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PubMed1988

Expanded program on immunization and its implementation in the Czech Socialist Republic.

National immunization programs carried out in the CSR are here confronted with the EPI regional targets for Europe, a component of the WHO global program "Health for all by the year 2000". The EPI target diseases to be brought under control in Europe by 1990 include measles, poliomyelitis, diphtheria and neonatal tetanus; control of congenital rubella infection is to be achieved by the year 2000. The presented data show that Czechoslovakia has succeeded in implementing this program much ahead of the WHO time schedule. The elimination of measles infection was achieved in 1982, poliomyelitis was brought under control in 1961, and the effective diphtheria control has been in effect since the mid-1960s. Cases of neonatal tetanus are absent in the CSR since 1965, the annual incidence of postnatal tetanus is permanently 0.1-0.2 per 100,000 population. The goal of achieving the rubella-free status and thus the elimination of congenital rubella cases at country level is expected to be reached in the early 1990s. Implementation of the remaining WHO recommendations pertinent to infections other than EPI target diseases appears also satisfactory. Regular immunization against whooping cough, one of the oldest immunization programs in Czechoslovakia, succeeded in effectively eliminating this infection in the early 1970s. Selective immunization campaigns against influenza infection, introduced many years ago, help protect, together with a large-scale use of available chemoprophylactics, some 200,000 individuals every year in CSR. The hepatitis B immunization program was started in 1983 and is primarily limited to health service staff, which is in line with the existing WHO recommendations. Inception of the regular immunization program against mumps is planned for the beginning of 1987.

Czechoslovakia↗
PubMed2000

Case-control evaluation of an adult diphtheria immunization program in Ukraine.

In response to concerns about diphtheria vaccine efficacy, a case-control study was undertaken in Ukraine in 1996 to determine whether those recently immunized were indeed protected from disease, whether multiple doses were more protective, whether contact with children was related to disease, and whether there were detectable differences in protective efficacy between Western and Russian vaccines. In each of the three sites (one rural and two urban), 60 adults with laboratory-confirmed cases of diphtheria were identified from health center records along with 2 adult controls, who were matched to the case by neighborhood. Demographic and vaccination data were gathered from health center records. Using conditional logistic regression to estimate odds ratios, it was determined that cases were more likely to have had no vaccine in the year prior to the index data (odds ratio, 5.0; 95% confidence interval, 2.8-9.0), for a vaccine efficacy of 80%. Two doses gave greater protection, living with children increased disease risk, and no difference was detectable between the Russian and Western vaccines.

Adolescent↗