S; Rockliffe, Lauren; Chorley, Amanda J; Marlow, Laura A V; Bedford, Helen; Smith, Samuel G; Waller, Jo

2017-06-01

Uptake of some childhood immunisations in the UK is lower among those from some Black and Asian Minority Ethnic (BAME) backgrounds. This systematic review of qualitative research sought to understand the factors that are associated with ethnicity that influence the immunisation decisions of parents from BAME backgrounds living in the UK. Databases were searched on 2 December 2014 for studies published at any time using the terms 'UK' and 'vaccination' and 'qualitative methods' (and variations of these). Included articles comprised participants who were parents from BAME backgrounds. Thematic synthesis methods were used to develop descriptive and higher order themes. Themes specific to ethnicity and associated factors are reported. Eight papers were included in the review. Most participants were from Black (n=62) or Asian (n=38) backgrounds. Two ethnicity-related factors affected immunisation decisions. First, factors that are related to ethnicity itself (namely religion, upbringing and migration, and language) affected parents' perceived importance of immunisations, whether immunisations were permitted or culturally acceptable and their understanding of immunisation/the immunisation schedule. Second, perceived biological differences affected decision-making and demand for information. Factors related to ethnicity must be considered when seeking to understand immunisation decisions among parents from BAME backgrounds. Where appropriate and feasible, vaccination information should be targeted to address beliefs about ethnic differences held by some individuals from some BAME backgrounds. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Adolescent confidence in immunisation: Assessing and comparing attitudes of adolescents and adults.

PubMed

Wang, Bing; Giles, Lynne; Afzali, Hossein Haji Ali; Clarke, Michelle; Ratcliffe, Julie; Chen, Gang; Marshall, Helen

2016-11-04

There is limited knowledge of adolescent views and attitudes towards immunisation. Our study investigated adolescent attitudes to immunisation and compared differences in vaccination attitudes between adolescents and adults. This study was a cross-sectional, national online survey. Recruitment was stratified by state and gender to ensure findings were nationally representative. Regression analyses were performed to assess and compare adolescent and adult views on vaccine benefits, community protection, risks, side effects, sources of information, and decision-making preference. In 2013, 502 adolescents and 2003 adults completed the online survey. Lower levels of vaccine confidence were observed in adolescents with adolescents less likely to believe vaccines are beneficial and/or safe compared to adults (p=0.043). Compared to females, males were less confident of vaccine benefits (p<0.05) but less concern about vaccine side effects (p<0.05). Adolescents were more concerned about vaccine side effects than adults for pain (p<0.001), redness or swelling (p<0.001), and fever (p=0.006). Adolescents were less likely than adults to consider health professionals (p<0.001) and the media (e.g. internet) (p=0.010) as important sources of information, and were more likely to seek information from social networks (p<0.001) including families and schools. Although 62.0% of adolescents agreed that parents should make the decision about vaccination for them, adolescents were more likely to prefer a joint decision with parents (p<0.001) or by themselves (p=0.007) compared with adults. Adolescents have a lesser understanding of vaccine safety and benefits than adults and have higher concerns about potential vaccine reactions. Improving adolescent awareness and knowledge of the benefits and risks of vaccination through school-based educational programs may improve confidence in and uptake of vaccines for adolescents and increase vaccine confidence in the next generation of parents

Influenza immunisation: attitudes and beliefs of UK healthcare workers

PubMed Central

Smedley, Julia; Poole, Jason; Waclawski, Eugene; Stevens, Anthony; Harrison, John; Watson, John; Hayward, Andrew; Coggon, David

2007-01-01

Aim To explore attitudes to influenza immunisation and rates of uptake among staff working in acute hospitals in the UK. Method A cross‐sectional survey of 11 670 healthcare workers in six UK hospitals was carried out using a postal questionnaire. Results Among 6302 responders (54% of those mailed), 19% had taken up influenza immunisation during winter 2002/3. Vaccination was well tolerated, with a low prevalence of side effects (13%) and associated time off work (2%). The majority of subjects who accepted vaccination (66%) were most strongly influenced by the personal benefits of protection against influenza. Prevention of sickness absence and protection of patients were the prime motivation for only 10% and 7% of subjects, respectively. Among 3967 who declined vaccination, the most common primary demotivators were concern about safety (31%) and efficacy (29%). 22% were most strongly deterred by lack of time to attend for vaccination. Free text answers indicated that 37% declined because of a perceived low ratio of personal benefits to adverse effects. Subjects said they would be persuaded to take up vaccination in future by easier access (36%), more information about personal benefit and risk (34%) and more information about effects on staff absence (24%). Conclusions These findings indicate that the uptake of influenza immunisation among UK healthcare workers remains low. There is some scope for increasing uptake by improving accessibility and encouragement from professional peers. However, the results suggest that perception of small personal benefit in relation to risk mitigates, importantly, against higher uptake of routine annual influenza vaccination. Thus, resource might better be allocated to ensuring efficient management in epidemic years. The effect of publicity about pandemic influenza on risk perception and vaccine uptake among healthcare workers during winter 2005/6 warrants further study. PMID:17182640

Immunisation coverage of adults: a vaccination counselling campaign in the pharmacies in Switzerland.

PubMed

Valeri, Fabio; Hatz, Christoph; Jordan, Dominique; Leuthold, Claudine; Czock, Astrid; Lang, Phung

2014-01-01

To assess vaccination coverage for adults living in Switzerland. Through a media campaign, the general population was invited during 1 month to bring their vaccination certificates to the pharmacies to have their immunisation status evaluated with the software viavac©, and to complete a questionnaire. A total of 496 pharmacies in Switzerland participated in the campaign, of which 284 (57%) submitted valid vaccination information. From a total of 3,634 participants in the campaign, there were 3,291 valid cases (participants born ≤ 1992) and 1,011 questionnaires completed. Vaccination coverage for the participants was 45.9% and 34.6% for five and six doses of diphtheria, 56.4% and 44.0% for tetanus and 66.3% and 48.0% for polio, respectively. Coverage estimates for one and two doses of measles vaccine were 76.5% and 49.4%, respectively, for the birth cohort 1967-1992 and 4.0% and 0.8%, respectively, for the cohort ≤ 1966. There was a significant difference in coverage for most vaccinations between the two aforementioned birth cohorts. A plot of the measles vaccine coverage over time shows that the increase in coverage correlated with policy changes in the Swiss Immunisation Schedule. Despite selection bias and low participation, this study indicates that vaccination coverage for the basic recommended immunisations in the adult population in Switzerland is suboptimal. More efforts using various means and methods are needed to increase immunisation coverage in adolescents before they leave school. An established method to determine vaccination coverage for the general population could provide invaluable insights into the effects of changes in vaccination policies and disease outbreaks.

Mobile phone-delivered reminders and incentives to improve childhood immunisation coverage and timeliness in Kenya (M-SIMU): a cluster randomised controlled trial.

PubMed

Gibson, Dustin G; Ochieng, Benard; Kagucia, E Wangeci; Were, Joyce; Hayford, Kyla; Moulton, Lawrence H; Levine, Orin S; Odhiambo, Frank; O'Brien, Katherine L; Feikin, Daniel R

2017-04-01

As mobile phone access continues to expand globally, opportunities exist to leverage these technologies to support demand for immunisation services and improve vaccine coverage. We aimed to assess whether short message service (SMS) reminders and monetary incentives can improve immunisation uptake in Kenya. In this cluster-randomised controlled trial, villages were randomly and evenly allocated to four groups: control, SMS only, SMS plus a 75 Kenya Shilling (KES) incentive, and SMS plus 200 KES (85 KES = USD$1). Caregivers were eligible if they had a child younger than 5 weeks who had not yet received a first dose of pentavalent vaccine. Participants in the intervention groups received SMS reminders before scheduled pentavalent and measles immunisation visits. Participants in incentive groups, additionally, received money if their child was timely immunised (immunisation within 2 weeks of the due date). Caregivers and interviewers were not masked. The proportion of fully immunised children (receiving BCG, three doses of polio vaccine, three doses of pentavalent vaccine, and measles vaccine) by 12 months of age constituted the primary outcome and was analysed with log-binomial regression and General Estimating Equations to account for correlation within clusters. This trial is registered with ClinicalTrials.gov, number NCT01878435. Between Oct 14, 2013, and Oct 17, 2014, we enrolled 2018 caregivers and their infants from 152 villages into the following four groups: control (n=489), SMS only (n=476), SMS plus 75 KES (n=562), and SMS plus 200 KES (n=491). Overall, 1375 (86%) of 1600 children who were successfully followed up achieved the primary outcome, full immunisation by 12 months of age (296 [82%] of 360 control participants, 332 [86%] of 388 SMS only participants, 383 [86%] of 446 SMS plus 75 KES participants, and 364 [90%] of 406 SMS plus 200 KES participants). Children in the SMS plus 200 KES group were significantly more likely to achieve full

Socioeconomic inequalities and vaccination coverage: results of an immunisation coverage survey in 27 Brazilian capitals, 2007–2008

PubMed Central

Sampaio de Almeida Ribeiro, Manoel Carlos; de Moraes, José Cássio; Flannery, Brendan

2012-01-01

Background Since 1988, Brazil's Unified Health System has sought to provide universal and equal access to immunisations. Inequalities in immunisation may be examined by contrasting vaccination coverage among children in the highest versus the lowest socioeconomic strata. The authors examined coverage with routine infant immunisations from a survey of Brazilian children according to socioeconomic stratum of residence census tract. Methods The authors conducted a household cluster survey in census tracts systematically selected from five socioeconomic strata, according to average household income and head of household education, in 26 Brazilian capitals and the federal district. The authors calculated coverage with recommended vaccinations among children until 18 months of age, according to socioeconomic quintile of residence census tract, and examined factors associated with incomplete vaccination. Results Among 17 295 children with immunisation cards, 14 538 (82.6%) had received all recommended vaccinations by 18 months of age. Among children residing in census tracts in the highest socioeconomic stratum, 77.2% were completely immunised by 18 months of age versus 81.2%–86.2% of children residing in the four census tract quintiles with lower socioeconomic indicators (p<0.01). Census tracts in the highest socioeconomic quintile had significantly lower coverage for bacille Calmette-Guérin, oral polio and hepatitis B vaccines than those with lower socioeconomic indicators. In multivariable analysis, higher birth order and residing in the highest socioeconomic quintile were associated with incomplete vaccination. After adjusting for interaction between socioeconomic strata of residence census tract and household wealth index, only birth order remained significant. Conclusions Evidence from Brazilian capitals shows success in achieving high immunisation coverage among poorer children. Strategies are needed to reach children in wealthier areas. PMID:22268129

Does frequent residential mobility in early years affect the uptake and timeliness of routine immunisations? An anonymised cohort study

PubMed Central

Hutchings, Hayley A.; Evans, Annette; Barnes, Peter; Healy, Melanie A.; James-Ellison, Michelle; Lyons, Ronan A.; Maddocks, Alison; Paranjothy, Shantini; Rodgers, Sarah E.; Dunstan, Frank

2016-01-01

Background There are conflicting findings regarding the impact of residential mobility on immunisation status. Our aim was to determine whether there was any association between residential mobility and take up of immunisations and whether they were delayed in administration. Methods We carried out a cohort analysis of children born in Wales, UK. Uptake and time of immunisation were collected electronically. We defined frequent movers as those who had moved: 2 or more times in the period prior to the final scheduled on-time date (4 months) for 5 in 1 vaccinations; and 3 or more times in the period prior to the final scheduled on-time date (12 months) for MMR, pneumococcal and meningitis C vaccinations. We defined immunisations due at 2–4 months delayed if they had not been given by age 1; and those due at 12–13 months as delayed if they had not been given by age 2. Results Uptake rates of routine immunisations and whether they were given within the specified timeframe were high for both groups. There was no increased risk (odds ratios (95% confidence intervals) between frequent movers compared to non-movers for the uptake of: primary MMR 1.08 (0.88–1.32); booster Meningitis C 1.65 (0.93–2.92); booster pneumococcal 1.60 (0.59–4.31); primary 5 in 1 1.28 (0.92–1.78); and timeliness: primary MMR 0.92 (0.79–1.07); booster Meningitis C 1.26 (0.77–2.07); booster pneumococcal 1.69 (0.23–12.14); and primary 5 in 1 1.04 (0.88–1.23). Discussion Findings suggest that children who move home frequently are not adversely affected in terms of the uptake of immunisations and whether they were given within a specified timeframe. Both were high and may reflect proactive behaviour in the primary healthcare setting to meet Government coverage rates for immunisation. PMID:26923454

Does frequent residential mobility in early years affect the uptake and timeliness of routine immunisations? An anonymised cohort study.

PubMed

Hutchings, Hayley A; Evans, Annette; Barnes, Peter; Healy, Melanie A; James-Ellison, Michelle; Lyons, Ronan A; Maddocks, Alison; Paranjothy, Shantini; Rodgers, Sarah E; Dunstan, Frank

2016-04-04

There are conflicting findings regarding the impact of residential mobility on immunisation status. Our aim was to determine whether there was any association between residential mobility and take up of immunisations and whether they were delayed in administration. We carried out a cohort analysis of children born in Wales, UK. Uptake and time of immunisation were collected electronically. We defined frequent movers as those who had moved: 2 or more times in the period prior to the final scheduled on-time date (4 months) for 5 in 1 vaccinations; and 3 or more times in the period prior to the final scheduled on-time date (12 months) for MMR, pneumococcal and meningitis C vaccinations. We defined immunisations due at 2-4 months delayed if they had not been given by age 1; and those due at 12-13 months as delayed if they had not been given by age 2. Uptake rates of routine immunisations and whether they were given within the specified timeframe were high for both groups. There was no increased risk (odds ratios (95% confidence intervals) between frequent movers compared to non-movers for the uptake of: primary MMR 1.08 (0.88-1.32); booster Meningitis C 1.65 (0.93-2.92); booster pneumococcal 1.60 (0.59-4.31); primary 5 in 1 1.28 (0.92-1.78); and timeliness: primary MMR 0.92 (0.79-1.07); booster Meningitis C 1.26 (0.77-2.07); booster pneumococcal 1.69 (0.23-12.14); and primary 5 in 1 1.04 (0.88-1.23). Findings suggest that children who move home frequently are not adversely affected in terms of the uptake of immunisations and whether they were given within a specified timeframe. Both were high and may reflect proactive behaviour in the primary healthcare setting to meet Government coverage rates for immunisation. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Inform or Not? An Exploratory Study of Motivations in Mothers for the Information Given to Their Toddlers before Immunisation

ERIC Educational Resources Information Center

Favez, Nicolas; Newman, Claire

2014-01-01

Toddlers experience stress and express distress during routine paediatric examinations with immunisation. Adjustment to this situation is important, as distress and pain are interrelated. A negative experience of immunisation of their child, moreover, is often mentioned by parents as a reason for refusing routine vaccinations. This paper focuses…

3 CFR 8485 - Proclamation 8485 of March 24, 2010. Greek Independence Day: A National Day of Celebration of...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Independence Day: A National Day of Celebration of Greek and American Democracy, 2010 8485 Proclamation 8485... National Day of Celebration of Greek and American Democracy, 2010By the President of the United States of... America's forebears to enshrine the pre-eminent idea of democracy in our Nation's founding documents...

Study of adverse events following immunisation with universal and newer vaccines in the Serampore IMA Child Clinic over a period of 7 years.

PubMed

Das, Pradip Kumar

2013-04-01

Immunisation is an important part of childcare practice. It is one of the most beneficial and cost effective measures for the prevention of diseases. From the previous retrospective studies, it was evident that smallpox has been completely eradicated throughout now-a-days with the wholehearted and sincere efforts of healthcare providers by applying efficient and safe vaccine against smallpox, same is true also to polio which is now close to worldwide eradication and measles and rubella are no longer endemic in certain parts of the world. Not only has that with the introduction of safer and more efficient newer vaccines, the incidence of most other vaccine preventable disease of childhood also reduced considerably. The aim of the present study is to estimate the incidence and clinical presentation of adverse events following immunisation with universal and newer vaccines for a period of seven years using prospective active surveillance. Children under the age of 7 years were taken for universal and newer scheduled vaccinations given in the Serampore IMA Child Clinic under the supervision of the clinicians maintaining strictly the guidelines of Expanded Programme of Immunisation (Government of India). This study of adverse events following immunisation in the Serampore IMA Child Clinic confirms that the adverse events such as fever (0.37%), pain and swelling at the site of injection (0.32%0, urticarial rash (0.02%), anaphylactic shock (0.003%) are negligible. There were only two reports of anaphylaxis following preschool and infant schedule vaccines, including measles, mumps and rubella (MMR), Haemophilus influenzae type B vaccines and typhoid vaccines in approximately 52,000 infants received over a period of 7 years starting from 1st April, 2005 to 31st March, 2012 and there were no deaths or longterm effects reported during the post follow-up period in the Serampore IMA Child Clinic.

78 FR 56807 - Patriot Day and National Day of Service and Remembrance, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-13

... Vol. 78 Friday, No. 178 September 13, 2013 Part III The President Proclamation 9015--Patriot Day and National Day of Service and Remembrance, 2013 #0; #0; #0; Presidential Documents #0; #0; #0;#0...;Title 3-- #0;The President [[Page 56809

Immunisation status and determinants of left-behind children aged 12-72 months in central China.

PubMed

Ni, Z L; Tan, X D; Shao, H Y; Wang, Y

2017-07-01

Many parents move from rural China to urban areas in search of job opportunities, and leave their children behind to be raised by relatives. We aimed to assess the immunisation coverage, including the 1:3:3:3:1 vaccine series (one dose of Bacilli Chalmette-Guérin vaccine; three doses of live attenuated oral poliomyelitis vaccine; three doses of diphtheria, tetanus and pertussis combined; three doses of hepatitis B vaccine; and one dose of measles-containing vaccine), in children aged 12-72 months and identify the determinants of immunisation uptake among left-behind children in Hubei Province, Central China, in 2014. In this cross-sectional study using the World Health Organization's cluster sampling technique, we surveyed 1368 children from 44 villages in 11 districts of Hubei Province. The socio-demographic and vaccination status data were collected by interviewing primary caregivers using a semi-structured questionnaire and reviewing the immunisation cards of the children. Univariate and multivariate analyses were used to identify the determinants of complete vaccination and age-appropriate vaccination. For each dose of the five vaccines, the vaccination coverage in the left-behind and non-left-behind children was >90%; however, the age-appropriate vaccination coverage for each vaccine was lower in left-behind than in non-left-behind children. For the five vaccines, the fully vaccinated rate of left-behind children were lower than those of non-left-behind children (89·1%, 92·7%; P = 0·013) and age-appropriate immunisation rate of left-behind children were lower than those of non-left-behind children (65·7%, 79·9%; P < 0·001). After controlling for potential confounders, we found that the parenting pattern, annual household income and attitude of the primary caregiver towards vaccination significantly influenced the vaccination status of children. Moreover, we noted a relatively high prevalence of delayed vaccination among left-behind children. Hence, we

National History Day 1997 Supplement: Triumph & Tragedy in History.

ERIC Educational Resources Information Center

Gorn, Cathy

1996-01-01

Reports on the procedures, standards, and topics involved in the 1997 National History Day. National History Day is a year-long contest where students research primary sources and prepare papers, projects, performances, and media based on a historical theme. The 1997 theme is "Triumph and Tragedy in History." (MJP)

Immunisation with recombinant proteins subolesin and Bm86 for the control of Dermanyssus gallinae in poultry.

PubMed

Harrington, David; Canales, Mario; de la Fuente, José; de Luna, Carlos; Robinson, Karen; Guy, Jonathan; Sparagano, Olivier

2009-06-19

Dermanyssus gallinae has a worldwide distribution and is considered to be the most serious and economically significant ectoparasite affecting egg-laying poultry in Europe. Recombinant Bm86 and subolesin proteins derived from Boophilus microplus ticks and Aedes albopictus mosquitoes were used to immunise poultry in an attempt to control D. gallinaein vitro. Immunisation with subolesin and Bm86 stimulated different profiles of IgY response, whilst Bm86 but not subolesin was recognized by IgY on western blots. Orthologues for Bm86 were not found in D. gallinae by PCR, but a 150 bp fragment aligned with mammalian akirin 1 and a 300 bp fragment aligned with Amblyomma hebraeum were amplified by subolesin PCR. D. gallinae mortality after feeding was 35.1% higher (P=0.009) in the Subolesin group and 23% higher (not significant) in the Bm86 compared to the Control group. Thus it can be concluded that immunisation with recombinant subolesin can stimulate a protective response in laying hens against D. gallinae.

76 FR 56943 - Patriot Day and National Day of Service and Remembrance, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... of life--from helping the homeless to teaching underserved students to bringing relief to disaster... loved, the lives they touched, and the courageous acts they inspired. On Patriot Day and National Day of... honor of the individuals who lost their lives on September 11, 2001. I invite the Governors of the...

Immunisation coverage and its determinants among children aged 12-23 months in Atakumosa-west district, Osun State Nigeria: a cross-sectional study.

PubMed

Adedire, Elizabeth B; Ajayi, Ikeoluwapo; Fawole, Olufunmilayo I; Ajumobi, Olufemi; Kasasa, Simon; Wasswa, Peter; Nguku, Patrick

2016-08-30

Routine immunisation (RI) contributes immensely to reduction in mortality from vaccine preventable diseases (VPD) among children. The Nigerian Demographic and Health Survey, 2008 revealed that only 58 % of children in Osun State had received all recommended vaccines, which is far below World Health Organization (WHO) target of 80 %. We therefore, assessed RI uptake and its determinants among children in Atakumosa-west district of Osun State. Atakumosa-west district has an estimated population of 90,525 inhabitants. We enrolled 750 mothers of children aged 12-23 months in this cross-sectional study. Semi-structured questionnaires were used to obtain data on socio-demographic characteristics, knowledge of mothers on RI, history of RI in children and factors associated with full RI uptake. A fully-immunised child was defined as a child who had received one dose of Bacillus-Calmette-Guerin, three doses of Oral-Polio-Vaccine, three doses of Diptheria-Pertusis-Tetanus vaccine and one dose of measles vaccine by 12 months of age. We tested for the association between immunisation uptake and its likely determinants using multivariable logistic regression at 0.05 level of significance and 95 % confidence Interval (CI). Mean ± (SD) age of the mothers and children were 27.9 ± 6.1 years and 17.2 ± 4.0 months, respectively. About 94 % (703/750) of mothers had received antenatal care (ANC) and 63.3 % (475) of the children possessed vaccination cards. Seventy-six percent (571/750) had good knowledge of RI and VPD. About 58 % (275/475) of children who possessed vaccination card were fully-immunised. Mothers antenatal care attendance (aOR = 3.3, 95 % CI = 1.1-8.3), maternal tetanus toxoid immunisation (aOR = 3.2, 95 % CI = 1.1-10.0) access to immunisation information (aOR = 1.8, 95 % CI = 1.1-2.5) and mothers having good knowledge of immunisation (aOR = 2.4, 95 % CI = 1.6-3.8) were significant determinants of full

3 CFR 8942 - Proclamation 8942 of March 22, 2013. Greek Independence Day: A National Day of Celebration of...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Proclamation 8942 of March 22, 2013. Greek Independence Day: A National Day of Celebration of Greek and American Democracy, 2013 8942 Proclamation 8942 Presidential Documents Proclamations Proclamation 8942 of March 22, 2013 Proc. 8942 Greek Independence Day: A National Day of Celebration of Greek an...

Equity in disease prevention: Vaccines for the older adults - a national workshop, Australia 2014.

PubMed

Raina MacIntyre, C; Menzies, Robert; Kpozehouen, Elizabeth; Chapman, Michael; Travaglia, Joanne; Woodward, Michael; Jackson Pulver, Lisa; Poulos, Christopher J; Gronow, David; Adair, Timothy

2016-11-04

On the 20th June, 2014 the National Health and Medical Research Council's Centre for Research Excellence in Population Health "Immunisation in under Studied and Special Risk Populations", in collaboration with the Public Health Association of Australia, hosted a workshop "Equity in disease prevention: vaccines for the older adults". The workshop featured international and national speakers on ageing and vaccinology. The workshop was attended by health service providers, stakeholders in immunisation, ageing, primary care, researchers, government and non-government organisations, community representatives, and advocacy groups. The aims of the workshop were to: provide an update on the latest evidence around immunisation for the older adults; address barriers for prevention of infection in the older adults; and identify immunisation needs of these groups and provide recommendations to inform policy. There is a gap in immunisation coverage of funded vaccines between adults and infants. The workshop reviewed provider misconceptions, lack of Randomised Control Trials (RCT) and cost-effectiveness data in the frail elderly, loss of autonomy, value judgements and ageism in health care and the need for an adult vaccination register. Workshop recommendations included recognising the right of elderly people to prevention, the need for promotion in the community and amongst healthcare workers of the high burden of vaccine preventable diseases and the need to achieve high levels of vaccination coverage, in older adults and in health workers involved in their care. Research into new vaccine strategies for older adults which address poor coverage, provider attitudes and immunosenescence is a priority. A well designed national register for tracking vaccinations in older adults is a vital and basic requirement for a successful adult immunisation program. Eliminating financial barriers, by addressing inequities in the mechanisms for funding and subsidising vaccines for the older

T-cell receptor BV gene usage in colorectal carcinoma patients immunised with recombinant Ep-CAM protein or anti-idiotypic antibody.

PubMed

Mosolits, Szilvia; Markovic, Katja; Fagerberg, Jan; Frödin, Jan-Erik; Rezvany, Mohammad-Reza; Kiaii, Shahryar; Mellstedt, Håkan; Jeddi-Tehrani, Mahmood

2005-06-01

The tumour-associated antigen, Ep-CAM, is over-expressed in colorectal carcinoma (CRC). In the present study, a recombinant Ep-CAM protein or a human anti-idiotypic antibody (anti-Id) mimicking Ep-CAM, either alone or in combination, was used for vaccination of CRC patients (n=9). GM-CSF was given as an adjuvant cytokine. A cellular immune response was assessed by measuring anti-Ep-CAM lymphoproliferation, IFN-gamma production (ELISPOT) and by analysing the TCR BV gene usage within the CD4+ and CD8+ T-cell subsets followed by CDR3 fragment analysis. A proliferative and/or IFN-gamma T-cell response was induced against the Ep-CAM protein in eight out of nine patients, and against Ep-CAM-derived peptides in nine out of nine patients. Analysis of the TCR BV gene usage showed a significantly higher usage of BV12 family in CD4+ T cells of patients both before and after immunisation than in those of healthy control donors (p<0.05). In the CD8+ T-cell subset, a significant (p<0.05) increase in the BV19 usage was noted in patients after immunisation. In individual patients, a number of TCR BV gene families in both CD4+ and CD8+ T cells were over-expressed mainly in post-immunisation samples. Analysis of the CDR3 length polymorphism revealed a higher degree of clonality in post-immunisation samples than in pre-immunisation samples. In vitro stimulation with Ep-CAM protein confirmed the expansion of anti-Ep-CAM T-cell clones. The results indicate that immunisation with the Ep-CAM protein and/or anti-Id entails the induction of an anti-Ep-CAM T-cell response in CRC patients, and suggest that BV19+ CD8+ T cells might be involved in a vaccine-induced immune response.

[Parental attitudes towards childhood immunisations in Poland].

PubMed

Rogalska, Justyna; Augustynowicz, Ewa; Gzyl, Anna; Stefanoff, Paweł

2010-01-01

The aim of the study was to obtain information on parents' attitudes towards vaccinations included in the childhood immunisation schedule. Computer-assisted telephone interviews (CATI) method was used. The interviews were collected from parents who had children aged three years old. Two-stage sampling was used: firstly, a list of 3,000 households with children < 3 years old was quota-selected from a consumer database collecting contact information from 95% mothers during deliveries. Random digit dialling was used to attempt the interview with parents. The 40-item questionnaire was based on the questionnaire developed by UK Department of Health. Overall, the perception of routine, mandatory immunization of children was positive. Only 17 parents (1.6%) refused the vaccination which had been offered, and 398 parents (38.0%) paid for a vaccine recommended for their child. In general, parents believed that immunisations were important for protecting the society against infectious diseases, although they found some problems in the way vaccines were delivered. Approximately half of respondents thought that vaccination against many diseases was harmful. In terms of perception of the risk related to vaccines parents were less confident in the currently introduced vaccines and those which protect against diseases rarely seen in the population. Pneumococcal vaccine was considered as risky by 27 persons (2.6%), and polio vaccine by 17 (1.6%). Greater concern about the safety of vaccines was expressed by older parents, residents of towns and highly educated individuals. Systematic monitoring of parents' attitudes towards vaccination would help to address public health actions more adequately.

Needles, Jabs and Jags: a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma.

PubMed

Jackson, Cath; Bedford, Helen; Cheater, Francine M; Condon, Louise; Emslie, Carol; Ireland, Lana; Kemsley, Philippa; Kerr, Susan; Lewis, Helen J; Mytton, Julie; Overend, Karen; Redsell, Sarah; Richardson, Zoe; Shepherd, Christine; Smith, Lesley; Dyson, Lisa

2017-03-14

Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services including immunisation. To improve immunisation rates, it is necessary to understand what helps and hinders individuals in these communities in taking up immunisations. This study had two aims. 1. Investigate the views of Travellers in the UK on the barriers and facilitators to acceptability and uptake of immunisations and explore their ideas for improving immunisation uptake; 2. Examine whether and how these responses vary across and within communities, and for different vaccines (childhood and adult). This was a qualitative, cross-sectional interview study informed by the Social Ecological Model. Semi-structured interviews were conducted with 174 Travellers from six communities: Romanian Roma, English Gypsy/Irish Travellers (Bristol), English Gypsy (York), Romanian/Slovakian Roma, Scottish Show people (Glasgow) and Irish Traveller (London). The focus was childhood and selected adult vaccines. Data were analysed using the Framework approach. Common accounts of barriers and facilitators were identified across all six Traveller communities, similar to those documented for the general population. All Roma communities experienced additional barriers of language and being in a new country. Men and women described similar barriers and facilitators although women spoke more of discrimination and low literacy. There was broad acceptance of childhood and adult immunisation across and within communities, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough and described barriers to booking and attending immunisation. Cultural concerns about antenatal vaccines and HPV vaccination were most evident in the Bristol English Gypsy/Irish Traveller community. Language, literacy, discrimination, poor school attendance, poverty and housing were

77 FR 18897 - Greek Independence Day: A National Day of Celebration of Greek and American Democracy, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... Independence Day: A National Day of Celebration of Greek and American Democracy, 2012 By the President of the United States of America A Proclamation Two hundred and thirty-six years ago, a new American Nation was... ancient Hellas, where Greeks brought forth the world's first democracy and kindled a philosophical...

National History Day in Arizona 2003 Theme Supplement: Rights and Responsibilities.

ERIC Educational Resources Information Center

Goen, Wendi, Comp.; Devine, Laurie, Comp.

Arizona's archives, libraries, and museums contain a wealth of source material that can be applied to local, regional, and national topics pertaining to the 2003 National History Day theme, rights and responsibilities. Repositories from around the state share ideas and resources that are available to National History Day students. So that…

76 FR 25531 - National Day of Prayer, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

... history, Americans have turned to prayer for strength, inspiration, and solidarity. Prayer has played an..., from the earliest years of our country's history, Congress and Presidents have set aside days to recognize the role prayer has played in so many definitive moments in our history. On this National Day of...

Costs of introducing pneumococcal, rotavirus and a second dose of measles vaccine into the Zambian immunisation programme: Are expansions sustainable?

PubMed

Griffiths, Ulla Kou; Bozzani, Fiammetta Maria; Chansa, Collins; Kinghorn, Anthony; Kalesha-Masumbu, Penelope; Rudd, Cheryl; Chilengi, Roma; Brenzel, Logan; Schutte, Carl

2016-07-29

Introduction of new vaccines in low- and lower middle-income countries has accelerated since Gavi, the Vaccine Alliance was established in 2000. This study sought to (i) estimate the costs of introducing pneumococcal conjugate vaccine, rotavirus vaccine and a second dose of measles vaccine in Zambia; and (ii) assess affordability of the new vaccines in relation to Gavi's co-financing and eligibility policies. Data on 'one-time' costs of cold storage expansions, training and social mobilisation were collected from the government and development partners. A detailed economic cost study of routine immunisation based on a representative sample of 51 health facilities provided information on labour and vaccine transport costs. Gavi co-financing payments and immunisation programme costs were projected until 2022 when Zambia is expected to transition from Gavi support. The ability of Zambia to self-finance both new and traditional vaccines was assessed by comparing these with projected government health expenditures. 'One-time' costs of introducing the three vaccines amounted to US$ 0.28 per capita. The new vaccines increased annual immunisation programme costs by 38%, resulting in economic cost per fully immunised child of US$ 102. Co-financing payments on average increased by 10% during 2008-2017, but must increase 49% annually between 2017 and 2022. In 2014, the government spent approximately 6% of its health expenditures on immunisation. Assuming no real budget increases, immunisation would account for around 10% in 2022. Vaccines represented 1% of government, non-personnel expenditures for health in 2014, and would be 6% in 2022, assuming no real budget increases. While the introduction of new vaccines is justified by expected positive health impacts, long-term affordability will be challenging in light of the current economic climate in Zambia. The government needs to both allocate more resources to the health sector and seek efficiency gains within service

77 FR 56745 - Patriot Day and National Day of Service and Remembrance, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... helped our Nation rebuild and recover long after the dust had settled, donating and volunteering and... compassion by serving their communities in the days and weeks ahead. From volunteering with a faith-based...

Determinants of immunisation coverage of children aged 12-59 months in Indonesia: a cross-sectional study.

PubMed

Herliana, Putri; Douiri, Abdel

2017-12-22

Despite the adoption of WHO's Expanded Programme on Immunisation in Indonesia since 1977, a large proportion of children are still completely unimmunised or only partly immunised. This study aimed to assess factors associated with low immunisation coverage of children in Indonesia. Children aged 12-59 months in Indonesia. The socioeconomic characteristics and immunisation status of the children were obtained from the most recent Demographic and Health Survey, the 2012 Indonesia Demographic and Health Survey. Participants were randomly selected through a two-stage stratified sampling design. Data from 14 401 children aged 12-59 months nested within 1832 census blocks were included in the analysis. Multilevel logistic regression models were constructed to account for hierarchical structure of the data. The mean age of the children was 30 months and they were equally divided by sex. According to the analysis, 32% of the children were fully immunised in 2012. Coverage was significantly lower among children who lived in Maluku and Papua region (adjusted OR: 1.94; 95% CI 1.42 to 2.64), were 36-47 months old (1.39; 1.20 to 1.60), had higher birth order (1.68; 1.28 to 2.19), had greater family size (1.47; 1.11 to 1.93), whose mother had no education (2.13; 1.22 to 3.72) and from the poorest households (1.58; 1.26 to 1.99). The likelihood of being unimmunised was also higher among children without health insurance (1.16; 1.04 to 1.30) and those who received no antenatal (3.28; 2.09 to 5.15) and postnatal care (1.50; 1.34 to 1.69). Socioeconomic factors were strongly associated with the likelihood of being unimmunised in Indonesia. Unimmunised children were geographically clustered and lived among the most deprived population. To achieve WHO target of protective coverage, public health interventions must be designed to meet the needs of these high-risk groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

Immunising with the transmembrane envelope proteins of different retroviruses including HIV-1

PubMed Central

Denner, Joachim

2013-01-01

The induction of neutralizing antibodies is a promising way to prevent retrovirus infections. Neutralizing antibodies are mainly directed against the envelope proteins, which consist of two molecules, the surface envelope (SU) protein and the transmembrane envelope (TM) protein. Antibodies broadly neutralizing the human immunodeficiencvy virus-1 (HIV-1) and binding to the TM protein gp41 of the virus have been isolated from infected individuals. Their epitopes are located in the membrane proximal external region (MPER). Since there are difficulties to induce such neutralizing antibodies as basis for an effective AIDS vaccine, we performed a comparative analysis immunising with the TM proteins of different viruses from the family Retroviridae. Both subfamilies, the Orthoretrovirinae and the Spumaretrovirinae were included. In this study, the TM proteins of three gammaretroviruses including (1) the porcine endogenous retrovirus (PERV), (2) the Koala retrovirus (KoRV), (3) the feline leukemia virus (FeLV), of two lentiviruses, HIV-1, HIV-2, and of two spumaviruses, the feline foamy virus (FFV) and the primate foamy virus (PFV) were used for immunisation. Whereas in all immunisation studies binding antibodies were induced, neutralizing antibodies were only found in the case of the gammaretroviruses. The induced antibodies were directed against the MPER and the fusion peptide proximal region (FPPR) of their TM proteins; however only the antibodies against the MPER were neutralizing. Most importantly, the epitopes in the MPER were localized in the same position as the epitopes of the antibodies broadly neutralizing HIV-1 in the TM protein gp41 of HIV-1, indicating that the MPER is an effective target for the neutralization of retroviruses. PMID:23249763

NREL Celebrates National Hydrogen and Fuel Cell Day October 8 | News | NREL

Science.gov Websites

Celebrates National Hydrogen and Fuel Cell Day October 8 NREL Celebrates National Hydrogen and Fuel Cell Day October 8 October 6, 2017 This week the U.S. Department of Energy's (DOE's) National Renewable and Fuel Cell Day on Oct. 8-10.08-a date chosen to represent the atomic weight of hydrogen (1.008

Effect of priming/booster immunisation protocols on immune response to canine parvovirus peptide induced by vaccination with a chimaeric plant virus construct.

PubMed

Nicholas, B L; Brennan, F R; Hamilton, W D O; Wakelin, D

2003-06-02

Expression of a 17-mer peptide sequence from canine parvovirus expressed on cowpea mosaic virus (CPMV) to form chimaeric virus particles (CVPs) creates vaccine antigens that elicit strong anti-peptide immune responses in mice. Systemic (subcutaneous, s.c.) immunisation and boosting with such CVP constructs produces IgG(2a) serum antibody responses, while mucosal (intranasal, i.n.) immunisation and boosting elicits intestinal IgA responses. Combinations of systemic and mucosal routes for priming and boosting immunisations were used to examine their influence on the level, type and location of immune response generated to one of these constructs (CVP-1). In all cases, s.c. administration, whether for immunisation or boosting, generated a Th1-biased response, reflected in a predominantly IgG(2a) serum antibody isotype and secretion of IFN-gamma from in vitro-stimulated lymphocytes. Serum antibody responses were greatest in animals primed and boosted subcutaneously, and least in mucosally vaccinated mice. The i.n. exposure also led to IFN-gamma release from in vitro-stimulated cells, but serum IgG(2a) was significantly elevated only in mice primed intranasally and boosted subcutaneously. Peptide- and wild-type CPMV-specific IgA responses in gut lavage fluid were greatest in animals exposed mucosally and least in those primed and boosted subcutaneously or primed subcutaneously and boosted orally. Lymphocytes from immunised mice proliferated in response to in vitro stimulation with CPMV but not with peptide. The predominant secretion of IFN-gamma from all immunising/boosting combinations indicates that the route of vaccination and challenge does not alter the Th1 bias of the response to CVP constructs. However, optimal serum and intestinal antibody responses were achieved by combining s.c. and i.n. administration.

No long-term evidence of hyporesponsiveness following the use of pneumococcal conjugate vaccine in children previously immunised with pneumococcal polysaccharide vaccine

PubMed Central

Licciardi, Paul V; Toh, Zheng Quan; Clutterbuck, Elizabeth A; Balloch, Anne; Marimla, Rachel A; Tikkanen, Leena; Lamb, Karen E; Bright, Kathryn J; Rabuatoka, Uraia; Tikoduadua, Lisi; Boelsen, Laura K; Dunne, Eileen M; Satzke, Catherine; Cheung, Yin Bun; Pollard, Andrew J; Russell, Fiona M; Mulholland, Edward K

2016-01-01

Background A randomised controlled trial in Fiji examined the immunogenicity and impact on nasopharyngeal carriage following 0, 1, 2 or 3 doses of pneumococcal conjugate vaccine (PCV7) in infancy followed by 23-valent pneumococcal polysaccharide (23vPPV) vaccine at 12 months of age. At 18 months of age, children given 23vPPV exhibited immune hyporesponsiveness to a micro-23vPPV (20%) challenge dose in terms of serotype-specific IgG and opsonophagocytosis, while 23vPPV had no impact on vaccine-type carriage. Objective This follow-up study examined the long-term impact of the 12-month 23vPPV dose by evaluating the immune response to PCV13 administration 4-5 years later. Methods Blood samples from 194 children (now 5-7 years old) were taken before and 28-days after PCV13 booster immunisation. Nasopharyngeal swabs were taken before PCV13 immunisation. We measured serotype-specific IgG to all 13 vaccine serotypes, opsonophagocytosis (OPA) for 8 vaccine serotypes and memory B-cell responses for 18 serotypes pre- and post-PCV13 immunisation. Results Paired samples were obtained from 185 children. There were no significant differences in the serotype-specific IgG, OPA or memory B-cell response at either time-point between children who did or did not receive 23vPPV at 12 months of age. Nasopharyngeal carriage of PCV7 and 23vPPV serotypes were similar among the groups. Priming with 1, 2 or 3 PCV7 doses during infancy did not impact on serotype-specific immunity or carriage. Conclusion Immune hyporesponsiveness induced by 23vPPV in toddlers does not appear to be sustained among preschool children in this context and does not affect the pneumococcal carriage rate in this age group. PMID:26825000

Family Day Care in the United States: Family Day Care Systems. Final Report of the National Day Care Home Study. Volume 5.

ERIC Educational Resources Information Center

Grasso, Janet; Fosburg, Steven

Fifth in a series of seven volumes reporting the design, methodology, and findings of the 4-year National Day Care Home Study (NDCHS), this volume presents a descriptive and statistical analysis of the day care institutions that administer day care systems. These systems, such as Learning Unlimited in Los Angeles and the family day care program of…

Non-invasive, epicutaneous immunisation with toxoid in deformable vesicles protects mice against tetanus, chiefly owing to a Th2 response.

PubMed

Chopra, Amla; Cevc, Gregor

2014-06-02

A non-invasive, intra/transcutaneous immunisation of mice with a suitable combination of tetanus toxoid, ultradeformable vesicle (Transfersome®) carrier, and monophosphoryl lipid A adjuvant targets immuno-competent cells in a body and can protect 100% of the tested mice against an otherwise lethal (50×LD50) parenteral tetanus toxin challenge. The late immune response to the epicutaneously applied tetanus toxoid in such vesicles consists chiefly of circulating IgG1 and IgG2b antibody isotypes, indicative of a specific Th2 cellular response bias. Immunisations by subcutaneous injections moreover protect 100% of mice against a similar, otherwise lethal, dose of tetanus toxin. However, the immune response to transcutaneous and invasive immunisation differs. The latter elicits mainly IgG1 and IgG2b as well as IgG2a antibody isotypes, indicative of a mixed Th1/Th2 response. The cytokine response of the intra/transcutaneously and subcutaneously immunised mice reflects the difference in the organ-specific manner. IFN-γ concentration is appreciably increased in the draining lymph nodes and IL-10 in spleen. Since tetanus is a neutral antigen, both the Th1-specific IFN-γ and the Th-2 specific-IL-10 are observable. Copyright © 2014 Elsevier B.V. All rights reserved.

Electronic and postal reminders for improving immunisation coverage in children: protocol for a systematic review and meta-analysis.

PubMed

Chachou, Martel J; Mukinda, Fidele K; Motaze, Villyen; Wiysonge, Charles S

2015-10-15

Worldwide, suboptimal immunisation coverage causes the deaths of more than one million children under five from vaccine-preventable diseases every year. Reasons for suboptimal coverage are multifactorial, and a combination of interventions is needed to improve compliance with immunisation schedules. One intervention relies on reminders, where the health system prompts caregivers to attend immunisation appointments on time or re-engages caregivers who have defaulted on scheduled appointments. We undertake this systematic review to investigate the potential of reminders using emails, phone calls, social media, letters or postcards to improve immunisation coverage in children under five. We will search for published and unpublished randomised controlled trials and non-randomised controlled trials in PubMed, Scopus, CINAHL, CENTRAL, Science Citation Index, WHOLIS, Clinicaltrials.gov and the WHO International Clinical Trials Platform. We will conduct screening of search results, study selection, data extraction and risk-of-bias assessment in duplicate, resolving disagreements by consensus. In addition, we will pool data from clinically homogeneous studies using random-effects meta-analysis; assess heterogeneity of effects using the χ(2) test of homogeneity; and quantify any observed heterogeneity using the I(2) statistic. This protocol does not need approval by an ethics committee because we will use publicly available data, without directly involving human participants. The results will provide updated evidence on the effects of electronic and postal reminders on immunisation coverage, and we will discuss the applicability of the findings to low and middle-income countries. We plan to disseminate review findings through publication in a peer-reviewed journal and presentation at relevant conferences. In addition, we will prepare a policymaker-friendly summary using a validated format (eg, SUPPORT Summary) and disseminate this through social media and email discussion

Community engagement and integrated health and polio immunisation campaigns in conflict-affected areas of Pakistan: a cluster randomised controlled trial.

PubMed

Habib, Muhammad Atif; Soofi, Sajid; Cousens, Simon; Anwar, Saeed; Haque, Najib Ul; Ahmed, Imran; Ali, Noshad; Tahir, Rehman; Bhutta, Zulfiqar A

2017-06-01

Pakistan faces huge challenges in eradicating polio due to widespread poliovirus transmission and security challenges. Innovative interventions are urgently needed to strengthen community buy-in, to increase the coverage of oral polio vaccine (OPV) and other routine immunisations, and to enhance immunity through the introduction of inactivated polio vaccine (IPV) in combination with OPV. We aimed to evaluate the acceptability and effect on immunisation coverage of an integrated strategy for community engagement and maternal and child health immunisation campaigns in insecure and conflict-affected polio-endemic districts of Pakistan. We did a community-based three-arm cluster randomised trial in healthy children aged 1 month to 5 years that resided within the study sites in three districts of Pakistan at high risk of polio. Clusters were randomly assigned by a computer algorithm using restricted randomisation in blocks of 20 by an external statistician (1:1:1) to receive routine polio programme activities (control, arm A), additional interventions with community outreach and mobilisation using an enhanced communication package and provision of short-term preventive maternal and child health services and routine immunisation (health camps), including OPV (arm B), or all interventions of arm B with additional provision of IPV delivered at the maternal and child health camps (arm C). An independent team conducted surveys at baseline, endline, and after each round of supplementary immunisation activity for acceptability and effect. The primary outcome measures for the study were coverage of OPV, IPV, and routine extended programme on immunisation vaccines and changes in the proportion of unvaccinated and fully vaccinated children. This trial is registered with ClinicalTrials.gov, number NCT01908114. Between June 4, 2013, and May 31, 2014, 387 clusters were randomised (131 to arm A, 127 to arm B, and 129 to arm C). At baseline, 28 760 children younger than 5 years were

Research Results of the National Day Care Study. Final Report of the National Day Care Study. Volume II.

ERIC Educational Resources Information Center

Travers, Jeffrey; And Others

This final report of the National Day Care Study (NDCS), Volume II, provides researchers, social scientists and lay readers with information for judging the soundness of the evidence underlying NDCS conclusions about relationships between regulatable center characteristics and the outcome of care for the child. Thus, Volume II makes free use of…

76 FR 20833 - National Former Prisoner of War Recognition Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... Former Prisoner of War Recognition Day, 2011 By the President of the United States of America A... hour of need. On National Former Prisoner of War Recognition Day, a grateful Nation acknowledges a debt... burden silently measured in sleepless nights and missed birthdays. America cherishes those veterans who...

Political epidemiology: strengthening socio-political analysis for mass immunisation - lessons from the smallpox and polio programmes.

PubMed

Taylor, S

2009-01-01

Control and reduction of infectious diseases is a key to attaining the Millennium Development Goals. An important element of this work is the successful immunisation, especially in resource-poor countries. Mass immunisation, most intensively in the case of eradication, depends on a combination of reliable demand (e.g. public willingness to comply with the vaccine protocol) and effective supply (e.g. robust, generally state-led, vaccine delivery). This balance of compliance and enforceability is, quintessentially, socio-political in nature - conditioned by popular perceptions of disease and risk, wider conditions of economic development and poverty, technical aspects of vaccine delivery, and the prevailing international norms regarding power relations between states and peoples. In the past 100 years, three out of six disease eradication programmes have failed. The explanations for failure have focused on biotechnical and managerial or financial issues. Less attention is paid to socio-political aspects. Yet socio-political explanations are key. Eradication is neither inherently prone to failure, nor necessarily doomed in the case of polio. However, eradication, and similar mass immunisation initiatives, which fail to address social and political realities of intervention may be. A comparison of the smallpox and polio eradication programmes illustrates the importance of disease-specific socio-political analysis in programme conceptualisation, design, and management.

Integrated package approach in delivering interventions during immunisation campaigns in a complex environment in Papua New Guinea: a case study.

PubMed

Vince, John David; Datta, Siddhartha Sankar; Toikilik, Steven; Lagani, William

2014-08-06

Papua New Guinea's difficult and varied topography, poor transport infrastructure, changing dynamics of population and economy in recent times and understaffed and poorly financed health service present major challenges for successful delivery of vaccination and other preventative health interventions to both the rural majority and urban populations, thereby posing risks for vaccine preventable disease outbreaks in the country. The country has struggled to meet the vaccination coverage targets required for the eradication of poliomyelitis and elimination of measles. Escalation of inter and intra country migration resulting from major industrial developments, particularly in extraction industries, has substantially increased the risk of infectious disease importation. This case study documents the evolution of immunisation programmes since the introduction of supplementary immunisation activities (SIAs). Single antigen SIAs have advantages and disadvantages. In situations in which the delivery of preventative health interventions is difficult, it is likely that the cost benefit is greater for multiple than for single intervention. The lessons learned from the conduct of single antigen SIAs can be effectively used for programmes delivering multiple SIA antigens, routine immunisations, and other health interventions. This paper describes a successful and cost effective multiple intervention programme in Papua New Guinea. The review of the last SIA in Papua New Guinea showed relatively high coverage of all the interventions and demonstrated the operational feasibility of delivering multiple interventions in resource constrained settings. Studies in other developing countries such as Lesotho and Ethiopia have also successfully integrated health interventions with SIA. In settings such as Papua New Guinea there is a strong case for integrating supplementary immunisation activity with routine immunisation and other health interventions through a comprehensive outreach

Revolution, Reaction, Reform in History. National History Day 2002.

ERIC Educational Resources Information Center

Hardy, Beatriz, Ed.; Gorn, Cathy, Ed.

National History Day, a year-long educational program, fosters academic achievement and intellectual growth. In addition to acquiring historical knowledge and perspective while developing entries and competing in a series of district, state, and national contests, students develop critical thinking and problem-solving skills that help them manage…

Complementary medicine and childhood immunisation: A critical review.

PubMed

Wardle, Jon; Frawley, Jane; Steel, Amie; Sullivan, Elizabeth

2016-08-31

Vaccination is one of the most significant and successful public health measures of recent times. Whilst the use of complementary medicine (CM) continues to grow, it has been suggested that CM practitioners hold anti-vaccination views. The objective of this critical review is to examine the evidence base in relation to CM practitioner attitudes to childhood vaccination alongside attitudes to vaccination among parents who visit CM practitioners and/or use CM products. A database search was conducted in MEDLINE, PubMed, CINAHL, EMBASE and AMED for research articles published between January 2000 and September 2015 that evaluated either CM practitioner or CM user attitudes and intention towards childhood vaccination. A total of 23 articles were found that detailed the attitudes of CM practitioners to vaccination. A further 16 papers examined the association between the use of CM products and visits to CM practitioners, and immunisation. The interface between CM and vaccination is complex, multi-factorial and often highly individualised. The articles suggest that there is no default position on immunisation by CM practitioners or parents who use CM themselves, or for their children. Although CM use does seem positively associated with lower vaccination uptake, this may be confounded by other factors associated with CM use (such as higher income, higher education or distrust of the medical system), and may not necessarily indicate independent or predictive relationships. Although anti-vaccination sentiment is significant amongst some CM practitioners, this review uncovers a more nuanced picture, and one that may be more agreeable to public health values than formerly assumed. Copyright © 2016 Elsevier Ltd. All rights reserved.

National Vaccine Policy: ethical equity issues.

PubMed

Jayakrishnan, T

2013-01-01

The ministry of health and family welfare published the national vaccination policy in April 2011. The policy document drew severe criticism from several public health experts. A review of the print and web-based literature on the national vaccine policy was done and the issues of ethics and equity involved in introducing new vaccines under the Universal Immunisation Programme (UIP) were studied. The average coverage of the UIP vaccines at the national level is below 50%. Despite this, the policy document did not state any concrete strategy for increasing the coverage. The main stumbling block for evidence-based vaccine policy in India is the lack of reliable epidemiological data, which makes it difficult for the National Technical Advisory Group on Immunisation to offer sound technical advice to the government. No attempts have been made to prioritise diseases or the selection of vaccines. The policy suggests the introduction of the following vaccines in the UIP: Haemophilus influenzae type b, pneumococcal vaccine, rotavirus vaccines and human papillomavirus (HPV). This selection is on the grounds of the vaccines' availability, not on the basis of epidemiological evidence or proven cost-effectiveness. This is a critical review of the current vaccination policy and the move to include the rotavirus and HPV vaccines in the UIP.

Immunisation against East Coast fever by the infection and treatment method: evaluation of the use of ice baths for field delivery and appraisal of an acid formulation of long-acting tetracycline.

PubMed

Marcotty, T; Billiouw, M; Chaka, G; Berkvens, D; Losson, B; Brandt, J

2001-08-20

Immunisation by the infection and treatment method using the Katete strain is currently the most efficient prophylactic technique to control East Coast fever (ECF) in the endemic areas of the Eastern Province of Zambia. The maintenance of the cold chain in liquid nitrogen up to the time of inoculation and the cost of the reference long-acting oxytetracycline (Terramycin LA, Pfizer) are the main drawbacks of the method. The work presented in this paper aims at reducing the cost of immunisation against ECF by using an ice bath for the field delivery and a cheaper long-acting oxytetracycline formulation as chemotherapeutic agent. In experimental conditions, the results from 40 calves immunised after various periods of storage on ice ranging from 4 to 32 h indicate that deferred immunisation performed with a stabilate kept on ice for up to 6h after thawing has an efficiency of 90%. Moreover, sporozoites kept on ice were still surviving 32 h after thawing. In a field trial, 91 calves were inoculated with a stabilate kept for 3.5-5.5 h after thawing and dilution whereas 86 calves were immunised using the standard method. Clinical and parasitological reactions to immunisation were monitored as well as the seroconversion. In the field trial, the deferred immunisation was more efficient than the standard method. The acid formulation of oxytetracycline that was tested was found as suitable as the reference alkaline formulation for the chemotherapeutic control of the Katete strain in ECF immunisation. One indoor trial was carried out on 10 animals and a field trial involved 93 calves.

The International Finance Facility for Immunisation: stakeholders' perspectives.

PubMed

Crocker-Buque, Tim; Mounier-Jack, Sandra

2016-09-01

To evaluate stakeholders' understanding and opinions of the International Finance Facility for Immunisation (IFFIm); to identify factors affecting funding levels; and to explore the future use of IFFIm. Between July and September 2015, we interviewed 33 individuals from 25 organizations identified as stakeholders in IFFIm. In total 22.5 hours of semi-structured interviews were recorded, transcribed and analysed using a framework method. Stakeholders' understanding of IFFIm's financing mechanism and its outcomes varied and many stakeholders wanted more information. Participants highlighted that the change in the macro-economic environment following the 2008 financial crisis affected national policy in donor countries and subsequently the number of new commitments IFFIm received. Since Gavi is now seen as a successful and mature organization, participants stated that donors prefer to donate directly to Gavi. The pharmaceutical industry valued IFFIm for providing funding stability and flexibility. Other stakeholders valued IFFIm's ability to access funds early and enable Gavi to increase vaccine coverage. Overall, stakeholders thought IFFIm was successful, but they had divergent views about IFFIm's on-going role. Participants listed two issues where bond financing mechanisms may be suitable: emergency preparedness and outcome-based time-limited interventions. The benefit of pledging funds through IFFIm needs to be re-evaluated. There are potential uses for bond financing to raise funds for other global health issues, but these must be carefully considered against criteria to establish effectiveness, with quantifiable pre-defined outcome indicators to evaluate performance.

Different routes and doses influence protection in pigs immunised with the naturally attenuated African swine fever virus isolate OURT88/3.

PubMed

Sánchez-Cordón, Pedro J; Chapman, Dave; Jabbar, Tamara; Reis, Ana L; Goatley, Lynnette; Netherton, Christopher L; Taylor, Geraldine; Montoya, Maria; Dixon, Linda

2017-02-01

This study compares different combinations of doses and routes of immunisation of pigs with low virulent African swine fever virus (ASFV) genotype I isolate OURT88/3, including the intramuscular and intranasal route, the latter not previously tested. Intranasal immunisations with low and moderate doses (10 3 and 10 4 TCID 50 ) of OURT88/3 provided complete protection (100%) against challenge with virulent genotype I OURT88/1 isolate. Only mild and transient clinical reactions were observed in protected pigs. Transient moderate virus genome levels were detected in blood samples after challenge that decreased, but persisted until the end of the experiment in some animals. In contrast, pigs immunised intramuscularly with low and moderate doses (10 3 and 10 4 TCID 50 ) displayed lower percentages of protection (50-66%), and low or undetectable levels of virus genome were detected in blood samples throughout the study. In addition, clinical courses observed in protected pigs were asymptomatic. In pigs that were not protected and developed acute ASF, an exacerbated increase of IL-10 sometimes accompanied by an increase of IFNγ was observed before euthanasia. These results showed that factors including delivery route and dose determine the outcome of immunisation with the naturally attenuated isolate OURT88/3. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

The need for sustainability and alignment of future support for National Immunization Technical Advisory Groups (NITAGs) in low and middle-income countries.

PubMed

Howard, Natasha; Bell, Sadie; Walls, Helen; Blanchard, Laurence; Brenzel, Logan; Jit, Mark; Mounier-Jack, Sandra

2018-02-22

National Immunisation Technical Advisory Groups (NITAGs) provide independent guidance to health ministries to support evidence-based and nationally relevant immunisation decisions. We examined NITAGs' value, sustainability, and need for support in low and middle-income countries, drawing from a mixed-methods study including 130 global and national-level key informant interviews. NITAGs were particularly valued for providing independent and nationally owned evidence-based decision-making (EBDM), but needed to be integrated within national processes to effectively balance independence and influence. Participants agreed that most NITAGs, being relatively new, would need developmental and strengthening support for at least a decade. While national governments could support NITAG functioning, external support is likely needed for requisite capacity building. This might come from Gavi mechanisms and WHO, but would require alignment among stakeholders to be effective.

Induction of humoural and cellular immunity by immunisation with HCV particle vaccine in a non-human primate model.

PubMed

Yokokawa, Hiroshi; Higashino, Atsunori; Suzuki, Saori; Moriyama, Masaki; Nakamura, Noriko; Suzuki, Tomohiko; Suzuki, Ryosuke; Ishii, Koji; Kobiyama, Kouji; Ishii, Ken J; Wakita, Takaji; Akari, Hirofumi; Kato, Takanobu

2018-02-01

Although HCV is a major cause of chronic liver disease worldwide, there is currently no prophylactic vaccine for this virus. Thus, the development of an HCV vaccine that can induce both humoural and cellular immunity is urgently needed. To create an effective HCV vaccine, we evaluated neutralising antibody induction and cellular immune responses following the immunisation of a non-human primate model with cell culture-generated HCV (HCVcc). To accomplish this, 10 common marmosets were immunised with purified, inactivated HCVcc in combination with two different adjuvants: the classically used aluminum hydroxide (Alum) and the recently established adjuvant: CpG oligodeoxynucleotide (ODN) wrapped by schizophyllan (K3-SPG). The coadministration of HCVcc with K3-SPG efficiently induced immune responses against HCV, as demonstrated by the production of antibodies with specific neutralising activity against chimaeric HCVcc with structural proteins from multiple HCV genotypes (1a, 1b, 2a and 3a). The induction of cellular immunity was also demonstrated by the production of interferon-γ mRNA in spleen cells following stimulation with the HCV core protein. These changes were not observed following immunisation with HCVcc/Alum preparation. No vaccination-related abnormalities were detected in any of the immunised animals. The current preclinical study demonstrated that a vaccine included both HCVcc and K3-SPG induced humoural and cellular immunity in marmosets. Vaccination with this combination resulted in the production of antibodies exhibiting cross-neutralising activity against multiple HCV genotypes. Based on these findings, the vaccine created in this study represents a promising, potent and safe prophylactic option against HCV. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Assessing vaccination coverage in infants, survey studies versus the Flemish immunisation register: achieving the best of both worlds.

PubMed

Braeckman, Tessa; Lernout, Tinne; Top, Geert; Paeps, Annick; Roelants, Mathieu; Hoppenbrouwers, Karel; Van Damme, Pierre; Theeten, Heidi

2014-01-09

Infant immunisation coverage in Flanders, Belgium, is monitored through repeated coverage surveys. With the increased use of Vaccinnet, the web-based ordering system for vaccines in Flanders set up in 2004 and linked to an immunisation register, this database could become an alternative to quickly estimate vaccination coverage. To evaluate its current accuracy, coverage estimates generated from Vaccinnet alone were compared with estimates from the most recent survey (2012) that combined interview data with data from Vaccinnet and medical files. Coverage rates from registrations in Vaccinnet were systematically lower than the corresponding estimates obtained through the survey (mean difference 7.7%). This difference increased by dose number for vaccines that require multiple doses. Differences in administration date between the two sources were observed for 3.8-8.2% of registered doses. Underparticipation in Vaccinnet thus significantly impacts on the register-based immunisation coverage estimates, amplified by underregistration of administered doses among vaccinators using Vaccinnet. Therefore, survey studies, despite being labour-intensive and expensive, currently provide more complete and reliable results than register-based estimates alone in Flanders. However, further improvement of Vaccinnet's completeness will likely allow more accurate estimates in the nearby future. Copyright © 2013 Elsevier Ltd. All rights reserved.

The International Finance Facility for Immunisation: stakeholders’ perspectives

PubMed Central

Mounier-Jack, Sandra

2016-01-01

Abstract Objective To evaluate stakeholders’ understanding and opinions of the International Finance Facility for Immunisation (IFFIm); to identify factors affecting funding levels; and to explore the future use of IFFIm. Methods Between July and September 2015, we interviewed 33 individuals from 25 organizations identified as stakeholders in IFFIm. In total 22.5 hours of semi-structured interviews were recorded, transcribed and analysed using a framework method. Findings Stakeholders’ understanding of IFFIm’s financing mechanism and its outcomes varied and many stakeholders wanted more information. Participants highlighted that the change in the macro-economic environment following the 2008 financial crisis affected national policy in donor countries and subsequently the number of new commitments IFFIm received. Since Gavi is now seen as a successful and mature organization, participants stated that donors prefer to donate directly to Gavi. The pharmaceutical industry valued IFFIm for providing funding stability and flexibility. Other stakeholders valued IFFIm’s ability to access funds early and enable Gavi to increase vaccine coverage. Overall, stakeholders thought IFFIm was successful, but they had divergent views about IFFIm’s on-going role. Participants listed two issues where bond financing mechanisms may be suitable: emergency preparedness and outcome-based time-limited interventions. Conclusion The benefit of pledging funds through IFFIm needs to be re-evaluated. There are potential uses for bond financing to raise funds for other global health issues, but these must be carefully considered against criteria to establish effectiveness, with quantifiable pre-defined outcome indicators to evaluate performance. PMID:27708474

National Day of Listening Comes to Midland, Michigan: A StoryCorps Project

ERIC Educational Resources Information Center

Burke, Ann

2011-01-01

In this article, the author describes a StoryCorps project for the National Day of Listening. StoryCorps is a non-profit organization whose mission is to provide Americans of all backgrounds and beliefs with the opportunity to record, share, and preserve the stories of their lives. The organization initiated The National Day of Listening in 2008…

Silica Nanoparticles as the Adjuvant for the Immunisation of Mice Using Hepatitis B Core Virus-Like Particles

PubMed Central

Skrastina, Dace; Petrovskis, Ivars; Lieknina, Ilva; Bogans, Janis; Renhofa, Regina; Ose, Velta; Dishlers, Andris; Dekhtyar, Yuri; Pumpens, Paul

2014-01-01

Advances in nanotechnology and nanomaterials have facilitated the development of silicon dioxide, or Silica, particles as a promising immunological adjuvant for the generation of novel prophylactic and therapeutic vaccines. In the present study, we have compared the adjuvanting potential of commercially available Silica nanoparticles (initial particles size of 10–20 nm) with that of aluminium hydroxide, or Alum, as well as that of complete and incomplete Freund's adjuvants for the immunisation of BALB/c mice with virus-like particles (VLPs) formed by recombinant full-length Hepatitis B virus core (HBc) protein. The induction of B-cell and T-cell responses was studied after immunisation. Silica nanoparticles were able to adsorb maximally 40% of the added HBc, whereas the adsorption capacity of Alum exceeded 90% at the same VLPs/adjuvant ratio. Both Silica and Alum formed large complexes with HBc VLPs that sedimented rapidly after formulation, as detected by dynamic light scattering, spectrophotometry, and electron microscopy. Both Silica and Alum augmented the humoral response against HBc VLPs to the high anti-HBc level in the case of intraperitoneal immunisation, whereas in subcutaneous immunisation, the Silica-adjuvanted anti-HBc level even exceeded the level adjuvanted by Alum. The adjuvanting of HBc VLPs by Silica resulted in the same typical IgG2a/IgG1 ratios as in the case of the adjuvanting by Alum. The combination of Silica with monophosphoryl lipid A (MPL) led to the same enhancement of the HBc-specific T-cell induction as in the case of the Alum and MPL combination. These findings demonstrate that Silica is not a weaker putative adjuvant than Alum for induction of B-cell and T-cell responses against recombinant HBc VLPs. This finding may have an essential impact on the development of the set of Silica-adjuvanted vaccines based on a long list of HBc-derived virus-like particles as the biological component. PMID:25436773

Role of the nurse immuniser in implementing and maintaining the National Human Papillomavirus 'Cervical Cancer' Vaccine rollout through a school-based program in Victoria.

PubMed

Kent, Helen; Heffernan, Margaret E; Silvers, Julie; Moore, Elya; Garland, Suzanne M

2010-09-01

In an effort to understand the strengths and limitations of current approaches to human papillomavirus vaccine (HPV) delivery in schools, we conducted an audit of nurse immunisers (NI). In this survey of 159 Victorian NI, the NI perceived that knowledge, safety and side effects were among the most important issues raised by parents, schoolgirls, and teachers in the school setting. The most common concern identified by NIs was the physical layout of the vaccination setting (41%), followed by safety, then knowledge of the vaccine. There is a need for ongoing assessment of factors that improve or impede the delivery of HPV vaccines.

3 CFR 8710 - Proclamation 8710 of September 9, 2011. Patriot Day and National Day of Service and Remembrance...

Code of Federal Regulations, 2012 CFR

2012-01-01

... the two hundred and thirty-sixth.BARACK OBAMA ... September 11 as an annually recognized “National Day of Service and Remembrance.” NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, do hereby proclaim September 11, 2011, as Patriot Day...

Oral immunisation of naive and primed animals with transgenic potato tubers expressing LT-B.

PubMed

Lauterslager, T G; Florack, D E; van der Wal, T J; Molthoff, J W; Langeveld, J P; Bosch, D; Boersma, W J; Hilgers, L A

2001-03-21

The efficacy of edible vaccines produced in potato tubers was examined in mice. Transgenic plants were developed by Agrobacterium tumefaciens-mediated transformation. The antigen selected was the non-toxic B subunit of the Escherichia coli enterotoxin (recLT-B). A synthetic gene coding for recLT-B was made and optimised for expression in potato tubers and accumulation in the endoplasmic reticulum. Introduction of this gene under control of the tuber-specific patatin promoter in potato plants resulted in the production of functional, i.e. Gm1-binding, recLT-B pentamers in tubers. Selected tubers containing about 13 microg of recLT-B per gram fresh weight were used for immunisation. Subcutaneous immunisation with an extract of recLT-B tubers yielded high antibody titres in serum that were similar to those obtained with bacterial recLT-B. The efficacy of oral administration of recLT-B tubers was determined by measuring mucosal and systemic immune responses in naive and primed mice. Animals were primed by subcutaneous injection of an extract of recLT-B tuber plus adjuvant. Naive and primed mice were fed 5 g of tubers ( approximately 65 microg of recLT-B) or were intubated intragastrically with 0.4 ml of tuber extract ( approximately 2 microg of recLT-B). In naive mice, feeding recLT-B tubers or intubation of tuber extract did not induce detectable anti-LT antibody titres. In primed animals, however, oral immunisation resulted in significant anti-LT IgA antibody responses in serum and faeces. Intragastric intubation of tuber extract revealed higher responses than feeding of tubers. These results indicate clearly that functional recLT-B can be produced in potato tubers, that this recombinant protein is immunogenic and that oral administration thereof elicits both systemic and local IgA responses in parentally primed, but not naive, animals.

Multistakeholder partnerships with the Democratic Peoples' Republic of Korea to improve childhood immunisation: A perspective from global health equity and political determinants of health equity.

PubMed

Kim, Hani; Marks, Florian; Novakovic, Uros; Hotez, Peter J; Black, Robert E

2016-08-01

To examine the current partnerships to improve the childhood immunisation programme in the Democratic Peoples' Republic of Korea (DPRK) in the context of the political determinants of health equity. A literature search was conducted to identify public health collaborations with the DPRK government. Based on the amount of publicly accessible data and a shared approach in health system strengthening among the partners in immunisation programmes, the search focused on these partnerships. The efforts by WHO, UNICEF, GAVI and IVI with the DPRK government improved the delivery of childhood vaccines (e.g. pentavalent vaccines, inactivated polio vaccine, two-dose measles vaccine and Japanese encephalitis vaccine) and strengthened the DPRK health system by equipping health centres, and training all levels of public health personnel for VPD surveillance and immunisation service delivery. The VPD-focused programmatic activities in the DPRK have improved the delivery of childhood immunisation and have created dialogue and contact with the people of the DPRK. These efforts are likely to ameliorate the political isolation of the people of the DPRK and potentially improve global health equity. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Assessing care-givers' satisfaction with child immunisation services in Zambia: Evidence from a national survey.

PubMed

Chama-Chiliba, Chitalu Miriam; Masiye, Felix; Mphuka, Chrispin

2017-10-09

The main aim of this study was to assess care-giver satisfaction with vaccination services in public health facilities in Zambia, and examine its determinants. This study used data from a recent population-based household survey, conducted from May to August 2015. Respondent satisfaction with vaccination services received during the last visit was measured on a five point Likert scale ranging from 1 to 5. We used an ordered logistic regression model to analyse the significance of perceived quality of vaccination services, immunisation delivery mode and a range of individual characteristics in predicting care-giver satisfaction. Findings show that one in five care givers were unsatisfied with the vaccination services that they had received, with rural populations showing a significantly higher level of satisfaction. Poor quality of care, defined by long waiting times, poor quality of communication between health staff and care givers, long distance to vaccination sites, mode of delivery, and personal characteristics were among major factors driving care-giver satisfaction ratings. We also find that receiving a vaccination at outreach mode of delivery was associated with higher odds of greater satisfaction compared to on-facility vaccination services. The odds of satisfaction were lower for respondents living further away from a health facility, which emphasizes the importance of access in seeking vaccination services. These findings suggest that major improvements in quality of vaccination and service organisation will be needed to increase client satisfaction and service utilisation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Early childhood infections and immunisation and the development of allergic disease in particular asthma in a high-risk cohort: A prospective study of allergy-prone children from birth to six years.

PubMed

Thomson, Jennifer A; Widjaja, Constance; Darmaputra, Abbi A P; Lowe, Adrian; Matheson, Melanie C; Bennett, Catherine M; Allen, Katrina; Abramson, Michael J; Hosking, Cliff; Hill, David; Dharmage, Shyamali C

2010-11-01

The role of early childhood infections and immunisation in the development of allergic diseases remains controversial. To examine these associations, six hundred and twenty infants with first-degree relatives with allergic diseases were recruited into the Melbourne Atopy Cohort Study. Information on risk factors and outcomes was collected by interviewer administered questionnaire and was based on parental report and/or a physician's diagnosis. Risk factors examined included early childhood infections (including gastroenteritis, otitis media and lower respiratory tract infections) and immunisations in the first 2 yr of life. Outcomes were current asthma, allergic rhinitis and eczema at 6 yr of age. Univariate and multivariate regression analysis were used to estimate relative risk (RR) and assess confounding. By 6 yr, 79% of the original cohort remained in the study. Those with at least three episodes of gastroenteritis showed an increased risk (crude RR 2.36, 95%CI 1.41 3.95; adjusted RR 2.03 95%CI 1.50 2.75) for the later development of asthma at age 6. Of the scheduled immunisations, Sabin immunisation in the second year had a reduced risk of asthma at 6 yr (crude RR 0.60, 95%CI 0.37 0.98; adjusted RR 0.63 95%CI 0.39 1.02). Combined diphtheria and tetanus (CDT) immunisation in the first year had an increased risk of asthma at 6 yr (RR 1.76, 95%CI 1.11 2.78; adjusted RR 1.88 95%CI 1.28 2.77). Recurrent gastroenteritis in early childhood is associated with a later risk of asthma. This may reflect a cause and effect relationship, or exposure to common risk factors. In contrast, Sabin immunisation in the second year is associated with a decreased risk of asthma in later childhood. CDT immunisation in the first year may be a risk factor for asthma, but the need for CDT immunisation may also be a marker of increased risk of asthma in later childhood. © 2010 John Wiley & Sons A/S.

A hepatitis A, B, C and HIV prevalence and risk factor study in ever injecting and non-injecting drug users in Luxembourg associated with HAV and HBV immunisations.

PubMed

Removille, Nathalie; Origer, Alain; Couffignal, Sophie; Vaillant, Michel; Schmit, Jean-Claude; Lair, Marie-Lise

2011-05-19

In Luxembourg, viral hepatitis and HIV infection data in problem drug users (PDUs) are primarily based on self-reporting. Our study aimed to determine the prevalence of HAV, HBV, HCV and HIV infections in ever injecting (IDUs) and non-injecting drug users (nIDUs) including inherent risk factors analysis for IDUs. Secondary objectives were immunisation against HAV and HBV, referral to care and treatment facilities as well as reduction in risk behaviour. A nationwide, cross-sectional multi-site survey, involving 5 in-, 8 out-treatment and 2 prison centres, included both an assisted questionnaire (n = 368) and serological detection of HIV and Hepatitis A, B, C (n = 334). A response rate of 31% resulted in the participation of 310 IDUs and 58 nIDUs. Risk factors such as drug use, sexual behaviour, imprisonment, protection and health knowledge (HAV, HBV status and immunisations, HCV, HIV), piercing/tattoo and use of social and medical services were studied by means of chi2 and logistic models. Seroprevalence results for IDUs were 81.3% (218/268, 95%CI=[76.6; 86.0]) for HCV, 29.1% (74/254, 95%CI=[25.5;34.7 ]) for HBV (acute/chronic infection or past cured infection), 2.5% (5/202, 95%CI=[0.3; 4.6]) for HIV-1 and 57.1% (108/189, 95%CI=[50.0; 64.1]) for HAV (cured infections or past vaccinations). Seroprevalence results for nIDUs were 19.1% (9/47, 95%CI=[7.9;30.3]) for HCV, 8.9% (4/45, 95%CI=[0.6;17.2]) for HBV (acute/chronic infection or past cured infection), 4.8% (2/42, 95%CI=[-1.7;11.3]) for HIV-1 and 65.9% (27/41, 95%CI=[51.4;80.4]) for HAV. Prisoners showed the highest rates for all infections. Age, imprisonment and setting of recruitment were statistically associated with HCV seropositivity. Age, speedball career and nationality were significantly associated with HBV seropositivity. Only 56% of the participants in outpatient centres collected their serology results and 43 doses of vaccine against HAV and/or HBV were administered. Despite the existing national risk

Reduction of aggregated Tau in neuronal processes but not in the cell bodies after Abeta42 immunisation in Alzheimer's disease.

PubMed

Boche, Delphine; Donald, Jane; Love, Seth; Harris, Scott; Neal, James W; Holmes, Clive; Nicoll, James A R

2010-07-01

Alzheimer's disease (AD) pathology is characterised by aggregation in the brain of amyloid-beta (Abeta) peptide and hyperphosphorylated tau (phospho-tau), although how these proteins interact in disease pathogenesis is unclear. Abeta immunisation results in removal of Abeta from the brain but cognitive decline continues to progress, possibly due to persistent phospho-tau. We quantified phospho-tau and Abeta42 in the brains of 10 AD patients (iAD) who were actively immunised with Abeta42 (AN1792, Elan Pharmaceuticals) compared with 28 unimmunised AD cases (cAD). The phospho-tau load was lower in the iAD than the cAD group in the cerebral cortex (cAD 1.08% vs. iAD 0.72%, P = 0.048), CA1 hippocampus (cAD 2.26% vs. iAD 1.05%; P = 0.001), subiculum (cAD 1.60% vs. iAD 0.31%; P = 0.001) and entorhinal cortex (cAD 1.10% vs. iAD 0.18%; P < 0.001). Assessment of the localisation within neurons of phospho-tau indicated that the Abeta immunotherapy-associated reduction was confined to neuronal processes, i.e. neuropil threads and dystrophic neurites. However, the phospho-tau accumulation in the neuronal cell bodies, contributing to neurofibrillary tangles, appeared not to be affected. In showing that Abeta immunisation can influence phospho-tau pathology, we confirm the position of Abeta as a target for modifying tau accumulation in AD and demonstrate a link between these proteins. However, the continuing progression of cognitive decline in AD patients after Abeta immunisation may be explained by its lack of apparent effect on tangles.

Strategies to implement maternal vaccination: A comparison between standing orders for midwife delivery, a hospital based maternal immunisation service and primary care.

PubMed

Krishnaswamy, Sushena; Wallace, Euan M; Buttery, Jim; Giles, Michelle L

2018-03-20

Maternal vaccination is a safe and effective strategy to reduce maternal and neonatal morbidity and mortality from pertussis and influenza. However, despite recommendations for maternal vaccination since 2010, uptake remains suboptimal. Barriers to uptake have been studied widely and include lack of integration of vaccination into routine pregnancy care and access to vaccination services. Standing orders for administration of vaccines without the need for a physician review or prescription have been demonstrated to improve uptake as part of multi-model interventions to increase antenatal influenza and post-partum pertussis vaccination. Monash Health is a university-affiliated, public healthcare network in Melbourne, Australia providing maternity services across three hospitals. In this study we compared three different immunisation models - an immunisation nurse-led immunisation service, standing orders for midwife-administered pertussis vaccination within pregnancy care clinics, and delivery by general practitioners in primary care. Uptake of maternal pertussis vaccine was measured as recorded in the state-wide perinatal data collection tool. Uptake improved significantly at all three hospitals over the study period with the most significant change (39% to 91%, p < .001) noted at the hospital where standing orders were introduced. Our study highlights the diversity of immunisation service models available in maternity care settings. We demonstrated significant improvement in uptake of maternal pertussis vaccination with introduction of midwife-administered vaccination but each maternity service should consider the model best suited to their needs. Copyright © 2018 Elsevier Ltd. All rights reserved.

3 CFR 8678 - Proclamation 8678 of May 18, 2011. National Maritime Day, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... citizens around the world. On National Maritime Day, we honor their invaluable contributions to America’s... of our transportation system. Last year, my Administration implemented “America’s Marine Highway..., 2011 Proc. 8678 National Maritime Day, 2011By the President of the United States of America A...

Economic rate of discount and estimating cost benefit of viral immunisation programmes.

PubMed

West, R R

1999-01-01

Many individual and societal decisions over purchase (or investment) involve consideration of timing, in that either the price may be paid now and the benefit enjoyed some time in the future or the converse the benefit enjoyed now and the price paid later. Since most individuals generally prefer the present to the future, economic theory has conventionally discounted future costs or benefits to estimate 'net present values'. The rationale for this is principally based on future uncertainty. In recent years, economists have turned their attention to valuing health as an economic 'good'. Observations of individual behaviour would imply that individuals discount future health, as other potential benefits, mostly because there is some uncertainty about their futures. Although economic theory is strongly predicated on the 'sovereignty of the individual', it does not necessarily follow that society discounts the future as do individuals, since for society the future is not so uncertain. Society's endorsement of many public health and preventive medicine objectives, which seek health gains in the future (rather than the present), imply that society's rate of discount may be appreciably lower than that of individuals. In immunisation, arguably one of the most effective of preventive measures, there is the additional benefit to others attributable to herd immunity. This paper argues that the future health gains for society arising from immunisation should not be underestimated by application of inappropriate discounting.

Performance score variation between days at Australian national and Olympic women's artistic gymnastics competition.

PubMed

Bradshaw, Elizabeth Jane; Hume, Patria Anne; Aisbett, Brad

2012-01-01

We determined the inter-day variability in elite-standard women's artistic gymnastics competition scores. National (50 gymnasts for up to three days) and Olympic (24 gymnasts for up to five days) competition scores published in the public domain ('Giant poster pull-out', 2010 ; Gymnastics Australia, 2008 ) were evaluated using three statistical measures. Analyses of the inter-day differences in the mean scores as a percentage (MDiff%), coefficient of variation percentages for the mean score across both days (CV%), and Pearson correlation coefficients for the inter-day score (r) were interpreted using thresholds from trivial to large. National-class gymnasts' two-day performance variation was trivial for vault, small for floor and beam, and moderate for bars. When senior gymnasts competed for a third day the performance variation increased to moderate for vault. Across five days of Olympic competition there were trivial (e.g. CV%: vault = 0.8) to small (e.g. CV%: bars = 2.0) variations in performances between days on all apparatus. Olympians' performance score consistency is superior to senior, national-class competitors. The performance score consistency required for gymnasts who aspire to participate at the Olympics as a top-24 competitor is better than 3%.

Economic Evaluation of Immunisation Programme of 23-Valent Pneumococcal Polysaccharide Vaccine and the Inclusion of 13-Valent Pneumococcal Conjugate Vaccine in the List for Single-Dose Subsidy to the Elderly in Japan.

PubMed

Hoshi, Shu-ling; Kondo, Masahide; Okubo, Ichiro

2015-01-01

Currently in Japan, both 23-valent pneumococcal polysaccharide vaccine (PPSV-23) and 13-valent pneumococcal conjugate vaccine (PCV-13) are available for the elderly for the prevention of S. pneumoniae-related diseases. PPSV-23 was approved in 1988, while the extended use of PCV-13 was approved for adults aged 65 and older in June 2014. Despite these two vaccines being available, the recently launched national immunisation programme for the elderly only subsidised PPSV-23. The framework of the current immunisation programme lasts for five years. The elderly population eligible for the subsidised PPSV-23 shot for the 1st year are those aged 65, 70, 75, 80, 85, 90, 95 and ≥ 100. While from the 2nd year to the 5th year, those who will age 65, 70, 75, 80, 85, 90, 95 and 100 will receive the same subsidised shot. We performed economic evaluations to (1) evaluate the efficiency of alternative strategies of PPSV-23 single-dose immunisation programme, and (2) investigate the efficiency of PCV-13 inclusion in the list for single-dose pneumococcal vaccine immunisation programme. Three alternative strategies were created in this study, namely: (1) current PPSV-23 strategy, (2) 65 to 80 (as "65-80 PPSV-23 strategy"), and (3) 65 and older (as "≥ 65 PPSV-23 strategy"). We constructed a Markov model depicting the S. pneumoniae-related disease course pathways. The transition probabilities, utility weights to estimate quality adjusted life year (QALY) and disease treatment costs were either calculated or cited from literature. Cost of per shot of vaccine was ¥ 8,116 (US$74; US$1 = ¥ 110) for PPSV-23 and ¥ 10,776 (US$98) for PCV-13. The model runs for 15 years with one year cycle after immunisation. Discounting was at 3%. Compared to current PPSV-23 strategy, 65-80 PPSV-23 strategy cost less but gained less, while the incremental cost-effectiveness ratios (ICERs) of ≥ 65 PPSV-23 strategy was ¥ 5,025,000 (US$45,682) per QALY gained. PCV-13 inclusion into the list for single

Economic Evaluation of Immunisation Programme of 23-Valent Pneumococcal Polysaccharide Vaccine and the Inclusion of 13-Valent Pneumococcal Conjugate Vaccine in the List for Single-Dose Subsidy to the Elderly in Japan

PubMed Central

Hoshi, Shu-ling; Kondo, Masahide; Okubo, Ichiro

2015-01-01

Background Currently in Japan, both 23-valent pneumococcal polysaccharide vaccine (PPSV–23) and 13-valent pneumococcal conjugate vaccine (PCV–13) are available for the elderly for the prevention of S. pneumoniae-related diseases. PPSV–23 was approved in 1988, while the extended use of PCV–13 was approved for adults aged 65 and older in June 2014. Despite these two vaccines being available, the recently launched national immunisation programme for the elderly only subsidised PPSV–23. The framework of the current immunisation programme lasts for five years. The elderly population eligible for the subsidised PPSV–23 shot for the 1st year are those aged 65, 70, 75, 80, 85, 90, 95 and ≥100. While from the 2nd year to the 5th year, those who will age 65, 70, 75, 80, 85, 90, 95 and 100 will receive the same subsidised shot. Methods We performed economic evaluations to (1) evaluate the efficiency of alternative strategies of PPSV–23 single-dose immunisation programme, and (2) investigate the efficiency of PCV–13 inclusion in the list for single-dose pneumococcal vaccine immunisation programme. Three alternative strategies were created in this study, namely: (1) current PPSV–23 strategy, (2) 65 to 80 (as “65–80 PPSV–23 strategy”), and (3) 65 and older (as “≥65 PPSV–23 strategy”). We constructed a Markov model depicting the S. pneumoniae-related disease course pathways. The transition probabilities, utility weights to estimate quality adjusted life year (QALY) and disease treatment costs were either calculated or cited from literature. Cost of per shot of vaccine was ¥8,116 (US$74; US$1 = ¥110) for PPSV–23 and ¥10,776 (US$98) for PCV–13. The model runs for 15 years with one year cycle after immunisation. Discounting was at 3%. Results Compared to current PPSV–23 strategy, 65–80 PPSV–23 strategy cost less but gained less, while the incremental cost-effectiveness ratios (ICERs) of ≥65 PPSV–23 strategy was ¥5,025,000 (US$45

42 CFR 484.215 - Initial establishment of the calculation of the national 60-day episode payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... national 60-day episode payment. 484.215 Section 484.215 Public Health CENTERS FOR MEDICARE & MEDICAID... calculation of the national 60-day episode payment. (a) Determining an HHA's costs. In calculating the initial unadjusted national 60-day episode payment applicable for a service furnished by an HHA using data on the...

42 CFR 484.215 - Initial establishment of the calculation of the national 60-day episode payment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... national 60-day episode payment. 484.215 Section 484.215 Public Health CENTERS FOR MEDICARE & MEDICAID... calculation of the national 60-day episode payment. (a) Determining an HHA's costs. In calculating the initial unadjusted national 60-day episode payment applicable for a service furnished by an HHA using data on the...

42 CFR 484.215 - Initial establishment of the calculation of the national 60-day episode payment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... national 60-day episode payment. 484.215 Section 484.215 Public Health CENTERS FOR MEDICARE & MEDICAID... calculation of the national 60-day episode payment. (a) Determining an HHA's costs. In calculating the initial unadjusted national 60-day episode payment applicable for a service furnished by an HHA using data on the...

Effects of Edutainment on Knowledge and Perceptions of Lisu Mothers about the Immunisation of Their Children

ERIC Educational Resources Information Center

Dway, Ngwa Sar; Soonthornworasiri, Ngamphol; Jandee, Kasemsak; Lawpoolsri, Saranath; Pan-Ngum, Wirichada; Sinthuvanich, Daorirk; Kaewkungwal, Jaranit

2016-01-01

Objective: This study assessed the immediate effects of edutainment modules on changes in knowledge and perceptions towards the Expanded Programme for Immunisation (EPI) among an under served minority (Lisu) population. Method: An edutainment module was developed on mobile tablets for use by village health volunteers. As the study was conducted…

3 CFR 8720 - Proclamation 8720 of September 23, 2011. National Hunting and Fishing Day, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... Hunting and Fishing Day, 2011 8720 Proclamation 8720 Presidential Documents Proclamations Proclamation 8720 of September 23, 2011 Proc. 8720 National Hunting and Fishing Day, 2011By the President of the... outdoors. As we mark National Hunting and Fishing Day, we are reminded of the uniquely American idea that...

Announcement: National Family History Day - November 24, 2016.

PubMed

2016-11-25

In 2004, the U.S. Surgeon General declared that Thanksgiving would be National Family History Day, a day designed to encourage American families to learn about and create a written record of their family health history. Family history can identify those persons with a higher-than-average risk for many common diseases, such as heart disease, cancer, and type 2 diabetes. Having at least one first-degree relative with a disease can increase a person's risk twofold or more (1). Family history is also a determinant of less common diseases like sickle cell disease and cystic fibrosis (1). Persons who might be at increased risk because of family history might benefit from screening or other interventions to prevent disease or detect it earlier.

78 FR 58865 - National POW/MIA Recognition Day, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

..., our veterans, our military families, and all those who placed themselves in harm's way to sustain the... symbolizing America's Missing in Action and Prisoners of War will be flown over the White House; the United... National POW/MIA Recognition Day, 2013 By the President of the United States of America A Proclamation Our...

Swine dysentery: protection of pigs by oral and parenteral immunisation with attenuated Treponema hyodysenteriae.

PubMed

Hudson, M J; Alexander, T J; Lysons, R J; Prescott, J F

1976-11-01

An attenuated strain of Treponema hyodysenteriae was used to immunise 18 pigs in three experiments. Live attenuated spirochaetes were dosed orally and injected intra-peritoneally, and killed spirochaetes were injected intramuscularly with adjuvant. The vaccinated pigs, which developed high serum agglutination titres against T hyodysenteriae, and 18 unvaccinated litter-mates were repeatedly challenged with virulent T hyodysenteriae. Nine vaccinated pigs and 16 control pigs developed typical swine dysentery.

Conducting a Successful National Girls and Women in Sports Day Event

ERIC Educational Resources Information Center

Appleby, Karen M.; Pemberton, Cynthia Lee A.

2010-01-01

National Girls and Women in Sports Day (NGWSD) is a nationally celebrated event that promotes sport and physical activity opportunities for girls and women. Over 1,500 events and activities are held annually in all 50 states to celebrate and promote female participation in sport. This article introduces the sport/activity-clinic model of the NGWSD…

[Immunisation schedule of the Spanish Association of Paediatrics: 2015 recommendations].

PubMed

Moreno-Pérez, D; Álvarez García, F J; Arístegui Fernández, J; Cilleruelo Ortega, M J; Corretger Rauet, J M; García Sánchez, N; Hernández Merino, A; Hernández-Sampelayo Matos, T; Merino Moína, M; Ortigosa Del Castillo, L; Ruiz-Contreras, J

2015-01-01

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on the safety, effectiveness and efficiency of current vaccines, including levels of recommendation. In our opinion, this is the optimal vaccination calendar for all children resident in Spain. Regarding the vaccines included in the official unified immunization schedule, the Committee emphasizes the administration of the first dose of hepatitis B either at birth or at 2 months of life; the recommendation of the first dose of MMR and varicella vaccine at the age of 12 months, with the second dose at the age of 2-3 years; DTaP or Tdap vaccine at the age of 6 years, followed by another Tdap booster dose at 11-12 years old; Tdap strategies for pregnant women and household contacts of the newborn, and immunization against human papillomavirus in girls aged 11-12 years old with a 2 dose scheme (0, 6 months). The Committee reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule, the same as it is being conducted in Western European countries. The recently authorised meningococcal B vaccine, currently blocked in Spain, exhibits the profile of a universal vaccine. The Committe insists on the need of having the vaccine available in communitary pharmacies. It has also proposed the free availability of varicella vaccines. Their efectiveness and safety have been confirmed when they are administred from the second year of life. Vaccination against rotavirus is recommended in all infants. The Committee stresses the need to vaccinate population groups considered at risk against influenza and hepatitis A. Copyright © 2014. Published by Elsevier Espana.

Influence of levamisole and Freund's adjuvant on mouse immunisation with antigens of adults of the liver fluke Fasciola hepatica Linnaeus, 1758.

PubMed

Gutierrez-Sanchez, Maria de Los Angeles; Luna-Herrera, Julieta; Trejo-Castro, Lauro; Montenegro-Cristino, Natividad; Almanza-Gonzalez, Alfredo; Escobar-Gutierrez, Alejandro; de la Rosa-Arana, Jorge Luis

2015-08-28

We have studied the influence of both levamisole (AL) and Freund's adjuvant (AF) on the immunisation of mice with the secretory antigens of adults of the liver fluke Fasciola hepatica Linnaeus, 1758. Total IgG antibodies were detected in all groups where the F. hepatica antigen was administered, been levels of IgG1 increased respect to IgG2a antibodies. During immunisation, IL-4 and IFN-γ were only detected in AL and AF groups, but after infection, IL-4 boosted in all groups. IFN-γ increased two fold in AF and AL groups compared to the saline solution (AS) group. Worm recovering was of 32-35% in groups administered without antigen whereas in AS, AL and AF groups recovering was of 25%, 12% and 8%, respectively. Macroscopical lesions in the liver were scarce in AL and AF groups. Our data suggest that immunisation of mice with antigens of F. hepatica enhances the immune response avoiding both liver damage and worm establishment after challenge infection. The murine model of fasciolosis has appeared to be useful to elucidate the mechanism by which the parasite modulates immune responses toward a Th2 type but also the development of Th1 type-inducing vaccines.

75 FR 76613 - National Pearl Harbor Remembrance Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-09

... million of America's sons and daughters served during World War II, and more than 400,000 paid the... hate. In honor of all who have borne the cost of battle throughout America's history, let us pledge to... National Pearl Harbor Remembrance Day, 2010 By the President of the United States of America A Proclamation...

Trade and Industry in History. National History Day, 1982.

ERIC Educational Resources Information Center

Womack, Miriam L.; And Others

Presented are winning essays written by junior and senior high school students for the historical paper category of the 1982 National History Day program contest. This unique program encourages young people to explore a historical subject related to a specific theme. The winning papers, responding to the 1982 theme of trade and industry in…

Dengue E Protein Domain III-Based DNA Immunisation Induces Strong Antibody Responses to All Four Viral Serotypes

PubMed Central

Chan, Kuan Rong; Tan, Hwee Cheng; Bestagno, Marco; Ooi, Eng Eong; Burrone, Oscar R.

2015-01-01

Dengue virus (DENV) infection is a major emerging disease widely distributed throughout the tropical and subtropical regions of the world affecting several millions of people. Despite constants efforts, no specific treatment or effective vaccine is yet available. Here we show a novel design of a DNA immunisation strategy that resulted in the induction of strong antibody responses with high neutralisation titres in mice against all four viral serotypes. The immunogenic molecule is an engineered version of the domain III (DIII) of the virus E protein fused to the dimerising CH3 domain of the IgG immunoglobulin H chain. The DIII sequences were also codon-optimised for expression in mammalian cells. While DIII alone is very poorly secreted, the codon-optimised fusion protein is rightly expressed, folded and secreted at high levels, thus inducing strong antibody responses. Mice were immunised using gene-gun technology, an efficient way of intradermal delivery of the plasmid DNA, and the vaccine was able to induce neutralising titres against all serotypes. Additionally, all sera showed reactivity to a recombinant DIII version and the recombinant E protein produced and secreted from mammalian cells in a mono-biotinylated form when tested in a conformational ELISA. Sera were also highly reactive to infective viral particles in a virus-capture ELISA and specific for each serotype as revealed by the low cross-reactive and cross-neutralising activities. The serotype specific sera did not induce antibody dependent enhancement of infection (ADE) in non-homologous virus serotypes. A tetravalent immunisation protocol in mice showed induction of neutralising antibodies against all four dengue serotypes as well. PMID:26218926

A novel approach to evaluating the UK childhood immunisation schedule: estimating the effective coverage vector across the entire vaccine programme.

PubMed

Crowe, Sonya; Utley, Martin; Walker, Guy; Panovska-Griffiths, Jasmina; Grove, Peter; Pagel, Christina

2015-12-29

The availability of new vaccines can prompt policy makers to consider changes to the routine childhood immunisation programme in the UK. Alterations to one aspect of the schedule may have implications for other areas of the programme (e.g. adding more injections could reduce uptake of vaccines featuring later in the schedule). Colleagues at the Department of Health (DH) in the UK therefore wanted to know whether assessing the impact across the entire programme of a proposed change to the UK schedule could lead to different decisions than those made on the current case-by-case basis. This work is a first step towards addressing this question. A novel framework for estimating the effective coverage against all of the diseases within a vaccination programme was developed. The framework was applied to the current (August 2015) UK childhood immunisation programme, plausible extensions to it in the foreseeable future (introducing vaccination against Meningitis B and/or Hepatitis B) and a "what-if" scenario regarding a Hepatitis B vaccine scare that was developed in close collaboration with DH. Our applications of the framework demonstrate that a programme-view of hypothetical changes to the schedule is important. For example, we show how introducing Hepatitis B vaccination could negatively impact aspects of the current programme by reducing uptake of vaccines featuring later in the schedule, and illustrate that the potential benefits of introducing any new vaccine are susceptible to behaviour changes affecting uptake (e.g. a vaccine scare). We show how it may be useful to consider the potential benefits and scheduling needs of all vaccinations on the horizon of interest rather than those of an individual vaccine in isolation, e.g. how introducing Meningitis B vaccination could saturate the early (2-month) visit, thereby potentially restricting scheduling options for Hepatitis B immunisation should it be introduced to the programme in the future. Our results demonstrate

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

Hemophilus influenzae meningitis and septicaemia in a 14-month-old child after primary immunisation.

PubMed

Tarai, B; Ravishankar, N; Vohra, P; Das, P

2015-01-01

We report a 14-month-male child, who developed Hemophilus influenzae meningitis after three primary doses of the vaccine. The child presented with fever and seizures. H. influenzae was isolated from both cerebrospinal fluid (CSF) and blood. The child also had features of septicaemia. Procalcitonin (104 ng/ml) and C-reactive protein (CRP--42.6 mg/dl) were high. Appropriate antibiotics were given. The child made an uneventful recovery. This case highlights vaccine failure, especially after primary immunisation alone.

Adult immunisation: A key element of public health programs: Synopsis of Asia Pacific Adult Immunisation Meeting, Tokyo, 1-2 December 2016.

PubMed

Rochman-Fowler, Jessica; Duarte Walsh, Virginia; Barratt, Jane

2018-06-01

To (i) improve scientific knowledge and understanding of the importance of adult vaccination within a public health framework; (ii) share an understanding of the principles of good practice that have improved adult vaccination uptake rates; (iii) appreciate the diverse nature of country-specific barriers; and (iv) reach consensus on principles of a call to action to increase adult vaccination uptake rates. Non-governmental organisations, the International Federation on Ageing and Friends of International Federation on Ageing Japan, convened the Asia Pacific Adult Immunisation Meeting, herein referred to as the 'Asia Pacific Meeting'. Delegates identified fundamental barriers to adult vaccination similar to those reported at previous meetings in Latin America and Europe and formed a road map to respond to key barriers in countries represented at the Asia Pacific Meeting. Older people are uniquely vulnerable to vaccine-preventable diseases and therefore need to be the target of a series of actions intended to improve uptake rates in this subpopulation. © 2018 AJA Inc.

77 FR 35807 - Flag Day and National Flag Week, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

.... Generations of service members have raised our country's colors over military bases and at sea, and... Day and National Flag Week, 2012 By the President of the United States of America A Proclamation... Woodrow Wilson asked us to ``stand with united hearts for an America which no man can corrupt, no...

Sample survey methods as a quality assurance tool in a general practice immunisation audit.

PubMed

Cullen, R

1994-04-27

In a multidoctor family practice there are often just too many sets of patients records to make it practical to repeat an audit by census of even an age band of the practice on a regular basis. This paper attempts to demonstrate how sample survey methodology can be incorporated into the quality assurance cycle. A simple random sample (with replacement) of 120 from 580 children with permanent records who were aged between 6 weeks and 2 years old from an Auckland general practice was performed, with sample size selected to give a predetermined precision. The survey was then repeated after 4 weeks. Both surveys were able to be completed within the course of a normal working day. An unexpectedly low level of under 2 years olds that were recorded as not overdue for any immunisations was found (22.5%) with only a modest improvement after a standard telephone/letter catch up campaign. Seventy-two percent of the sample held a group one community services card. The advantages of properly conducted sample surveys in producing useful estimates of known precision without disrupting office routines excessively were demonstrated. Through some attention to methodology, the trauma of a practice census can be avoided.

Civil Sanctity and National Memorial Days: An Analysis of Israeli Teachers' Educational Beliefs

ERIC Educational Resources Information Center

Iluz, Shira; Rich, Yisrael

2014-01-01

Teachers' beliefs regarding civil sanctity were studied in the context of their pedagogical activities regarding two Israeli national memorial days--Yitzhak Rabin Memorial Day and Holocaust Remembrance Day. Interviews were conducted with 30 educators in six secular and six religious junior high schools with diverse populations and 12 memorial…

76 FR 56937 - National Days of Prayer and Remembrance, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... and remembrance the men, women, and children who died in New York City, in Pennsylvania, and at the... we lost is a safer, stronger, and more resilient Nation. Since that day, a generation has come of age.... At home, communities have come together to make us a stronger country, united by our diversity, our...

77 FR 56523 - National Days of Prayer and Remembrance, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... Proclamation Eleven years ago, America confronted one of our darkest days. The events of September 11, 2001... dear. Many have returned with dark memories of distant places and fallen friends; too many will never... September 11, 2001, in our hour of grief, a Nation came together. No matter where we came from, what God we...

Influenza immunisation rate for 2005 and factors associated with receiving this vaccine in patients aged 65 years and over admitted to a general medical ward at Auckland City Hospital.

PubMed

Curry, Elizabeth; Kerr, Nathan; Yang, Joseph; Briggs, Simon

2006-10-13

To assess the influenza immunisation rate for 2005 in patients aged 65 years and over admitted to a general medical ward at Auckland City Hospital, New Zealand; to identify factors associated with receiving this vaccine; and to assess whether particular patient groups have a low influenza immunisation rate. Consecutive patients aged 65 years and over admitted to two medical wards were surveyed. Demographic data, how recently patients had last seen their general practitioner (GP), whether patients had received an influenza vaccine reminder from their GP, and whether patients had received the influenza vaccine in 2005 were recorded. Logistic regression analysis was performed to investigate which variables were associated with receiving the influenza vaccine. 148 of 200 (74%) patients who answered the questionnaire received the influenza vaccine. The variables found to be associated with receiving the influenza vaccine were whether patients had seen their GP in the last 6 months and whether patients had received an influenza vaccine reminder from their GP. Three-quarters of patients in this study received the influenza vaccine. We have not been able to identify patient groups that have a low influenza immunisation rate. Reminding patients of the benefits of the influenza vaccine or offering this at the time of discharge from hospital as autumn approaches each year may increase the influenza immunisation rate of those recently hospitalised.

Characterization of Days Based On Analysis of National Airspace System Performance Metrics

NASA Technical Reports Server (NTRS)

Chatterji, Gano B.; Musaffar, Bassam; Meyn, Larry A.; Quon, Leighton K.

2006-01-01

Days of operations in the National Airspace System can be described in term of traffic demand, runway conditions, equipment outages, and surface and enroute weather conditions. These causes manifest themselves in terms of departure delays, arrival delays, enroute delays and traffic flow management delays, Traffic flow management initiatives such as, ground stops, ground delay programs, miles-in-trail restrictions, rerouting and airborne holding are imposed to balance the air traffic demand with respect to the available capacity, In order to maintain operational efficiency of the National Airspace System, the Federal Aviation Administration (FAA) maintains delay sad other statistics in the Air Traffic Operations Network (OPSNET) and the Aviation System Performance Metrics (ASPM) databases. OPSNET data includes reportable delays of fifteen minutes ox more experienced by Instrument Flight Rule (IFR) flights. Numbers of aircraft affected by departure delays, enroute delays, arrival delays and traffic flow delays are recorded in the OPSNET data. ASPM data consist of number of actual departures, number of canceled departures, percentage of on time departures, percentage of on time gate arrivals, taxi-out delays. taxi-in delays, gate delays, arrival delays and block delays. Surface conditions at the major U.S. airports are classified in terms of Instrument Meteorological Condition (IMC) and Visual Meteorological Condition (VMC) as a function of the time of the day in the ASPM data. The main objective of this paper is to use OPSNET and ASPM data to classify the days in the datasets into few distinct groups, where each group is separated from the other groups in terms of a distance metric. The motivations for classifying the days are two-fold, 1) to enable selection of days of traffic with particular operational characteristics for concept evaluation using system-wide simulation systems such as the National Aeronautics and Space Administration's Airspace Concepts Evaluation

Effect of the Global Alliance for Vaccines and Immunisation on diphtheria, tetanus, and pertussis vaccine coverage: an independent assessment.

PubMed

Lu, Chunling; Michaud, Catherine M; Gakidou, Emmanuela; Khan, Kashif; Murray, Christopher J L

2006-09-23

The Global Alliance for Vaccines and Immunisation (GAVI) was created in 1999 to enable even the poorest countries to provide vaccines to all children. We aimed to assess the effect of GAVI on combined diphtheria, tetanus, and pertussis vaccine (DTP3) coverage. We examined the relation between DTP3 coverage for GAVI recipient countries from 1995 to 2004 and immunisation services support (ISS) and non-ISS expenditure per surviving child, controlling for income per head and local political governance variables. We analysed DTP3 coverage reported by governments and estimated by WHO/UNICEF. We also investigated the effect of GAVI on country reporting behaviour. In countries with DTP3 coverage of 65% or less at baseline, ISS spending per surviving child had a significant positive effect on DTP3 coverage (p=0.0005). This effect was not present in countries with DTP3 coverage of 65-80% or 80% or more at baseline. If ISS expenditure only is assessed, the estimated cost per additional child immunised in countries with baseline coverage of 65% or less is US$14 and if ISS and non-ISS expenditures are included the cost per child is almost $20. The success of ISS funding in countries with baseline DTP3 coverage of 65% or less provides evidence that a public-private partnership can work to reverse a negative trend in global health and that performance-related disbursement can work in some settings. Because ISS funding seems to have no effect in countries with baseline coverage greater than 65%, GAVI should consider redistributing its resources to countries with the lowest coverage.

3 CFR 8526 - Proclamation 8526 of May 20, 2010. National Maritime Day, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... ships and seafarers to our economic and national security. Since 1775, America’s maritime fleet has... their contributions to America’s leadership in the global marketplace, and to our security. Civilian..., 2010 Proc. 8526 National Maritime Day, 2010By the President of the United States of America A...

[Vaccination among students in grades 6-10, 2011 - a comparison of German states: need for action for a targeted nationwide immunisation strategy].

PubMed

Ellsäßer, G; Trost-Brinkhues, G

2013-11-01

In Germany, surveillance of the population's immunisation is only mandatory for school beginners, not for adolescents. Therefore, no current data are available from the public health service related to the immunisation of adolescents. Also lacking are nationwide monitoring data regarding HPV vaccination among girls aged 12-18 years and the meningococcal C vaccination, both recently introduced by the German Standing Committee on Vaccination (STIKO) in 2009 and 2006, respectively. The present research and analysis therefore aims to determine which German states perform a monitoring of the vaccination status of adolescents, how immunisation rates differ across German states and what need for action, in terms of a nationwide immunisation strategy, can be derived. A systematic survey of vaccination coverage among students in grades 6-10 (age group 12-16 years) for the school year 2010/11 was undertaken. The defined documentation standard is based on the standard vaccinations for children and adolescents according to STIKO, requiring complete primary immunization (PI) and the number of booster vaccinations. In the analysis, 8 of 16 states were included, due to lack of data for the remaining states. In total, the public health service -examined 157,599 school children in 8 German states and checked 103,250 vaccination certificates (on average 68.1%, range 54.9-85.2%). The implementation of the booster vaccination among students in grades 6-10 proved to be insufficient. The 2-dose measles vaccination, required by the WHO for 95% of the population, was only nearly achieved by 2 of 8 German states -(Saxony-Anhalt, Brandenburg). The effects of insufficient immunisation coverage are shown by, for example, a higher measles incidence rate in children under 15 years and a persisting peak of pertussis incidence in 10- to 15-year-olds. The meningococcal C vaccination, introduced in 2006, was insufficiently taken up by students and very differently implemented among the 8 -German

3 CFR 8844 - Proclamation 8844 of July 27, 2012. National Korean War Veterans Armistice Day, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

... 3 The President 1 2013-01-01 2013-01-01 false Proclamation 8844 of July 27, 2012. National Korean War Veterans Armistice Day, 2012 8844 Proclamation 8844 Presidential Documents Proclamations Proclamation 8844 of July 27, 2012 Proc. 8844 National Korean War Veterans Armistice Day, 2012By the President...

3 CFR 8985 - Proclamation 8985 of May 21, 2013. National Maritime Day, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Proclamation 8985 of May 21, 2013. National Maritime..., 2013 Proc. 8985 National Maritime Day, 2013By the President of the United States of America A... extraordinary things as members of the United States Merchant Marine. When the idea of America depended on the...

3 CFR 9014 - Proclamation 9014 of September 6, 2013. National Days of Prayer and Remembrance, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Proclamation 9014 of September 6, 2013. National Days of Prayer and Remembrance, 2013 9014 Proclamation 9014 Presidential Documents Proclamations Proclamation 9014 of September 6, 2013 Proc. 9014 National Days of Prayer and Remembrance, 2013By the President of the United States of America A...

Factors determining anti-poliovirus type 3 antibodies among orally immunised Indian infants.

PubMed

Kaliappan, Saravanakumar Puthupalayam; Venugopal, Srinivasan; Giri, Sidhartha; Praharaj, Ira; Karthikeyan, Arun S; Babji, Sudhir; John, Jacob; Muliyil, Jayaprakash; Grassly, Nicholas; Kang, Gagandeep

2016-09-22

Among the three poliovirus serotypes, the lowest responses after vaccination with trivalent oral polio vaccine (tOPV) are to serotype 3. Although improvements in routine immunisation and supplementary immunisation activities have greatly increased vaccine coverage, there are limited data on antibody prevalence in Indian infants. Children aged 5-11months with a history of not having received inactivated polio vaccine were screened for serum antibodies to poliovirus serotype 3 (PV3) by a micro-neutralisation assay according to a modified World Health Organization (WHO) protocol. Limited demographic information was collected to assess risk-factors for a lack of protective antibodies. Student's t-test, logistic regression and multilevel logistic regression (MLR) model were used to estimate model parameters. Of 8454 children screened at a mean age of 8.3 (standard deviation [SD]-1.8) months, 88.1% (95% confidence interval (CI): 87.4-88.8) had protective antibodies to PV3. The number of tOPV doses received was the main determinant of seroprevalence; the maximum likelihood estimate yields a 37.7% (95% CI: 36.2-38.3) increase in seroprevalence per dose of tOPV. In multivariable logistic regression analysis increasing age, male sex, and urban residence were also independently associated with seropositivity (Odds Ratios (OR): 1.17 (95% CI: 1.12-1.23) per month of age, 1.27 (1.11-1.46) and 1.24 (1.05-1.45) respectively). Seroprevalence of antibodies to PV3 is associated with age, gender and place of residence, in addition to the number of tOPV doses received. Ensuring high coverage and monitoring of response are essential as long as oral vaccines are used in polio eradication. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Exploration, Encounter, Exchange in History: National History Day Curriculum Book, 2004.

ERIC Educational Resources Information Center

Mazzenga, Maria, Comp.

The theme for 2004's National History Day is "Exploration, Encounter, Exchange in History." This is a broad theme, so topics should be carefully selected and developed in ways that best reflect student talents and abilities. Studies should include an investigation into available primary and secondary sources, analysis of the evidence,…

Analysis of immune responses in genital tracts of mice immunised with purified ribosomal fractions of Neisseria gonorrhoeae.

PubMed Central

Kita, E; Kashiba, S

1984-01-01

Immunisation of ddY mice with the purified ribosomal fraction of Neisseria gonorrhoeae was found to protect against intravaginal challenge with homologous organisms. This protection correlated with the presence of bactericidal antibody to purified ribosomal fraction in serum as well as in vaginal secretions. Analysis of the vaginal fluids from control mice and those immunised with purified ribosomal fraction showed that the enhanced elimination of gonococci in immune mice might be because of an early response of leucocytes generated by the reaction mediated by antibody and complement. Absorption studies showed that there was at least one major protective antigen in purified ribosomal fraction, other than cell surface substances such as lipopolysaccharide, outer membrane proteins, and pili. Bactericidal assays mediated by antibody and complement showed that matched samples of serum and vaginal fluid from immune mice had comparable gonococcidal activity, which was augmented by the effect of progesterone. Although delayed hypersensitivity was produced in immune mice that were resistant to N gonorrhoeae, the exact role of cellular immunity could not be clarified in this study. These results suggest that antibody to purified ribosomal fraction plays a major part in protection against gonococcal infection in the genital tract, and that such protection may entail both cellular immunity and hormonal changes. PMID:6430462

Financial performance among adult day centers: results of a national demonstration program.

PubMed

Reifler, B V; Henry, R S; Rushing, J; Yates, M K; Cox, N J; Bradham, D D; McFarlane, M

1997-02-01

This paper describes the financial performance (defined as percent of total expenses covered by net operating revenue) of 16 adult day centers participating in a national demonstration program on day services for people with dementia, including examination of possible predictors of financial performance. Participating sites submitted quarterly financial and utilization reports to the National Program Office. Descriptive statistics summarize the factors believed to influence financial performance. Sites averaged meeting 35% of expenses from self-pay and 29% from government (mainly Medicaid) revenue, totaling 64% of all (cash plus in-kind) expenses met by operating revenue. Examination of center characteristics suggests that factors related to meeting consumer needs, such as being open a full day (i.e., 7:30 am to 6:00 pm) rather than shorter hours, and providing transportation, may be related to improved utilization and, thus, improved financial performance. Higher fees were not related to lower enrollment, census, or revenue. Adult day centers are able to achieve financial viability through a combination of operating (i.e., fee-for-service) and non-operating revenue. Operating revenue is enhanced by placing emphasis on consumer responsiveness, such as being open a full day. Because higher fees were not related to lower utilization, centers should set fees to reflect actual costs. The figure of 64% of expenses met by operating revenue is conservative inasmuch as sites included in-kind revenue as expenses in their budgeting calculations, and percent of cash expenses met by operating revenue would be higher (approximately 75% for this group of centers).

A Heterologous Multiepitope DNA Prime/Recombinant Protein Boost Immunisation Strategy for the Development of an Antiserum against Micrurus corallinus (Coral Snake) Venom.

PubMed

Ramos, Henrique Roman; Junqueira-de-Azevedo, Inácio de Loiola M; Novo, Juliana Branco; Castro, Karen; Duarte, Clara Guerra; Machado-de-Ávila, Ricardo A; Chavez-Olortegui, Carlos; Ho, Paulo Lee

2016-03-01

Envenoming by coral snakes (Elapidae: Micrurus), although not abundant, represent a serious health threat in the Americas, especially because antivenoms are scarce. The development of adequate amounts of antielapidic serum for the treatment of accidents caused by snakes like Micrurus corallinus is a challenging task due to characteristics such as low venom yield, fossorial habit, relatively small sizes and ophiophagous diet. These features make it difficult to capture and keep these snakes in captivity for venom collection. Furthermore, there are reports of antivenom scarcity in USA, leading to an increase in morbidity and mortality, with patients needing to be intubated and ventilated while the toxin wears off. The development of an alternative method for the production of an antielapidic serum, with no need for snake collection and maintenance in captivity, would be a plausible solution for the antielapidic serum shortage. In this work we describe the mapping, by the SPOT-synthesis technique, of potential B-cell epitopes from five putative toxins from M. corallinus, which were used to design two multiepitope DNA strings for the genetic immunisation of female BALB/c mice. Results demonstrate that sera obtained from animals that were genetically immunised with these multiepitope constructs, followed by booster doses of recombinant proteins lead to a 60% survival in a lethal dose neutralisation assay. Here we describe that the genetic immunisation with a synthetic multiepitope gene followed by booster doses with recombinant protein is a promising approach to develop an alternative antielapidic serum against M. corallinus venom without the need of collection and the very challenging maintenance of these snakes in captivity.

A New National MODIS-Derived Phenology Data Set Every 16 Days, 2002 through 2006

NASA Astrophysics Data System (ADS)

Hargrove, W. W.; Spruce, J.; Gasser, G.; Hoffman, F. M.; Lee, D.

2008-12-01

A new national phenology data set has been developed, comprised of a series of seamless 231m national maps, every 16 days from 2001 through 2006. The data set was developed jointly by the Eastern Forest Environmental Threat Assessment Center (EFETAC) of the USDA Forest Service, and contractors of the NASA Stennis Space Center. The data are available now for dissemination and use. The first half of the National Phenology Data Set is the cumulative area under the NDVI curve since Jan 1, and increases monotonically every 16 days until the end of the year. These cumulative data values "latch" in the event of clouds or snow, remaining at the value when we last saw this cell. The second half is a set of diagnostic parameters fit to the annual NDVI function. The spring minimum, the 20% rise, the 80% rise, the leaf-on maximum, the 80% fall, the 20% fall, and the trailing fall minimum are determined for each map cell. For each parameter, we produce both a national map of the NDVI value, and a map of the day-of-year when that NDVI value was reached. Length of growing season, as the difference between the spring and fall 20% DOYs, and date of middle of growing season can be mapped as well. The new dataset has permitted the development of a set of national phonological ecoregions, and has also proven useful for mapping Gypsy Moth defoliation, simultaneously delineating the aftermath of three Gulf Coast hurricanes, and quantifying suburban/ex-urban development surrounding metro Atlanta.

3 CFR 8502 - Proclamation 8502 of April 20, 2010. National Equal Pay Day, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... Enforcement Task Force to bolster enforcement of pay discrimination laws, making sure women get equal pay for... National Equal Pay Day. I call upon all Americans to acknowledge the injustice of wage discrimination and... 3 The President 1 2011-01-01 2011-01-01 false Proclamation 8502 of April 20, 2010. National Equal...

Pneumococcal disease in Australia: current status and future challenges. A report of the workshop held at the National Centre for Immunisation Research and Surveillance, 8-9 November, 2002.

PubMed

Roche, Paul; McIntyre, Peter; Spencer, Jenean

2003-01-01

In relation to surveillance, the predominant issue discussed was universal versus sentinel enhanced surveillance of IPD. In northern Australia, it will be important for enhanced surveillance to continue and to be as complete as possible. There are a number of reasons for this. First, the high incidence and high serotype diversity of IPD in Indigenous children in these areas has prompted the recommendation for boosters with 23vPPV to increase serotype coverage. This makes high quality, comprehensive surveillance essential for national policy. It is also important internationally as such as vaccine program has not been implemented anywhere else but is potentially applicable to other comparable populations. Secondly, the small absolute numbers of cases require data to be accumulated as comprehensively as possible. In relation to vaccine issues, both 23vPPV and 7vPCV policy are important. There was strong support from the meeting for the recent recommendation from the Australian Technical Advisory Group on Immunisation that both 23vPPV (for those over 65 years) and 7vPCV (for those less than 2 years) be publicly funded as universal programs. With respect to the current programs, there were important issues for Aboriginal and Torres Strait Islander people for both 23vPPV and 7vPCV. For 23vPPV, research is required into both the utility and frequency of boosters in adults as well as any potential role for 7vPCV in adults. Improving the identification of Aboriginal and Torres Strait Islander children is important, especially in urban areas.

Immune response to the mumps component of the MMR vaccine in the routine of immunisation services in the Brazilian National Immunisation Program

PubMed Central

dos Santos, Eliane Matos; Sá, Gloria Regina da Silva e; Siqueira, Marilda Mendonça; Martins, Reinaldo de Menezes; Camacho, Luiz Antonio Bastos; von Doellinger, Vanessa dos Reis; Maia, Maria de Lourdes de Sousa

2014-01-01

A non-controlled longitudinal study was conducted to evaluate the combined vaccine against measles, mumps and rubella (MMR) immunogenicity in 150 children vaccinated in the routine of three health units in the city of Rio de Janeiro, Brazil, 2008-2009, without other vaccines administered during the period from 30 days before to 30 days after vaccination. A previous study conducted in Brazil in 2007, in 1,769 children ranging from 12-15 months of age vaccinated against yellow fever and MMR simultaneously or at intervals of 30 days or more between doses, had shown low seroconversion for mumps regardless of the interval between administration of the two vaccines. The current study showed 89.5% (95% confidence interval: 83.3; 94.0) seroconversion rate for mumps. All children seroconverted for measles and rubella. After revaccination, high antibody titres and seroconversion rates were achieved against mumps. The results of this study and others suggest that two MMR doses confer optimal immunoresponses for all three antigens and the possible need for additional doses should be studied taking into account not only serological, but also epidemiological data, as there is no serological correlate of protection for mumps. PMID:24821058

Protocol for Pertussis Immunisation and Food Allergy (PIFA): a case–control study of the association between pertussis vaccination in infancy and the risk of IgE-mediated food allergy among Australian children

PubMed Central

Marsh, Julie A; Campbell, Dianne E; Gold, Michael S; Allen, Katrina J; Richmond, Peter; Waddington, Claire S; Snelling, Thomas L

2018-01-01

Introduction Atopic diseases, including food allergy, have become a predominant cause of chronic illness among children in developed countries. In Australia, a rise in hospitalisations among infants coded as anaphylaxis to foods coincided with the replacement of whole-cell pertussis (wP) vaccine with subunit acellular pertussis (aP) vaccine on the national immunisation schedule in the late 1990s. Atopy is characterised by a tendency to mount T helper type 2 (Th2) responses to otherwise innocuous environmental antigens. Compared with infants who receive aP as their first pertussis vaccine, those who receive wP appear less likely to mount Th2 immune responses to either vaccine or extraneous antigens. We therefore speculate that removal of wP from the vaccine schedule contributed to the observed rise in IgE-mediated food allergy among Australian infants. Methods and analysis This is a retrospective individually matched case–control study among a cohort of Australian children born from 1997 to 1999, the period of transition from wP to aP vaccines; we include in the cohort children listed on Australia’s comprehensive population-based immunisation register as having received a first dose of either pertussis vaccine by 16 weeks old. 500 cohort children diagnosed as having IgE-mediated food allergy at specialist allergy clinics will be included as cases. Controls matched to each case by date and jurisdiction of birth and regional socioeconomic index will be sampled from the immunisation register. Conditional logistic regression will be used to estimate OR (±95% CI) of receipt of wP (vs aP) as the first vaccine dose among cases compared with controls. Ethics and dissemination The study is approved by all relevant human research ethics committees: Western Australia Child and Adolescent Health Services (2015052EP), Women’s and Children’s Hospital (HREC/15/WCHN/162), Royal Children’s Hospital (35230A) and Sydney Children’s Hospital Network (HREC/15/SCHN/405

Health and Economic Outcomes of Introducing the New MenB Vaccine (Bexsero) into the Italian Routine Infant Immunisation Programme

PubMed Central

Tirani, Marcello; Meregaglia, Michela; Melegaro, Alessia

2015-01-01

Introduction In January 2013 a novel type of multicomponent protein-based vaccine against group B meningococcal disease was licensed by the European Medicines Agency. With the widespread use of the meningococcal serogroup C conjugate vaccines, serogroup B remains now the major cause of bacterial meningitis and septicaemia in young children in Europe. The aim of this study is to investigate the health and the economic outcomes of MenB vaccine introduction into the Italian routine mass vaccination programme. Methods The present work is structured in two main parts. Firstly, we assess the epidemiological burden of group B meningococcal disease using official hospitalisation and notification data from two of the most populated Italian regions (Lombardia and Piemonte) during a 6-year study period (2007-2012). Secondly, we evaluate the cost-effectiveness of the immunisation programme in Italy from the public health payer perspective under base case parameters assumptions and performing a comprehensive sensitivity analysis to assess the robustness and the uncertainty of our model results. Results MenB serotype is responsible for 59% of the 341 cases of Invasive Meningococcal Disease in Lombardia and Piemonte. Incidence rate for MenB infection is estimated to be 0.21/100,000/y resulting at the highest level in children ≤4 years of age. Although the new MenB vaccine can potentially prevent about one third of the disease cases in the Italian population, model results show this strategy is unlikely to be cost-effective (ICER value over €350,000/QALY) with a vaccine that prevents disease only. These results are robust under most of the sensitivity scenarios except when allowing for lower discount rates. Discussion The introduction of the novel vaccine into the routine immunisation schedule needs to be carefully evaluated. The new MenB vaccine has the potential to reduce the disease burden at the population level. However, from the Italian Health Service perspective, the

Health and economic outcomes of introducing the new MenB vaccine (Bexsero) into the Italian routine infant immunisation programme.

PubMed

Tirani, Marcello; Meregaglia, Michela; Melegaro, Alessia

2015-01-01

In January 2013 a novel type of multicomponent protein-based vaccine against group B meningococcal disease was licensed by the European Medicines Agency. With the widespread use of the meningococcal serogroup C conjugate vaccines, serogroup B remains now the major cause of bacterial meningitis and septicaemia in young children in Europe. The aim of this study is to investigate the health and the economic outcomes of MenB vaccine introduction into the Italian routine mass vaccination programme. The present work is structured in two main parts. Firstly, we assess the epidemiological burden of group B meningococcal disease using official hospitalisation and notification data from two of the most populated Italian regions (Lombardia and Piemonte) during a 6-year study period (2007-2012). Secondly, we evaluate the cost-effectiveness of the immunisation programme in Italy from the public health payer perspective under base case parameters assumptions and performing a comprehensive sensitivity analysis to assess the robustness and the uncertainty of our model results. MenB serotype is responsible for 59% of the 341 cases of Invasive Meningococcal Disease in Lombardia and Piemonte. Incidence rate for MenB infection is estimated to be 0.21/100,000/y resulting at the highest level in children ≤4 years of age. Although the new MenB vaccine can potentially prevent about one third of the disease cases in the Italian population, model results show this strategy is unlikely to be cost-effective (ICER value over €350,000/QALY) with a vaccine that prevents disease only. These results are robust under most of the sensitivity scenarios except when allowing for lower discount rates. The introduction of the novel vaccine into the routine immunisation schedule needs to be carefully evaluated. The new MenB vaccine has the potential to reduce the disease burden at the population level. However, from the Italian Health Service perspective, the immunisation programme is unlikely to be

Secrets in the Thirdspace: The National Day on Writing as Campus Engagement

ERIC Educational Resources Information Center

Fedukovich, Casie J.

2016-01-01

This article presents the National Day on Writing (NDOW) as an annual opportunity for writing programs to create program-supported thirdspaces (Burns; Mauk; Soja) that allow first-year writing students a laboratory in which to practice their developing rhetorical skills. The author proposes a contracted view of Ann Feldman's definition of…

Definition of an HPV18/45 cross-reactive human T-cell epitope after DNA immunisation of HLA-A2/KB transgenic mice.

PubMed

McCarthy, Corinna; Youde, Sarah J; Man, Stephen

2006-05-15

Although human papillomavirus (HPV) types 16 and 18 are the most common types associated with cervical cancer worldwide, other related HPV types such as HPV 35, 45 and 58 have significant prevalence in geographically distinct populations. For development of global prophylactic and therapeutic vaccine strategies, it is important to study immune responses against these viruses and to define the degree of cross-reactivity between related HPV types. To investigate the potential for T cell cross-reactivity after vaccination, HLA-A2/Kb transgenic mice were immunised with DNA plasmid constructs containing HPV18 and 45 E6 and E7. Splenocytes from immunised mice were tested in direct ELIspot assays against overlapping pools of HPV 18 peptides. Immunisation with either HPV18 or HPV45 E6 DNA produced dominant T cell responses against an epitope (KCIDFYSRI) that was shared between HPV18 and HPV45. This peptide was shown to bind to HLA-A*0201 but not Db or Kb molecules on the cell surface. Furthermore this peptide was shown to be immunogenic in vitro to human T cells from 2 out of 3 HLA-A2+ healthy donors. Collectively, these results demonstrate that HPV 18 and 45 E6 DNA vaccines are immunogenic in mice and demonstrate that cross-reactive T cell responses against closely related HPV types can be induced in vivo. The use of the HLA-A2/Kb transgenic mice allowed definition of an HLA-A*0201 binding peptide epitope that would have been rejected on the basis of predicted major histocompatibility complex binding affinity. Copyright (c) 2005 Wiley-Liss, Inc.

3 CFR 8870 - Proclamation 8870 of September 21, 2012. National Hunting and Fishing Day, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

... and streams where generations of families have connected with the land around them, America's great outdoors have always played an important role in our national life. On National Hunting and Fishing Day, we... who have helped make our country what it is today. Fulfilling our role as environmental stewards in...

Polio as a platform: using national immunization days to deliver vitamin A supplements.

PubMed Central

Goodman, T.; Dalmiya, N.; de Benoist, B.; Schultink, W.

2000-01-01

In 1988 the 41st World Health Assembly committed WHO to the goal of global eradication of poliomyelitis by 2000 "in ways which strengthen national immunization programmes and health infrastructure". The successful use of polio National Immunization Days (NIDs) to deliver vitamin A is an example of how polio eradication can serve as a platform to address other problems of child health. Importantly, this integration is helping to achieve the World Summit for Children goal of eliminating vitamin A deficiency by the year 2000. It is estimated that between 140 million and 250 million preschool children are at risk of subclinical vitamin A deficiency. In 1998 more than 60 million children at risk received vitamin A supplements during polio national immunization days (NIDs). While food fortification and dietary approaches are fundamental to combating vitamin A deficiency, the administration of vitamin A supplements during NIDs helps raise awareness, enhance technical capacity, improve assessment and establish a reporting system. Moreover, polio NIDs provide an entry point for the sustainable provision of vitamin A supplements with routine immunization services and demonstrate how immunization campaigns can be used for the delivery of other preventive health services. PMID:10812726

Monitoring of timely and delayed vaccinations: a nation-wide registry-based study of Norwegian children aged < 2 years.

PubMed

Riise, Øystein Rolandsen; Laake, Ida; Bergsaker, Marianne Adeleide Riise; Nøkleby, Hanne; Haugen, Inger Lise; Storsæter, Jann

2015-11-13

Delayed vaccinations increase the risk for vaccine preventable diseases (VPDs). Monitoring of delayed vaccinations by using a national immunisation registry has not been studied in countries recommending a two-dose (3 and 5 months of age) primary series of e.g., pertussis vaccine. Surveillance/monitoring of all vaccinations may improve vaccination programmes functioning. We obtained information from the Norwegian immunisation registry (SYSVAK) on all programme vaccinations received at age up to 730 days in children born in 2010 (n = 63,382). Timely vaccinations were received up to 7 days after the recommended age. Vaccinations were considered delayed if they were received more than one month after the recommended age in the schedule. In vaccinated children, timely administration of the subsequent three doses of pertussis and one dose of measles occurred in 73.8, 47.6, 53.6 and 43.5 % respectively. Delay for one or more programme vaccinations (diphtheria, tetanus, pertussis, polio, Haemophilus influenza type B, invasive pneumococcal disease, measles, mumps or rubella) was present in 28,336 (44.7 %) children. Among those who were delayed the mean duration was 139 days. The proportion of children that had vaccinations delayed differed among counties (range 37.4 %-57.8 %). Immigrant children were more frequently delayed 52.3 % vs. 43.1 %, RR 1.21 (95 % CI 1.19, 1.24). Children scheduled for vaccines in the summer holiday month (July) were more frequently delayed than others (1(st) dose pertussis vaccine 6.5 % vs. 3.9 % RR 1.65 (95 % CI 1.48, 1.85). Priming against pertussis (2(nd) dose), pneumococcal (2(nd) dose) and measles (1(st) dose) was delayed in 16.8, 18.6 and 29.3 % respectively. Vaccinations were frequently delayed. Delayed vaccinations differed among counties and occurred more frequently during the summer vacation (July) and in the immigrant population. Monitoring improves programme surveillance and may be used on an annual basis.

The formulation and immunisation of oral poly(DL-lactide-co-glycolide) microcapsules containing a plasmid vaccine against lymphocystis disease virus in Japanese flounder (Paralichthys olivaceus).

PubMed

Tian, Jiyuan; Sun, Xiuqin; Chen, Xiguang; Yu, Juan; Qu, Lingyun; Wang, Lingchong

2008-06-01

Nucleic acid-based immunotherapy is a new treatment option for fish immunisation in intensive culture. However, DNA-based vaccines would be hydrolyzed or denaturized because of the existence of nucleases and severe gastrointestinal conditions. Poly(DL-lactide-co-glycolide) (PLGA) microcapsules, loaded with plasmid DNA (pDNA) against lymphocystis disease virus (LCDV), were prepared by modified water in oil in water (W/O/W) double emulsion method in our laboratory. Encapsulation efficiency, loading percent and diameter of microcapsules were 78-88%, 0.5-0.7% and less than 10 mum, respectively. In simulated gastric fluid (SGF), less than 10% of pDNA was released from microcapsules in 12 h, and about 6.5% of pDNA was released in 12 h in simulated intestinal fluid (SIF). The content of the supercoiled of pDNA in microcapsules and control was 80% and 89% respectively, which indicated that a little supercoiled pDNA degradation occurred during encapsulation. RT-PCR showed that lots of RNA containing information of MCP gene existed in all tissues of fish vaccinated with microcapsules 10-90 days after oral administration. SDS-PAGE and immunoblots, as well as immunofluorescence images, displayed that major capsid protein (MCP) of LCDV was expressed in tissues of fish vaccinated with pDNA-loaded microcapsules. In addition, indirect enzyme-linked immunosorbent assay (ELISA) showed that the immune responses of sera were positive (O.D> or =0.3) from week 1 to week 24 for fish vaccinated with microcapsules, in comparison with fish vaccinated with naked pDNA. Our results suggested that PLGA microcapsules were promising oral carriers for pDNA delivery. This encapsulation technique had potential for drug delivery applications due to its ease of operation and notable immunisation efficacy.

Sustainability of National Immunization Programme (NIP) performance and financing following Global Alliance for Vaccines and Immunization (GAVI) support to the Democratic Republic of the Congo (DRC).

PubMed

Le Gargasson, Jean-Bernard; Breugelmans, J Gabrielle; Mibulumukini, Benoît; Da Silva, Alfred; Colombini, Anaïs

2013-04-08

The Global Alliance for Vaccines and Immunization (GAVI) is a public-private global health partnership aiming to increase access to immunisation in poor countries. The Democratic Republic of the Congo (DRC) is the third largest recipient of GAVI funds in terms of cumulative disbursed support. We provided a comprehensive assessment of GAVI support and analysed trends in immunisation performance and financing in the DRC from 2002 to 2010. The scope of the analysis includes GAVI's total financial support and the value of vaccines and syringes purchased by GAVI for the DRC from 2002 to 2010. Data were collected through a review of published and grey literature and interviews with key stakeholders in the DRC. We assessed the allocation and use of GAVI funds for each of GAVI's support areas, as well as trends in immunisation performance and financing. DTP3 coverage increased from 2002 (38%) to 2007 (72%) but had decreased to a level below 70% in 2008 (68%) and 2010 (63%). The overall funding for vaccines increased from US$5.4 million in 2006 to US$30.5 million in 2010 (mostly from GAVI support for new vaccines). However, during the same period, the funding from national (government) and international (GAVI and other donors) sources for routine immunisation services (except vaccines) decreased from US$36.4 million to US$24.4 million. This drop in overall funding (33%) primarily affected surveillance, transport, and cold chain equipment. GAVI support to DRC has enhanced significant progress in routine immunisation performance and financing during 2002-2010. Although progress has been partly sustained, the initial observed increase in DTP3 coverage and available funding for routine immunisation halted towards the end of the analysis period, coinciding with tetravalent and pentavalent vaccine introduction. These findings highlight the need for additional efforts to ensure the sustainability of routine immunization program performance and financing. Copyright © 2013 Elsevier

Industry and Day Care II. Proceedings of the National Conference on Industry and Day Care (2nd, March, 1972, Chicago, Illinois).

ERIC Educational Resources Information Center

Schatz, Eunice, Ed.; Flaum, Thea K., Ed.

The Second National Conference on Industry and Day Care, sponsored by Urban Research Corporation in 1970, brought together representatives of industry, community agencies, and early childhood specialists to discuss mutual concerns and explore the role that industry might play in the development of child care services. The report lists 17 ways in…

Effect of the glucocorticosteroid budesonide and a novel phosphodiesterase type 4 inhibitor CDP840 on antigen-induced airway responses in neonatally immunised rabbits.

PubMed Central

Gozzard, N.; el-Hashim, A.; Herd, C. M.; Blake, S. M.; Holbrook, M.; Hughes, B.; Higgs, G. A.; Page, C. P.

1996-01-01

1. The effects of the inhaled corticosteroid budesonide and a novel PDE 4 inhibitor CDP840 given systematically, were evaluated in a model of antigen-induced airway inflammation in the rabbit. 2. Adult litter-matched NZW rabbits (2.4-3.5 kg) immunised within 24 h of birth with Alternaria tenuis antigen were pretreated with budesonide (total dose 100 micrograms, inhaled over 2 days) or CDP840 (total dose 7 mg kg-1, i.p. over 3 days), before antigen challenge. For each drug-treated group a parallel group of rabbits was pretreated with the appropriate vehicle. In all groups airway responsiveness to inhaled histamine was assessed and bronchoalveolar lavage (BAL) performed 24 h before and after antigen challenge. 3. Basal lung function in terms of total lung resistance (RL; cmH2O l 1s-1) and dynamic compliance (Cdyn; ml cmH2O-1) were unaltered by pretreatment with budesonide or CDP840 compared to their respective vehicles 24 h before or after antigen challenge. 4. The RL component of the acute bronchoconstriction induced by inhaled Alternaria tenuis aerosol was unaffected by pretreatment with budesonide. However, budesonide prevented the fall in Cdyn due to antigen. Treatment with CDP840 significantly reduced antigen-induced acute bronchoconstriction in terms of both RL and Cdyn. 5. Airway hyperresponsiveness (AHR) to inhaled histamine was indicated by reduced RL PC50 (2.4-4.5 fold) and Cdyn PC35 (2.1-3.9 fold) values 24 h after antigen challenge. Treatment with either budesonide or CDP840 abolished the antigen-induced increase in responsiveness to inhaled histamine. 6. Total cells recovered per ml of BAL fluid increased 24 h after antigen challenge. Antigen-induced pulmonary eosinophilia was reduced (93%) in budesonide and (85%) in CDP840 treated rabbits. Antigen-induced increases in neutrophil numbers were reduced (76%) with budesonide but not CDP840 pretreatment. 7. Inhalation of Alternaria tenuis aerosol elicited an acute bronchoconstriction, followed 24 hours later

3 CFR 8709 - Proclamation 8709 of September 9, 2011. National Grandparents Day, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... September 9, 2011 Proc. 8709 National Grandparents Day, 2011By the President of the United States of America A Proclamation The support of loved ones provides the earliest and often most powerful influence on... our grandparents as they have for us. We must keep Social Security strong and viable, while preserving...

Paediatric otogenic tetanus: an evidence of poor immunization in Nigeria.

PubMed

Ogunkeyede, Segun Ayodeji; Daniel, Adekunle; Ogundoyin, Omowonuola

2017-01-01

Suppurative otitis media is a common childhood infection that predisposes to otogenic tetanus. Tetanus is a vaccine preventable disease that is associated with high cost of care and mortality. This study highlights reasons for otogenic tetanus in Nigerian children and way of reducing the menace. This is a 5-year retrospective review of all patients managed for otogenic tetanus in at the Department of Otorhinolaryngology, University College Hospital, Ibadan. The data collected include demographic, clinical presentations, tetanus immunisation history, and duration of hospital admission, and management- outcome. There were 23 patients comprising of 13(56.5 %) males and 10 (43.5%) females, male to female ratio was 1.3:1. The age ranged between 11 months and12 years (mean age 3.4 years ± 2.1). All the patients presented with discharging ear, trismus and spasms. The onset of symptoms prior hospital presentation ranged between 2 - 11 days (mean 3.0 days ± 1.3). Only 12(52.1%) patients had complete childhood tetanus immunisation, 6(26.1) % had no tetanus immunisation and no other childhood immunisation, while 5(21.7%) had partial tetanus immunisation. The discharging ears were managed by self-medication and other harmful health practices. The hospital admission ranged from 20 days - 41days (average of 23days) and there were 3(13.0 %) death. Tetanus immunization was not received because of; non- availability of the vaccine at health centers, lack of health facility in communities, fear of complications from immunization, poor awareness of the immunization programme. Tetanus, an immunisable disease, is still a major problem in Nigeria.

Evaluation of a pilot intervention to redesign the decentralised vaccine supply chain system in Nigeria.

PubMed

Molemodile, Shola; Wotogbe, Maruchi; Abimbola, Seye

2017-05-01

Responsibility for immunisation in Nigeria is decentralised to sub-national governments. So far, they have failed to achieve optimal coverage for their populations. We evaluated a pilot intervention implemented between 2013 and 2014 to redesign a vaccine supply chain management system in Kano, Nigeria. The intervention included financing immunisation services from a designated pool of government and donor funds, a visibility tool to track vaccine stock, and a private vendor engaged to deliver vaccines directly to health facilities. The number of local government areas within the state with adequate vaccine stock increased from 21% to 98% after 10 months. To understand how the intervention achieved this outcome, we analysed immunisation coverage for the period and interviewed 18 respondents across different levels of government. We found that the intervention worked by improving ownership and accountability for immunisation by sub-national governments and their capacity for generating resources and management (of data and the supply chain). While the intervention focused on improving immunisation coverage, we identified gaps in the demand for services. Efforts to improve immunisation coverage and vaccine supply systems should streamline decentralised structures, empower sub-national governments with financial and technical capacity, and promote strategies to improve the demand and use of services.

3 CFR 8339 - Proclamation 8339 of January 15, 2009. National Sanctity of Human Life Day, 2009

Code of Federal Regulations, 2010 CFR

2010-01-01

... Sanctity of Human Life Day, 2009 8339 Proclamation 8339 Presidential Documents Proclamations Proclamation 8339 of January 15, 2009 Proc. 8339 National Sanctity of Human Life Day, 2009By the President of the United States of America A Proclamation All human life is a gift from our Creator that is sacred, unique...

Use of Mobile Information Technology during Planning, Implementation and Evaluation of a Polio Campaign in South Sudan.

PubMed

Haskew, John; Kenyi, Veronica; William, Juma; Alum, Rebecca; Puri, Anu; Mostafa, Yehia; Davis, Robert

2015-01-01

Use of mobile information technology may aid collection of real-time, standardised data to inform and improve decision-making for polio programming and response. We utilised Android-based smartphones to collect data electronically from more than 8,000 households during a national round of polio immunisation in South Sudan. The results of the household surveys are presented here, together with discussion of the application of mobile information technology for polio campaign planning, implementation and evaluation in a real-time setting. Electronic questionnaires were programmed onto Android-based smartphones for mapping, supervision and survey activities during a national round of polio immunisation. National census data were used to determine the sampling frame for each activity and select the payam (district). Individual supervisors, in consultation with the local district health team, selected villages and households within each payam. Data visualisation tools were utilised for analysis and reporting. Implementation of mobile information technology and local management was feasible during a national round of polio immunisation in South Sudan. Red Cross visits during the polio campaign were equitable according to household wealth index and households who received a Red Cross visit had significantly higher odds of being aware of the polio campaign than those who did not. Nearly 95% of children under five were reported to have received polio immunisation (according to maternal recall) during the immunisation round, which varied by state, county and payam. A total of 11 payams surveyed were identified with less than 90% reported immunisation coverage and the least poor households had significantly higher odds of being vaccinated than the most poor. More than 95% of households were aware of the immunisation round and households had significantly higher odds of being vaccinated if they had prior awareness of the campaign taking place. Pre-campaign community education

Use of Mobile Information Technology during Planning, Implementation and Evaluation of a Polio Campaign in South Sudan

PubMed Central

Haskew, John; Kenyi, Veronica; William, Juma; Alum, Rebecca; Puri, Anu; Mostafa, Yehia; Davis, Robert

2015-01-01

Background Use of mobile information technology may aid collection of real-time, standardised data to inform and improve decision-making for polio programming and response. We utilised Android-based smartphones to collect data electronically from more than 8,000 households during a national round of polio immunisation in South Sudan. The results of the household surveys are presented here, together with discussion of the application of mobile information technology for polio campaign planning, implementation and evaluation in a real-time setting. Methods Electronic questionnaires were programmed onto Android-based smartphones for mapping, supervision and survey activities during a national round of polio immunisation. National census data were used to determine the sampling frame for each activity and select the payam (district). Individual supervisors, in consultation with the local district health team, selected villages and households within each payam. Data visualisation tools were utilised for analysis and reporting. Results Implementation of mobile information technology and local management was feasible during a national round of polio immunisation in South Sudan. Red Cross visits during the polio campaign were equitable according to household wealth index and households who received a Red Cross visit had significantly higher odds of being aware of the polio campaign than those who did not. Nearly 95% of children under five were reported to have received polio immunisation (according to maternal recall) during the immunisation round, which varied by state, county and payam. A total of 11 payams surveyed were identified with less than 90% reported immunisation coverage and the least poor households had significantly higher odds of being vaccinated than the most poor. More than 95% of households were aware of the immunisation round and households had significantly higher odds of being vaccinated if they had prior awareness of the campaign taking place

Mortality on match days of the German national soccer team: a time series analysis from 1995 to 2009.

PubMed

Medenwald, D; Kuss, O

2014-09-01

There is inconsistent evidence on population mortality, especially cardiovascular disease mortality, on match days of national soccer teams during particular international tournaments. This study examines the number of deaths in Germany on match days of the national soccer team during a long-term period including several tournaments. We analysed all registered daily deaths in Germany from 1995 to 2009 (11 225 966 cases) using time series analysis methods. Following the Box/Jenkins approach, we applied a seasonal autoregressive integrated moving average model. To assess the effect of match days, we performed an intervention analysis by including a transfer function model representing match days of the national team in the statistical analyses. We conducted separate analyses for all matches and for matches during international tournaments (European and World Championships) only. Time series and results were stratified in terms of sex, age (<50 years, 50-70 years, >70 years) and cause of death (cardiovascular deaths, injuries, others). We performed a further independent analysis focusing only on the effect of match results (victory, loss, draw) and kind of tournament (international championships, qualifications, friendly matches). Most of the results did not indicate a distinct effect of matches of the national team on general mortality. Moreover, all null value deviations were small when compared with the average number of daily deaths (n=2270). There is no relevant increase or decrease in mortality on match days of the German national soccer team. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The polio endgame: rationale behind the change in immunisation.

PubMed

Garon, Julie; Patel, Manish

2017-04-01

The decades long effort to eradicate polio is nearing the final stages and oral polio vaccine (OPV) is much to thank for this success. As cases of wild poliovirus continue to dwindle, cases of paralysis associated with OPV itself have become a concern. As type-2 poliovirus (one of three) has been certified eradicated and a large proportion of OPV-related paralysis is caused by the type-2 component of OPV, the World Health Assembly endorsed the phased withdrawal of OPV and the introduction of inactivated polio vaccine (IPV) into routine immunisation schedules as a crucial step in the polio endgame plan. The rapid pace of IPV scale-up and uptake required adequate supply, planning, advocacy, training and operational readiness. Similarly, the synchronised switch from trivalent OPV (all three types) to bivalent OPV (types 1 and 3) involved an unprecedented level of global coordination and country commitment. The important shift in vaccination policy seen through global IPV introduction and OPV withdrawal represents an historical milestone reached in the polio eradication effort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

3 CFR 8785 - Proclamation 8785 of March 19, 2012. National Day of Honor

Code of Federal Regulations, 2013 CFR

2013-01-01

... Proc. 8785 National Day of HonorBy the President of the United States of America A Proclamation Nine... began one of the most challenging missions our military has ever known. They left the comforts of home... Nation’s longest wars, veterans of Operation Iraqi Freedom and Operation New Dawn wrote one of the most...

HIV blocking antibodies following immunisation with chimaeric peptides coding a short N-terminal sequence of the CCR5 receptor.

PubMed

Chain, Benjamin M; Noursadeghi, Mahdad; Gardener, Michelle; Tsang, Jhen; Wright, Edward

2008-10-23

The chemokine receptor CCR5 is required for cellular entry by many strains of HIV, and provides a potential target for molecules, including antibodies, designed to block HIV transmission. This study investigates a novel approach to stimulate antibodies to CCR5. Rabbits were immunised with chimaeric peptides which encode a short fragment of the N-terminal sequence of CCR5, as well as an unrelated T cell epitope from Tetanus toxoid. Immunisation with these chimaeric peptides generates a strong antibody response which is highly focused on the N-terminal CCR5 sequence. The antibody to the chimaeric peptide containing an N-terminal methionine also recognises the full length CCR5 receptor on the cell surface, albeit at higher concentrations. Further comparison of binding to intact CCR5 with binding to CCR5 peptide suggest that the receptor specific antibody generated represents a very small fragment of the total anti-peptide antibody. These findings are consistent with the hypothesis that the N-terminal peptide in the context of the intact receptor has a different structure to that of the synthetic peptide. Finally, the antibody was able to block HIV infection of macrophages in vitro. Thus results of this study suggest that N-terminal fragments of CCR5 may provide potential immunogens with which to generate blocking antibodies to this receptor, while avoiding the dangers of including T cell auto-epitopes.

HIV blocking antibodies following immunisation with chimaeric peptides coding a short N-terminal sequence of the CCR5 receptor

PubMed Central

Chain, Benjamin M.; Noursadeghi, Mahdad; Gardener, Michelle; Tsang, Jhen; Wright, Edward

2008-01-01

The chemokine receptor CCR5 is required for cellular entry by many strains of HIV, and provides a potential target for molecules, including antibodies, designed to block HIV transmission. This study investigates a novel approach to stimulate antibodies to CCR5. Rabbits were immunised with chimaeric peptides which encode a short fragment of the N-terminal sequence of CCR5, as well as an unrelated T cell epitope from Tetanus toxoid. Immunisation with these chimaeric peptides generates a strong antibody response which is highly focused on the N-terminal CCR5 sequence. The antibody to the chimaeric peptide containing an N-terminal methionine also recognises the full length CCR5 receptor on the cell surface, albeit at higher concentrations. Further comparison of binding to intact CCR5 with binding to CCR5 peptide suggest that the receptor specific antibody generated represents a very small fragment of the total anti-peptide antibody. These findings are consistent with the hypothesis that the N-terminal peptide in the context of the intact receptor has a different structure to that of the synthetic peptide. Finally, the antibody was able to block HIV infection of macrophages in vitro. Thus results of this study suggest that N-terminal fragments of CCR5 may provide potential immunogens with which to generate blocking antibodies to this receptor, while avoiding the dangers of including T cell auto-epitopes. PMID:18765264

Adding justice to the clinical and public health ethics arguments for mandatory seasonal influenza immunisation for healthcare workers.

PubMed

Lee, Lisa M

2015-08-01

Ethical considerations from both the clinical and public health perspectives have been used to examine whether it is ethically permissible to mandate the seasonal influenza vaccine for healthcare workers (HCWs). Both frameworks have resulted in arguments for and against the requirement. Neither perspective resolves the question fully. By adding components of justice to the argument, I seek to provide a more fulsome ethical defence for requiring seasonal influenza immunisation for HCWs. Two critical components of a just society support requiring vaccination: fairness of opportunity and the obligation to follow democratically formulated rules. The fairness of opportunity is informed by Rawls' two principles of justice. The obligation to follow democratically formulated rules allows us to focus simultaneously on freedom, plurality and solidarity. Justice requires equitable participation in and benefit from cooperative schemes to gain or profit socially as individuals and as a community. And to be just, HCW immunisation exemptions should be limited to medical contraindications only. In addition to the HCWs fiduciary duty to do what is best for the patient and the public health duty to protect the community with effective and minimally intrusive interventions, HCWs are members of a just society in which all members have an obligation to participate equitably in order to partake in the benefits of membership. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[An epidemic risk of yellow fever in Burkina Faso despite a rapid immunisation riposte: role of a multidisciplinary investigation team].

PubMed

Barennes, H; Baldet, T; Cassel, A-M; Kabiré, C; Kambou, C

2002-01-01

On October 8, 1999, one yellow fever (YF) case is confirmed in the South West of Burkina Faso by the Centre Muraz' virology unit. Epidemic extension is suspected as large movements of population are occurring due to troubles in Côte d'Ivoire nearby and as the Aedes vector is endemic in the region. On October 23, the Gaoua's Health Regional Head immunizes 1,000 people around the detected YF case, i.e. 70% of the estimated population and requests an epidemiological investigation. A multidisciplinary team (epidemiologist, entomologist, virologist) from the Centre Muraz, a medical research centre based in Bobo Dioulasso investigate in order to answer the following questions: are there any other or asymptomatic cases of YF? How far is the epidemic risk? Is a paper filter a valuable method for collecting blood samples? What benefit can be gained from a multidisciplinary team? An epidemiological analysis of the patient, a research of asymptomatic or ignored patient is performed (Health Centre registers, interview of the population). This includes the research of people missing the immunisation campaign. Blood samples are collected through 5 ml EDTA glass tubes or through filter paper in order to measure immunoglobuline M. A classical entomological prospecting completes the investigation. Two possible cases are suspected in the patient's home. History of the patient's is in agreement with a local contamination. In the village 110 people missed the immunisation campaign and samples were collected in 58 people including 26 children. Among them, four (15.3%) were positive with immunoglobuline M, while there were none in the adults. Aedes Luteocephalus, a potential vector is collected through night-captures but is absent of home-water collection. Paper filter assays shows a 100% concordance with classical method. The team could determine the persistency of a yellow fever epidemic risk in the region despite a rapid and adequate immunisation riposte. Due to iterative sporadic

3 CFR 8799 - Proclamation 8799 of April 9, 2012. National Former Prisoner of War Recognition Day, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

... Prisoner of War Recognition Day, 2012 8799 Proclamation 8799 Presidential Documents Proclamations Proclamation 8799 of April 9, 2012 Proc. 8799 National Former Prisoner of War Recognition Day, 2012By the...’s call with courage and valor, braving the peril of combat and pressing onward in the face of...

Nano-sized Soluplus® polymeric micelles enhance the induction of tetanus toxin neutralising antibody response following transcutaneous immunisation with tetanus toxoid.

PubMed

Saydam, Manolya; Cheng, Woei Ping; Palmer, Nathan; Tierney, Robert; Francis, Robert; MacLellan-Gibson, Kirsty; Khan, Ambreen; Mawas, Fatme

2017-04-25

The use of Soluplus® polymeric micelles as a novel adjuvant for tetanus toxoid (TTxd) in transcutaneous immunisation was evaluated. TTxd was added to Soluplus® polymeric micelles to form TTxd-Soluplus® nano-aggregates with a size of 68nm. Non-adjuvanted TTxd commonly induces very poor antibody response by the transcutaneous route. However, in this study, the use of TTxd-Soluplus® resulted in a significant increase in the antibody response to TTxd, which was similar to that induced in the presence of CPG-oligodeoxynucleotides (CPG-ODNs) adjuvant. The toxin neutralising potency of the immune sera induced by TTxd-Soluplus® was also much stronger than that from TTxd alone, in a passive transfer experiment in mice. Soluplus® also enhanced the immunogenicity of the toxoid when TTxd-Soluplus® was stored at 4°C for 4weeks, but not at higher temperatures. Confocal microscopy imaging showed a much higher uptake of TTxd in the epidermis and dermis layers of the skin when it was associated with Soluplus®, suggesting that the mechanism for Soluplus® adjuvanticity is through enhanced uptake of the TTxd through the skin. Overall, our findings demonstrated that Soluplus® is an effective novel adjuvant for transcutaneous immunisation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Certification of poliomyelitis eradication in Singapore and the challenges ahead.

PubMed

Lee, Hwee Ching; Tay, Joanne; Kwok, Cynthia Y H; Wee, Moi Kim; Ang, Li Wei; Kita, Yuske; Cutter, Jeffery L; Chan, Kwai Peng; Chew, Suok Kai; Goh, Kee Tai

2012-11-01

This study reviewed the epidemiological trends of poliomyelitis from 1946 to 2010, and the impact of the national immunisation programme in raising the population herd immunity against poliovirus. We also traced the efforts Singapore has made to achieve certification of poliomyelitis eradication by the World Health Organisation. Epidemiological data on all reported cases of poliomyelitis were obtained from the Communicable Diseases Division of the Ministry of Health as well as historical records. Coverage of the childhood immunisation programme against poliomyelitis was based on the immunisation data maintained by the National Immunisation Registry, Health Promotion Board. To assess the herd immunity of the population against poliovirus, 6 serological surveys were conducted in 1962, 1978, 1982 to 1984, 1989, 1993 and from 2008 to 2010. Singapore was among the fi rst countries in the world to introduce live oral poliovirus vaccine (OPV) on a mass scale in 1958. With the comprehensive coverage of the national childhood immunisation programme, the incidence of paralytic poliomyelitis declined from 74 cases in 1963 to 5 cases from 1971 to 1973. The immunisation coverage for infants, preschool and primary school children has been maintained at 92% to 97% over the past decade. No indigenous poliomyelitis case had been reported since 1978 and all cases reported subsequently were imported. Singapore was certified poliomyelitis free along with the rest of the Western Pacific Region in 2000 after fulfilling all criteria for poliomyelitis eradication, including the establishment of a robust acute flaccid paralysis surveillance system. However, post-certification challenges remain, with the risk of wild poliovirus importation. Furthermore, it is timely to consider the replacement of OPV with the inactivated poliovirus vaccine in Singapore's national immunisation programme given the risk of vaccine-associated paralytic poliomyelitis and circulating vaccine-derived polioviruses.

3 CFR 8719 - Proclamation 8719 of September 22, 2011. National Public Lands Day, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

...—vital economic engines in both rural and urban communities. On National Public Lands Day, we take time... lakes, and pick up litter in city parks. Through their service, families and children will find..., America’s Great Outdoors: A Promise to Future Generations. To act on these findings, we are undertaking...

Evaluation of Compliance to National Nutrition Policies in Summer Day Camps

PubMed Central

Tilley, Falon; W.Beets, Michael; Jones, Sonya; Turner-McGrievy, Gabrielle

2015-01-01

Objective The National Afterschool Association (NAA) standards specify the role of summer day camps (SDCs) in promoting healthy nutrition habits of children attending, identifying foods and beverages to be provided to children, and staff roles in promoting good nutrition habits; however, many SDCs to not provide meals. Currently, national guidelines specifying what children are allowed to bring to such settings does not exist, nor is there a solid understanding of the current landscape surrounding healthy eating within SDCs. Design A cross-sectional study design using validated measures with multiple observations was used to determine the types of foods and beverage brought to SDC programs. Setting Four large-scale, community-based SDCs participated in the study during summer 2011. Subjects The types of foods and beverages brought by children (N=766) and staff (N=87) as well as any instances of staff promoting healthy eating behaviors were examined via direct observation over 27 days. Additionally, the extent to which current foods and beverages at SDCs complied with NAA standards was evaluated. Results Less than half of the children brought water, 47% brought non-100% juices, 4% brought soda, 4% brought a vegetable, and 20% brought fruit. Staff foods/beverages modeled similar patterns. Promotion of healthy eating by staff was observed <1% of the time. Conclusions Findings suggest that foods and beverages brought to SDC by children and staff do support nutrition standards and staff do not regularly promote healthy eating habits. To assist, professional development, parent education, and organizational policies are needed. PMID:24909716

3 CFR 8974 - Proclamation 8974 of May 1, 2013. National Day of Prayer, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... Prayer, 2013 8974 Proclamation 8974 Presidential Documents Proclamations Proclamation 8974 of May 1, 2013 Proc. 8974 National Day of Prayer, 2013By the President of the United States of America A Proclamation Americans have long turned to prayer both in times of joy and times of sorrow. On their voyage to the New...

3 CFR 8475 - Proclamation 8475 of January 20, 2010. National Angel Island Day, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... and their children. Many arrived at Angel Island, weary but hopeful, only to be unjustly confined for... contributed immeasurably to our Nation as leaders in every sector of American life. The children of Angel... and activities. IN WITNESS WHEREOF, I have hereunto set my hand this twentieth day of January, in the...

Inequalities in immunisation and breast feeding in an ethnically diverse urban area: cross-sectional study in Manchester, UK.

PubMed

Baker, Deborah; Garrow, Adam; Shiels, Christopher

2011-04-01

To examine inequalities in immunisation and breast feeding by ethnic group and their relation to relative deprivation. Cross-sectional study. Manchester, UK. 20 203 children born in Manchester (2002-2007), who had been coded as of white, mixed, Indian, Pakistani, Bangladeshi and black or black British ethnicity in the Child Health System database. Breast feeding at 2 weeks post partum; uptake of triple vaccine (diphtheria, pertussis and tetanus) at 16 weeks post partum; uptake of the measles, mumps and rubella vaccine (MMR) by the age of 2. Black or black British infants had the highest rates of breast feeding at 2 weeks post partum (89%), and South Asian infants had the highest triple and MMR vaccination rates (Indian, 95%, 96%; Pakistani 95%, 95%; Bangladeshi 96%, 95%) after area level of deprivation, parity, parenthood status and age had been controlled for. White infants were least likely to be breast fed at 2 weeks post partum (36%), and to be vaccinated with triple (92%) and MMR vaccines (88%). Within the white ethnic group, lower percentages of immunisation and breast feeding were significantly associated with living in a deprived area and with increasing parity. This was not found within black or black British and Pakistani ethnic groups. Practices that are protective of child health were consistently less likely to be adopted by white mothers living in deprived areas. Methods of health education and service delivery that are designed for the general population are unlikely to be successful in this context, and evidence of effective interventions needs to be established.

Sun-Earth Days- "Have a Solar Blast"- Educational Outreach on a National Scale

NASA Astrophysics Data System (ADS)

Mortfield, P.; Lewis, E. M.; Cline, T.; Thieman, J. R.

2001-05-01

Sun-Earth Days was an Educational Outreach on a Massive Scale. This was NASA's first-ever "Sun-Earth Days," April 27-28, 2001, developed to share information and excitement about our star and its electric connection to Earth. For the year 2001, NASA's Sun-Earth Connection missions and The Astronomical League partnered to sponsor this educational and entertaining event in the context of National Astronomy Day and Week. As part of NASA's Sun-Earth Connection Education Forum's Sun-Earth Day events, a webcast was hosted by EPO team at Stanford SOLAR Center in collaboration with Astronomy Day and Project Astro. Prior to the webcast NASA Centers and the Educator Resource Centers conducted training workshops to aid 4000 teachers in their participation in the interactive webcast. The webcast involved 35,000 students from across the country and allowed students an opportunity to present results from a variety of solar activities and interact with fellow students. NASA Scientists were on hand to field questions, and had the opportunity to tell viewers why they chose their exciting careers. Webcasts are a great way to reach and interact with a large audience of educators and students who wish to incorporate the science of the Sun into their curriculum. Sun-Earth Days was on the Web, with a single website of information, featuring excellent classroom activities and ideas, selections of the best background reading on the science, links to our many spacecraft and science missions, and some pointers to raw science data and imagery on the web. Sun-Earth Days kits were assembled and packaged through NASA's CORE, a distribution facility in Ohio and mailed to each of the NASA Centers and 25 Educator Resource Centers who participated in a training workshop for educators. Over 4000 educators attended workshops through the NASA network to learn about the Sun. " An Event Near You", portion of the website, listed the events within the USA that linked scientists with educators and created

76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-26

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2013 Through June 30, 2014...

76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

Cold chain status at immunisation centres in Ethiopia.

PubMed

Berhane, Y; Demissie, M

2000-09-01

Child immunisation is among the most cost-effective ways of preventing premature child deaths, and the potency of vaccines, crucial for vaccine efficacy, is dependent on effective management of the cold chain at all levels of vaccine handling. To assess the status of the cold chain at peripheral vaccine stores in Ethiopia. Institution based cross-sectional survey in two rural and one urban administrative areas were included in the study. Sixty seven health institutions providing static vaccination services were included in the study but cold chain system was assessed fully in only sixty four. Data were collected by interviewing health workers and by directly observing the cold chain equipment and records using structured forms. Conditions of the cold chain system were described based on 64 of the 67 centres visited, three were excluded because of non-functioning cold chain. Complete temperature record was observed in 37 (57.8%) of the centres. Thermometer was not available in four (6.3%) and thermometer reading was found to be outside the optimal range in another seven (10.9%) centres. Vaccine storage in the refrigerator was not proper in 47 (73.4%) centres. Majority of the centres had neither trained personnel nor budget for maintenance of the cold chain. There is a real danger of vaccines losing their potency at these centres even if they were potent on arrival. Relevant training for those handling the cold chain, improving the maintenance conditions of refrigerators and introduction of cold chain monitoring devises are recommended.

Healthcare providers’ knowledge, experience and challenges of reporting adverse events following immunisation: a qualitative study

PubMed Central

2013-01-01

Background Healthcare provider spontaneous reporting of suspected adverse events following immunisation (AEFI) is central to monitoring post-licensure vaccine safety, but little is known about how healthcare professionals recognise and report to surveillance systems. The aim of this study was explore the knowledge, experience and attitudes of medical and nursing professionals towards detecting and reporting AEFI. Methods We conducted a qualitative study, using semi-structured, face to face interviews with 13 Paediatric Emergency Department consultants from a tertiary paediatric hospital, 10 General Practitioners, 2 local council immunisation and 4 General Practice nurses, recruited using purposive sampling in Adelaide, South Australia, between December 2010 and September 2011. We identified emergent themes related to previous experience of an AEFI in practice, awareness and experience of AEFI reporting, factors that would facilitate or impede reporting and previous training in vaccine safety. Thematic analysis was used to analyse the data. Results AEFI reporting was infrequent across all groups, despite most participants having reviewed an AEFI. We found confusion about how to report an AEFI and variability, according to the provider group, as to the type of events that would constitute a reportable AEFI. Participants’ interpretation of a “serious” or “unexpected” AEFI varied across the three groups. Common barriers to reporting included time constraints and unsatisfactory reporting processes. Nurses were more likely to have received formal training in vaccine safety and reporting than medical practitioners. Conclusions This study provides an overview of experience and beliefs of three healthcare professional groups in relation to identifying and reporting AEFI. The qualitative assessment reveals differences in experience and awareness of AEFI reporting across the three professional groups. Most participants appreciated the importance of their role in

17 CFR 240.15a-4 - Forty-five day exemption from registration for certain members of national securities exchanges.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Forty-five day exemption from registration for certain members of national securities exchanges. 240.15a-4 Section 240.15a-4 Commodity and... national securities exchanges. (a) A natural person who is a member of a national securities exchange shall...

78 FR 44136 - Submission for OMB review; 30-day Comment Request: National Cancer Institute (NCI) Cancer...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

...; 30-day Comment Request: National Cancer Institute (NCI) Cancer Nanotechnology Platform Partnership...: Dorothy Farrell, Center for Strategic Scientific Initiatives, Office of Cancer Nanotechnology Research... Cancer Institute (NCI) Alliance for Nanotechnology in Cancer Platform Partnership Scientific Progress...

The 2006 National Labor Day impaired driving enforcement crackdown : Drunk driving. Over the limit. Under arrest.

DOT National Transportation Integrated Search

2008-09-01

The National Highway Traffic Safety Administrations 2006 Drunk Driving. Over the Limit. Under Arrest. Labor Day holiday campaign had three main components: (1) DWI enforcement, (2) public awareness efforts, and (3) evaluation. The 2006 program use...

Increased measles-mumps-rubella (MMR) vaccine uptake in the context of a targeted immunisation campaign during a measles outbreak in a vaccine-reluctant community in England.

PubMed

Le Menach, Arnaud; Boxall, Naomi; Amirthalingam, Gayatri; Maddock, Liz; Balasegaram, Sooria; Mindlin, Miranda

2014-02-26

Following a measles outbreak in a vaccine-rejecting community between April and September 2011 in South-East England, local health agencies implemented a two-pronged measles-mumps-rubella (MMR) immunisation campaign from August to October offered at the local general practice where most cases were registered. The campaign included (a) accelerated vaccination of children earlier than scheduled (1st dose at 6-11 months, or 2nd dose at 18-39 months), (b) catch-up of those aged over 18 months who had had no MMR immunisations or were late for second MMR. We investigated the impact of the outbreak and campaign on the number of MMR doses given. In January 2012, we collected information on MMR vaccination for children registered at the practice aged 6 months-16 years on 1 August 2011, through the child health information system. We counted the number of MMR doses administered in 2011 and compared it to 2008-2010 data. We estimated the proportion vaccinated among the children eligible for the accelerated and catch-up campaign. The local practice administered 257 MMR doses in 2011, a 114% increase on the average for 2008-2010. Among children eligible for earlier MMR vaccination 5/26 (19%) received a first dose, and 34/57 (60%) a second dose. Among children eligible for catch-up, 20/329 (6%) received their first MMR and 39/121 (32%) their second. Of 1538 children, the proportion completely unimmunised for MMR declined by 3 percentage-points after the outbreak. Uptake of MMR vaccination significantly increased during the outbreak following the immunisation campaign. Those amenable to MMR vaccination seem to have benefited from the campaign more than those with no previous vaccinations. Future evaluations should address what made a few parents change their mind and have their children vaccinated for the first time during the outbreak. Copyright © 2014 Elsevier Ltd. All rights reserved.

Maternal immunisation with trivalent inactivated influenza vaccine for prevention of influenza in infants in Mali: a prospective, active-controlled, observer-blind, randomised phase 4 trial.

PubMed

Tapia, Milagritos D; Sow, Samba O; Tamboura, Boubou; Tégueté, Ibrahima; Pasetti, Marcela F; Kodio, Mamoudou; Onwuchekwa, Uma; Tennant, Sharon M; Blackwelder, William C; Coulibaly, Flanon; Traoré, Awa; Keita, Adama Mamby; Haidara, Fadima Cheick; Diallo, Fatoumata; Doumbia, Moussa; Sanogo, Doh; DeMatt, Ellen; Schluterman, Nicholas H; Buchwald, Andrea; Kotloff, Karen L; Chen, Wilbur H; Orenstein, Evan W; Orenstein, Lauren A V; Villanueva, Julie; Bresee, Joseph; Treanor, John; Levine, Myron M

2016-09-01

Despite the heightened risk of serious influenza during infancy, vaccination is not recommended in infants younger than 6 months. We aimed to assess the safety, immunogenicity, and efficacy of maternal immunisation with trivalent inactivated influenza vaccine for protection of infants against a first episode of laboratory-confirmed influenza. We did this prospective, active-controlled, observer-blind, randomised phase 4 trial at six referral centres and community health centres in Bamako, Mali. Third-trimester pregnant women (≥28 weeks' gestation) were randomly assigned (1:1), via a computer-generated, centre-specific list with alternate block sizes of six or 12, to receive either trivalent inactivated influenza vaccine or quadrivalent meningococcal vaccine. Study personnel administering vaccines were not masked to treatment allocation, but allocation was concealed from clinicians, laboratory personnel, and participants. Infants were visited weekly until age 6 months to detect influenza-like illness; laboratory-confirmed influenza diagnosed with RT-PCR. We assessed two coprimary objectives: vaccine efficacy against laboratory-confirmed influenza in infants born to women immunised any time prepartum (intention-to-treat population), and vaccine efficacy in infants born to women immunised at least 14 days prepartum (per-protocol population). The primary outcome was the occurrence of a first case of laboratory-confirmed influenza by age 6 months. This trial is registered with ClinicalTrials.gov, number NCT01430689. We did this trial from Sept 12, 2011, to Jan 28, 2014. Between Sept 12, 2011, and April 18, 2013, we randomly assigned 4193 women to receive trivalent inactivated influenza vaccine (n=2108) or quadrivalent meningococcal vaccine (n=2085). There were 4105 livebirths; 1797 (87%) of 2064 infants in the trivalent inactivated influenza vaccine group and 1793 (88%) of 2041 infants in the quadrivalent meningococcal vaccine group were followed up until age 6 months

Adverse events following immunisation with a meningococcal serogroup B vaccine: report from post-marketing surveillance, Germany, 2013 to 2016.

PubMed

Mentzer, Dirk; Oberle, Doris; Keller-Stanislawski, Brigitte

2018-04-01

Background and aimIn January 2013, a novel vaccine against Neisseria meningitidis serogroup B, the multicomponent meningococcal serogroup B vaccine (4CMenB), was approved by the European Medicines Agency. We aimed to evaluate the safety profile of this vaccine. Methods: All adverse events following immunisation (AEFI) reported from Germany since the vaccine's launch in Germany in November 2013 through December 2016 were reviewed and analysed. Results: Through December 2016, a total of 664 individual case safety reports (ICSR) notifying 1,960 AEFI were received. A majority of vaccinees for whom AEFI were reported were children 2 to 11 years of age (n = 280; 42.2%) followed by infants and toddlers aged 28 days to 23 months (n = 170; 25.6%). General disorders and administration site conditions was the System Organ Class (SOC) with the majority of AEFI (n = 977; 49.8%), followed by nervous system disorders (n = 249; 12.7%), and skin and subcutaneous tissue disorders (n = 191; 9.7%). Screening of patient records for immune-mediated and neurological diseases did not raise any safety signal in terms of an increased proportional reporting ratio (PRR). Conclusions: The safety profile described in the Summary of Product Characteristics, in general, is confirmed by data from spontaneous reporting. No safety concerns were identified.

3 CFR 9068 - Proclamation 9068 of December 5, 2013. National Pearl Harbor Remembrance Day, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

.... On National Pearl Harbor Remembrance Day, we honor the men and women who selflessly sacrificed for... the war effort to women who joined the assembly line alongside workers of every background and... Depression, and built the largest middle class and strongest economy in history. Today, with solemn pride and...

76 FR 66845 - United Nations Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

... become ever more intertwined, the leadership, staff, and member states of the United Nations continue to... a time of dramatic political transformation, the United Nations can embrace democratic movements and...

Changes in the epidemiology of gastroenteritis in a paediatric short stay unit following the introduction of rotavirus immunisation.

PubMed

Akikusa, Jonathan D; Hopper, Sandy M; Kelly, Julian J; Kirkwood, Carl D; Buttery, Jim P

2013-02-01

Acute gastroenteritis (AGE) has been a significant component of the clinical load in the short stay unit (SSU) at the Royal Children's Hospital (RCH) since its establishment in 2004. Since the introduction of routine rotavirus immunisation in Australia in 2007 there has been a clinical impression of a substantial reduction in AGE managed in the SSU. This study aimed to examine changes in the epidemiology of AGE in the SSU, and RCH overall, between 2005 and 2009 and explore whether this reflects a change specifically in AGE due to rotavirus. Discharge coding data for AGE from all inpatient wards, the SSU and emergency department (ED) at the RCH were examined. Stool virology results for the same period were analysed. Since 2007 there has been a 58% reduction in AGE admissions to the SSU. The median age of patients admitted to the RCH with rotaviral enteritis has increased from 1.3 years to 3.8 years. Presentations to the ED for AGE have fallen from 53 to 34 cases per 1000 attendances between 2004 and 2009, and admission rates from the ED have fallen from 23 to 13% of AGE presentations. Detection rates of rotavirus fell from 13.1 to 6.7% between 2005 and 2009. A marked decrease in AGE-related clinical activity and reduction in rotavirus detection at the RCH has occurred since the introduction of routine rotavirus immunisation in Australia. This has significant resource planning implications for units based on short stay models of care. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

National History Day Contest Guide.

ERIC Educational Resources Information Center

National History Day, Inc., Cleveland, OH.

The guide presents an overview of a national contest designed to make history come alive to students in grades 6 through 12 through imaginative projects, original performances, media presentations, and papers. Students submit their entries into contests in which they are judged by historians, educators, and other experienced professionals.…

Defense.gov Special Report: Memorial Day 2012

Science.gov Websites

; President Barack Obama Presidential Proclamation: Prayer for Peace, Memorial Day Memorial Day 2012 Published the priority for our nation, President Barack Obama said during the Memorial Day observance at Arlington National Cemetery. Story Panetta Urges Nation to Remember Fallen Troops on Memorial Day In his

Results of National Alcohol Screening Day: College Demographics, Clinical Characteristics, and Comparison with Online Screening

ERIC Educational Resources Information Center

Wallenstein, Gene V.; Pigeon, Sharon; Kopans, Barbara; Jacobs, Douglas G.; Aseltine, Robert

2007-01-01

Abstract Objective: The authors evaluated the efficacy of the 2002 college-based National Alcohol Screening Day (NASD) by determining: (1) the demographic and clinical characteristics of the participants that were screened and (2) the degree to which those scoring at hazardous drinking levels received clinical intervention or were referred for…

3 CFR 8713 - Proclamation 8713 of September 15, 2011. National POW/MIA Recognition Day, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... Affairs, the Selective Service System Headquarters, the World War II Memorial, the Korean War Veterans... 3 The President 1 2012-01-01 2012-01-01 false Proclamation 8713 of September 15, 2011. National... many have never come home, or have endured unthinkable hardship as prisoners of war. On this day, we...

Health in Day Care: A Training Guide for Day Care Providers.

ERIC Educational Resources Information Center

Pokorni, Judith L.; Kaufmann, Roxane K.

Written for trainers of day care staff, this guide provides help in communicating to day care personnel the information presented in "Health in Day Care: A Manual for Day Care Providers," originally developed by a division of the Massachusetts Department of Health and adapted for national use by the Georgetown University Child Development Center.…

Predictors to parental knowledge about childhood immunisation/EPI vaccines in two health districts in Cameroon prior to the introduction of 13-valent Pneumococcal Conjugate Vaccines (PCV-13)

PubMed Central

Libwea, John Njuma; Kobela, Marie; Ollgren, Jukka; Emah, Irene; Tchio, Robert; Nohynek, Hanna

2014-01-01

Introduction Pneumonia is vaccine-preventable, but the increasing death toll resulting from the disease in Sub-Saharan Africa is alarming. Several factors account for vaccine failing to reach every child, besides incomplete vaccine coverage. Most of these include the perceptions of parents/guardians and healthcare providers. Previous studies on the introduction of new vaccines have focused on experimental trials, coverage figures and vaccine efficacy in developed countries. Little is known on the factors which may hinder the implementation process despite the huge challenges this may encounter in developing countries. This study described the knowledge, attitude and practices (KAP) of parents/guardians on pneumonia and immunisations/EPI vaccines; identify predictive parental socio-economic/demographic characteristics that of good knowledge on pneumonia infections, routine EPI vaccines and the PCV-13. Finally, the study described health center personnel perceptions about immunisations. Methods The WHO's immunisation coverage cluster survey design was used, involving parents/guardians (n = 205) of children aged 0-59 months and health centre personnel (n = 13) directly concerned with vaccination activities between July-September 2010 in two health districts in Yaounde, Cameroon. Descriptive statistics and multivariate logistic models were used to analyse the parental/guardian data while the health personnel data was only analysed descriptively using SPSS version 17.0. Results Only 19% of the parents/guardians were aware of the availability of the PCV-13. Logistic modelling identified important associations between parental socio-economic/demographic factors and good knowledge on pneumonia disease burden and prevention. Conclusion According to parents/guardians a short and clear message on the dangers of pneumonia and the need for prevention provided to parents/guardians during sensitisation/out-reach campaigns and use of social network avenues would be primordial, if

76 FR 25529 - Loyalty Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

... Day, 2011 By the President of the United States of America A Proclamation When our Nation's Founders... devotion on a Nation that reflects its people's highest moral aspirations. On this day, we celebrate our... amended, has designated May 1 of each year as ``Loyalty Day.'' On this day, let us reaffirm our allegiance...

National Day Care Study First Annual Report. Volume III: Information Management and Data Collection Systems.

ERIC Educational Resources Information Center

Goodrich, Nancy; And Others

Volume III of the National Day Care Study First Annual Report funded by the Office of Child Development describes the information management system which was developed and tested during Phase I. In addition, the volume includes overviews of the sample instruments from the three major data collection systems developed during the year: the Research…

Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data.

PubMed

Quinn, Julie-Anne; Munoz, Flor M; Gonik, Bernard; Frau, Lourdes; Cutland, Clare; Mallett-Moore, Tamala; Kissou, Aimee; Wittke, Frederick; Das, Manoj; Nunes, Tony; Pye, Savia; Watson, Wendy; Ramos, Ana-Maria Alguacil; Cordero, Jose F; Huang, Wan-Ting; Kochhar, Sonali; Buttery, Jim

2016-12-01

Preterm birth is commonly defined as any birth before 37 weeks completed weeks of gestation. An estimated 15 million infants are born preterm globally, disproportionately affecting low and middle income countries (LMIC). It contributes directly to estimated one million neonatal deaths annually and is a significant contributor to childhood morbidity. However, in many clinical settings, the information available to calculate completed weeks of gestation varies widely. Accurate dating of the last menstrual period (LMP), as well as access to clinical and ultrasonographic evaluation are important components of gestational age assessment antenatally. This case definition assign levels of confidence to categorisation of births as preterm, utilising assessment modalities which may be available across different settings. These are designed to enable systematic safety evaluation of vaccine clinical trials and post-implementation programmes of immunisations in pregnancy. Copyright © 2016. Published by Elsevier Ltd.

75 FR 65561 - United Nations Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... most devastating wars to rededicate themselves to peace, justice, and progress. The founders of the United Nations vowed to work together to ensure that the horrors seen in World War II would never be... all peoples. The United Nations has made great advances since it first developed out of ruin and...

3 CFR 8343 - Proclamation 8343 of January 20, 2009. National Day of Renewal and Reconciliation, 2009

Code of Federal Regulations, 2010 CFR

2010-01-01

... 3 The President 1 2010-01-01 2010-01-01 false Proclamation 8343 of January 20, 2009. National Day of Renewal and Reconciliation, 2009 8343 Proclamation 8343 Presidential Documents Proclamations... in the words of President Abraham Lincoln, let us remember that: “The mystic chords of memory...

Importance of background rates of disease in assessment of vaccine safety during mass immunisation with pandemic H1N1 influenza vaccines

PubMed Central

Black, Steven; Eskola, Juhani; Siegrist, Claire-Anne; Halsey, Neal; MacDonald, Noni; Law, Barbara; Miller, Elizabeth; Andrews, Nick; Stowe, Julia; Salmon, Daniel; Vannice, Kirsten; Izurieta, Hector S; Akhtar, Aysha; Gold, Mike; Oselka, Gabriel; Zuber, Patrick; Pfeifer, Dina; Vellozzi, Claudia

2010-01-01

Because of the advent of a new influenza A H1N1 strain, many countries have begun mass immunisation programmes. Awareness of the background rates of possible adverse events will be a crucial part of assessment of possible vaccine safety concerns and will help to separate legitimate safety concerns from events that are temporally associated with but not caused by vaccination. We identified background rates of selected medical events for several countries. Rates of disease events varied by age, sex, method of ascertainment, and geography. Highly visible health conditions, such as Guillain-Barré syndrome, spontaneous abortion, or even death, will occur in coincident temporal association with novel influenza vaccination. On the basis of the reviewed data, if a cohort of 10 million individuals was vaccinated in the UK, 21·5 cases of Guillain-Barré syndrome and 5·75 cases of sudden death would be expected to occur within 6 weeks of vaccination as coincident background cases. In female vaccinees in the USA, 86·3 cases of optic neuritis per 10 million population would be expected within 6 weeks of vaccination. 397 per 1 million vaccinated pregnant women would be predicted to have a spontaneous abortion within 1 day of vaccination. PMID:19880172

Immunisation with a Multivalent, Subunit Vaccine Reduces Patent Infection in a Natural Bovine Model of Onchocerciasis during Intense Field Exposure

PubMed Central

Makepeace, Benjamin L.; Jensen, Siv Aina; Laney, Sandra J.; Nfon, Charles K.; Njongmeta, Leo M.; Tanya, Vincent N.; Williams, Steven A.; Bianco, Albert E.; Trees, Alexander J.

2009-01-01

Human onchocerciasis, caused by the filarial nematode Onchocerca volvulus, is controlled almost exclusively by the drug ivermectin, which prevents pathology by targeting the microfilariae. However, this reliance on a single control tool has led to interest in vaccination as a potentially complementary strategy. Here, we describe the results of a trial in West Africa to evaluate a multivalent, subunit vaccine for onchocerciasis in the naturally evolved host-parasite relationship of Onchocerca ochengi in cattle. Naïve calves, reared in fly-proof accommodation, were immunised with eight recombinant antigens of O. ochengi, administered separately with either Freund's adjuvant or alum. The selected antigens were orthologues of O. volvulus recombinant proteins that had previously been shown to confer protection against filarial larvae in rodent models and, in some cases, were recognised by serum antibodies from putatively immune humans. The vaccine was highly immunogenic, eliciting a mixed IgG isotype response. Four weeks after the final immunisation, vaccinated and adjuvant-treated control calves were exposed to natural parasite transmission by the blackfly vectors in an area of Cameroon hyperendemic for O. ochengi. After 22 months, all the control animals had patent infections (i.e., microfilaridermia), compared with only 58% of vaccinated cattle (P = 0.015). This study indicates that vaccination to prevent patent infection may be an achievable goal in onchocerciasis, reducing both the pathology and transmissibility of the infection. The cattle model has also demonstrated its utility for preclinical vaccine discovery, although much research will be required to achieve the requisite target product profile of a clinical candidate. PMID:19901988

Public opinion on childhood immunisations in Iceland.

PubMed

Óskarsson, Ýmir; Guðnason, Þórólfur; Jónsdóttir, Guðbjörg A; Kristinsson, Karl G; Briem, Haraldur; Haraldsson, Ásgeir

2015-12-16

In recent years, vaccine preventable diseases such as measles and pertussis have been re-emerging in Western countries, maybe because of decreasing participation in childhood vaccination programs in some countries. There is clear evidence for vaccine efficacy and the risk of adverse effects is low. This needs to be communicated to the general public. The aim of the study was to evaluate the public opinion on childhood vaccinations in Iceland. An internet based study was used to evaluate the opinion on childhood immunisations in Iceland. The cohort was divided in three groups: (a) general public (b) employees of the University Hospital Iceland and (c) employees (teachers and staff) of the University of Iceland. The cohorts could be stratified according to age, gender, education, household income, parenthood and residency. Responses were received from 5584 individuals (53% response rate). When asked about childhood vaccinations in the first and second year of life, approximately 95% of participants were "positive" or "very positive", approximately 1% were "negative" or "very negative". When participants were asked whether they would have their child immunized according to the Icelandic childhood vaccination schedule, 96% were "positive" or "very positive", 1.2% were "negative" or "very negative". Similarly, 92% trust Icelandic Health authorities to decide on childhood vaccination schedule, 2.3% did not. In total, 9.3% "rather" or "strongly" agreed to the statement "I fear that vaccinations can cause severe adverse effects", 17.5% were undecided and 66.9% "disagreed" or "strongly disagreed". Individuals with higher education were more likely to disagree with this statement (OR=1.45, CI95=1.29-1.64, p<0.001) as did males (OR=1.22, CI95=1.087-1.379, p=0.001). This study shows a very positive attitude towards vaccinations raising expectations for an ongoing success in preventing preventable communicable diseases in childhood in Iceland. Copyright © 2015 Elsevier Ltd

75 FR 17835 - Census Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... Part II The President Proclamation 8488--Census Day, 2010 Proclamation 8489--National Cancer... of March 31, 2010 Census Day, 2010 By the President of the United States of America A Proclamation Since our Nation's earliest days, the census has played an important role in identifying where resources...

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2014 CFR

2014-10-01

...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients. To...

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2013 CFR

2013-10-01

...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients. To...

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2011 CFR

2011-10-01

...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients. To...

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2012 CFR

2012-10-01

...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels... case-mix using a case-mix index to explain the relative resource utilization of different patients. To...

Defense.gov Special Report: Veterans Day 2013

Science.gov Websites

Department of Defense Submit Search Veterans Day 2013 - Honoring our Nation's Veterans November 11, 2013 News Veterans Day at Arlington National Cemetery, calling the holiday a reminder of the nation's "sacred piece titled "Joining Forces with you on Veterans Day," First Lady Michelle Obama and Dr. Jill

How to optimise the coverage rate of infant and adult immunisations in Europe

PubMed Central

Schmitt, Heinz-J; Booy, Robert; Aston, Robert; Van Damme, Pierre; Schumacher, R Fabian; Campins, Magda; Rodrigo, Carlos; Heikkinen, Terho; Weil-Olivier, Catherine; Finn, Adam; Olcén, Per; Fedson, David; Peltola, Heikki

2007-01-01

Background Although vaccination has been proved to be a safe, efficacious, and cost-effective intervention, immunisation rates remain suboptimal in many European countries, resulting in poor control of many vaccine-preventable diseases. Discussion The Summit of Independent European Vaccination Experts focused on the perception of vaccines and vaccination by the general public and healthcare professionals and discussed ways to improve vaccine uptake in Europe. Despite the substantial impact and importance of the media, healthcare professionals were identified as the main advocates for vaccination and the most important source of information about vaccines for the general public. Healthcare professionals should receive more support for their own education on vaccinology, have rapid access to up-to-date information on vaccines, and have easy access to consultation with experts regarding vaccination-related problems. Vaccine information systems should be set up to facilitate promotion of vaccination. Summary Every opportunity to administer vaccines should be used, and active reminder systems should be set up. A European vaccine awareness week should be established. PMID:17535430

Aerosol optical properties observation and its relationship to meteorological conditions and emission during the Chinese National Day and Spring Festival holiday in Beijing

NASA Astrophysics Data System (ADS)

Zheng, Yu; Che, Huizheng; Zhao, Tianliang; Zhao, Hujia; Gui, Ke; Sun, Tianze; An, Linchang; Yu, Jie; Liu, Chong; Jiang, Yongcheng; Zhang, Lei; Wang, Hong; Wang, Yaqiang; Zhang, Xiaoye

2017-11-01

The reduction of traffic flow in downtown areas during the Chinese National Day holiday and the fireworks during the Spring Festival provide a unique opportunity for investigating the impact of urban anthropogenic activities on aerosol optical properties during these important Chinese festivals in Beijing. The National Day in 2014 and 2015 and Spring Festival in 2015 and 2016 were selected as study periods. The aerosol optical depth (AOD) at 440 nm increased over the all holiday periods and the average AODs during the 2015 National Day, 2015 Spring Festival and 2016 Spring Festival were about 81%, 21% and 36% higher than the background levels, respectively. The average AOD in 2014 National Day holiday was lower than background level partly influenced by precipitation event. The absorption AOD (AAOD) at 440 nm showed consistent variations with the AOD and the average AAODs during the 2015 National Day, 2015 Spring Festival and 2016 Spring Festival holidays were about 75%, 19% and 23% higher than the background level, respectively. The mean values of single scattering albedo were greater than the background level during the Spring Festival holidays, whereas the values during the National Day holiday in 2015 were lower partly due to the reduction of vehicular emissions in downtown areas. Fine- and coarse-mode particle volumes during pollution periods in holidays were 0.04-0.25 μm3 and 0.03-0.15 μm3 larger than background level, respectively. The results of potential source contribution function and concentration-weighted trajectory analyses identified the areas south of Beijing as the main source regions of PM2.5 and were responsible for the extremely high PM2.5 concentrations in Beijing during the holiday periods. The findings of this study may aid understanding the effects of human activities on aerosol optical properties over Beijing area and contribute to improving regional air quality.

78 FR 76311 - Submission for OMB Review; 30-Day Comment Request: Outcomes Evaluation of the National Cancer...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

...Under the provisions of Section 3507(a)(1)(D) of the Paperwork Reduction Act of 1995, the National Institutes of Health (NIH), has submitted to the Office of Management and Budget (OMB) a request to review and approve the information collection listed below. This proposed information collection was previously published in the Federal Register on August 12, 2013, (Vol. 78 FR p. 48879) and allowed 60 days for public comment. One public comment was received on August 18, 2013 which questioned the effectiveness of the program and whether the study was an effective use of taxpayer funds. An email response was sent on September 9, 2013 stating, ``Your response will be reviewed in further consideration of all comments submissions made during the 60-day public notice period for this proposed information collection. Thank you for your inquiry, comments and/or suggestions''. The purpose of this notice is to allow an additional 30 days for public comment. The National Cancer Institute (NCI), National Institutes of Health may not conduct or sponsor, and the respondent is not required to respond to, an information collection that has been extended, revised, or implemented on or after October 1, 1995, unless it displays a currently valid OMB control number. Direct Comments to OMB: Written comments and/or suggestions regarding the item(s) contained in this notice, especially regarding the estimated public burden and associated response time, should be directed to the: Office of Management and Budget, Office of Regulatory Affairs, [email protected] or by fax to 202-395-6974. Attention: NIH Desk Officer. Comments Due Date: Comments regarding this information collection are best assured of having their full effect if received within 30-days of the date of this publication.

Do existing research summaries on health systems match immunisation managers' needs in middle- and low-income countries? Analysis of GAVI health systems strengthening support

PubMed Central

2011-01-01

Background The GAVI Alliance was created in 2000 to increase access to vaccines. More recently, GAVI has supported evidence-based health systems strengthening to overcome barriers to vaccination. Our objectives were: to explore countries' priorities for health systems strengthening; to describe published research summaries for each priority area in relation to their number, quality and relevance; and to describe the use of national data from surveys in identifying barriers to immunisation. Methods From 44 health systems strengthening proposals submitted to GAVI in 2007 and 2008, we analysed the topics identified, the coverage of these topics by existing systematic reviews and the use of nation-wide surveys with vaccination data to justify the needs identified in the proposals. Results Thirty topics were identified and grouped into three thematic areas: health workforce (10 topics); organisation and management (14); and supply, distribution and maintenance (6). We found 51 potentially relevant systematic reviews, although for the topic that appeared most frequently in the proposals ('Health information systems') no review was identified. Thematic and geographic relevance were generally categorised as "high" in 33 (65%) and 25 (49%) reviews, respectively, but few reviews were categorised as "highly relevant for policy" (7 reviews, 14%). With regard to methodological quality, 14 reviews (27%) were categorised as "high". The number of topics that were addressed by at least one high quality systematic review was: seven of the 10 topics in the 'health workforce' thematic area; six of the 14 topics in the area of 'organisation and management'; and none of the topics in the thematic area of 'supply, distribution and maintenance'. Only twelve of the 39 countries with available national surveys referred to them in their proposals. Conclusion Relevant, high quality research summaries were found for few of the topics identified by managers. Few proposals used national surveys

42 CFR 484.220 - Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and...

Code of Federal Regulations, 2010 CFR

2010-10-01

... address changes to the case-mix that are a result of changes in the coding or classification of different...-day episode payment rate for case-mix and area wage levels. 484.220 Section 484.220 Public Health... Calculation of the adjusted national prospective 60-day episode payment rate for case-mix and area wage levels...

75 FR 21977 - Earth Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... Day, 2010 By the President of the United States of America A Proclamation In the fall of 1969, Wisconsin Senator Gaylord Nelson announced plans for a national ``environmental teach- in''--one day, each year, of action and advocacy for the environment. His words rallied our Nation, and the first Earth Day...

Defense.gov Special Report: Veterans Day 2011

Science.gov Websites

Department of Defense Submit Search Veterans Day 2011 - Honoring our Nation's Veterans - 11.11.11 Sept. 26 deserve our country's gratitude - not just on Veterans Day, but every day." Defense Secretary Leon E . Story Leaders Participate in Vets Day Events WASHINGTON, Nov. 11, 2011 - Today's Arlington National

Investigating Canadian parents' HPV vaccine knowledge, attitudes and behaviour: a study protocol for a longitudinal national online survey.

PubMed

Shapiro, Gilla K; Perez, Samara; Naz, Anila; Tatar, Ovidiu; Guichon, Juliet R; Amsel, Rhonda; Zimet, Gregory D; Rosberger, Zeev

2017-10-11

Human papillomavirus (HPV), a sexually transmitted infection, can cause anogenital warts and a number of cancers. To prevent morbidity and mortality, three vaccines have been licensed and are recommended by Canada's National Advisory Committee on Immunisation (for girls since 2007 and boys since 2012). Nevertheless, HPV vaccine coverage in Canada remains suboptimal in many regions. This study will be the first to concurrently examine the correlates of HPV vaccine decision-making in parents of school-aged girls and boys and evaluate changes in parental knowledge, attitudes and behaviours over time. Using a national, online survey utilising theoretically driven constructs and validated measures, this study will identify HPV vaccine coverage rates and correlates of vaccine decision-making in Canada at two time points (August-September 2016 and June-July 2017). 4606 participants will be recruited to participate in an online survey through a market research and polling firm using email invitations. Data cleaning methods will identify inattentive or unmotivated participants. The study received research ethics board approval from the Research Review Office, Integrated Health and Social Services University Network for West-Central Montreal (CODIM-FLP-16-219). The study will adopt a multimodal approach to disseminate the study's findings to researchers, clinicians, cancer and immunisation organisations and the public in Canada and internationally. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Hypothetical Labor Market Response of Black and White Women to a National Program of Free Day Care Centers.

ERIC Educational Resources Information Center

Shortlidge, Richard L., Jr.

Data obtained from the National Longitudinal Surveys of women who were 17 to 27 and 34 to 48 years of age in 1971 were utilized to analyze the potential female labor supply response to a national program of free day care centers. Women who were out of the labor force at the time of the 1971 survey were asked about their willingness to seek…

77 FR 68134 - Submission for OMB Review; Comment Request (30-day): National Institute of Nursing Research (NINR...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-15

... Research (NINR) Summer Genetics Institute Alumni Survey, -0925-New Need and Use of Information Collection...; Comment Request (30-day): National Institute of Nursing Research (NINR) Summer Genetics Institute Alumni Survey SUMMARY: Under the provisions of Section 3507(a)(1)(D) of the Paperwork Reduction Act of 1995, the...

Participant-centred active surveillance of adverse events following immunisation: a narrative review

PubMed Central

Cashman, Patrick; Macartney, Kristine; Khandaker, Gulam; King, Catherine; Gold, Michael; Durrheim, David N.

2017-01-01

Abstract The importance of active, participant-centred monitoring of adverse events following immunisation (AEFI) is increasingly recognised as a valuable adjunct to traditional passive AEFI surveillance. The databases OVID Medline and OVID Embase were searched to identify all published articles referring to AEFI. Only studies which sought participant response after vaccination were included. A total of 6060 articles published since the year 2000 were identified. After the application of screening inclusion and exclusion criteria, 25 articles describing 23 post-marketing AEFI systems were identified. Most countries had a single system: Ghana, Japan, China, Korea, Netherlands, Singapore, Brazil, Cambodia, Sri Lanka, Turkey and Cameroon except the USA (2), Canada (4) and Australia (6). Data were collected from participants with and without AEFI in all studies reviewed with denominator data enabling AEFI rate calculations. All studies considered either a single vaccine or specified vaccines or were time limited except one Australian system, which provides continuous automated participant-centred active surveillance of all vaccines. Post-marketing surveillance systems using solicited patient feedback are emerging as a novel AEFI monitoring tool. A number of exploratory systems utilising e-technology have been developed and their potential for scaling up and application in low and middle income countries deserves further investigation. PMID:28582563

Storytelling in the context of vaccine refusal: a strategy to improve communication and immunisation.

PubMed

Cawkwell, Philip B; Oshinsky, David

2016-03-01

The December 2014 outbreak of measles in California impacted over 100 children and served as a reminder that this disease still plagues the USA, even 50 years following the first licensed vaccine. Refusal of vaccination is a complicated and multifaceted issue, one that clearly demands a closer look by paediatricians and public health officials alike. While medical doctors and scientists are trained to practice 'evidence-based medicine', and studies of vaccine safety and efficacy speak the language of statistics, there is reason to believe that this is not the most effective strategy for communicating with all groups of parents. Herein, we consider other methods such as narrative practices that employ stories and appeal more directly to parents. We also examine how doctors are trained to disseminate information and whether there are reasonable supplementary methods that could be used to improve vaccine communication and ultimately immunisation rates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The National Surgical Quality Improvement Program 30-Day Challenge: Microsurgical Breast Reconstruction Outcomes Reporting Reliability

PubMed Central

Chen, Austin D.; Kamali, Parisa; Chattha, Anmol S.; Bucknor, Alexandra; Cohen, Justin B.; Bletsis, Patrick P.; Flecha-Hirsch, Renata; Tobias, Adam M.; Lee, Bernard T.

2018-01-01

Background: The aim was to assess reliability of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) 30-day perioperative outcomes and complications for immediate, free-tissue transfer breast reconstruction by direct comparisons with our 30-day and overall institutional data, and assessing those that occur after 30 days. Methods: Data were retrieved for consecutive immediate, free-tissue transfer breast reconstruction patients from a single-institution database (2010–2015) and the ACS-NSQIP (2011–2014). Multiple logistic regressions were performed to compare adjusted outcomes between the 2 datasets. Results: For institutional versus ACS-NSQIP outcomes, there were no significant differences in surgical-site infection (SSI; 30-day, 3.6% versus 4.1%, P = 0.818; overall, 5.3% versus 4.1%, P = 0.198), wound disruption (WD; 30-day, 1.3% versus 1.5%, P = 0.526; overall, 2.3% versus 1.5%, P = 0.560), or unplanned readmission (URA; 30-day, 2.3% versus 3.3%, P = 0.714; overall, 4.6% versus 3.3%, P = 0.061). However, the ACS-NSQIP reported a significantly higher unplanned reoperation (URO) rate (30-day, 3.6% versus 9.5%, P < 0.001; overall, 5.3% versus 9.5%, P = 0.025). Institutional complications consisted of 5.3% SSI, 2.3% WD, 5.3% URO, and 4.6% URA, of which 25.0% SSI, 28.6% WD, 12.5% URO, and 7.1% URA occurred at 30–60 days, and 6.3% SSI, 14.3% WD, 18.8% URO, and 42.9% URA occurred after 60 days. Conclusion: For immediate, free-tissue breast reconstruction, the ACS-NSQIP may be reliable for monitoring and comparing SSI, WD, URO, and URA rates. However, clinicians may find it useful to understand limitations of the ACS-NSQIP for complications and risk factors, as it may underreport complications occurring beyond 30 days. PMID:29707443

In vivo protection against ZIKV infection and pathogenesis through passive antibody transfer and active immunisation with a prMEnv DNA vaccine.

PubMed

Muthumani, Karuppiah; Griffin, Bryan D; Agarwal, Sangya; Kudchodkar, Sagar B; Reuschel, Emma L; Choi, Hyeree; Kraynyak, Kimberly A; Duperret, Elizabeth K; Keaton, Amelia Anne; Chung, Christopher; Kim, Yinho K; Booth, Stephanie A; Racine, Trina; Yan, Jian; Morrow, Matthew P; Jiang, Jingjing; Lee, Brian; Ramos, Stephanie; Broderick, Kate E; Reed, Charles C; Khan, Amir S; Humeau, Laurent; Ugen, Kenneth E; Park, Young K; Maslow, Joel N; Sardesai, Niranjan Y; Joseph Kim, J; Kobinger, Gary P; Weiner, David B

2016-01-01

Significant concerns have been raised owing to the rapid global spread of infection and disease caused by the mosquito-borne Zika virus (ZIKV). Recent studies suggest that ZIKV can also be transmitted sexually, further increasing the exposure risk for this virus. Associated with this spread is a dramatic increase in cases of microcephaly and additional congenital abnormalities in infants of ZIKV-infected mothers, as well as a rise in the occurrence of Guillain Barre' syndrome in infected adults. Importantly, there are no licensed therapies or vaccines against ZIKV infection. In this study, we generate and evaluate the in vivo efficacy of a novel, synthetic, DNA vaccine targeting the pre-membrane+envelope proteins (prME) of ZIKV. Following initial in vitro development and evaluation studies of the plasmid construct, mice and non-human primates were immunised with this prME DNA-based immunogen through electroporation-mediated enhanced DNA delivery. Vaccinated animals were found to generate antigen-specific cellular and humoral immunity and neutralisation activity. In mice lacking receptors for interferon (IFN)-α/β (designated IFNAR -/- ) immunisation with this DNA vaccine induced, following in vivo viral challenge, 100% protection against infection-associated weight loss or death in addition to preventing viral pathology in brain tissue. In addition, passive transfer of non-human primate anti-ZIKV immune serum protected IFNAR -/- mice against subsequent viral challenge. This study in NHP and in a pathogenic mouse model supports the importance of immune responses targeting prME in ZIKV infection and suggests that additional research on this vaccine approach may have relevance for ZIKV control and disease prevention in humans.

In vivo protection against ZIKV infection and pathogenesis through passive antibody transfer and active immunisation with a prMEnv DNA vaccine

PubMed Central

Muthumani, Karuppiah; Griffin, Bryan D; Agarwal, Sangya; Kudchodkar, Sagar B; Reuschel, Emma L; Choi, Hyeree; Kraynyak, Kimberly A; Duperret, Elizabeth K; Keaton, Amelia Anne; Chung, Christopher; Kim, Yinho K; Booth, Stephanie A; Racine, Trina; Yan, Jian; Morrow, Matthew P; Jiang, Jingjing; Lee, Brian; Ramos, Stephanie; Broderick, Kate E; Reed, Charles C; Khan, Amir S; Humeau, Laurent; Ugen, Kenneth E; Park, Young K; Maslow, Joel N; Sardesai, Niranjan Y; Joseph Kim, J; Kobinger, Gary P; Weiner, David B

2016-01-01

Significant concerns have been raised owing to the rapid global spread of infection and disease caused by the mosquito-borne Zika virus (ZIKV). Recent studies suggest that ZIKV can also be transmitted sexually, further increasing the exposure risk for this virus. Associated with this spread is a dramatic increase in cases of microcephaly and additional congenital abnormalities in infants of ZIKV-infected mothers, as well as a rise in the occurrence of Guillain Barre’ syndrome in infected adults. Importantly, there are no licensed therapies or vaccines against ZIKV infection. In this study, we generate and evaluate the in vivo efficacy of a novel, synthetic, DNA vaccine targeting the pre-membrane+envelope proteins (prME) of ZIKV. Following initial in vitro development and evaluation studies of the plasmid construct, mice and non-human primates were immunised with this prME DNA-based immunogen through electroporation-mediated enhanced DNA delivery. Vaccinated animals were found to generate antigen-specific cellular and humoral immunity and neutralisation activity. In mice lacking receptors for interferon (IFN)-α/β (designated IFNAR−/−) immunisation with this DNA vaccine induced, following in vivo viral challenge, 100% protection against infection-associated weight loss or death in addition to preventing viral pathology in brain tissue. In addition, passive transfer of non-human primate anti-ZIKV immune serum protected IFNAR−/− mice against subsequent viral challenge. This study in NHP and in a pathogenic mouse model supports the importance of immune responses targeting prME in ZIKV infection and suggests that additional research on this vaccine approach may have relevance for ZIKV control and disease prevention in humans. PMID:29263859

[Seroprevalence of varicella-zoster virus antibodies after the recent introduction of the universal childhood immunisation schedule in the Community of Madrid].

PubMed

García-Comas, Luis; Ordobás Gavín, María; Sanz Moreno, Juan Carlos; Ramos Blázquez, Belén; Gutiérrez Rodríguez, M Angeles; Barranco Ordóñez, Dolores

2016-12-01

In November 2006, the Community of Madrid included the chickenpox vaccine into the immunisation schedule for children from 15 months of age. This was withdrawn in January 2014. Seroprevalence of antibodies to the virus is estimated after the first 2-3 years from the inclusion of the vaccine, and as well as its evolution since 1999. A cross-sectional study was conducted on the target population consisting of residents in the Community of Madrid between 2 and 60 years of age. Measurement of IgG antibodies was performed using an ELISA technique. Seroprevalence was estimated according to sociodemographic characteristics using multiple logistic regressions. The results are compared with previous surveys. Also, the seroprevalence and geometric mean of the antibody according immunisation status and history of the disease are presented. The confidence level used is 95%. A total of 4,378 subjects were included, with a response rate of 69%. The estimated seroprevalence was 95.3% (95% CI: 94.6% - 95.9%). Over 90% of children from the age of 10 have antibodies. The seroprevalence was higher in people with less education. The seroprevalence of immunity vaccine exceeds 90% in the first year after vaccination, but in the second year decreased to 82.6% (95% CI 56.0 - 94.7). Significant differences, attributable to universal vaccination, were found compared to previous surveys. Continued surveillance is needed in order to assess the impact of the withdrawal of the recommendation to vaccinate at 15 months. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Every Day Is Mathematical

ERIC Educational Resources Information Center

Barger, Rita H.; Jarrah, Adeeb M.

2012-01-01

March 14 is special because it is Pi Day. Mathematics is celebrated on that day because the date, 3-14, replicates the first three digits of pi. Pi-related songs, websites, trivia facts, and more are at the fingertips of interested teachers and students. Less celebrated, but still fairly well known, is National Metric Day, which falls on October…

76 FR 59879 - National Public Lands Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-27

... energy, grazing, and recreation--vital economic engines in both rural and urban communities. On National... children will find opportunities for outdoor activity on the millions of acres of national forests, parks... conversation in the report, America's Great Outdoors: A Promise to Future Generations. To act on these findings...

Paternal education status significantly influences infants' measles vaccination uptake, independent of maternal education status.

PubMed

Rammohan, Anu; Awofeso, Niyi; Fernandez, Renae C

2012-05-08

Despite increased funding of measles vaccination programs by national governments and international aid agencies, structural factors encumber attainment of childhood measles immunisation to levels which may guarantee herd immunity. One of such factors is parental education status. Research on the links between parental education and vaccination has typically focused on the influence of maternal education status. This study aims to demonstrate the independent influence of paternal education status on measles immunisation. Comparable nationally representative survey data were obtained from six countries with the highest numbers of children missing the measles vaccine in 2008. Logistic regression analysis was applied to examine the influence of paternal education on uptake of the first dose of measles vaccination, independent of maternal education, whilst controlling for confounding factors such as respondent's age, urban/rural residence, province/state of residence, religion, wealth and occupation. The results of the analysis show that even if a mother is illiterate, having a father with an education of Secondary (high school) schooling and above is statistically significant and positively correlated with the likelihood of a child being vaccinated for measles, in the six countries analysed. Paternal education of secondary or higher level was significantly and independently correlated with measles immunisation uptake after controlling for all potential confounders. The influence of paternal education status on measles immunisation uptake was investigated and found to be statistically significant in six nations with the biggest gaps in measles immunisation coverage in 2008. This study underscores the imperative of utilising both maternal and paternal education as screening variables to identify children at risk of missing measles vaccination prospectively.

National HIV Testing Day at CDC-funded HIV counseling, testing, and referral sites--United States, 1994-1998.

PubMed

2000-06-23

CDC-funded human immunodeficiency virus (HIV) counseling, testing, and referral sites are an integral part of national HIV prevention efforts (1). Voluntary counseling, testing, and referral opportunities are offered to persons at risk for HIV infection at approximately 11,000 sites, including dedicated HIV counseling and testing sites, sexually transmitted disease (STD) clinics, drug-treatment centers, hospitals, and prisons. Services also are offered to women in family planning and prenatal/obstetric clinics to increase HIV prevention efforts among women and decrease the risk for perinatal HIV transmission. To increase use of HIV counseling, testing, and referral services by those at risk for HIV infection, in 1995, the National Association of People with AIDS designated June 27 each year as National HIV Testing Day. This report compares use of CDC-funded counseling, testing, and referral services the week before and the week of June 27 from 1994 through 1998 and documents the importance of a national public health campaign designed to increase knowledge of HIV serostatus.

Whooping cough—where are we now? A review.

PubMed

Kiedrzynski, Tomasz; Bissielo, Ange; Suryaprakash, Mishra; Bandaranayake, Don

2015-06-12

This paper describes the recent trends of pertussis and vaccine uptake in New Zealand based on notifications and immunisation registration information since 2011. It highlights the current risk for the infant in the first months after birth and the crucial role a pertussis booster in pregnancy could play. It also aims to show that protection of infants by the acellular pertussis vaccine can be improved by timely immunisation even in a situation of improving overall uptake rates that are nearing the national target of 95%. We analysed New Zealand notification data for pertussis, extracted from EpiSurv between August 2011 and December 2013, which included the period of the last epidemic. Pertussis immunisation coverage data were extracted from the National Immunisation Register (NIR). Population estimates were based on 2006 census data. Deprivation was analysed using the New Zealand Deprivation Index 2006. Despite immunisation coverage at 12 months having exceeded 90% New Zealand experienced a large epidemic from 2011 to 2014, with several hundred infant hospitalisations and three deaths. Notification data indicated an average annual rate of pertussis in the New Zealand population of 102 per 100,000 with the highest rates in the youngest age groups. While an overall increase in immunisation coverage in New Zealand was evident and the timeliness showed improvement across ethnic groups and deprivation deciles, there was a marked geographical variation within DHBs and between ethnic groups. Given the recent published evidence, pertussis vaccination should be offered to all mothers between weeks 28 and 38 of pregnancy. Further improvements are still possible in coverage at 6 months, particularly in Māori and but also in Pacific populations, as well as in more deprived populations. DHBs work towards achieving the 95% target can contribute to the improvement in the timeliness of immunisation.

Declining incidence of chickenpox in the absence of universal childhood immunisation

PubMed Central

Lowe, G; Salmon, R; Thomas, D; Evans, M

2004-01-01

Objective: To examine the epidemiology of chickenpox in Wales from 1986 to 2001. Design: Descriptive analysis of chickenpox consultations reported by the Welsh general practice sentinel surveillance scheme for infectious diseases, compared with annual shingles consultation rates from the same scheme to exclude reporting fatigue and data from a general practice morbidity database to validate results. Setting: A total of 226 884 patients registered with one of 30 volunteer general practices participating in the sentinel surveillance scheme. Main outcome measures: Age standardised and age specific incidence of chickenpox. Results: Crude and age standardised consultation rates for chickenpox declined from 1986 to 2001, with loss of epidemic cycling. Rates remained stable in 0–4 year olds but declined in all older age groups, particularly those aged 5–14 years. Shingles consultation rates remained constant over the same period. Data from the morbidity database displayed similar trends. Conclusion: General practitioner consultation rates for chickenpox are declining in Wales except in pre-school children. These findings are unlikely to be a reporting artefact but may be explained either by an overall decline in transmission or increased social mixing in those under 5 years old, through formal child care and earlier school entry, and associated increasing rates of mild or subclinical infection in this age group. Further investigation, particularly by serological surveillance, is necessary before universal varicella immunisation can be considered in the UK. PMID:15383443

3 CFR 8501 - Proclamation 8501 of April 16, 2010. National Day of Service and Remembrance for Victims and...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Proclamation There is no greater evil than willful violence against innocents. On this National Day of Service... of the Oklahoma City bombing, the September 11 attacks, and other incidents of violence around the... with appropriate ceremonies, activities, and acts of community service in memory of the victims and...

Participant-centred active surveillance of adverse events following immunisation: a narrative review.

PubMed

Cashman, Patrick; Macartney, Kristine; Khandaker, Gulam; King, Catherine; Gold, Michael; Durrheim, David N

2017-05-01

The importance of active, participant-centred monitoring of adverse events following immunisation (AEFI) is increasingly recognised as a valuable adjunct to traditional passive AEFI surveillance. The databases OVID Medline and OVID Embase were searched to identify all published articles referring to AEFI. Only studies which sought participant response after vaccination were included. A total of 6060 articles published since the year 2000 were identified. After the application of screening inclusion and exclusion criteria, 25 articles describing 23 post-marketing AEFI systems were identified. Most countries had a single system: Ghana, Japan, China, Korea, Netherlands, Singapore, Brazil, Cambodia, Sri Lanka, Turkey and Cameroon except the USA (2), Canada (4) and Australia (6). Data were collected from participants with and without AEFI in all studies reviewed with denominator data enabling AEFI rate calculations. All studies considered either a single vaccine or specified vaccines or were time limited except one Australian system, which provides continuous automated participant-centred active surveillance of all vaccines. Post-marketing surveillance systems using solicited patient feedback are emerging as a novel AEFI monitoring tool. A number of exploratory systems utilising e-technology have been developed and their potential for scaling up and application in low and middle income countries deserves further investigation. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

30-days mortality in patients with perforated peptic ulcer: A national audit

PubMed Central

Nakano, Anne; Bendix, Jørgen; Adamsen, Sven; Buck, Daniel; Mainz, Jan; Bartels, Paul; Nørgård, Bente

2008-01-01

Background In 2005, The Danish National Indicator Project (DNIP) reported findings on patients hospitalized with perforated ulcer. The indicator “30-days mortality” showed major discrepancy between the observed mortality of 28% and the chosen standard (10%). Rationale An audit committee was appointed to examine quality problems linked to the high mortality. The purpose was to (i) examine patient characteristics, (ii) evaluate the appropriateness of the standard, and (iii) audit all cases of deaths within 30 days after surgery. Methods Four hundred and twelve consecutive patients were included and used for the analyses of patient characteristics. The evaluation of the standard was based on a literature review, and a structured audit was performed according to the 115 deaths that occurred. Results The mean age was 69.1 years, 42.0% had one co-morbid disease and 17.7% had two co-morbid diseases. 45.9% had an American Association of Anaesthetists score of 3–4. We found no results on mortality in studies similar to ours. The audit process indicated that the postoperative observation of patients was insufficient. Discussion As a result of this study, the standard for mortality was increased to 20%, and the new indicators for postoperative monitoring were developed. The DNIP continues to evaluate if these initiatives will improve the results on mortality. PMID:22312201

NASA Participates in Mars Day Activities at National Air and Space Museum

NASA Image and Video Library

2017-07-21

NASA participated in the July 21 Mars Day event at the Smithsonian National Air and Space Museum (NASM) in Washington, D.C. The museum hosts this annual event, which includes exhibits, speakers and educational activities, to celebrate the Red Planet.    Jim Green, director of NASA’s Planetary Science Division, along with other NASA scientists and engineers, was on hand to talk with visitors about the agency’s Mars exploration missions. There was also a Mars concept rover on display, developed by vehicle designers the Parker Brothers with advice from NASA. The vehicle is currently on an East Coast tour from its home base at the Kennedy Space Center Visitor’s Complex in Florida. The concept rover is designed to engage and educate the public by demonstrating the types of features and equipment a future human exploration vehicle may need.

Trends in the types and quality of childhood immunisations research output from Africa 1970-2010: mapping the evidence base.

PubMed

Machingaidze, Shingai; Hussey, Gregory D; Wiysonge, Charles S

2014-02-04

Over the past four decades, extraordinary progress has been made in establishing and improving childhood immunization programmes around Africa. In order to ensure effective and sustainable positive growth of these childhood immunisations programmes, the development, adaptation and implementation of all interventions (programme activities, new vaccines, new strategies and policies) should be informed by the best available local evidence. An assessment of the peer-reviewed literature on childhood immunization research published in English from 1970 to 2010 was conducted in PubMed and Africa-Wide databases. All study types were eligible for inclusion. A standard form was used to extract information from all studies identified as relevant and entered into a Microsoft Access database for analysis. Our initial search yielded 5436 articles from the two databases, from which 848 full text articles were identified as relevant. Among studies classified as clinical research (417), 40% were clinical trials, 24% were burden of disease/epidemiology and 36% were other clinical studies. Among studies classified as operational research (431), 77% related to programme management, 18% were policy related and 5% were related to vaccine financing. Studies were conducted in 48 African countries with six countries (South Africa, The Gambia, Nigeria, Senegal, Guinea-Bissau and Kenya) accounting for 56% of the total research output. Studies were published in 152 different journals with impact factors ranging from 0.192 to 53.29; with a median impact factor of 3.572. A similar proportion of clinical versus operational research output was found. However, an uneven distribution across Africa was observed with only six countries accounting for over half of the research output. The research conducted was of moderate to high quality, with 62% being published in journals with 2010 impact factors greater than two. Urgent attention should be given to the development of research capacity in low

Impact of Anthelminthic Treatment in Pregnancy and Childhood on Immunisations, Infections and Eczema in Childhood: A Randomised Controlled Trial

PubMed Central

Mawa, Patrice A.; Nampijja, Margaret; Muhangi, Lawrence; Kihembo, Macklyn; Lule, Swaib A.; Rutebarika, Diana; Apule, Barbara; Akello, Florence; Akurut, Hellen; Oduru, Gloria; Naniima, Peter; Kizito, Dennison; Kizza, Moses; Kizindo, Robert; Tweyongere, Robert; Alcock, Katherine J.; Muwanga, Moses; Elliott, Alison M.

2012-01-01

Background Helminth infections may modulate immune responses to unrelated pathogens and allergens; these effects may commence prenatally. We addressed the hypothesis that anthelminthic treatment in pregnancy and early childhood would improve responses to immunisation and modulate disease incidence in early childhood with both beneficial and detrimental effects. Methods and Findings A randomised, double-blind, placebo-controlled trial was conducted in Entebbe, Uganda [ISRCTN32849447]. In three independent randomisations, 2507 pregnant women were allocated to receive single-dose albendazole or placebo, and praziquantel or placebo; 2016 of their offspring were randomised to receive quarterly single-dose albendazole or placebo from age 15 months to 5 years. Primary outcomes were post-immunisation recall responses to BCG and tetanus antigens, and incidence of malaria, diarrhoea, and pneumonia; incidence of eczema was an important secondary outcome. Analysis was by intention-to-treat. Of 2345 live births, 1622 (69%) children remained in follow-up at age 5 years. 68% of mothers at enrolment, and 11% of five-year-olds, had helminth infections. Maternal hookworm and Schistosoma mansoni were effectively treated by albendazole and praziquantel, respectively; and childhood hookworm and Ascaris by quarterly albendazole. Incidence rates of malaria, diarrhoea, pneumonia, and eczema were 34, 65, 10 and 5 per 100 py, respectively. Albendazole during pregnancy caused an increased rate of eczema in the children (HR 1.58 (95% CI 1.15–2.17), p = 0.005). Quarterly albendazole during childhood was associated with reduced incidence of clinical malaria (HR 0.85 (95% CI 0.73–0.98), p = 0.03). There were no consistent effects of the interventions on any other outcome. Conclusions Routine use of albendazole in pregnancy may not always be beneficial, even in tropical developing countries. By contrast, regular albendazole treatment in preschool children may have an additional

Adult Day Services

MedlinePlus

... views of various members of the National Adult Day Services Association. 2. U.S. Health Care Costs: Background Brief , The Henry J. Kaiser Family Foundation (2008) (www.kaiseredu.org); excerpt ...

Retrospective hospital based surveillance of intussusception in children in a sentinel paediatric hospital: benefits and pitfalls for use in post-marketing surveillance of rotavirus vaccines.

PubMed

Lloyd-Johnsen, C; Justice, F; Donath, S; Bines, J E

2012-04-27

Evaluation of the safety of rotavirus vaccines, particularly with respect to the risk of intussusception, is recommended for countries planning to introduce rotavirus vaccines into the National Immunisation Program. However, as prospective studies are costly, require time to conduct and may be difficult to perform in some settings, retrospective hospital based surveillance at sentinel sites has been suggested as an option for surveillance for intussusception following introduction of rotavirus vaccines. To assess the value of retrospective hospital based surveillance to describe clinical and epidemiological features of intussusception in children aged <24 months and to investigate any temporal association between receipt of a rotavirus vaccine and intussusception. A retrospective chart review of all patients diagnosed with intussusception at Royal Children's Hospital, Melbourne, Australia over an 8-year period including before and after rotavirus vaccine introduction into the National Immunisation Program, was conducted using patients identified by a medical record database (ICD-10-CM 56.1). Patient profile, clinical presentation, treatment and outcome were analysed along with records of immunisation status obtained using the Australian Childhood Immunisation Register. A 9% misclassification rate of discharge diagnosis of intussusception was identified on critical chart review. The incidence rate of intussusception at the Royal Children's Hospital over the study period was 1.91 per 10,000 infants <24 months (95% CI 1.65-2.20). Intestinal resection was required in 6.5% of infants (95% CI 3.6%, 11.0%). Intussusception occurred within 30 days after vaccination in 2 of 27 patients who had received at least 1 dose of a rotavirus vaccine. Valuable data on the incidence, clinical presentation and treatment outcomes of intussusception can be obtained from data retrieved from hospital medical records in a sentinel paediatric hospital using standardised methodology. However

Introducing a Girl to Engineering Day

NASA Image and Video Library

2018-02-22

NASA engineer Krista Shaffer, left, speaks to Rachel Power of NASA’s Digital Expansion to Engage the Public (DEEP) Network inside Kennedy Space Center’s Vehicle Assembly Building during Introduce a Girl to Engineering Day. Held in conjunction with National Engineers Week and Girl Day, the event allowed students from throughout the nation to speak with female NASA scientists and technical experts.

Introducing a Girl to Engineering Day

NASA Image and Video Library

2018-02-22

NASA engineer Krista Shaffer, right, is interviewed by Rachel Power of NASA’s Digital Expansion to Engage the Public (DEEP) Network inside Kennedy Space Center’s Vehicle Assembly Building during Introduce a Girl to Engineering Day. Held in conjunction with National Engineers Week and Girl Day, the event allowed students from throughout the nation to speak with female NASA scientists and technical experts.

Paternal education status significantly influences infants’ measles vaccination uptake, independent of maternal education status

PubMed Central

2012-01-01

Background Despite increased funding of measles vaccination programs by national governments and international aid agencies, structural factors encumber attainment of childhood measles immunisation to levels which may guarantee herd immunity. One of such factors is parental education status. Research on the links between parental education and vaccination has typically focused on the influence of maternal education status. This study aims to demonstrate the independent influence of paternal education status on measles immunisation. Methods Comparable nationally representative survey data were obtained from six countries with the highest numbers of children missing the measles vaccine in 2008. Logistic regression analysis was applied to examine the influence of paternal education on uptake of the first dose of measles vaccination, independent of maternal education, whilst controlling for confounding factors such as respondent’s age, urban/rural residence, province/state of residence, religion, wealth and occupation. Results The results of the analysis show that even if a mother is illiterate, having a father with an education of Secondary (high school) schooling and above is statistically significant and positively correlated with the likelihood of a child being vaccinated for measles, in the six countries analysed. Paternal education of secondary or higher level was significantly and independently correlated with measles immunisation uptake after controlling for all potential confounders. Conclusions The influence of paternal education status on measles immunisation uptake was investigated and found to be statistically significant in six nations with the biggest gaps in measles immunisation coverage in 2008. This study underscores the imperative of utilising both maternal and paternal education as screening variables to identify children at risk of missing measles vaccination prospectively. PMID:22568861

75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... adjustments to the national average payment rates for meals and snacks served in child care centers, outside... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...] Lunch and Centers Breakfast supper \\1\\ Snack Contingous States: Paid 0.26 0.26 0.06 Reduced Price 1.18 2...

Introducing a Girl to Engineering Day

NASA Image and Video Library

2018-02-22

Inside Kennedy Space Center’s Vehicle Assembly Building, Bethanne’ Hull, left, of NASA Outreach, and engineer Krista Shaffer, right, participate in Introduce a Girl to Engineering Day on NASA’s Digital Expansion to Engage the Public (DEEP) Network. Held in conjunction with National Engineers Week and Girl Day, the event allowed students from throughout the nation to speak with female NASA scientists and technical experts.

77 FR 70679 - Thanksgiving Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

... Thanksgiving Day, 2012 By the President of the United States of America A Proclamation On Thanksgiving Day... day is a time to take stock of the fortune we have known and the kindnesses we have shared, grateful... distinguished our Nation since its earliest days. Many Thanksgivings have offered opportunities to celebrate...

75 FR 29395 - National Maritime Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

... America's leadership in the global marketplace, and to our security. Civilian mariners and their ships... continues today. Merchant mariners support military operations in Iraq and Afghanistan, as well as.... They help strengthen our Nation's economy; bolster job-creating businesses; and, along with the...

76 FR 72607 - National Child's Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

... Michelle Obama's Let's Move! initiative, which is dedicated to solving the problem of childhood obesity... Americans achieved the Presidential Active Lifestyle Award. By empowering children and their caregivers with... that open higher education to more Americans. In communities across our Nation, parents, teachers...

75 FR 56463 - Patriot Day and National Day of Service and Remembrance, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... from every corner of our country joined together to demonstrate the unparalleled human capacity for... our Nation continue to honor the memory of those lost on September 11, and they reaffirm our charge to...

Food Consumption According to the Days of the Week – National Food Survey, 2008-2009

PubMed Central

Monteiro, Luana Silva; Hassan, Bruna Kulik; Estima, Camilla Chermont Prochnik; Souza, Amanda de Moura; Verly, Eliseu; Sichieri, Rosely; Pereira, Rosangela Alves

2017-01-01

ABSTRACT OBJECTIVE Evaluate the variations in energy, nutrients, and food groups intake between days of the week and weekend days in the Brazilian population. METHODS We used data from the first National Food Survey (2008-2009) of a one-day food log of a representative sample of the Brazilian population aged 10 years or older (n = 34,003). For the analyses, we considered the sample weights and the effect of the study design. The mean (and standard deviations) and frequencies (%) of energy, nutrients, and food groups consumption were estimated for weekdays (Monday to Friday) and weekend (Saturday and Sunday), we then estimated the differences according to the days of the week for the population strata analyzed. RESULTS The average daily energy intake for the weekend was 8% higher than the one observed for weekdays. The average percentage contribution of carbohydrate to the daily energy intake was higher during the week compared to Saturday and Sunday (56.3% versus 54.1%, p < 0.01). The inverse was observed for averages of the contribution to the daily intake of energy from total fat (26.8% versus 28.4%), saturated fat (9.1% versus 9.9%) and trans fat (1.4% versus 1.6%). The most significant changes between weekdays and weekend days were observed for eggs, sugar-added beverages, puff snacks and chips, beans, and pasta. During weekends, the frequency of beverage with added sugar consumption increased by 34%, the amount consumed increased by 42%, and the contribution to energy intake increased by 62% when compared to weekdays. CONCLUSIONS The Brazilian population increases energy intake and unhealthy food markers on weekends compared to weekdays. PMID:29020121

A National Survey of Current and Anticipated Media Equipment in Residential and Day Programs for the Hearing Impaired.

ERIC Educational Resources Information Center

Grant, William D.; Clark, Norma

Five investigations sponsored by the Office of Research and Evaluation (ORE) of the Model Secondary School for the Deaf (MSSD) are reported. Presented first are results of a national survey (April 1974) of media equipment in 123 residential and day programs for the hearing impaired, in which the number of cassette video recorders and color video…

Socio-economic determinants and inequities in coverage and timeliness of early childhood immunisation in rural Ghana.

PubMed

Gram, Lu; Soremekun, Seyi; ten Asbroek, Augustinus; Manu, Alexander; O'Leary, Maureen; Hill, Zelee; Danso, Samuel; Amenga-Etego, Seeba; Owusu-Agyei, Seth; Kirkwood, Betty R

2014-07-01

To assess the extent of socio-economic inequity in coverage and timeliness of key childhood immunisations in Ghana. Secondary analysis of vaccination card data collected from babies born between January 2008 and January 2010 who were registered in the surveillance system supporting the ObaapaVita and Newhints Trials was carried out. 20 251 babies had 6 weeks' follow-up, 16 652 had 26 weeks' follow-up, and 5568 had 1 year's follow-up. We performed a descriptive analysis of coverage and timeliness of vaccinations by indicators for urban/rural status, wealth and educational attainment. The association of coverage with socio-economic indicators was tested using a chi-square-test and the association with timeliness using Cox regression. Overall coverage at 1 year of age was high (>95%) for Bacillus Calmette-Guérin (BCG), all three pentavalent diphtheria-pertussis-tetanus-haemophilus influenzae B-hepatitis B (DPTHH) doses and all polio doses except polio at birth (63%). Coverage against measles and yellow fever was 85%. Median delay for BCG was 1.7 weeks. For polio at birth, the median delay was 5 days; all other vaccine doses had median delays of 2-4 weeks. We found substantial health inequity across all socio-economic indicators for all vaccines in terms of timeliness, but not coverage at 1 year. For example, for the last DPTHH dose, the proportion of children delayed more than 8 weeks were 27% for urban children and 31% for rural children (P < 0.001), 21% in the wealthiest quintile and 41% in the poorest quintile (P < 0.001), and 9% in the most educated group and 39% in the least educated group (P < 0.001). However, 1-year coverage of the same dose remained above 90% for all levels of all socio-economic indicators. Ghana has substantial health inequity across urban/rural, socio-economic and educational divides. While overall coverage was high, most vaccines suffered from poor timeliness. We suggest that countries achieving high coverage should include timeliness

76 FR 29989 - National Maritime Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... and tugs, in our ports and shipyards, close to home or far at sea, to connect businesses, service... our waterways safer and more efficient every day. Today, our maritime industry is a valuable source of... Highway Program,'' an effort that enables American businesses to participate in improving the safety and...

Antarctica Day: An International Celebration

NASA Astrophysics Data System (ADS)

Pope, A.; Hambrook Berkman, J.; Berkman, P. A.

2013-12-01

For more than half a century, the 1959 Antarctic Treaty continues to shine as a rare beacon of international cooperation. To celebrate this milestone of peace in our civilization with hope and inspiration for future generations, Antarctica Day is celebrated each year on December 1st , the anniversary of the Antarctic Treaty signing. As an annual event - initiated by the Foundation for the Good Governance of International Spaces (www.internationalspaces.org/) in collaboration with the Association of Polar Early Carer Scientists (www.apecs.is) - Antarctica Day encourages participation from around the world. The Antarctic Treaty set aside 10% of the earth, 'forever to be used exclusively for peaceful purposes in the interest of mankind.' It was the first nuclear arms agreement and the first institution to govern all human activities in an international region beyond sovereign jurisdictions. In this spirit, Antarctica Day aims to: - Demonstrate how diverse nations can work together peacefully, using science as a global language of cooperation for decision making beyond national boundaries, - Provide strategies for students learning about Antarctica through art, science and history at all school levels, - Increase collaboration and communication between classrooms, communities, researchers and government officials around the world, and - Provide a focus for polar educators to build on each year. Through close collaboration with a number of partners. Antarctica Day activities have included: a Polar Film Festival convened by The Explorers Club; live sessions connecting classrooms with scientists in Antarctica thanks to PolarTREC and ARCUS; an international activity that involved children from 13 countries who created over 600 flags which exemplify Antarctica Day (these were actually flown in Antarctica with signed certificates then returned to the classes); a map where Antarctica Day participants all over the world could share what they were doing; an Antarctic bird count

Introducing a Girl to Engineering Day

NASA Image and Video Library

2018-02-22

The camera in the foreground is recording NASA engineer Krista Shaffer, left, and Rachel Power of NASA’s Digital Expansion to Engage the Public (DEEP) Network inside Kennedy Space Center’s Vehicle Assembly Building during Introduce a Girl to Engineering Day. Held in conjunction with National Engineers Week and Girl Day, the event allowed students from throughout the nation to speak with female NASA scientists and technical experts.

Adjuvant action of melittin following intranasal immunisation with tetanus and diphtheria toxoids.

PubMed

Bramwell, V W; Somavarapu, S; Outschoorn, I; Alpar, H O

2003-01-01

Melittin, a 26-amino acid peptide and the major active component of the venom of the honey bee--Apis mellifera--has recently been shown to have absorption enhancing properties in Caco-2 cells at levels well below the level required for the generation of cytotoxicity. Given the potential of absorption enhancing agents to act as adjuvants when administered nasally [Alpar, H.O., Eyles, J.E., Williamson, E.D. and Somavarapu, S. (2001) "Intranasal vaccination against plague, tetanus and diphtheria", Adv. Drug Delivery Rev. 51, 173-201] we hypothesized that melittin may have potential as a mucosal adjuvant. Following our initial studies reported here, it was found that the co-administration of 4 microg of melittin in conjunction with tetanus toxoid in BALB/c mice was effective in eliciting markedly enhanced antibody titres in comparison to control groups and groups receiving free antigen administered intranasally. Lower concentrations of melittin were less effective and mice receiving 4 microg of melittin plus antigen exhibited antibody titres significantly higher (i.e. P<0.05) than any of the other groups tested. The observed IgG2a titres were shown to be dependent upon the dose of melittin co-administered with the immunising antigen in a similar fashion to the observed total IgG responses. In summary, melittin has been shown here to have potential as a novel mucosal adjuvant for antigens administered via the nasal route.

Assessment of cold-chain maintenance in vaccine carriers during Pulse Polio National Immunization Day in a rural block of India.

PubMed

Pakhare, Abhijit P; Bali, Surya; Pawar, Radhakishan B; Lokhande, Ganesh S

2014-01-01

India was certified polio free on 27 March 2014. Supplementary immunization activities, in the form of national immunization days, is one of the core strategies for eradication, where oral polio vaccine is administered to children aged under 5 years throughout the country. Oral polio vaccine is heat sensitive and requires maintenance of a stringent cold chain. Therefore, vaccine carriers with ice packs are used in the Pulse Polio Immunization (PPI) programme. This study assessed whether the cold chain is maintained during National Immunization Day in Beed district. A cross-sectional study was conducted at six randomly selected booths, one each from six primary health centres in Georai block of Beed district in Maharashtra. Electronic data loggers, configured to measure half-hourly temperatures, were kept in vaccine carriers throughout the day of PPI. The vaccine carrier temperature was below 8 °C at all six booths; minimum temperature recorded was -9.5 °C, while the maximum was 4.5 °C. The vaccine vial monitor did not reach discard point in any booth. A vaccine carrier with four ice packs very effectively maintains the cold chain required for oral polio vaccine.

Trends in the types and quality of childhood immunisations research output from Africa 1970–2010: mapping the evidence base

PubMed Central

2014-01-01

Background Over the past four decades, extraordinary progress has been made in establishing and improving childhood immunization programmes around Africa. In order to ensure effective and sustainable positive growth of these childhood immunisations programmes, the development, adaptation and implementation of all interventions (programme activities, new vaccines, new strategies and policies) should be informed by the best available local evidence. Methods An assessment of the peer-reviewed literature on childhood immunization research published in English from 1970 to 2010 was conducted in PubMed and Africa-Wide databases. All study types were eligible for inclusion. A standard form was used to extract information from all studies identified as relevant and entered into a Microsoft Access database for analysis. Results Our initial search yielded 5436 articles from the two databases, from which 848 full text articles were identified as relevant. Among studies classified as clinical research (417), 40% were clinical trials, 24% were burden of disease/epidemiology and 36% were other clinical studies. Among studies classified as operational research (431), 77% related to programme management, 18% were policy related and 5% were related to vaccine financing. Studies were conducted in 48 African countries with six countries (South Africa, The Gambia, Nigeria, Senegal, Guinea-Bissau and Kenya) accounting for 56% of the total research output. Studies were published in 152 different journals with impact factors ranging from 0.192 to 53.29; with a median impact factor of 3.572. Conclusion A similar proportion of clinical versus operational research output was found. However, an uneven distribution across Africa was observed with only six countries accounting for over half of the research output. The research conducted was of moderate to high quality, with 62% being published in journals with 2010 impact factors greater than two. Urgent attention should be given to the

77 FR 16903 - National Day of Honor

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-22

... and unwavering commitment to duty, our men and women in uniform served tour after tour, fighting block... their love of country, nearly 4,500 men and women are eternally bound; though we have laid them to rest... through trials, we will always emerge stronger than before. Now, our Nation reaffirms our commitment to...

Introducing a Girl to Engineering Day

NASA Image and Video Library

2018-02-22

The laptop computer in the foreground displays Rachel Power, left, of NASA’s Digital Expansion to Engage the Public (DEEP) Network; Bethanne’ Hull, center, of NASA Outreach; and NASA engineer Krista Shaffer inside Kennedy Space Center’s Vehicle Assembly Building during Introduce a Girl to Engineering Day. Held in conjunction with National Engineers Week and Girl Day, the event allowed students from throughout the nation to speak with female NASA scientists and technical experts.

Sun-Earth Day, 2001

NASA Technical Reports Server (NTRS)

Adams, Mitzi L.; Mortfield, P.; Hathaway, D. H.; Whitaker, Ann F. (Technical Monitor)

2001-01-01

To promote awareness of the Sun-Earth connection, NASA's Marshall Space Flight Center, in collaboration with the Stanford SOLAR Center, sponsored a one-day Sun-Earth Day event on April 27, 2001. Although "celebrated" on only one day, teachers and students from across the nation, prepared for over a month in advance. Workshops were held in March to train teachers. Students performed experiments, results of which were shared through video clips and an internet web cast. Our poster includes highlights from student experiments (grades 2 - 12), lessons learned from the teacher workshops and the event itself, and plans for Sun-Earth Day 2002.

Thirty-Day Readmission Rate and Costs After Percutaneous Coronary Intervention in the United States: A National Readmission Database Analysis.

PubMed

Tripathi, Avnish; Abbott, J Dawn; Fonarow, Gregg C; Khan, Abdur R; Barry, Neil G; Ikram, Sohail; Coram, Rita; Mathew, Verghese; Kirtane, Ajay J; Nallamothu, Brahmajee K; Hirsch, Glenn A; Bhatt, Deepak L

2017-12-01

The association of short-term readmissions after percutaneous coronary intervention (PCI) on healthcare costs has not been well studied. The Healthcare Cost and Utilization Project National Readmission Database encompassing 722 US hospitals was used to identify index PCI cases in patients ≥18 years old. Hierarchical regression analyses were used to examine the factors associated with risk of 30-day readmission and higher cumulative costs. We evaluated 206 869 hospitalized patients who survived to discharge after PCI from January through November 2013 and analyzed readmissions over 30 days after discharge. A total of 24 889 patients (12%) were readmitted within 30 days, with rates ranging from 6% to 17% across hospitals. Among the readmitted patients, 13% had PCI, 2% had coronary artery bypass surgery, and 3% died during the readmission. The most common reasons for readmission included nonspecific chest pain/angina (24%) and heart failure (11%). Mean cumulative costs were higher for those with readmissions ($39 634 versus $22 058; P <0.001). The multivariable analyses showed that readmission increased the log 10 cumulative costs by 45% (β: 0.445; P <0.001). There was no significant difference in cumulative costs by the type of insurance. In a national sample of inpatient PCI cases, 30-day readmissions were associated with a significant increase in cumulative costs. The majority of readmissions were because of low-risk chest pain that did not require any intervention. Ongoing effort is warranted to recognize and mitigate potentially preventable post-PCI readmissions. © 2017 American Heart Association, Inc.

Gender bias among children in India in their diet and immunisation against disease.

PubMed

Borooah, Vani K

2004-05-01

This paper conducts an econometric analysis of data for a sample of over 4000 children in India, between the ages of 1 and 2 years, with a view to studying two aspects of the neglect of children: their likelihood of being immunised against disease and their likelihood of receiving a nutritious diet. The starting hypothesis, consistent with an universal interest in gender issues, was that girls were more likely to be neglected than boys. The analysis confirmed this hypothesis. In respect of vaccinations, the likelihood of girls being fully vaccinated, after controlling for other variables, was 5 percentage points lower than that for boys. In respect of receiving a nutritious diet, the treatment of girls depended very much on whether or not their mothers were literate: there was no gender discrimination between children of literate mothers; on the other hand, when the mother was illiterate, girls were 5 percentage points less likely to be well-fed relative to their brothers and the presence of a literate father did little to dent this gender gap. But the analysis also pointed to a broader conclusion which was that all children in India suffered from sharper, but less publicised forms of disadvantage than that engendered solely by gender. These were the consequences which stemmed from children being born to illiterate mothers and being brought up in the more impoverished parts of India.

Designing the Expanded Programme on Immunisation (EPI) as a service: Prioritising patients over administrative logic.

PubMed

McKnight, Jacob; Holt, Douglas B

2014-01-01

Expanded Programme on Immunisation (EPI) vaccination rates remain well below herd immunity in regions of many countries despite huge international resources devoted to both financing and access. We draw upon service marketing theory, organisational sociology, development anthropology and cultural consumer research to conduct an ethnographic study of vaccination delivery in Jimma Zone, Ethiopia - one such region. We find that Western public health sector policies are dominated by an administrative logic. Critical failures in delivery are produced by a system that obfuscates the on-the-ground problems that mothers face in trying to vaccinate their children, while instead prioritising administrative processes. Our ethnographic analysis of 83 mothers who had not vaccinated their children reveals key barriers to vaccination from a 'customer' perspective. While mothers value vaccination, it is a 'low involvement' good compared to the acute daily needs of a subsistence life. The costs imposed by poor service - such as uncaring staff with class hostilities, unpredictable and missed schedules and long waits - are too much and so they forego the service. Our service design framework illuminates specific service problems from the mother's perspective and points towards simple service innovations that could improve vaccination rates in regions that have poor uptake.

77 FR 73889 - National Pearl Harbor Remembrance Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... pay solemn tribute to America's sons and daughters who made the ultimate sacrifice at Oahu. As we do... United States of America A Proclamation On December 7, 1941, our Nation suffered one of the most... our Nation through some of the 20th century's darkest moments. In his address to the Congress...

Fish DNA vaccine against infectious hematopoietic necrosis virus: efficacy of various routes of immunization

USGS Publications Warehouse

Corbeil, Serge; Kurath, Gael; LaPatra, Scott E.

2000-01-01

The DNA vaccine, pIHNVw-G, contains the gene for the glycoprotein (G) of the rhabdovirus infectious hematopoietic necrosis virus (IHNV), a major pathogen of salmon and trout. The relative efficacy of various routes of immunisation with pIHNVw-G was evaluated using 1.8 g rainbow trout fry vaccinated via intramuscular injection, scarification of the skin, intraperitoneal injection, intrabuccal administration, cutaneous particle bombardment using a gene gun, or immersion in water containing DNA vaccine-coated beads. Twenty-seven days after vaccination neutralising antibody titres were determined, and 2 days later groups of vaccinated and control unvaccinated fish were subjected to an IHNV immersion challenge. Results of the virus challenge showed that the intramuscular injection and the gene gun immunisation induced protective immunity in fry, while intraperitoneal injection provided partial protection. Neutralising antibodies were not detected in sera of vaccinated fish regardless of the route of immunisation used, suggesting that cell mediated immunity may be at least partially responsible for the observed protection.

Rethinking the Day of Silence

ERIC Educational Resources Information Center

Murphy, Adriana

2013-01-01

Back in 2006, 7th and 8th graders at Green Acres, the K-8 independent school where the author taught in suburban Maryland, participated in the Day of Silence. The Day of Silence is a national event: Students across the country take a one-day pledge of silence to show that they want to make schools safe for all students, regardless of their sexual…

77 FR 28761 - Mother's Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... Day, 2012 By the President of the United States of America A Proclamation Mothers are cornerstones of our families and our communities. On Mother's Day, we honor the remarkable women who strive and sacrifice every day to ensure their children have every opportunity to pursue their dreams. Our Nation first...

Effect of vaccination of cattle with the low virulence Nc-Spain 1H isolate of Neospora caninum against a heterologous challenge in early and mid-gestation

PubMed Central

2013-01-01

Live vaccines have emerged as one of the most potentially cost-effective measures for the control of bovine neosporosis. Previous studies have shown that Nc-Spain 1H is a naturally attenuated isolate of Neospora caninum and that immunisation with live Nc-Spain 1H tachyzoites generated a protective immune response in mice. The aim of this study was to evaluate the safety and efficacy of immunisation in cattle. N. caninum-seronegative heifers were immunised subcutaneously twice with 107 live Nc-Spain 1H tachyzoites prior to artificial insemination. No adverse reactions or negative effects on reproductive parameters were recorded following immunisation. In immunised and non-challenged heifers, no foetal deaths were observed, and none of the calves was congenitally infected. The efficacy against N. caninum-associated foetal death and vertical transmission was determined after challenge with high doses of the Nc-1 isolate at 70 and 135 days of gestation, respectively. After the challenge in early gestation, the immunisation induced a protection of 50% against foetal death. In addition, the microsatellite analysis performed in PCR-positive tissue samples from foetuses that died after challenge infection showed that the profiles corresponded to the challenge isolate Nc-1. A degree of protection against vertical transmission was observed after challenge at mid-gestation; calves from immunised heifers showed significantly lower pre-colostral Neospora-specific antibody titres than calves from the non-immunised/challenge group (P < 0.05). Strong antibody and interferon gamma responses were induced in the immunised heifers. This study indicates that the immunisation before pregnancy with the Nc-Spain 1H vaccine isolate appeared to be safe and reduced the occurrence of N. caninum-associated abortion and vertical transmission in experimentally infected cattle. In light of these encouraging results, the next step for testing this live attenuated candidate should be the

NASA Participates in Mars Day Activities at the National Air and Space Museum

NASA Image and Video Library

2017-07-21

NASA participated in the July 21 Mars Day event at the Smithsonian National Air and Space Museum (NASM) in Washington, D.C. The museum hosts this annual event, which includes exhibits, speakers and educational activities, to celebrate the Red Planet. Jim Green, director of NASA’s Planetary Science Division, along with other NASA scientists and engineers, was on hand to talk with visitors about the agency’s Mars exploration missions. There was also a Mars concept rover on display, developed by vehicle designers the Parker Brothers with advice from NASA. The vehicle is currently on an East Coast tour from its home base at the Kennedy Space Center Visitor’s Complex in Florida. The concept rover is designed to engage and educate the public by demonstrating the types of features and equipment a future human exploration vehicle may need.

A three-day anatomy revision course taught by senior peers effectively prepares junior students for their national anatomy exam.

PubMed

Rengier, Fabian; Rauch, Philipp Julian; Partovi, Sasan; Kirsch, Joachim; Nawrotzki, Ralph

2010-12-20

this study examines whether peer-teaching, in the setting of a three-day revision course in anatomy, is effective in preparing medical students for their national anatomy exam. the anatomy course was designed for candidates taking the first part of the German national medical exam. Increase of knowledge during the course was assessed by tests before and after the course (group A). To test equivalence, two control groups participated in the pre-test (group B) or in the course and in the post-test (group C). Participants anonymously rated 14 feedback items on a five-point Likert scale ranging from 1 (full agreement) to 5 (full disagreement). group A students' performance improved significantly during the course with a mean increase of 7.15 points (11.9% improvement; p<0.001). Equivalence testing showed that performance of group A students in the pre-/post-tests was equal to those of group B pre-tests and group C post-tests, respectively. Agreement on the 14 feedback items was highly significant (p<0.001 for all items), with a global median of 1. this study shows that a three-day anatomy revision course is effective and highly appreciated by medical students in their preparation for the national exam. Moreover, peer-teaching is reliable at this stage of the medical curriculum. 2010 Elsevier GmbH. All rights reserved.

Peptide immunisation of HLA-DR-transgenic mice permits the identification of a novel HLA-DRbeta1*0101- and HLA-DRbeta1*0401-restricted epitope from p53.

PubMed

Rojas, José Manuel; McArdle, Stephanie E B; Horton, Roger B V; Bell, Matthew; Mian, Shahid; Li, Geng; Ali, Selman A; Rees, Robert C

2005-03-01

Because of the central role of CD4(+) T cells in antitumour immunity, the identification of the MHC class II-restricted peptides to which CD4(+) T cells respond has become a priority of tumour immunologists. Here, we describe a strategy permitting us to rapidly determine the immunogenicity of candidate HLA-DR-restricted peptides using peptide immunisation of HLA-DR-transgenic mice, followed by assessment of the response in vitro. This strategy was successfully applied to the reported haemaglutinin influenza peptide HA(307-319), and then extended to three candidate HLA-DR-restricted p53 peptides predicted by the evidence-based algorithm SYFPEITHI to bind to HLA-DRbeta1*0101 (HLA-DR1) and HLA-DRbeta1*0401 (HLA-DR4) molecules. One of these peptides, p53(108-122), consistently induced responses in HLA-DR1- and in HLA-DR4-transgenic mice. Moreover, this peptide was naturally processed by dendritic cells (DCs), and induced specific proliferation in the splenocytes of mice immunised with p53 cDNA, demonstrating that immune responses could be naturally mounted to the peptide. Furthermore, p53(108-122) peptide was also immunogenic in HLA-DR1 and HLA-DR4 healthy donors. Thus, the use of this transgenic model permitted the identification of a novel HLA-DR-restricted epitope from p53 and constitutes an attractive approach for the rapid identification of novel immunogenic MHC class II-restricted peptides from tumour antigens, which can ultimately be incorporated in immunotherapeutic protocols.

Measuring the Social Recreation Per-Day Net Benefit of the Wildlife Amenities of a National Park: A Count-Data Travel-Cost Approach

NASA Astrophysics Data System (ADS)

Mendes, Isabel; Proença, Isabel

2011-11-01

In this article, we apply count-data travel-cost methods to a truncated sample of visitors to estimate the Peneda-Gerês National Park (PGNP) average consumer surplus (CS) for each day of visit. The measurement of recreation demand is highly specific because it is calculated by number of days of stay per visit. We therefore propose the application of altered truncated count-data models or truncated count-data models on grouped data to estimate a single, on-site individual recreation demand function, with the price (cost) of each recreation day per trip equal to out-of-pocket and time travel plus out-of-pocket and on-site time costs. We further check the sensitivity of coefficient estimations to alternative models and analyse the welfare measure precision by using the delta and simulation methods by Creel and Loomis. With simulated limits, CS is estimated to be €194 (range €116 to €448). This information is of use in the quest to improve government policy and PNPG management and conservation as well as promote nature-based tourism. To our knowledge, this is the first attempt to measure the average recreation net benefits of each day of stay generated by a national park by using truncated altered and truncated grouped count-data travel-cost models based on observing the individual number of days of stay.

Measuring the social recreation per-day net benefit of the wildlife amenities of a national park: a count-data travel-cost approach.

PubMed

Mendes, Isabel; Proença, Isabel

2011-11-01

In this article, we apply count-data travel-cost methods to a truncated sample of visitors to estimate the Peneda-Gerês National Park (PGNP) average consumer surplus (CS) for each day of visit. The measurement of recreation demand is highly specific because it is calculated by number of days of stay per visit. We therefore propose the application of altered truncated count-data models or truncated count-data models on grouped data to estimate a single, on-site individual recreation demand function, with the price (cost) of each recreation day per trip equal to out-of-pocket and time travel plus out-of-pocket and on-site time costs. We further check the sensitivity of coefficient estimations to alternative models and analyse the welfare measure precision by using the delta and simulation methods by Creel and Loomis. With simulated limits, CS is estimated to be 194 (range 116 to 448). This information is of use in the quest to improve government policy and PNPG management and conservation as well as promote nature-based tourism. To our knowledge, this is the first attempt to measure the average recreation net benefits of each day of stay generated by a national park by using truncated altered and truncated grouped count-data travel-cost models based on observing the individual number of days of stay.

2016 America's Recycle Day

NASA Image and Video Library

2016-11-15

Computers, monitors, vacuum cleaners and other electronics have been donated by employees at NASA's Kennedy Space Center in Florida in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more. The two-day event was sponsored by Kennedy's Sustainability team.

76 FR 25527 - Law Day, U.S.A., 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

... as ``a day of national dedication to the principles of government under law.'' Each Law Day, we... nation of laws and that a fair trial is the right of all people. President Adams' legacy of dedication to...

Yellow fever control in Cameroon: Where are we now and where are we going?

PubMed Central

Wiysonge, Charles Shey; Nomo, Emmanuel; Mawo, Jeanne; Ofal, James; Mimbouga, Julienne; Ticha, Johnson; Ndumbe, Peter M

2008-01-01

Background Cameroon is one of 12 African countries that bear most of the global burden of yellow fever. In 2002 the country developed a five-year strategic plan for yellow fever control, which included strategies for prevention as well as rapid detection and response to outbreaks when they occur. We have used data collected by the national Expanded Programme on Immunisation to assess the progress made and challenges faced during the first four years of implementing the plan. Methods In January 2003, case-based surveillance of suspected yellow fever cases was instituted in the whole country. A year later, yellow fever immunisation at nine months of age (the same age as routine measles immunisation) was introduced. Supplementary immunisation activities (SIAs), both preventive and in response to outbreaks, also formed an integral part of the yellow fever control plan. Each level of the national health system makes a synthesis of its activities and sends this to the next higher level at defined regular intervals; monthly for routine data and daily for SIAs. Results From 2004 to 2006 the national routine yellow fever vaccination coverage rose from 58.7% to 72.2%. In addition, the country achieved parity between yellow fever and measles vaccination coverage in 2005 and has since maintained this performance level. The number of suspected yellow fever cases in the country increased from 156 in 2003 to 859 in 2006, and the proportion of districts that reported at least one suspected yellow fever case per year increased from 31.4% to 68.2%, respectively. Blood specimens were collected from all suspected cases (within 14 days of onset of symptoms) and tested at a central laboratory for yellow fever IgM antibodies; leading to confirmation of yellow fever outbreaks in the health districts of Bafia, Méri and Ntui in 2003, Ngaoundéré Rural in 2004, Yoko in 2005 and Messamena in 2006. Owing to constraints in rapidly mobilising the necessary resources, reactive SIAs were only

Yellow fever control in Cameroon: where are we now and where are we going?

PubMed

Wiysonge, Charles Shey; Nomo, Emmanuel; Mawo, Jeanne; Ofal, James; Mimbouga, Julienne; Ticha, Johnson; Ndumbe, Peter M

2008-02-08

Cameroon is one of 12 African countries that bear most of the global burden of yellow fever. In 2002 the country developed a five-year strategic plan for yellow fever control, which included strategies for prevention as well as rapid detection and response to outbreaks when they occur. We have used data collected by the national Expanded Programme on Immunisation to assess the progress made and challenges faced during the first four years of implementing the plan. In January 2003, case-based surveillance of suspected yellow fever cases was instituted in the whole country. A year later, yellow fever immunisation at nine months of age (the same age as routine measles immunisation) was introduced. Supplementary immunisation activities (SIAs), both preventive and in response to outbreaks, also formed an integral part of the yellow fever control plan. Each level of the national health system makes a synthesis of its activities and sends this to the next higher level at defined regular intervals; monthly for routine data and daily for SIAs. From 2004 to 2006 the national routine yellow fever vaccination coverage rose from 58.7% to 72.2%. In addition, the country achieved parity between yellow fever and measles vaccination coverage in 2005 and has since maintained this performance level. The number of suspected yellow fever cases in the country increased from 156 in 2003 to 859 in 2006, and the proportion of districts that reported at least one suspected yellow fever case per year increased from 31.4% to 68.2%, respectively. Blood specimens were collected from all suspected cases (within 14 days of onset of symptoms) and tested at a central laboratory for yellow fever IgM antibodies; leading to confirmation of yellow fever outbreaks in the health districts of Bafia, Méri and Ntui in 2003, Ngaoundéré Rural in 2004, Yoko in 2005 and Messamena in 2006. Owing to constraints in rapidly mobilising the necessary resources, reactive SIAs were only conducted in Bafia and M�

Evaluating the accuracy of sampling to estimate central line-days: simplification of the National Healthcare Safety Network surveillance methods.

PubMed

Thompson, Nicola D; Edwards, Jonathan R; Bamberg, Wendy; Beldavs, Zintars G; Dumyati, Ghinwa; Godine, Deborah; Maloney, Meghan; Kainer, Marion; Ray, Susan; Thompson, Deborah; Wilson, Lucy; Magill, Shelley S

2013-03-01

To evaluate the accuracy of weekly sampling of central line-associated bloodstream infection (CLABSI) denominator data to estimate central line-days (CLDs). Obtained CLABSI denominator logs showing daily counts of patient-days and CLD for 6-12 consecutive months from participants and CLABSI numerators and facility and location characteristics from the National Healthcare Safety Network (NHSN). Convenience sample of 119 inpatient locations in 63 acute care facilities within 9 states participating in the Emerging Infections Program. Actual CLD and estimated CLD obtained from sampling denominator data on all single-day and 2-day (day-pair) samples were compared by assessing the distributions of the CLD percentage error. Facility and location characteristics associated with increased precision of estimated CLD were assessed. The impact of using estimated CLD to calculate CLABSI rates was evaluated by measuring the change in CLABSI decile ranking. The distribution of CLD percentage error varied by the day and number of days sampled. On average, day-pair samples provided more accurate estimates than did single-day samples. For several day-pair samples, approximately 90% of locations had CLD percentage error of less than or equal to ±5%. A lower number of CLD per month was most significantly associated with poor precision in estimated CLD. Most locations experienced no change in CLABSI decile ranking, and no location's CLABSI ranking changed by more than 2 deciles. Sampling to obtain estimated CLD is a valid alternative to daily data collection for a large proportion of locations. Development of a sampling guideline for NHSN users is underway.

Back trajectory analysis of high-ozone days from a 15-year record of measurements at Great Basin National Park, Nevada

NASA Astrophysics Data System (ADS)

Gustin, M. S.; Weiss-Penzias, P. S.; Jaffe, D. A.; Guo, W.

2011-12-01

It has been suggested that pristine locations in western North America are influenced by long-range transport of ozone (O3) precursors in the atmosphere from Asia, especially during the spring. There are also local and regional anthropogenic as well as biogenic sources of O3 precursors in the western United States and the potential for influx from the stratosphere that could influence air concentrations at the surface. High O3 events have been reported for Great Basin National Park located in remote eastern Nevada that will result in the park area being out of attainment with the proposed 60 to 70 ppb standard. In this work, we determine the potential sources of O3 using a 15 year record of O3 measurements at Great Basin National Park in Nevada, in conjunction with 72-hour HYSPLIT back trajectories and aerosol data from the IMPROVE network. Only days in which maximum 8-hour daily average O3 concentration exceeded 70 ppb were considered, and these totaled 97 days between 1995 and 2009. For these days a simple trajectory residence time (TRT) model was employed to compare the times an air mass spent in two different transport regimes: 1) a 2 degree x 3 degree x 1 km altitude box centered on Los Angeles, and 2) all horizontal locations > 3 km altitude. Only the days with high TRT in one box (> upper quartile) and zero TRT in the other box were considered, and IMPROVE aerosol data for these days were incorporated. This resulted in 18 days classified as "LA transport" and 9 days classified as "high altitude (HA) transport". The remaining days displayed some combination of LA and HA transport and were not considered. High "LA transport" days were associated with significantly enhanced aerosol parameters such as fine and coarse mass, nitrate, sulfate, and organics compared to high "HA transport" days. "LA transport" was associated with air flow in a counter clock-wise motion at altitudes below the boundary layer height, which tended to pass over Las Vegas. "HA transport

78 FR 26229 - Loyalty Day, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... Day, 2013 By the President of the United States of America A Proclamation In the centuries since... all. This is our Nation's heritage, and it is what we remember on Loyalty Day. It is an occasion that..., we have the power to set our country's course. Let us mark this day by pressing on in the march...

Lessons of Liberty: Veterans Day 2001 Teacher's Guide.

ERIC Educational Resources Information Center

Department of Veterans Affairs, Washington, DC.

This teacher's guide helps teachers plan a class program for Veterans Day. The guide contains the following components (many with activities): "History of Veterans Day"; "Veterans Day National Ceremony"; "Suggested Veterans Day Programs"; "America's Wars (Statistics)"; "Fly Your Flag Regularly and…

77 FR 18895 - Cesar Chavez Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... Chavez Day, 2012 By the President of the United States of America A Proclamation One of our Nation's... Cesar Chavez Day. I call upon all Americans to observe this day with appropriate service, community, and... this twenty-third day of March, in the year of our Lord two thousand twelve, and of the Independence of...

77 FR 60277 - National Public Lands Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-03

... communities across our country will join together to restore the lands and waters we share, and families... reminded of the varied roles our public lands play in our national life. These areas boost tourism and...

77 FR 26657 - National Day of Prayer, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

.... Let us also pay tribute to the men and women of our Armed Forces who have answered our country's call... this first day of May, in the year of our Lord two thousand twelve, and of the Independence of the...

Water availability and flood hazards in the John Day Fossil Beds National Monument, Oregon

USGS Publications Warehouse

Frank, Frank J.; Oster, E.A.

1979-01-01

The rock formations of the John Day Fossil Beds National Monument area are aquifers that can be expected to yield less than 10 gallons of water per minute to wells. The most permeable of the geologic units is the alluvium that occurs at low elevations along the John Day River and most of the smaller streams. Wells in the alluvial deposits can be expected to yield adequate water supplies for recreational areas; also, wells completed in the underlying bedrock at depths ranging from 50 to 200 feet could yield as much as 10 gallons per minute. Pumping tests on two unused wells indicated yields of 8 gallons per minute and 2 gallons per minute. Nine of the ten springs measured in and near the monument area in late August of 1978 were flowing 0.2 to 30 gallons per minute. Only the Cant Ranch spring and the Johnny Kirk Spring near the Sheep Rock unit had flows exceeding 6 gallons per minute. Chemical analyses of selected constituents of the ground water indicated generally low concentrations of dissolved minerals. Although cloudbursts in the Painted Hills unit could generate a flood wave on the valley floors, flood danger can be reduced by locating recreational sites on high ground. The campground in Indian Canyon of the Clarno unit is vulnerable to cloudburst flooding. About 80 percent of the proposed campground on the John Day River in the Sheep Rock unit is above the estimated level of 1-percent chance flood (100-year flood) of the river. The 1-percent chance flood would extend about 120 feet from the riverbank into the upstream end of the campground. (USGS).

75 FR 28181 - National Defense Transportation Day and National Transportation Week, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-20

... ensure America has a world-class logistics and transportation system to support our military readiness... the President of the United States of America A Proclamation The transportation networks of early America connected our rapidly growing Nation with natural waterways and dirt roads, making travel...

76 FR 29135 - National Defense Transportation Day and National Transportation Week, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... movement created by America's transportation infrastructure facilitates our Nation's economic vitality. Our... also permits our military to move personnel and supplies at a moment's notice. The ability to deploy... America A Proclamation America has long depended on a robust and reliable transportation network to...

2016 America's Recycle Day

NASA Image and Video Library

2016-11-15

A sign points the way to the electronic waste collection site, where NASA Kennedy Space Center employees donated computers, monitors, vacuum cleaners and other electronics in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more. The two-day event was sponsored by Kennedy's Sustainability team.

2016 America's Recycle Day

NASA Image and Video Library

2016-11-15

A sign tells NASA Kennedy Space Center employees they have come to the right place to donate items for reuse or recycling in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more. The two-day event was sponsored by Kennedy's Sustainability team.

2016 America's Recycle Day

NASA Image and Video Library

2016-11-15

Members of the Sustainability team at NASA's Kennedy Space Center in Florida set up giveaway items and sort through donations for reuse or recycling in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more. The two-day event was sponsored by Kennedy's Sustainability team.

Ninety-Day Postoperative Mortality after Robot-assisted Laparoscopic Prostatectomy and Retropubic Radical Prostatectomy. Nation-wide population-based study

PubMed Central

Björklund, Johan; Folkvaljon, Yasin; Cole, Alexander; Carlsson, Stefan; Robinson, David; Loeb, Stacy; Stattin, Pär; Akre, Olof

2016-01-01

Objective To assess 90-day postoperative mortality after Robot assisted laparoscopic Radical prostatectomy (RARP) and retropubic radical prostatectomy (RRP) by use of nationwide population-based registry data. Patients and methods Cohort study in the National Prostate Cancer Register (NPCR) of Sweden of 22 344 men with prostate cancer in clinical local stage T1-T3, PSA <50 μg/ml who had undergone primary RP in 1998 - 2012. Vital status was ascertained through the Total Population Register. 90-day postoperative mortality was analysed by use of logistic regression analysis and comparison of 90-day mortality with the background population were made using standardised mortality ratios (SMR). Results 29 out of 14820 men (0.20%) died after RRP and 10 out of 7524 men (0.13%) died after RARP. Mortality during the 90-day postoperative period in the cohort was lower than in an age-matched background population, SMR 0.57 (CI 95% 0.39-0.75). There was no statistically significant difference in 90-day mortality according to surgical method, RARP vs. RRP (odds ratio, OR 1.14; 95% CI, 0.46-2.81). Postoperative 90-day mortality decreased over time, 2008-2012 vs. 1998-2007 (OR 0.44; 95% CI, 0.21-0.95), mainly due to decreased mortality after RARP. Limitations of our study include the non-randomised design and that more RARP were performed in recent years compared to RRP. Conclusion 90-day postoperative mortality was low after RARP and RRP and there was nostatistically significant difference between the methods. Given the long life expectancy among men with low and intermediate risk prostate cancer, very low postoperative mortality is a prerequisite for RP which was fulfilled by both RRP and RARP. The selection of healthy men for RP is highlighted by the lower 90-day mortality after RP compared to the background population. PMID:26762928

An outbreak of East Coast Fever on the Comoros: a consequence of the import of immunised cattle from Tanzania?

PubMed

De Deken, R; Martin, V; Saido, A; Madder, M; Brandt, J; Geysen, D

2007-02-28

In 2003 and 2004, a severe epidemic decimated the cattle population on Grand Comore, the largest island of the Union of Comoros. Fatalities started soon after the import of cattle from Tanzania. Theileria parva and its vector, Rhipicephalus appendiculatus, could be identified as the main culprits of the epidemic. Characterisation by multilocus genotyping revealed that the T. parva parasites isolated on the Comoros were identical to the components of the Muguga cocktail vaccine used in Tanzania to immunise cattle. Therefore, it is believed that East Coast Fever reached the Comoros while some of the imported livestock got infected in Tanzania by ticks of which the immature stadia fed on Muguga cocktail vaccinated animals. Since the Comorian government neither has the financial means nor the competent staff to pursue an adequate epidemiosurveillance, the danger exists that without external assistance and in a context of continuing globalisation more transboundary diseases will affect the Comorian livestock sector in the future.

78 FR 28707 - National Defense Transportation Day and National Transportation Week, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-15

... challenges we face. We need to restore our roads, bridges, and ports-- transportation networks that are... security. At a time when our cities face unprecedented threats and hazards, we must do more to ensure our... infrastructure. In recognition of the importance of our Nation's transportation infrastructure, and of the men...

Diet quality on meatless days: National Health and Nutrition Examination Survey (NHANES), 2007-2012.

PubMed

Conrad, Zach; Karlsen, Micaela; Chui, Kenneth; Jahns, Lisa

2017-06-01

To compare diet quality scores between adult non-meat eaters and meat eaters, and to compare the consumption of diet components across quintiles of diet quality. Cross-sectional analysis. The Healthy Eating Index-2010 (HEI-2010) and Alternative Healthy Eating Index-2010 (AHEI-2010) were used to assess mean diet quality. Differences in consumption of diet components between quintiles of diet quality were tested using post hoc Wald tests and z tests. The National Health and Nutrition Examination Survey (NHANES), 2007-2012. The sample consisted of 16810 respondents aged≥18 years, including 280 individuals who reported not consuming meat, poultry, game birds or seafood on two non-consecutive days of dietary recall. Dietary data were obtained from one dietary recall per individual. Non-meat eaters had substantially greater HEI-2010 and AHEI-2010 scores than meat eaters (P<0·05). Among non-meat eaters, mean consumption across HEI-2010 quintiles demonstrated different (P<0·05) amounts of empty calories and unsaturated:saturated fatty acids. Mean consumption across AHEI-2010 quintiles demonstrated different (P<0·05) amounts of nuts and legumes, vegetables and PUFA. Public health messages targeted at vegetarians and others who may choose to eat meat-free on certain days should emphasize decreased consumption of empty calories, and increased consumption of nuts and legumes, PUFA and vegetables, as a way to improve overall dietary quality.

Customizing national models for a medical center's population to rapidly identify patients at high risk of 30-day all-cause hospital readmission following a heart failure hospitalization.

PubMed

Cox, Zachary L; Lai, Pikki; Lewis, Connie M; Lindenfeld, JoAnn; Collins, Sean P; Lenihan, Daniel J

2018-05-28

Nationally-derived models predicting 30-day readmissions following heart failure (HF) hospitalizations yield insufficient discrimination for institutional use. Develop a customized readmission risk model from Medicare-employed and institutionally-customized risk factors and compare the performance against national models in a medical center. Medicare patients age ≥ 65 years hospitalized for HF (n = 1,454) were studied in a derivation cohort and in a separate validation cohort (n = 243). All 30-day hospital readmissions were documented. The primary outcome was risk discrimination (c-statistic) compared to national models. A customized model demonstrated improved discrimination (c-statistic 0.72; 95% CI 0.69 - 0.74) compared to national models (c-statistics of 0.60 and 0.61) with a c-statistic of 0.63 in the validation cohort. Compared to national models, a customized model demonstrated superior readmission risk profiling by distinguishing a high-risk (38.3%) from a low-risk (9.4%) quartile. A customized model improved readmission risk discrimination from HF hospitalizations compared to national models. Copyright © 2018 Elsevier Inc. All rights reserved.

75 FR 56461 - National Days of Prayer and Remembrance, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... September to honor the memory of the women, men, and children lost in New York City, in rural Pennsylvania..., 2001, and in the dark days that followed. Innocent men and women were beginning a routine day at work... men and women in uniform who have lost their lives serving in Iraq, Afghanistan, and elsewhere, while...

Defense.gov Special Report: Memorial Day 2013

Science.gov Websites

friends." President Barack Obama Presidential Proclamation: Prayer for Peace Memorial Day 2013 May 2013 Top Stories Obama Urges Remembrance in Memorial Day Remarks Photo: President Barack Obama is Memorial Day ceremony in Arlington National Cemetery, May 27, 2013. Welch is the sergeant of the guard of

75 FR 34307 - King Kamehameha Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... Kamehameha Day, 2010 By the President of the United States of America A Proclamation Two hundred years ago...'s concern for public safety.'' On this bicentennial King Kamehameha Day, we celebrate the history... all have to grow and learn from one another as we carry our Nation toward a brighter day. NOW...

76 FR 63531 - German-American Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

...-American Day, 2011 By the President of the United States of America A Proclamation As a Nation of... observe German-American Day, we celebrate how far we have come together and remember the lasting legacy... States, do hereby proclaim October 6, 2011, as German-American Day. I encourage all Americans to learn...

Kinetics of the immune response to the (F1+V) vaccine in models of bubonic and pneumonic plague.

PubMed

Williamson, E D; Stagg, A J; Eley, S M; Taylor, R; Green, M; Jones, S M; Titball, R W

2007-01-22

Protection against aerosol challenge with > 300 MLD of Yersinia pestis was observed 7 days after a single immunisation of mice with the F1+V vaccine. At day 60, mice were protected against injected challenge (10(7)MLD) in a vaccine dose-related manner. Recall responses to rV in splenocytes ex vivo at day 98 correlated significantly (p<0.001) with the immunising dose-level of V antigen; no memory response or anti-V serum IgG was detected in killed whole cell vaccine (KWCV) recipients. This may explain the susceptibility of KWCV recipients to aerosol challenge and the enhanced protection conferred by the F1+V sub-unit vaccine, particularly since the anti-F1 responses induced by either vaccine were similarly IgG1-polarised.

78 FR 60177 - National Public Lands Day, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

... diverse and rugged landscapes reflect our national character, the way we care for these open spaces.... Since I established this initiative, we have expanded access to recreation, restored critical landscapes, and created urban parks and water trails. We are also working with partners to let young people serve...

75 FR 3981 - National Angel Island Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

..., villages, and farms of their birth, they journeyed across the Pacific, seeking better lives for themselves... contributed immeasurably to our Nation as leaders in every sector of American life. The children of Angel... things are possible in America, this vibrant community has created a beacon of hope for future...

76 FR 21221 - National Equal Pay Day, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

... America A Proclamation Generations of women have fought for the advancement of their sisters, daughters, and themselves in acts of great courage--reaching for and winning the right to vote, breaking barriers.... While our Nation has come far, obstacles continue to exist for working women, who still earn less on...

2016 America's Recycle Day

NASA Image and Video Library

2016-11-15

Members of the Sustainability team at NASA's Kennedy Space Center in Florida accept items donated by employees in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more.

2016 America's Recycle Day

NASA Image and Video Library

2016-11-15

Members of the Sustainability team at NASA's Kennedy Space Center in Florida shred a disposed hard drive in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more.

75 FR 62453 - German-American Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-12

...-American Day, 2010 By the President of the United States of America A Proclamation The American story has... national life. On German-American Day, we pay tribute to the role this community has played in shaping... the laws of the United States, do hereby proclaim October 6, 2010, as German-American Day. I encourage...

Local Students Celebrate Earth Day at NREL

Science.gov Websites

Students Celebrate Earth Day at NREL For more information contact: e:mail: Public Affairs Golden , Colo., April 17, 1998 — Media are invited to cover Earth Day celebration designed to inspire a new Energy's (DOE) National Renewable Energy Laboratory (NREL) will host an Earth Day celebration for 60

75 FR 25101 - National Day of Prayer, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... freedom both to believe and to live our beliefs, and for the many other freedoms and opportunities that... address the great challenges of our time. We are blessed to live in a Nation that counts freedom of conscience and free exercise of religion among its most fundamental principles, thereby ensuring that all...

VACCINATION--COLLECTIVE RESPONSIBILITY OR VIOLATION OF RIGHTS?

PubMed

Florescu, Laura; Rugina, Aurica; Temneanu, Oana Raluca; Paduraru, Dana Teodora Anton; Matei, Mioara Calipsoana; Safta, Cosmin; Mindru, Dana Elena

2015-01-01

Vaccination is considered to be the most effective and the cheapest medical intervention through which individual and collective immunisation is achieved. Statistics show that, at present, immunisation annually saves 400 million lives and protects approximately 750,000 children against disabilities of varying degrees. Approximately 80% of worldwide children are vaccinated against diphtheria, tetanus, pertussis, polio, measles, etc.; these diseases used to be considered incurable in the past. Vaccines help the body to produce antibodies; they help the immune system to detect germs and inactivate their cells. The immunological protection is installed after a variable period of time following the inoculation and is long lasting. Immunisations can be achieved in several ways: through national immunisation campaigns with general recommendation--they may be compulsory, optional or prophylactic (for the diseases for which a vaccine is available); vaccinations not included in the compulsory immunisation programmes; they may also be targeted to the contagious infectious outbreaks or to groups of population in certain situations. There is no guarantee that a vaccine will provide 100% protection. However, it will significantly reduce the risk of getting an infection. Vaccines have side effects which can be divided into reactions triggered by the vaccine or reactions exacerbated by it, without a causal relationship to the vaccine.

High Quality Family Day Care: Financial Considerations.

ERIC Educational Resources Information Center

Corsini, David A.; Caruso, Grace-Ann

The expenses and sources of income for two supervised family day care (SFDC) systems in Denmark, where SFDC is the national family day care model, are compared with two supervised systems in Connecticut, where SFDC is rare, as in the United States generally. SFDC differs from family day care in general by the systematic involvement of trained…

Defense.gov Special Report: Veterans Day 2012

Science.gov Websites

Department of Defense Submit Search Veterans Day 2012 - Honoring our Nation's Veterans - 11.11.12 Nov. 11 Veterans Day holiday, Defense Secretary Leon E. Panetta has issued a message paying tribute to the men and devastation, thousands gathered to watch the 2012 New York City Veterans Day Parade, with Deputy Defense