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PubMed1999

[Analysis of actual coverage of the immunization program in Niigata Prefecture and development of a simple estimation of its coverage].

OBJECTIVE: We investigated measles immunization coverage and the actual situation of immunization in Niigata Pref. METHOD: We distributed questionnaires to all parents of pediatric outpatients who went to hospitals and clinics in Niigata Pref. from January 20 to 31. In the questionnaire, we asked parents about the measles immunization status of not only patients but also their sisters and brothers in each household, reasons for their immunization failure, and sources of information on immunization. We were able to collect 4,840 questionnaires from the parents who lived in Niigata Pref. and analyzable data obtained from 9,783 children. Furthermore we compared these with data from official annual reports of public health centers in Niigata Pref. RESULT: Our survey showed that around 90% of the children who had been born since 1979 to 1993 had received measles vaccine, while the official annual reports indicated low immunization coverage (around 70%). The age at which children received measles vaccine was one year old (38.2% of the vaccinated) and two years old (37.5%), and finally 93.6% of children were immunized by three years old. The primary reason for failure to receive immunization was that he or she was infected with measles before immunization (30.4%). Around 53% of these were infected with measles by 2 years old. With regard to sources of information on immunization, public announcements and letters were the greatest sources, whereas the contribution of doctors and paramedical staffs which was expected to be the main providers of the information to parents was quite low. CONCLUSIONS: 1) It was shown that there was a difference of measles immunization coverage between our results (90%) and the official record (70%), indicating that the current coverage survey method does not reflect the actual situation of immunization. Since more than 90% of children were immunized by three years old, we recommend that measles immunization coverage should be surveyed through interviews and data in maternity record book at the health examination for three year-old children which is operated by the government and has good attendance. 2) More than 50% of children who were infected with measles before immunization were infected by two years old, suggesting further promotion of measles immunization before two years old. 3) The main source of information on immunization was public announcements and publications. Further participation of doctors and paramedical staffs in disseminating information and providing education activities is desired.

Actuarial Analysis↗
PubMed1976

Factors involved in immunization program for swine influenza.

The decision to undertake a nationwide program of vaccination against swine influenza requires assessment of the status of immunity of those in various age groups in our population against this agent. Pools of serum were collected from persons born in the years from 1889 to 1943; they were tested for hemaggultinin inhibiting (HI) antibody against the HSW 1N1 influenza virus strains isolated in 1931 and 1976. The titers secured serve as an indication of the average level of immunity of those of different ages. Persons less than 43 years of age are found to be without antibody protection. The need for vaccination of people in different age groups based on mortality statistics of previous epidemics is evaluated. It is realized that no epidemic may occur and that a reduced virulence of the viral agent and use of antibiotics may reduce the death rate if the infection recurs. The extraordinary high mortality in 1918 in people between 15 and 44 years of age deserves recognition together with the fact that those in the same age group are now without protection. The fact that women of childbearing age fall into this group deserves special consideration in view of increased mortality in puerperal women observed in the pandemics of 1918 and 1957. The degree of protection afforded the newborn by transplacental transmission of maternal antibodies is discussed. The need of increasing the level of immunity in those who have varying titers of HI antibodies is considered in relation to the prevalence of cardiopulmonary complications and other chronic diseases in older subjects.

Adolescent↗