Assessment of missing immunizations and immunization-related barriers among WIC populations at the local level. (57/163)

OBJECTIVE: Low childhood immunization rates have been a challenge in Colorado, an issue that was exacerbated by a diphtheria-tetanus-acellular pertussis (DTaP) vaccine shortage that began in 2001. To combat this shortage, the locally based Tri-County Health Department conducted a study to assess immunization-related barriers among children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk for undervaccination. METHODS: This study assessed characteristics and perceptions of WIC mothers in conjunction with their children's immunization status in four clinics. RESULTS: Results indicated poor immunization rates, which improved with assessment and referral. The uninsured were at higher risk for undervaccination. DTaP was the most commonly missing vaccine, and discrepancies existed between the children's perceived and actual immunization status, particularly regarding DTaP. Targeted interventions were initiated as a result of this study. CONCLUSION: Local health departments should target immunization-related interventions by assessing their own WIC populations to identify unique vaccine-related deficiencies, misperceptions, and high-risk subpopulations.  (+info)

Can hexavalent vaccines be simultaneously administered with pneumococcal or meningococcal conjugate vaccines? (58/163)

BACKGROUND: Local immunization programs may include hexavalent and conjugate pneumococcal or meningococcal vaccines administered in the same vaccination visit. Information based on evidence is necessary for correctly planning schedules and for parents who often fear the administration of too many vaccines. We reviewed the available literature to assess the effects on immunogenicity and safety of simultaneous administration of hexavalent and conjugate pneumococcal and meningococcal C vaccines in healthy children. METHODS: We searched for papers including a comparison of coadministration and single administration of hexavalent with conjugate pneumococcal or meningococcal C vaccines. Data sources included Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. Immunogenicity and safety results were extracted and compared. We calculated the absolute risk increase of being a non responder to any antigen and of experiencing common adverse events. RESULTS: Four relevant articles were included in the review. Immunogenicity of components included in the hexavalent vaccines was maintained with coadministration of conjugate pneumococcal and meningococcal C vaccines. However individuals who received hexavalent vaccine with conjugate pneumococcal vaccines were 18% more likely to have anti-PRP < 1 microg/mL after the third dose although this difference disappeared after the fourth dose, and titres against meningococcal C antigens were higher when vaccines were administered separately. Children who received simultaneous administration of hexavalent vaccines with conjugate pneumococcal vaccines had a 13-17% additional risk of experiencing fever compared with single administration. CONCLUSION: Few studies deal with coadministration of vaccines. Hexavalent and conjugate pneumococcal or meningococcal vaccines may however be administered simultaneously without noteworthy negative effects on immunogenicity or safety profile. Parents of vaccinees should be appropriately informed on the effects of coadministration to improve their compliance. Studies on vaccine coadministration should be promoted and unpublished studies realized for vaccine registration should be made available.  (+info)

Is childhood vaccination associated with asthma? A meta-analysis of observational studies. (59/163)

BACKGROUND: The possible link between immunization and atopic diseases has been under intense debate in the last decade. OBJECTIVE: The aim of this study was to systematically review the available evidence on the association of whole-cell pertussis and BCG vaccination with the risk of asthma in childhood and adolescence. METHODS: The major medical electronic databases (Medline, National Library of Medicine Gateway, and Cochrane Library) were searched, and reference lists of the relevant publications were reviewed for relevant birth-cohort studies and randomized, controlled trials from 1966 to March 2006. Only studies that directly compared vaccinated and unvaccinated children, validated vaccination status by medical charts, and used preset criteria to define asthma were included. Data were abstracted by using a standardized protocol and computerized report form. Results were analyzed by applying a fixed-effect or random-effect model, according to the heterogeneity of the studies. Sensitivity analyses by scoring criteria were performed. RESULTS: Seven studies of pertussis vaccination (with a total of 186,663 patients) and 5 studies of BCG vaccination (with a total of 41,479 patients) met our inclusion criteria. No statistically significant association was detected between either whole-cell pertussis or BCG vaccination and incidence rates of asthma during childhood and adolescence. This lack of a significant association proved to be robust on sensitivity analyses for BCG but not for pertussis vaccine. CONCLUSIONS: Currently available data, based on observational studies, do not support an association, provocative or protective, between receipt of the BCG or whole-cell pertussis vaccine and risk of asthma in childhood and adolescence.  (+info)

Prospective assessment of the effect of needle length and injection site on the risk of local reactions to the fifth diphtheria-tetanus-acellular pertussis vaccination. (60/163)

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Changes in DT vaccine frequency and indications for use following introduction of DTaP vaccine. (61/163)

Our population-based study among HMO members under seven years of age in 1993-2000 showed that frequency of diphtheria and tetanus toxoid vaccine (DT) use declined significantly following the introduction of acellular pertussis-containing (DTaP) vaccine. We also observed changes in indications for DT following the transition to DTaP among children under two years of age; notably, a decline in the proportion of children receiving DT due to a reported prior vaccine reaction and an increase in the proportion of children receiving DT due to parental request and a history of pertussis.  (+info)

Immunogenicity of a two-component (PT & FHA) acellular pertussis vaccine in various combinations. (62/163)

Immunogenicity data for the pertussis components of the French diphtheria-tetanus-two component acellular pertussis vaccine (DTaP(2Fr)) obtained after primary series of immunizations were compiled from 75 study groups comprising 36 clinical trials or vaccination programs conducted between 1987 and 2006. DTaP(2Fr) vaccine was administered either as a standalone vaccine or as the backbone of several combination vaccines that included IPV, HepB and/or PRP-T antigens. Most of the variability in responses was associated with differences in the schedules, and to a lesser extent the geographical region where the study was performed, suggesting the importance of ethno-ecological factors. However the addition of other vaccine antigens did not affect the immunogenicity of the aP(2Fr) antigens. The immune responses to the PT and FHA antigens of the DTaP(2Fr) vaccine used in the Senegal efficacy trial, which established its good efficacy relative to a highly effective DTwP vaccine, was in the middle of the range of titers observed during other studies using the 2-4-6 months schedule conducted with the same vaccine. The consistent immunogenicity of the DTaP(2Fr) vaccine is accompanied by effectiveness in controlling pertussis disease in the areas where it is used on a large scale with good vaccination coverage.  (+info)

Absence of an increase in cardiorespiratory events after diphtheria-tetanus-acellular pertussis immunization in preterm infants: a randomized, multicenter study. (63/163)

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Syncope after vaccination--United States, January 2005-July 2007. (64/163)

Syncope (vasovagal reaction), or fainting, can be triggered by various stimuli, including medical procedures. Syncope has been documented to occur after vaccination, most commonly among adolescents, and can result in hospitalization for a medical evaluation or because of injury. During 2005 and 2006, the Advisory Committee on Immunization Practices (ACIP) recommended use of three newly licensed vaccines for adolescents: the quadrivalent human papillomavirus recombinant vaccine (HPV) (Gardasil(R), Merck & Co., Inc., Whitehouse Station, New Jersey) in a 3-dose series, the quadrivalent meningococcal conjugate vaccine (MCV4) (Menactra, Sanofi Pasteur, Inc., Swiftwater, Pennsylvania) in a single dose, and the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) (Adacel, Sanofi Pasteur; Boostrix, GlaxoSmithKline Biologicals, Research Triangle Park, North Carolina) in a single dose. To describe trends in occurrence of postvaccination syncope, CDC and the Food and Drug Administration (FDA) analyzed data from the Vaccine Adverse Event Reporting System (VAERS) for January 1, 2005-July 31, 2007, and compared the results with VAERS reports received during January 1, 2002-December 31, 2004. The findings indicated that, since 2005, reports to VAERS regarding postvaccination syncope have increased, primarily among females aged 11-18 years, and rarely, subsequent serious injuries have occurred. To prevent syncope-related injuries, vaccine providers should follow the ACIP recommendation to strongly consider observing patients for 15 minutes after vaccination.  (+info)