A compulsory school immunization program in Tennessee.
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This research project was conducted in the Ottawa-Carleton region of Ontario to provide information on reasons why students did not participate in a Grade 7 hepatitis B school immunization project, and to determine whether telephone contact increased attendance at the community catch-up clinics above that achieved by a notice sent home with the child from school. A matched comparison group design was used. The overall uptake of the first dose of the vaccine in the region was 94% of 8,560 eligible students; 90% were immunized at the school clinic and 4% at the community catch-up clinic. About 4% of the parents refused to have their child immunized at the school or catch-up clinics. Of parents in the intervention group 198 (95%) were contacted by phone. The major reasons for non-participation at the school clinics were: (1) the child was not at school on the clinic day, or the child was sick (51%), (2) there were problems with the consent form (21%), and (3) the parents did not know of the program (10%). More students from the intervention group (72%) came for vaccination than did those of the control group (50%) (p < 0.01).
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During the 12 years from January, 1977, to December, 1988, the Hamilton Centre of the Canadian Red Cross Society (CRCS) Blood Transfusion Service screened 98,712 pregnant patients for hepatitis B surface antigen (HBsAg) and identified 120 positives (0.12%). The number of positives ranged from six to 16 per year. We were able to trace and enroll 65 mothers (54%) and 96 of their children in the follow-up study. The majority of the women were between 20 and 30 years of age (95.4%) and married (86%), and about one-half were employed outside the home. Sixty-five percent were white and 34% Asian, and 20 countries were listed as their places of origin. Hepatitis B immune globulin (HBIG) was available for neonatal immunization since 1977 and combined with vaccine since 1982. Of the 96 candidates for HBIG, 60 (63%) received HBIG within 24 hr, one after 3 months, four unknown, and 31 did not receive it. Of the 56 candidates for vaccination from 1982 to 1989, 26 (46%) received three doses, seven had two doses, eight had one dose, one was unknown, and 14 had none. HBsAg tests were performed on 69 children (71.8%) and anti-HBs on 61 (63.5%). Four of the children are HBsAg positive, 31 have anti-HBs, and 31 have no detectable antibodies. All four HBsAg positives had not received vaccine, and only one had received HBIG. Of the children positive for hepatitis B surface antibodies, five had received no immunization and therefore had been subclinically infected.(ABSTRACT TRUNCATED AT 250 WORDS)
School districts across the nation are implementing school-based hepatitis B virus vaccination programs. Because adolescents are at risk of contracting hepatitis B virus, these programs are important in preventing infections. Critical to the success of these programs is having qualified and cost-effective health professionals to administer the vaccine. This article describes the recruitment and training of professional nurse volunteers to administer vaccines in school-based clinics. During the 1998-1999 school year, approximately 60 nurses in Durham, North Carolina, volunteered 300 hours of time to the program. In the first year, the cost of recruiting and training volunteers exceeded the savings from salaried school nurse time. However, savings are expected in future years. Other benefits of recruiting volunteers to administer vaccine include allowing school nurses to remain in their usual assignments, increasing awareness of the health department's mission and school health in the community, and improving collaboration among local health agencies.
Despite extensive use of atttenuated rubella vaccine during the past five years, the degree of fetal risk in susceptible women inoculated early in pregnancy is still an unresolved issue. Although there is considerable evidence of chronic vaccine virus infection of the products of gestation in aborted fetuses, congenital defects have not yet been reported in the newborn infants of susceptible vaccinated pregnant women. The normal findings in the newborn infant can be misleading with respect to the safety of the vaccines in early pregnancy, because they represent only a small selected group of reported cases. The immediate need is for more complete reporting of all relevant cases wherever they occur in order to determine without many more years of delay whether the fetal risk has public health significance or is so low as to be of negligible importance.