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At least 163 records · Page 9Linked to original sources
PubMed2002

Vaccinology for control of apicomplexan parasites: a simplified language of immune programming and its use in vaccine design.

Most mammalian immune systems and parasites have co-evolved over the millennia, interacting within a common environment and communicating through a common language. This language is comprised of copious dialects in which a variety of host innate and acquired immune pathways actively interact with a multitude of parasite-specific survival strategies. Nonetheless, a simplified language is likely present since the same basic molecular and cellular mechanisms are associated with resistance or susceptibility to parasite infection. Protective immunity against protozoa within the phylum Apicomplexa (e.g. Cryptosporidia, Eimeria, Neospora, Plasmodia and Toxoplasma) is generally CD4+ T cell-dependent and elicited along the IL-12/IFN-gamma/iNOS effector axis. This simplified language can be decoded in part by significant advances in understanding naïve T cell activation, differentiation and generation of immunologic memory. Vaccine adjuvants and new immunisation strategies for generation of more potent immunity can also be viewed through this common language lens. The aim of this paper is to summarise recently published fundamental immunology studies, their relevance through examples in specific coccidian-host immune dialects, and how this simplified language can be used for the more rationale design of parasite vaccine control strategies.

Adjuvants, Immunologic↗
PubMed1997

NGO-promoted women's credit program, immunization coverage, and child mortality in rural Bangladesh.

A growing number of non-governmental organizations (NGOs) are adopting the collateral-free credit programs by anchoring them with their social development programs aimed at improved program effectiveness and sustainability. Drawing upon a sample of 3,564 targeted poor households covered by five small NGOs in rural Bangladesh, this study finds that the NGO credit-members as well as those who reside in the NGO program area are higher adopters of child immunization than those in the non-program area. Similarly, the study found that infant and child mortality is lower among the NGO credit members than among the non-members and that under five-year deaths of children progressively decline with the increase in the doses of vaccines. Implications of these findings are discussed in the study.

Adult↗
PubMed2000

Federalism, entitlements, and discretionary grants: the fiscal context of national support for immunization programs.

This paper defines the appropriation and resource allocation structure of federal government programs that deliver vaccines to the public through state and local governments, with a special focus on the Centers for Disease Control and Prevention (CDC) Section 317 program. The paper places these programs in the context of the overall intergovernmental finance system of the United States, and the manner in which that system has responded to societal changes in other areas, such as unemployment insurance and environmental protection. The paper concludes that a changing environment for vaccine financing, and uncertain appropriations for state government immunization infrastructure, may have made the current CDC Section 317 program inadequate. Increased entitlement resources for federally funded vaccines have not been matched with increased and stable resources for the balance of program costs. To the contrary, funding provided to the Section 317 program has proven unstable, and its discretionary appropriations have proven vulnerable to both executive and legislative branch earmarking for such activities as overseas disease eradication or home state earmarking by congressional appropriations subcommittee members. In addition, the rigidity of some CDC program requirements makes it difficult for states to effectively use program funds. Consideration should be given to strengthening the Section 317 program and its relationships to other federal aid programs to ensure that adequate immunization protections are provided in all states to adequately protect all citizens.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Immunization programs in non-traditional settings.

BACKGROUND: The Downtown Eastside (DTES) of Vancouver is an inner-city neighbourhood of 10 square blocks where poverty, crowded housing, homelessness, poor nutrition and hygiene, chronic illness, and substance abuse put residents at risk for communicable diseases. The objective of the program was to minimize the burden of illness from vaccine-preventable diseases in this vulnerable population. This article describes the process and lessons learned to enable others to implement similar programs. INTERVENTION: Influenza and pneumococcal vaccinations were offered in community settings to all persons living in, working in, or visiting the DTES by teams of public health nurses and volunteers in the fall of 1999. Hepatitis A and B vaccinations were offered in January/February 2000. All 4 vaccines were offered in Fall 2000, influenza vaccine alone was offered in Fall 2001 and 2002; and pneumococcal, hepatitis A and B vaccines were offered in June 2002. RESULTS: During the initial 5-week influenza/pneumococcal immunization blitz, 8,723 persons were immunized; 79% received both vaccines. There was a reduction in visits for pneumonia to local emergency departments in the 3 months following this blitz. During the 5-week 2000 hepatitis A and B vaccination blitz, 3,542 persons were immunized; 58% received both vaccines. A reduction in reported cases of hepatitis A followed. Uptake of influenza vaccine was considerably reduced when offered in combination with 3 other vaccines. To maximize uptake, influenza vaccine was offered alone in subsequent years. CONCLUSIONS: Immunizations can be successfully delivered to high-risk inner-city populations in non-traditional settings, using public health nursing outreach in a blitz format.

British Columbia↗
PubMed2000

Analysis of a bi-state, multi-district, school-based hepatitis B immunization program.

A descriptive correlational research design assessed factors influencing participation and completion rates, and to determine vaccine administration costs, in a school-based Hepatitis B vaccination program. Of 18,046 students in public and private schools in the metropolitan Kansas City, Mo., area, 12,986 (73.4%) participated with approximately 75% of these students completing the vaccine series. Larger schools reported decreased participation and completion rates. Both rates were highest in schools providing educational interventions. Schools with a large population of commercially insured students reported low participation rates (65%), but high completion rates (85%). Schools with a high number of Medicaid-eligible students had high participation rates (97%), but low completion rates (67%). The vaccine cost $5.06 per dose to administer.

Adolescent↗
PubMed1996

The need for more aggressive follow-up of children born to hepatitis B surface antigen-positive mothers: lessons from the Louisiana Perinatal Hepatitis B Immunization Program.

BACKGROUND: Preventing perinatal transmission of hepatitis B virus (HBV) is an important part of strategies to prevent HBV-related disease. To help prevent perinatal transmission the Louisiana Office of Public Health began in 1990 a statewide program to track children of hepatitis B surface antigen (HBsAg)-positive mothers. We examined data from this program to evaluate the effectiveness of the program and to assess the value of serologic testing in the program. METHODS: We examined vaccination and testing records for all children listed in the program database who were old enough to have been tested, according to program recommendations, as of July, 1993. RESULTS: Of 426 children 269 (63%) had been completely vaccinated. Also of these 426 children 194 (46%) were tested for hepatitis B surface antibody (anti-HBs) and 163 (38%) were tested for HBsAg. Among tested children 6 (4%) were HBsAg-positive and 22 (11%) were anti-HBs-negative. Incompletely vaccinated children were more likely than completely vaccinated children to be HBsAg-positive (risk ratio, 7.9; 95% confidence interval, 1.5 to 41.2) and less likely to be positive for anti-HBs (risk ratio, 0.5, confidence interval, 0.3 to 0.7). Children tested > or = 18 months after the last vaccine dose were more likely than children tested earlier to be anti-HBs-negative (risk ratio, 0.8; 95% confidence interval, 0.7 to 1.1). CONCLUSIONS: Rates of vaccination completion and postvaccination serologic testing were low for children in this program. Even with these low vaccination rates, however, we estimate that the program prevented 74% of HBV infection and 87% of HBV carriage in this group of high risk children, suggesting that failure to vaccinate rather than vaccine failure was the major obstacle to prevention of perinatal HBV transmission. Serologic testing was useful in that it identified children with chronic HBV infection and children who may have needed additional doses of vaccine, but it should be performed < 18 months after the last dose of vaccine is given. More aggressive follow-up of these children for both vaccination and serologic testing is needed.

Adolescent↗
PubMed1995

Bucking the health establishment: Alexander Milne and the fight for a New Zealand hepatitis B immunization program.

In order to successfully combat a disease it is necessary that their exists an individual or a group willing to 'champion' that ailment by arguing that it is serious enough to warrant the expenditure of scarce resources. In the case of hepatitis B such champions have often arisen outside of the public health establishments that are mandated to play that role. In New Zealand it was left up to one unusual and determined man to not only discover the seriousness of the hepatitis B epidemic but to practically single-handedly force a reluctant government to acknowledge the threat and act to contain it. He accomplished this by combining high quality scientific research with unrelenting political pressure generated by appeals to the public by means of the mass media. Alexander Milne demonstrates the vital role that the concerned citizen can make even in an age of timid bureaucracies.

Disease Outbreaks↗
PubMed1982

Hepatitis B immunity in hospital staff targeted for vaccination. Role of screening tests in immunization programs.

To estimate how many hospital workers might be exempted from immunization with newly available but expensive hepatitis B vaccine, baseline serum samples were analyzed to determine prevalence and titer of hepatitis B (HB) surface antibody (anti-HBs) and prevalence of core antibody (anti-HBc). Among 1,370 persons tested, anti-HBs was present in 279 (20.4%), including 192 (14.0%) with titers of 10 ratio units or greater. In a subset of 746 subjects who denied recent exposures, and who were tested for anti-HBc and anti-HBs, at least one of the two antibodies was found in 172 (23.1%). There were 47 (6.3%) who had anti-HBs alone and 27 (3.6%) with anti-HBc alone. Prevalence was related more closely to clinical service (eg, renal dialysis or surgery) than to title (eg, physician or technician).

Antibodies, Viral↗
PubMed1999

Epidemiological features of rotavirus infection in Caracas, Venezuela: implications for rotavirus immunization programs.

The epidemiological features of rotavirus infection may be quite relevant for evaluation of the performance of a rotavirus vaccine in different settings, as well as for monitoring its impact during vaccination under routine conditions. This article describes some important issues regarding rotavirus epidemiology in Venezuela, where major field trials of rotavirus vaccine have been carried out. Rotaviruses was significantly more frequently observed in inpatient (43%) than in outpatient (21%) consultations for diarrhea in infants and young children. There was a high prevalence of rotavirus illness, regardless of socioeconomic conditions, but the risk of dehydration was greater among the lower socioeconomic groups. Rotavirus disease occurs year-round, with a slight seasonal pattern. Eighty-five percent of rotavirus-positive diarrheal episodes, as well as 86% of cases of dehydration due to rotavirus, occurred during the first year of life. However, rotavirus illnesses occur less commonly during the first months of life (0-2 months), which may be a result of protection by transplacental antibodies. The pattern of acquisition of rotavirus antibody was consistent with this age distribution of disease and with optimal age for vaccination. Thus, regional epidemiological characteristics of rotavirus infection may affect optimal performance of rotavirus vaccine.

Age Distribution↗
PubMed1994

[Intervention with community health agents in immunization programs in the gypsy population].

OBJECTIVE: To measure how the vaccination coverage of the Gypsy child population in the Cartuja and Almanjayar quarters evolved throughout a Health Education Intervention using Community Health workers belonging to the Gypsy community. DESIGN: A descriptive study, pre-test/post-test, with no control group. SETTING: Community level. Primary Care. PATIENTS AND OTHER PARTICIPANTS: The whole of the Gypsy child population under 14, consisting of 1,073 children, and four Community Health workers. INTERVENTIONS: Health Education for mothers and carers, by means of home visits carried out by four Health workers, previously trained and contracted for this purpose for a year by the Andalusian School of Public Health. MEASUREMENTS AND MAIN RESULTS: We measured the Vaccination Coverage in September 1988 (42.2%) in order to establish the situation both at the start of the intervention in March 1990 (46.2%) and at its end in March 1991 (68.2%). We measured Vaccination Coverage of the different vaccine doses through frequency allocations. CONCLUSIONS: The Health Centre increased Vaccination Coverage by 4% in 18 months. The intervention increased it by 22.2% in 12 months. This demonstrates the intervention's effectiveness and underlines the importance of carrying out this kind of intervention when working with at-risk population groups.

Adolescent↗
PubMed2007

Elimination of hepatitis a infection outbreaks in day care and school settings in southern Israel after introduction of the national universal toddler hepatitis a immunization program.

BACKGROUND: In 1999, Israel became the first country to begin universal toddler immunization against hepatitis A infection with a 2-dose schedule at 18 and 24 months. The effect of the Israeli program on outbreaks of Hepatitis A in day care and school settings was studied. METHODS: The records of all hepatitis A illness outbreaks in day care and school settings reported to the Ministry of Health in Southern Israel during 1993 through 2005 were reviewed. The number of exposed contacts for whom postexposure prophylaxis was administered was retrieved from records of epidemiologic investigations. Rates of immunization coverage were extracted from records of Maternal and Child Health Clinics. RESULTS: Three hundred nineteen cases of hepatitis A illness during the years 1993 through 2005 were associated with 113 outbreaks in day care and school settings of which 92% occurred before the institution of universal toddler immunization. Since 2000, no hepatitis A infection outbreaks have been reported in any day care and school settings in the region. An average of 732 children received immunoglobulin prophylaxis yearly because of exposure to an outbreak in an educational setting during the preimmunization period, 106 in 2000 and zero in the 5 years since 2001. The data showed marked herd immunity since school-aged children born before 1999 were not immunized, but elimination of outbreaks occurred equally in that age group. Immunization coverage was 86.4% for one dose of hepatitis A vaccine by age 3 years and 77.3% for 2 doses among the birth cohort of 2000. CONCLUSIONS: Universal hepatitis A immunization of toddlers was associated with disappearance of outbreaks in educational settings. This included cohorts of nonimmunized children representing marked herd immunity.

Adolescent↗