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Biomedical subjects

E A Mortimer

Publications and source records attributed to E A Mortimer.

At least 37 records · Page 2Linked to original sources
PubMed1988

Pertussis immunization: science and the public.

Problems with pertussis immunization are not unique to the developing world. Problems exist in at least six nations in the industrialized world, in five of which epidemic pertussis has either never been controlled or has recurred because of low rates of immunization against pertussis. The poor rates of immunization have resulted in several instances from decisions by health authorities and in others from public fear of vaccine reactions. In all instances poor understanding of science by the public and by decision makers has been a major contributing factor.

Child, Preschool↗
PubMed1988

Preliminary report on household contact studies of the prevention of pertussis in Japanese children by Takeda diphtheria and tetanus toxoids and acellular pertussis vaccine combined.

Acellular pertussis vaccines combined with diphtheria and tetanus toxoids and adsorbed onto an aluminum salt (AcPDT) have been used exclusively in Japan for the immunization of children since 1981. (Interagency Report 2), 1987; Kimura et al. 1), 1985) Immunization of children is initiated at two years of age with a booster dose one year later. Morbidity and mortality rates from pertussis, which had steadily increased since 1975 because of poor acceptance of the whole cell preparation, have declined since widespread use of AcPDT (Kimura, 1985). The apparent efficacy of AcPDT has also been demonstrated by several household contact studies in which rates of pertussis in immunized and unimmunized children exposed to the disease in their own homes were determined. In these studies vaccine efficacy ranged between 78 and 93 percent (Interagency Report). However, there are six different manufacturers of AcPDT in Japan, and their products vary in antigenic constituents. One manufacturer produces AcPDT that contains about 50 percent pertussis toxoid and 50 percent filamentous hemagglutinin (B-type AcPDT). Four manufacturers market vaccines that contain predominantly FHA, approximately 10 percent pertussis toxoid, and approximately one percent agglutinogens (T-type AcPDT). The sixth product comprises pertussis toxoid and FHA in amounts that are intermediate between the B- and T-types. With the exception of one small study (Aoyama, 1988) all of the Japanese studies have considered these AcPDT products as a group, and accordingly product-specific information concerning efficacy is not available.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1988

Age at pertussis immunization as it relates to current epidemiology and disease control.

Decisions about vaccine use involve the risks of disease, efficacy of the vaccine, and adverse events associated with the vaccine. The goal is to provide protection at the earliest possible age. Available data suggest that even very young infants develop a protective response to a multi-dose series of pertussis vaccine. There are not conclusive data to indicate that true reactions to pertussis vaccine are age-related. The approach in the United States has been to recommend pertussis vaccination early in infancy, usually giving pertussis vaccine in combination with tetanus and diphtheria toxoids as DTP at 2, 4 and 6 months of age with a fourth dose at 15-18 months and a booster dose at 4-6 years just prior to school entry. In recent years, concern about adverse effects possibly caused by pertussis vaccine have led to suggestions that the administration of DTP be delayed by varying periods. To estimate the effects of a 6-month delay in the primary vaccination series, we conducted a decision analysis, following two hypothetical cohorts of 3.7 million children each from birth to their fourth birthday. One cohort was vaccinated at 2, 4, 6 and 18 months of age (the current schedule) whereas the other cohort was vaccinated at 8, 10, 12 and 18 months of age (the proposed schedule). Under base case conditions, assuming no change in adverse events attributable to DTP, a 6-month delay in initiating DTP vaccination would result in 636 more reported cases of pertussis, many with complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1987

Estimated effects of a delay in the recommended vaccination schedule for diphtheria and tetanus toxoids and pertussis vaccine.

The occurrence of adverse events temporally associated with diphtheria and tetanus toxoids and pertussis vaccine (DTP) has led to consideration of a delay in the schedule of initial vaccination. We developed an inferential model estimating the changes in pertussis- and DTP-associated health outcomes that might occur if initial DTP administration were delayed from 2, 4, and 6 months to 8, 10, and 12 months of age. An additional 636 cases of pertussis--115 of which would be associated with complications, including two encephalopathies--were projected to occur under the proposed as compared to the current schedule. Adverse medical events attributable to the vaccine were assumed to remain unchanged following the change in schedule. We projected 353 fewer chance associations with sudden infant death syndrome but 1311 more chance associations between DTP and seizures. These estimates suggest that the current schedule of vaccinating infants at 2, 4, and 6 months of age is casually associated with less morbidity and should be continued.

Brain Diseases↗
PubMed1982

Psychological distress in mothers of disabled children.

We examined the impact of child disability on psychological distress in mothers, by comparing scores on two indexes of psychological distress of 369 mothers of children with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps, with those of 456 mothers from a randomly selected sample of families ("control" subjects). Mothers of disabled children scored significantly higher than control subjects on both indexes of psychological distress. This finding persisted when the mothers' education, family income, and racial composition were controlled for. Type of disability, ie, the diagnostic classification of the disabled children, was unrelated to the mother's level of psychological distress. In contrast, the disabled child's dependence on others in daily activities had a significant effect on both measures of psychological distress; the more dependent the child, the greater was the mother's distress.

Abnormalities, Multiple↗