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Marx GE, Burakoff A, Barnes M, Hite D, Metz A, Miller K, Davizon ES, Chase J, McDonald C, McClean M, Miller L, Albanese BA. Mumps Outbreak in a Marshallese Community - Denver Metropolitan Area, Colorado, 2016-2017. MMWR Morb Mortal Wkly Rep 2018; 67:1143-1146. [PMID: 30335736 PMCID: PMC6193691 DOI: 10.15585/mmwr.mm6741a2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mellerson JL, Maxwell CB, Knighton CL, Kriss JL, Seither R, Black CL. Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten - United States, 2017-18 School Year. MMWR Morb Mortal Wkly Rep 2018; 67:1115-1122. [PMID: 30307904 PMCID: PMC6181259 DOI: 10.15585/mmwr.mm6740a3] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Wallin T, Holzschuh E, Kintner C. Notes from the Field: Rubella Infection in an Unvaccinated Pregnant Woman - Johnson County, Kansas, December 2017. MMWR Morb Mortal Wkly Rep 2018; 67:1132-1133. [PMID: 30307903 PMCID: PMC6181256 DOI: 10.15585/mmwr.mm6740a7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Affiliation(s)
- Helen Bedford
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - David Elliman
- Great Ormond Street Hospital NHS Foundation Trust, London, UK
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Mercader S, McGrew M, Sowers SB, Williams NJ, Bellini WJ, Hickman CJ. Development and Use of an Endpoint Titration Assay To Characterize Mumps IgG Avidity following Measles, Mumps, and Rubella Vaccination and Wild-Type Mumps Infection. mSphere 2018; 3:e00320-18. [PMID: 30209129 PMCID: PMC6135962 DOI: 10.1128/msphere.00320-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/02/2018] [Indexed: 11/29/2022] Open
Abstract
Waning mumps IgG antibody and incomplete IgG avidity maturation may increase susceptibility to mumps virus infection in some vaccinees. To measure mumps IgG avidity, serum specimens serially diluted to the endpoint were incubated on a commercial mumps-specific IgG enzyme immunoassay and treated with the protein denaturant diethylamine (60 mM, pH 10). End titer avidity indices (etAIs [percent ratio of detected diethylamine-resistant IgG at endpoint]) were calculated. Unpaired serum specimens (n = 108) from 15-month-old children living in a low-incidence setting were collected 1 month and 2 years after the first measles, mumps, and rubella vaccine dose (MMR1) and tested for mumps avidity. Per the receiver operating characteristic curve, the avidity assay is accurate (area under the curve, 0.994; 95% confidence interval [CI], 0.956 to 1.000), 96.5% sensitive (95% CI, 87.9 to 99.6%), and 92.2% specific (95% CI, 81.1 to 97.8%) at an etAI of 30%. When 9 sets of paired serum specimens collected 1 to 60 months post-MMR1 were tested for mumps and measles IgG avidity using comparable methods, the mumps etAI increased from 11% to 40 to 60% in 6 months. From 6 to 60 months, avidity was sustained at a mean etAI of 50% (95% CI, 46 to 54%), significantly lower (P < 0.0001) than the mean measles etAI of 80% (95% CI, 74 to 86%). Mean etAIs in children 2 years post-MMR1 (n = 51), unvaccinated adults with distant mumps disease (n = 29), and confirmed mumps cases (n = 23) were 54, 62, and 57%, respectively. A mumps-specific endpoint avidity assay was developed and validated, and mumps avidity was determined to be generally sustained at etAIs of 40 to 60%, reaching etAIs of >80% in some individuals.IMPORTANCE Numerous outbreaks of mumps have occurred in the United States among two-dose measles-mumps-rubella (MMR)-vaccinated populations since 2006. The avidity of mumps-specific IgG antibodies may affect susceptibility to mumps virus infection in some vaccinated individuals. To accurately measure mumps avidity, we developed and validated a mumps-specific IgG avidity assay that determines avidity at the endpoint titer of serially diluted serum specimens, providing results that are independent of IgG concentration. At low antibody titers, endpoint methods are considered more accurate than methods that determine avidity at a single dilution. We determined that 6 months after the first MMR dose, mumps IgG avidity is high and generally sustained at avidity indices of 40 to 60%, reaching values of >80% in some individuals. Additionally, 4% (4/103) of individuals had avidity indices of ≤30% (low avidity) 2 years after vaccination. Inadequate mumps avidity maturation may be one factor influencing susceptibility to mumps virus infection among previously vaccinated or naturally infected individuals.
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Affiliation(s)
- Sara Mercader
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marcia McGrew
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sun B Sowers
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nobia J Williams
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William J Bellini
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carole J Hickman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Walker TY, Elam-Evans LD, Yankey D, Markowitz LE, Williams CL, Mbaeyi SA, Fredua B, Stokley S. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2017. MMWR Morb Mortal Wkly Rep 2018; 67:909-917. [PMID: 30138305 PMCID: PMC6107323 DOI: 10.15585/mmwr.mm6733a1] [Citation(s) in RCA: 270] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11–12 years with human papillomavirus (HPV) vaccine, quadrivalent meningococcal conjugate vaccine (MenACWY), and tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap). A booster dose of MenACWY is recommended at age 16 years (1), and catch-up vaccination is recommended for hepatitis B vaccine (HepB), measles, mumps, and rubella vaccine (MMR), and varicella vaccine (VAR) for adolescents whose childhood vaccinations are not up to date (UTD) (1). ACIP also recommends that clinicians may administer a serogroup B meningococcal vaccine (MenB) series to adolescents and young adults aged 16–23 years, with a preferred age of 16–18 years (2). To estimate U.S. adolescent vaccination coverage, CDC analyzed data from the 2017 National Immunization Survey–Teen (NIS-Teen) for 20,949 adolescents aged 13–17 years.* During 2016–2017, coverage increased for ≥1 dose of HPV vaccine (from 60.4% to 65.5%), ≥1 dose of MenACWY (82.2% to 85.1%), and ≥2 doses of MenACWY (39.1% to 44.3%). Coverage with Tdap remained stable at 88.7%. In 2017, 48.6% of adolescents were UTD with the HPV vaccine series (HPV UTD) compared with 43.4% in 2016.† On-time vaccination (receipt of ≥2 or ≥3 doses of HPV vaccine by age 13 years) also increased. As in 2016, ≥1-dose HPV vaccination coverage was lower among adolescents living in nonmetropolitan statistical areas (MSAs) (59.3%) than among those living in MSA principal cities (70.1%).§ Although HPV vaccination initiation remains lower than coverage with MenACWY and Tdap, HPV vaccination coverage has increased an average of 5.1 percentage points annually since 2013, indicating that continued efforts to target unvaccinated teens and eliminate missed vaccination opportunities might lead to HPV vaccination coverage levels comparable to those of other routinely recommended adolescent vaccines.
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Tiffany A, Shannon D, Mamtchueng W, Castrodale L, McLaughlin J. Notes from the Field: Mumps Outbreak - Alaska, May 2017-July 2018. MMWR Morb Mortal Wkly Rep 2018; 67:940-941. [PMID: 30138308 PMCID: PMC6107318 DOI: 10.15585/mmwr.mm6733a6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Choe YJ, Park K, Park E, Kong I, Lee JK. School entry vaccination requirement program: Experience from the Republic of Korea. Vaccine 2018; 36:5497-5499. [PMID: 30107995 DOI: 10.1016/j.vaccine.2018.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/12/2018] [Accepted: 07/06/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Young June Choe
- Division of Pediatric Infectious Diseases, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Kwangsuk Park
- Division of Vaccine-Preventable Disease Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Eunyoung Park
- Division of Vaccine-Preventable Disease Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Insik Kong
- Division of Vaccine-Preventable Disease Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Jong-Koo Lee
- Department of Family Medicine, Seoul National University College of Medicine, Republic of Korea; JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Böröcz K, Csizmadia Z, Markovics Á, Mészáros V, Farkas K, Telek V, Varga V, Maloba GO, Bodó K, Najbauer J, Berki T, Németh P. Development of a robust and standardized immunoserological assay for detection of anti-measles IgG antibodies in human sera. J Immunol Methods 2018; 464:1-8. [PMID: 30056035 DOI: 10.1016/j.jim.2018.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/09/2018] [Accepted: 07/25/2018] [Indexed: 01/04/2023]
Abstract
Because of measles outbreaks there is a need for continuous monitoring of immunological protection against infection at population level. For such monitoring to be feasible, a cost-effective, reliable and high-throughput assay is necessary. Herein we describe an ELISA protocol for assessment of anti-measles antibody levels in human serum samples that fulfills the above criteria and is easily adaptable by various laboratories. A serum bank of anonymous patient sera was established (N > 3000 samples). Sera were grouped based on measles immunization schedules and/or changes in vaccine components since the introduction of the first measles vaccine in Hungary in 1969. Newly designed ELISA was performed by using Siemens BEP 2000 Advance System and data were confirmed using commercially available kits. Our indirect ELISA was compared to indirect immunfluoresence and to anti-measles nucleocapsid (N) monoclonal antibody-based sandwich ELISA. The results obtained are in high agreement with the confirmatory methods, and reflect measles vaccination history in Hungary ranging from pre-vaccination era, through the initial period of measles vaccination, to present. Based on measurement of 1985 sera, the highest ratio of low/questionable antibody level samples was detected in cluster '1978-1987' (~25.4%), followed by cluster '1969-1977' (~15.4%).Our assay is suitable for assessment of anti-measles immunity in a large cohort of subjects. The assay is cost-effective, allows high-throughput screening and has superior signal-to-noise ratio. This assay can serve as a first step in assessment of the effectiveness of all three components of the MMR vaccine.
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Affiliation(s)
- Katalin Böröcz
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary.
| | - Zsuzsanna Csizmadia
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Ákos Markovics
- Department of General and Physical Chemistry, Faculty of Natural Sciences, University of Pécs, Pécs, Hungary
| | - Viktória Mészáros
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Kornélia Farkas
- Department of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Vivien Telek
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Vivien Varga
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Geofrey Ouma Maloba
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Kornélia Bodó
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
| | - József Najbauer
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Tímea Berki
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Péter Németh
- Department of Immunology and Biotechnology, Clinical Centre, University of Pécs, Pécs, Hungary
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Chang LV. Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy. Health Econ 2018; 27:1043-1062. [PMID: 29717799 DOI: 10.1002/hec.3645] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 01/05/2018] [Accepted: 01/12/2018] [Indexed: 05/09/2023]
Abstract
In the wake of strong, although later refuted, claims of a link between autism and the measles-mumps-rubella (MMR) vaccine, I examine whether fewer parents immunized or delayed vaccinations for their children and if there was a differential response by mother's education level. Using various controls and a differencing strategy that compares in MMR take-up with other vaccines, I find that the MMR-autism controversy led to a decline in the immediate years and that there were negative spillovers onto other vaccines. I also find evidence that more highly educated mothers responded more strongly to the controversy either by not immunizing their children altogether or, to a lesser degree, delaying vaccination. Moreover, the educational gap was greater in states where there was greater media attention devoted to the controversy. This is consistent with the health allocative efficiency hypothesis whereby part of the education gradient in health outcomes is due to more-educated individuals absorbing and responding to health information more quickly. However, unlike in the United Kingdom, where previous studies find that the gap was eliminated after the link was refuted, the evidence for the United States suggests that the educational gap persisted.
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Affiliation(s)
- Lenisa V Chang
- Department of Economics, University of Cincinnati, Cincinnati, OH, USA
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62
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Siira L, Nøkleby H, Barlinn R, Riise ØR, Aaberge IS, Dudman SG. Response to third rubella vaccine dose. Hum Vaccin Immunother 2018; 14:2472-2477. [PMID: 29771601 PMCID: PMC6284511 DOI: 10.1080/21645515.2018.1475814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/05/2018] [Indexed: 02/07/2023] Open
Abstract
Limited data exist on the immunogenicity of a third dose of the measles, mumps, and rubella vaccine (MMR). In this study, our aim was to evaluate the long-term rubella immunogenicity afforded by two childhood MMR doses of the Norwegian vaccination program in a cohort of conscripts and to determine the effect of an additional dose of MMR vaccine, in order to inform vaccination policy. Blood samples from Norwegian conscripts (n = 495) taken both before and eight months after administration of a dose of MMR vaccine were tested using an enzyme immunoassay to measure anti-rubella IgG. Concentrations <5 IU/mL were regarded as negative, 5.0-9.9 IU/mL as equivocal, and ≥10 IU/mL as positive. Overall, the seropositivity before vaccination was 84.6%, and 99.0% of the conscripts had anti-rubella IgG concentrations ≥5 IU/mL. The seropositivity after vaccination was 94.5%, and 99.8% of the conscripts had antibody concentrations ≥5 IU/mL. The geometrical mean IgG concentrations increased from 21.4 IU/mL before vaccination to 28.9 IU/mL after. Four out of five conscripts, with seronegative concentrations before administrations of an additional MMR dose, had equivocal or seropositive results following vaccination. The cohort of young adults in Norway, which was eligible for two childhood MMR doses, was protected against rubella, and efforts should be made to maintain high vaccine coverage to ensure immunity in the future. A third dose of MMR administered in early adulthood led to an increase in the antibody concentration in our cohort and seroconversion for the majority of seronegative persons.
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Affiliation(s)
- Lotta Siira
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- European Program for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
| | - Hanne Nøkleby
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Regine Barlinn
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Øystein R. Riise
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Ingeborg S. Aaberge
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Susanne G. Dudman
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
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63
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Izadi S, Zahraei SM, Mokhtari-Azad T. Seroprevalence of antibodies to measles and rubella eight months after a vaccination campaign in the southeast of Iran. Hum Vaccin Immunother 2018; 14:1412-1416. [PMID: 29420120 PMCID: PMC6037465 DOI: 10.1080/21645515.2018.1436920] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/14/2018] [Accepted: 01/30/2018] [Indexed: 10/18/2022] Open
Abstract
Eight months after the mass immunization campaign of November 2015 against measles and rubella in the southeast of Iran, in order to evaluate the sero-immunity level of the people living in the mentioned region, a serosurvey study was performed. Using a multi-stage probability proportional to size cluster sampling, the sera of 1,056 participants, ranging from 15 months to 20 years old, were tested for measles and rubella IgG antibodies in the National Reference Laboratory at Tehran University of Medical Sciences, Tehran, Iran. The seroprevalence rates of antibodies against measles and rubella in the age groups below 16 years were respectively 98.4 and 93.2%. In the age group of 16 to 20 years, who was not the target of the mass immunization campaign, the said rates were respectively 91.7% and 87.4%. The herd immunity of the age groups below 16 years, who were the target of the campaign, is favourably high and reassuring both for measles and for rubella. Campaigns of supplementary vaccination play a substantial role for filling the gaps in the herd immunity.
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Affiliation(s)
- Shahrokh Izadi
- Health Promotion Research Centre, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Seyed Mohsen Zahraei
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Talat Mokhtari-Azad
- National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Tippins A, Murthy N, Meghani M, Solsman A, Apaisam C, Basilius M, Eckert M, Judicpa P, Masunu Y, Pistotnik K, Pedro D, Sasamoto J, Underwood JM. Vaccination Coverage Among Children Aged 2 Years — U.S. Affiliated Pacific Islands, April–October, 2016. MMWR Morb Mortal Wkly Rep 2018; 67:579-584. [PMID: 29795077 PMCID: PMC6433335 DOI: 10.15585/mmwr.mm6720a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Hansashree P, Verma S, Rawat A, Sankhyan N, Bharti B. Long-term Seroprotection Rates Following Second Dose of Measles as MMR Vaccine at 15 months in Indian Children. Indian Pediatr 2018; 55:405-407. [PMID: 29428921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To find out seropositivity rates at 4-6 and 9-12 years of age; among those who received one-dose measles at 9 months and one-dose MMR at 15 months of age. METHODS 80 healthy children (53 males) at 4-6 or 9-12 years of age, attending outpatient department for vaccination were enrolled. Antibody titers were estimated using commercially available quantitative-IgG ELISA kits. RESULTS The seropositivity rates against measles, mumps, rubella were 80% (40/50), 86% (43/50), and 96% (48/50), respectively at 4-6 years, and 83.3% (25/30), 96.7% (29/30) and 96.7% (29/30), respectively at 9-12 years of age. CONCLUSION Single dose of rubella vaccine seems to provide adequate long-term protection; however, measles vaccine requires more doses for similar protection.
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Affiliation(s)
- P Hansashree
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Verma
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to: Dr Sanjay Verma, Additional Professor, Department of Pediatrics, PGIMER, Chandigarh, India.
| | - Amit Rawat
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Sankhyan
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhavneet Bharti
- Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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66
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Moyer-Gusé E, Robinson MJ, Mcknight J. The Role of Humor in Messaging about the MMR Vaccine. J Health Commun 2018; 23:514-522. [PMID: 29757123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Outbreaks of vaccine-preventable diseases have increased due, in part, to misconceptions about vaccine safety (Kennedy et al., 2011). Extant literature has examined various messages designed to correct false beliefs about vaccination risks and to urge parents to vaccinate their children. The present study is designed to contribute to this literature by drawing on the broader research and theory on resistance to persuasion and correcting false beliefs. We examine the effects of a humorous (vs. non-humorous) message about the importance of the measles, mumps, and rubella vaccine on parents' vaccine hesitancy. Results revealed that compared to a more serious message, a satirical message reduced reactance and led to greater perceptions of measles severity, which reduced vaccine hesitancy. Practical and theoretical implications are discussed.
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Affiliation(s)
- Emily Moyer-Gusé
- a School of Communication , The Ohio State University , Columbus , OH , USA
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Leslie TF, Delamater PL, Yang YT. It could have been much worse: The Minnesota measles outbreak of 2017. Vaccine 2018; 36:1808-1810. [PMID: 29496348 PMCID: PMC6626669 DOI: 10.1016/j.vaccine.2018.02.086] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 12/18/2022]
Abstract
In 2017, Minnesota battled its largest measles outbreak in nearly 30 years, with 79 cases, most of them Somali-American children. In this study, we gathered vaccination and enrollment data for incoming kindergarteners in Minnesota over fall 2012-2016 from the Minnesota Department of Health. We also gathered the number of measles cases by county in 2017. We found that MMR coverage has substantial variation across districts and district types. The minimum MMR coverage is 58.3% and the maximum is 100%. Private schools, which represent approximately six percent of Minnesota's kindergarten enrollment, have a substantially lower coverage rate, with an overall coverage of 83.00%. The 2017 outbreak was relatively isolated. However, the MMR coverage data suggests that other communities could have been at risk given their geographic proximity to the outbreak and modest coverage rates.
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Affiliation(s)
- Timothy F Leslie
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, VA, USA.
| | - Paul L Delamater
- Department of Geography, University of North Carolina, Chapel Hill, NC, USA
| | - Y Tony Yang
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
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Affiliation(s)
- Jozefien Roose
- Department of Pediatrics, OLV Hospital Aalst, NL-9300 Aalst, Belgium
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Bonwitt J, Kawakami V, Wharton A, Burke RM, Murthy N, Lee A, Dell B, Kay M, Duchin J, Hickman C, McNall RJ, Rota PA, Patel M, Lindquist S, DeBolt C, Routh J. Notes from the Field: Absence of Asymptomatic Mumps Virus Shedding Among Vaccinated College Students During a Mumps Outbreak - Washington, February-June 2017. MMWR Morb Mortal Wkly Rep 2017; 66:1307-1308. [PMID: 29190262 PMCID: PMC5708686 DOI: 10.15585/mmwr.mm6647a5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Haralambieva IH, Gibson MJ, Kennedy RB, Ovsyannikova IG, Warner ND, Grill DE, Poland GA. Characterization of rubella-specific humoral immunity following two doses of MMR vaccine using proteome microarray technology. PLoS One 2017; 12:e0188149. [PMID: 29145521 PMCID: PMC5690594 DOI: 10.1371/journal.pone.0188149] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/01/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction//Background The lack of standardization of the currently used commercial anti-rubella IgG antibody assays leads to frequent misinterpretation of results for samples with low/equivocal antibody concentration. The use of alternative approaches in rubella serology could add new information leading to a fuller understanding of rubella protective immunity and neutralizing antibody response after vaccination. Methods We applied microarray technology to measure antibodies to all rubella virus proteins in 75 high and 75 low rubella virus-specific antibody responders after two MMR vaccine doses. These data were used in multivariate penalized logistic regression modeling of rubella-specific neutralizing antibody response after vaccination. Results We measured antibodies to all rubella virus structural proteins (i.e., the glycoproteins E1 and E2 and the capsid C protein) and to the non-structural protein P150. Antibody levels to each of these proteins were: correlated with the neutralizing antibody titer (p<0.006); demonstrated differences between the high and the low antibody responder groups (p<0.008); and were components of the model associated with/predictive of vaccine-induced rubella virus-specific neutralizing antibody titers (misclassification error = 0.2). Conclusion Our study supports the use of this new technology, as well as the use of antibody profiles/patterns (rather than single antibody measures) as biomarkers of neutralizing antibody response and correlates of protective immunity in rubella virus serology.
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Affiliation(s)
- Iana H. Haralambieva
- Mayo Vaccine Research Group, Mayo Clinic and Foundation, Rochester, MN, United States of America
| | - Michael J. Gibson
- Mayo Vaccine Research Group, Mayo Clinic and Foundation, Rochester, MN, United States of America
| | - Richard B. Kennedy
- Mayo Vaccine Research Group, Mayo Clinic and Foundation, Rochester, MN, United States of America
| | - Inna G. Ovsyannikova
- Mayo Vaccine Research Group, Mayo Clinic and Foundation, Rochester, MN, United States of America
| | - Nathaniel D. Warner
- Division of Biomedical Statistics and Informatics- Department of Health Science Research, Mayo Clinic and Foundation, Rochester, MN, United States of America
| | - Diane E. Grill
- Division of Biomedical Statistics and Informatics- Department of Health Science Research, Mayo Clinic and Foundation, Rochester, MN, United States of America
| | - Gregory A. Poland
- Mayo Vaccine Research Group, Mayo Clinic and Foundation, Rochester, MN, United States of America
- * E-mail:
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Tippins A, Leidner AJ, Meghani M, Griffin A, Helgenberger L, Nyaku M, Underwood JM. Timeliness of childhood vaccination in the Federated States of Micronesia. Vaccine 2017; 35:6404-6411. [PMID: 29029941 PMCID: PMC6167924 DOI: 10.1016/j.vaccine.2017.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Vaccination coverage is typically measured as the proportion of individuals who have received recommended vaccine doses by the date of assessment. This approach does not provide information about receipt of vaccines by the recommended age, which is critical for ensuring optimal protection from vaccine-preventable diseases (VPDs). OBJECTIVE To assess vaccination timeliness in the Federated States of Micronesia (FSM), and the projected impact of suboptimal vaccination in the event of an outbreak. METHODS Timeliness of the 4th dose of diphtheria, tetanus, and acellular pertussis vaccine (DTaP) and 1st dose of measles, mumps, and rubella vaccine (MMR) among children 24-35 months was assessed in FSM. Both doses are defined as on time if administered from 361 through 395 days in age. Timeliness was calculated by one-way frequency analysis, and dose delays, measured in months after recommended age, were described using inverse Kaplan-Meier analysis. A time-series susceptible-exposed-infected-recovery (TSEIR) model simulated measles outbreaks in populations with on time and late vaccination. RESULTS Total coverage for the 4th dose of DTaP ranged from 36.6% to 98.8%, and for the 1st dose of MMR ranged from 80.9% to 100.0% across FSM states. On time coverage for the 4th dose of DTaP ranged from 3.2% to 52.3%, and for the 1st dose of MMR ranged from 21.1% to 66.9%. Maximum and median dose delays beyond the recommended age varied by state. TSEIR models predicted 10.8-13.7% increases in measles cases during an outbreak based on these delays. CONCLUSIONS In each of the FSM states, a substantial proportion of children received DTaP and MMR doses outside the recommended timeframe. Children who receive vaccinations later than recommended remain susceptible to VPDs during the period they remain unvaccinated, which may have a substantial impact on health systems during an outbreak. Immunization programs should consider vaccination timeliness in addition to coverage as a measure of susceptibility to VPDs in young children.
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Affiliation(s)
- Ashley Tippins
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Atlanta, GA, United States.
| | | | | | - Aja Griffin
- Association of Schools & Programs of Public Health, Atlanta, GA, United States
| | - Louisa Helgenberger
- Federated States of Micronesia Department of Health & Social Affairs, Pohnpei, Federated States of Micronesia
| | - Mawuli Nyaku
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Atlanta, GA, United States
| | - J Michael Underwood
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, Atlanta, GA, United States
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Abstract
Measles has been declared eliminated from the Korea since 2006. In April 2014, a measles outbreak occurred at a University in Seoul. A total of 85 measles cases were identified. In order to estimate vaccine effectiveness of measles vaccine, we reviewed the vaccination records of the university students. The vaccine effectiveness of two doses of measles containing vaccine was 60.0% (95% CI, 38.2-74.1; P < 0.05). Transmission was interrupted after the introduction of outbreak-response immunization. The outbreak shows that pockets of under-immunity among college students may have facilitated the disease transmission despite the high 2-dose vaccination coverage in the community.
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Affiliation(s)
- Young June Choe
- Seoul Center for Infectious Disease Control, Seoul, Korea
- Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Young Joon Park
- Division of VPD Control and NIP, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Ju Whi Kim
- Division of VPD Control and NIP, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Hye Eun Eom
- Division of VPD Control and NIP, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Ok Park
- Division of VPD Control and NIP, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Myoung Don Oh
- Seoul Center for Infectious Disease Control, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Koo Lee
- Seoul Center for Infectious Disease Control, Seoul, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
- JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Seither R, Calhoun K, Street EJ, Mellerson J, Knighton CL, Tippins A, Underwood JM. Vaccination Coverage for Selected Vaccines, Exemption Rates, and Provisional Enrollment Among Children in Kindergarten - United States, 2016-17 School Year. MMWR Morb Mortal Wkly Rep 2017; 66:1073-1080. [PMID: 29023430 PMCID: PMC5657930 DOI: 10.15585/mmwr.mm6640a3] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cardemil CV, Dahl RM, James L, Wannemuehler K, Gary HE, Shah M, Marin M, Riley J, Feikin DR, Patel M, Quinlisk P. Effectiveness of a Third Dose of MMR Vaccine for Mumps Outbreak Control. N Engl J Med 2017; 377:947-956. [PMID: 28877026 PMCID: PMC6546095 DOI: 10.1056/nejmoa1703309] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The effect of a third dose of the measles-mumps-rubella (MMR) vaccine in stemming a mumps outbreak is unknown. During an outbreak among vaccinated students at the University of Iowa, health officials implemented a widespread MMR vaccine campaign. We evaluated the effectiveness of a third dose for outbreak control and assessed for waning immunity. METHODS Of 20,496 university students who were enrolled during the 2015-2016 academic year, mumps was diagnosed in 259 students. We used Fisher's exact test to compare unadjusted attack rates according to dose status and years since receipt of the second MMR vaccine dose. We used multivariable time-dependent Cox regression models to evaluate vaccine effectiveness, according to dose status (three vs. two doses and two vs. no doses) after adjustment for the number of years since the second dose. RESULTS Before the outbreak, 98.1% of the students had received at least two doses of MMR vaccine. During the outbreak, 4783 received a third dose. The attack rate was lower among the students who had received three doses than among those who had received two doses (6.7 vs. 14.5 cases per 1000 population, P<0.001). Students had more than nine times the risk of mumps if they had received the second MMR dose 13 years or more before the outbreak. At 28 days after vaccination, receipt of the third vaccine dose was associated with a 78.1% lower risk of mumps than receipt of a second dose (adjusted hazard ratio, 0.22; 95% confidence interval, 0.12 to 0.39). The vaccine effectiveness of two doses versus no doses was lower among students with more distant receipt of the second vaccine dose. CONCLUSIONS Students who had received a third dose of MMR vaccine had a lower risk of mumps than did those who had received two doses, after adjustment for the number of years since the second dose. Students who had received a second dose of MMR vaccine 13 years or more before the outbreak had an increased risk of mumps. These findings suggest that the campaign to administer a third dose of MMR vaccine improved mumps outbreak control and that waning immunity probably contributed to propagation of the outbreak. (Funded by the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Cristina V Cardemil
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Rebecca M Dahl
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Lisa James
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Kathleen Wannemuehler
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Howard E Gary
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Minesh Shah
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Mona Marin
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Jacob Riley
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Daniel R Feikin
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Manisha Patel
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
| | - Patricia Quinlisk
- From the Centers for Disease Control and Prevention, Atlanta (C.V.C., K.W., H.E.G., M.S., M.M., D.R.F., M.P.); Maximus Federal, Falls Church, VA (R.M.D.); and the University of Iowa (L.J.) and Johnson County Public Health (J.R.), Iowa City, and the Iowa Department of Public Health, Des Moines (P.Q.)
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Tielemans SMAJ, de Melker HE, Hahné SJM, Boef AGC, van der Klis FRM, Sanders EAM, van der Sande MAB, Knol MJ. Non-specific effects of measles, mumps, and rubella (MMR) vaccination in high income setting: population based cohort study in the Netherlands. BMJ 2017; 358:j3862. [PMID: 28855159 PMCID: PMC5576097 DOI: 10.1136/bmj.j3862] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives To investigate whether measles, mumps, and rubella (MMR) vaccine has positive non-specific effects in a high income setting and to compare rates of hospital admissions for infections between children aged ≤2 years who received live MMR vaccine and those who received an inactivated vaccine against diphtheria, tetanus, pertussis, polio, and Haemophilus influenzae type b (DTaP-IPV-Hib) as their most recent vaccination.Design Nationwide population based cohort study.Setting In the Netherlands, DTaP-IPV-Hib+pneumococcal vaccination (PCV) is recommended at ages 2, 3, 4, and 11 months and MMR + meningococcal C (MenC) vaccination at age 14 months. Data from the national vaccine register were linked to hospital admission data.Participants 1 096 594 children born in 2005-11 who received the first four DTaP-IPV-Hib+PCV vaccines.Main outcome measures Hazard ratio for admission to hospital for infection in children with MMR+MenC compared with the fourth DTaP-IPV-Hib+PCV as their most recent vaccination. Cox regression was performed with most recent vaccination as time dependent variable, adjusted for potential confounders. Analyses were repeated with admission for injuries or poisoning as a negative control outcome. In addition, rate of admission for infection was compared between the fourth and third DTaP-IPV-Hib+PCVas most recent vaccination.Results Having had MMR+MenC as the most recent vaccination was associated with a hazard ratio of 0.62 (95% confidence interval 0.57 to 0.67) for admission to hospital for infection and 0.84 (0.73 to 0.96) for injuries or poisoning, compared with the fourth DTaP-IPV-Hib+PCV as most recent vaccination. The fourth DTaP-IPV-Hib+PCV as most recent vaccination was associated with a hazard ratio of 0.69 (0.63 to 0.76) for admission to hospital for infection, compared with the third DTaP-IPV-Hib+PCV as most recent vaccination.Conclusions Healthy vaccinee bias could at least partly explain the observed lower rate of admission to hospital with infection after MMR vaccination. The lower rate is associated with receipt of any additional vaccine, not specifically MMR vaccine. This emphasises the caution required in the interpretation of findings from observational studies on non-specific effects of vaccination.
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Affiliation(s)
- Susanne M A J Tielemans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands
| | - Susan J M Hahné
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands
| | - Anna G C Boef
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands
| | - Fiona R M van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands
| | - Elisabeth A M Sanders
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands
- Department of Paediatrics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Marianne A B van der Sande
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, Netherlands
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, Netherlands
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Walker TY, Elam-Evans LD, Singleton JA, Yankey D, Markowitz LE, Fredua B, Williams CL, Meyer SA, Stokley S. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2016. MMWR Morb Mortal Wkly Rep 2017; 66:874-882. [PMID: 28837546 PMCID: PMC5687818 DOI: 10.15585/mmwr.mm6633a2] [Citation(s) in RCA: 304] [Impact Index Per Article: 43.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Hall V, Banerjee E, Kenyon C, Strain A, Griffith J, Como-Sabetti K, Heath J, Bahta L, Martin K, McMahon M, Johnson D, Roddy M, Dunn D, Ehresmann K. Measles Outbreak - Minnesota April-May 2017. MMWR Morb Mortal Wkly Rep 2017; 66:713-717. [PMID: 28704350 PMCID: PMC5687591 DOI: 10.15585/mmwr.mm6627a1] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Venkat H, Kassem AM, Su CP, Hill C, Timme E, Briggs G, Komatsu K, Robinson S, Sunenshine R, Patel M, Elson D, Gastañaduy P, Brady S. Notes from the Field: Measles Outbreak at a United States Immigration and Customs Enforcement Facility - Arizona, May-June 2016. MMWR Morb Mortal Wkly Rep 2017; 66:543-544. [PMID: 28542125 PMCID: PMC5657873 DOI: 10.15585/mmwr.mm6620a5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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García Comas L, Ordobás Gavín M, Sanz Moreno JC, Ramos Blázquez B, Rodríguez Baena E, Córdoba Deorador E, García Barquero M, Gil Montalbán E, Arce Arnáez A, Rodero Garduño I, Barranco Ordóñez D, Mochales JA. Community-wide measles outbreak in the Region of Madrid, Spain, 10 years after the implementation of the Elimination Plan, 2011-2012. Hum Vaccin Immunother 2017; 13:1078-1083. [PMID: 28059628 PMCID: PMC5443381 DOI: 10.1080/21645515.2016.1267081] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/12/2016] [Accepted: 11/26/2016] [Indexed: 10/20/2022] Open
Abstract
We describe a community-wide outbreak of measles due to a D4 genotype virus that took place in the Region of Madrid, Spain, between February 2011 and August 2012, along with the control measures adopted. The following variables were collected: date of birth, sex, symptoms, complications, hospital admission, laboratory test results, link with another cases, home address, places of work or study, travel during the incubation period, ethnic group, and Mumps-Measles-Rubella (MMR) vaccination status. Incidences were calculated by 100,000 inhabitants. A total of 789 cases were identified. Of all cases, 36.0% belonged to Roma community, among which 68.7% were 16 months to 19 y old. Non-Roma cases were predominantly patients from 6 to 15 months (28.1%) and 20 to 39 y (52.3%). Most cases were unvaccinated. We found out that 3.0% of cases were healthcare workers. The first vaccination dose was brought forward to 12 months, active recruitment of unvaccinated children from 12 months to 4 y of age was performed and the vaccination of healthcare workers and of members of the Roma community was reinforced. High vaccination coverage must be reached with 2 doses of MMR vaccine, aimed at specific groups, such as young adults, Roma population and healthcare workers.
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Affiliation(s)
- L. García Comas
- General Directorate of Public Health of the Community of Madrid, Department of Epidemiology, Madrid, Spain
| | - M. Ordobás Gavín
- General Directorate of Public Health of the Community of Madrid, Department of Epidemiology, Madrid, Spain
| | - J. C. Sanz Moreno
- General Directorate of Public Health of the Community of Madrid, Regional Laboratory of Public Health, Madrid, Spain
| | - B. Ramos Blázquez
- General Directorate of Public Health of the Community of Madrid, Regional Laboratory of Public Health, Madrid, Spain
| | - E. Rodríguez Baena
- General Directorate of Public Health of the Community of Madrid, Territorial Department of Public Health 1, Madrid, Spain
| | - E. Córdoba Deorador
- General Directorate of Public Health of the Community of Madrid, Territorial Department of Public Health 1, Madrid, Spain
| | - M. García Barquero
- General Directorate of Public Health of the Community of Madrid, Territorial Department of Public Health 1, Madrid, Spain
| | - E. Gil Montalbán
- General Directorate of Public Health of the Community of Madrid, Territorial Department of Public Health 11, Madrid, Spain
| | - A. Arce Arnáez
- General Directorate of Public Health of the Community of Madrid, Department of Epidemiology, Madrid, Spain
| | - I. Rodero Garduño
- General Directorate of Public Health of the Community of Madrid, Department of Epidemiology, Madrid, Spain
| | - D. Barranco Ordóñez
- General Directorate of Public Health of the Community of Madrid, Department of Disease Prevention, Madrid, Spain
| | - J. Astray Mochales
- General Directorate of Public Health of the Community of Madrid, Area of Epidemiology, Madrid, Spain
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Donahue M, Schneider A, Ukegbu U, Shah M, Riley J, Weigel A, James L, Wittich K, Quinlisk P, Cardemil C. Notes from the Field: Complications of Mumps During a University Outbreak Among Students Who Had Received 2 Doses of Measles-Mumps-Rubella Vaccine - Iowa, July 2015-May 2016. MMWR Morb Mortal Wkly Rep 2017; 66:390-391. [PMID: 28406886 PMCID: PMC5657803 DOI: 10.15585/mmwr.mm6614a4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Iro MA, Sadarangani M, Goldacre R, Nickless A, Pollard AJ, Goldacre MJ. 30-year trends in admission rates for encephalitis in children in England and effect of improved diagnostics and measles-mumps-rubella vaccination: a population-based observational study. Lancet Infect Dis 2017; 17:422-430. [PMID: 28259562 DOI: 10.1016/s1473-3099(17)30114-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/03/2017] [Accepted: 01/11/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Encephalitis is a serious neurological disorder, yet data on admission rates for all-cause childhood encephalitis in England are scarce. We aimed to estimate admission rates for childhood encephalitis in England over 33 years (1979-2011), to describe trends in admission rates, and to observe how these rates have varied with the introduction of vaccines and improved diagnostics. METHODS We did a retrospective analysis of hospital admission statistics for encephalitis for individuals aged 0-19 years using national data from the Hospital Inpatient Enquiry (HIPE, 1979-85) and Hospital Episode Statistics (HES, 1990-2011). We analysed annual age-specific and age-standardised admission rates in single calendar years and admission rate trends for specified aetiologies in relation to introduction of PCR testing and measles-mumps-rubella (MMR) vaccination. We compared admission rates between the two International Classification of Diseases (ICD) periods, ICD9 (1979-94) and ICD10 (1995-2011). FINDINGS We found 16 571 encephalitis hospital admissions in the period 1979-2011, with a mean hospital admission rate of 5·97 per 100 000 per year (95% CI 5·52-6·41). Hospital admission rates declined from 1979 to 1994 (ICD9; annual percentage change [APC] -3·30%; 95% CI -2·88 to -3·66; p<0·0001) and increased between 1995 and 2011 (ICD10; APC 3·30%; 2·75-3·85; p<0·0001). Admissions for measles decreased by 97% (from 0·32 to 0·009) and admissions for mumps encephalitis decreased by 98% (from 0·60 to 0·01) after the introduction of the two-dose MMR vaccine. Hospital admission rates for encephalitis of unknown aetiology have increased by 37% since the introduction of PCR testing. INTERPRETATION Hospital admission rates for all-cause childhood encephalitis in England are increasing. Admissions for measles and mumps encephalitis have decreased substantially. The numbers of encephalitis admissions without a specific diagnosis are increasing despite availability of PCR testing, indicating the need for strategies to improve aetiological diagnosis in children with encephalitis. FUNDING None.
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Affiliation(s)
- Mildred A Iro
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK; University of Oxford, Oxford, UK.
| | - Manish Sadarangani
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK; University of Oxford, Oxford, UK; Vaccine Evaluation Center, BC Children's Hospital, University of British Columbia, Vancouver BC, Canada
| | - Raphael Goldacre
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Alecia Nickless
- Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK; University of Oxford, Oxford, UK
| | - Michael J Goldacre
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Rossi R, Assaad R, Rebeschini A, Hamadeh R. Vaccination Coverage Cluster Surveys in Middle Dreib - Akkar, Lebanon: Comparison of Vaccination Coverage in Children Aged 12-59 Months Pre- and Post-Vaccination Campaign. PLoS One 2016; 11:e0168145. [PMID: 27992470 PMCID: PMC5167265 DOI: 10.1371/journal.pone.0168145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 11/25/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction With the high proportion of refugee population throughout Lebanon and continuous population movement, it is sensible to believe that, in particular vulnerable areas, vaccination coverage may not be at an optimal level. Therefore, we assessed the vaccination coverage in children under 5 in a district of the Akkar governorate before and after a vaccination campaign. During the vaccination campaign, conducted in August 2015, 2,509 children were vaccinated. Materials and Methods We conducted a pre- and post-vaccination campaign coverage surveys adapting the WHO EPI cluster survey to the Lebanese MoPH vaccination calendar. Percentages of coverage for each dose of each vaccine were calculated for both surveys. Factors associated with complete vaccination were explored. Results Comparing the pre- with the post-campaign surveys, coverage for polio vaccine increased from 51.9% to 84.3%, for Pentavalent from 49.0% to 71.9%, for MMR from 36.2% to 61.0%, while the percentage of children with fully updated vaccination calendar increased from 32.9% to 53.8%. While Lebanese children were found to be better covered for some antigens compared to Syrians at the first survey, this difference disappeared at the post-campaign survey. Awareness and logistic obstacles were the primary reported causes of not complete vaccination in both surveys. Discussion Vaccination campaigns remain a quick and effective approach to increase vaccination coverage in crisis-affected areas. However, campaigns cannot be considered as a replacement of routine vaccination services to maintain a good level of coverage.
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Affiliation(s)
- Rodolfo Rossi
- International Committee of the Red Cross, Health Department, Beirut, Lebanon
- * E-mail:
| | - Ramia Assaad
- Republic of Lebanon, Ministry of Public Health, Primary Health Care services, Halba, Lebanon
| | - Arianna Rebeschini
- International Committee of the Red Cross, Health Department, Beirut, Lebanon
| | - Randa Hamadeh
- Republic of Lebanon, Ministry of Public Health, Social Health Service & Primary Health Care Department, Immunization and Essential Drugs Program, Beirut, Lebanon
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Santoro V, Pettinicchio V, Lancia A, Vazzoler C, De Luca F, Franco E. [The active offering of measles, rubella and mumps vaccine in new mothers: the experience of health facilities in one of the Local Health Unit of Rome, Lazio, Italy]. Ig Sanita Pubbl 2016; 72:589-597. [PMID: 28214912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Rubella is a contagious disease that can be very serious, especially in unvaccinated pregnant women. The best way to be protected is getting vaccinated: MMR vaccine is very effective at protecting people against measles, mumps, and rubella, and preventing the complications caused by these diseases. According to PASSI 2012-2015 (the Italian behavioral risk factor surveillance system) in the territory of ex ASL Roma C only 56% of women between 18 and 49 years were immunized against rubella, thanks to vaccination (34%) or past infection detected by rubeotest (22%); 2% was susceptible and 42% of respondents did not know their immune status against rubella. The Italian National Plan for the Elimination of Measles and Congenital Rubella (PNEMoRc) 2010-15 had the aim to reduce the prevalence of rubella susceptibility in young women (<5%), to reduce the prevalence of congenital rubella and to increase MMR vaccination coverage. This plan suggested to promote actions to spread correct information about MMR vaccine in the general population and healthcare workers and to offer this vaccine to susceptible women during every appropriate contact with the Family planning clinics. In order to ensure and monitor these recommendations, a recovery procedure for MMR vaccine was activated in 2015 for women who contacted the health facilities for their first child vaccination. A form was developed in order to collect information about women's immune status against rubella and measles. According to this tool all women who stated they had never been vaccinated for rubella or MMR and/or did not remember vaccination and/or had never had a rubeotest were considered susceptible to rubella. Women susceptible to rubella were invited to undergo vaccination. Data collected during one year activity were recorded and analyzed with Epinfo 7.0 software. We collected 1801 correctly filled forms; 88.6% (1595) of women were evaluated immune to rubella and 11.4% susceptible. The prevalence of susceptibility seems to be influenced by age, from 16% in the youngest age group to 9% in the >35 years. Among 206 women susceptible to rubella: 38% were vaccinated, 31% preferred to wait, 11% refused vaccination and for 20% data is missing. The protocol of MMR vaccine recovery was effective, and allowed to reach a good number of women who had a contact with the health facilities and we hope this number to be bigger, adding a part of those women who preferred to wait. However, data of a year activity indicate that vaccine recovery initiatives should be proposed and implemented, in consideration of the proportion of rubella susceptibility in women who were recently pregnant.
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Affiliation(s)
- Viviana Santoro
- Scuola di Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma "Tor Vergata", Roma, Italia
| | - Valentina Pettinicchio
- Scuola di Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma "Tor Vergata", Roma, Italia
| | | | | | | | - Elisabetta Franco
- Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma "Tor Vergata", Roma, Italia
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Kandasamy R, Voysey M, McQuaid F, de Nie K, Ryan R, Orr O, Uhlig U, Sande C, O'Connor D, Pollard AJ. Non-specific immunological effects of selected routine childhood immunisations: systematic review. BMJ 2016; 355:i5225. [PMID: 27737830 PMCID: PMC5063033 DOI: 10.1136/bmj.i5225] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To identify and characterise non-specific immunological effects after routine childhood vaccines against BCG, measles, diphtheria, pertussis, and tetanus. DESIGN Systematic review of randomised controlled trials, cohort studies, and case-control studies. DATA SOURCES Embase, PubMed, Cochrane library, and Trip searched between 1947 and January 2014. Publications submitted by a panel of experts in the specialty were also included. ELIGIBILITY CRITERIA FOR SELECTING STUDIES All human studies reporting non-specific immunological effects after vaccination with standard childhood immunisations. Studies using recombinant vaccines, no vaccine at all, or reporting only vaccine specific outcomes were excluded. The primary aim was to systematically identify, assemble, and review all available studies and data on the possible non-specific or heterologous immunological effects of BCG; measles; mumps, measles, and rubella (MMR); diphtheria; tetanus; and pertussis vaccines. RESULTS The initial search yielded 11 168 references; 77 manuscripts met the inclusion criteria for data analysis. In most included studies (48%) BCG was the vaccine intervention. The final time point of outcome measurement was primarily performed (70%) between one and 12 months after vaccination. There was a high risk of bias in the included studies, with no single study rated low risk across all assessment criteria. A total of 143 different immunological variables were reported, which, in conjunction with differences in measurement units and summary statistics, created a high number of combinations thus precluding any meta-analysis. Studies that compared BCG vaccinated with unvaccinated groups showed a trend towards increased IFN-γ production in vitro in the vaccinated groups. Increases were also observed for IFN-γ measured after BCG vaccination in response to in vitro stimulation with microbial antigens from Candida albicans, tetanus toxoid, Staphylococcus aureas, lipopolysaccharide, and hepatitis B. Cohort studies of measles vaccination showed an increase in lymphoproliferation to microbial antigens from tetanus toxoid and C albicans Increases in immunogenicity to heterologous antigens were noted after diphtheria-tetanus (herpes simplex virus and polio antibody titres) and diphtheria-tetanus-pertussis (pneumococcus serotype 14 and polio neutralising responses) vaccination. CONCLUSIONS The papers reporting non-specific immunological effects had heterogeneous study designs and could not be conventionally meta-analysed, providing a low level of evidence quality. Some studies, such as BCG vaccine studies examining in vitro IFN-γ responses and measles vaccine studies examining lymphoproliferation to microbial antigen stimulation, showed a consistent direction of effect suggestive of non-specific immunological effects. The quality of the evidence, however, does not provide confidence in the nature, magnitude, or timing of non-specific immunological effects after vaccination with BCG, diphtheria, pertussis, tetanus, or measles containing vaccines nor the clinical importance of the findings.
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Affiliation(s)
- Rama Kandasamy
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Fiona McQuaid
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Karlijn de Nie
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Rebecca Ryan
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Olivia Orr
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Ulrike Uhlig
- Department of Paediatrics, Children's Hospital Oxford, Oxford University Hospitals NHS Trust, Oxford, OX3 9DU, UK
| | - Charles Sande
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Daniel O'Connor
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK NIHR Oxford Biomedical Research Centre, Oxford, OX3 7LE, UK
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Seither R, Calhoun K, Mellerson J, Knighton CL, Street E, Dietz V, Underwood JM. Vaccination Coverage Among Children in Kindergarten - United States, 2015-16 School Year. MMWR Morb Mortal Wkly Rep 2016; 65:1057-1064. [PMID: 27711037 DOI: 10.15585/mmwr.mm6539a3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
State-mandated vaccination requirements for school entry protect children and communities against vaccine-preventable diseases (1). Each school year, federally funded immunization programs (e.g., states, territories, jurisdictions) collect and report kindergarten vaccination data to CDC. This report describes vaccination coverage estimates in all 50 states and the District of Columbia (DC), and the estimated number of kindergartners with at least one vaccine exemption in 47 states and DC, during the 2015-16 school year. Median vaccination coverage* was 94.6% for 2 doses of measles, mumps and rubella vaccine (MMR); 94.2% for diphtheria, tetanus, and acellular pertussis vaccine (DTaP); and 94.3% for 2 doses of varicella vaccine. MMR coverage increased in 32 states during the last year, and 22 states reported coverage ≥95% (2). A total of 45 states and DC had either a grace period allowing students to attend school before providing documentation of vaccination or provisional enrollment that allows undervaccinated students to attend school while completing a catch-up schedule. Among the 23 states that were able to voluntarily report state-level data on grace period or provisional enrollment to CDC, a median of 2.0% of kindergartners were not documented as completely vaccinated and were attending school within a grace period or were provisionally enrolled. The median percentage of kindergartners with an exemption from one or more vaccinations† was 1.9%. State and local immunization programs, in cooperation with schools, can improve vaccination coverage by ensuring that all kindergartners are vaccinated during the grace period or provisional enrollment.
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Gastañaduy PA, Budd J, Fisher N, Redd SB, Fletcher J, Miller J, McFadden DJ, Rota J, Rota PA, Hickman C, Fowler B, Tatham L, Wallace GS, de Fijter S, Parker Fiebelkorn A, DiOrio M. A Measles Outbreak in an Underimmunized Amish Community in Ohio. N Engl J Med 2016; 375:1343-1354. [PMID: 27705270 DOI: 10.1056/nejmoa1602295] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although measles was eliminated in the United States in 2000, importations of the virus continue to cause outbreaks. We describe the epidemiologic features of an outbreak of measles that originated from two unvaccinated Amish men in whom measles was incubating at the time of their return to the United States from the Philippines and explore the effect of public health responses on limiting the spread of measles. METHODS We performed descriptive analyses of data on demographic characteristics, clinical and laboratory evaluations, and vaccination coverage. RESULTS From March 24, 2014, through July 23, 2014, a total of 383 outbreak-related cases of measles were reported in nine counties in Ohio. The median age of case patients was 15 years (range, <1 to 53); a total of 178 of the case patients (46%) were female, and 340 (89%) were unvaccinated. Transmission took place primarily within households (68% of cases). The virus strain was genotype D9, which was circulating in the Philippines at the time of the reporting period. Measles-mumps-rubella (MMR) vaccination coverage with at least a single dose was estimated to be 14% in affected Amish households and more than 88% in the general (non-Amish) Ohio community. Containment efforts included isolation of case patients, quarantine of susceptible persons, and administration of the MMR vaccine to more than 10,000 persons. The spread of measles was limited almost exclusively to the Amish community (accounting for 99% of case patients) and affected only approximately 1% of the estimated 32,630 Amish persons in the settlement. CONCLUSIONS The key epidemiologic features of a measles outbreak in the Amish community in Ohio were transmission primarily within households, the small proportion of Amish people affected, and the large number of people in the Amish community who sought vaccination. As a result of targeted containment efforts, and high baseline coverage in the general community, there was limited spread beyond the Amish community. (Funded by the Ohio Department of Health and the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Paul A Gastañaduy
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Jeremy Budd
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Nicholas Fisher
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Susan B Redd
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Jackie Fletcher
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Julie Miller
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Dwight J McFadden
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Jennifer Rota
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Paul A Rota
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Carole Hickman
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Brian Fowler
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Lilith Tatham
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Gregory S Wallace
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Sietske de Fijter
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Amy Parker Fiebelkorn
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Mary DiOrio
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
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Buda P, Gietka P, Wieteska-Klimczak A, Smorczewska-Kiljan A, Książyk J. Autoimmune/inflammatory syndrome leading to macrophage activation syndrome: An example of autoinflammatory spectrum disorder? Isr Med Assoc J 2016; 18:571. [PMID: 28681590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- P Buda
- Department of Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - P Gietka
- Eleonore Reicher's Rheumatology Institute, Warsaw, Poland
| | - A Wieteska-Klimczak
- Department of Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - A Smorczewska-Kiljan
- Department of Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - J Książyk
- Department of Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
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Guo X, Simmonds KA, Svenson J, MacDonald SE. Do children who receive an 'early dose' of MMR vaccine during a measles outbreak return for their regularly scheduled dose? A retrospective population-based study. BMJ Open 2016; 6:e012803. [PMID: 27580838 PMCID: PMC5013531 DOI: 10.1136/bmjopen-2016-012803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Children under the age of 12 months may receive an early dose of measles-mumps-rubella (MMR) vaccine to provide short-term protection in the case of a disease outbreak. Following a measles outbreak in Alberta, Canada, there was concern that children who received an early dose may not be returning for their routinely scheduled dose at 12 months, leaving them vulnerable to disease in the long term. METHODS This population-based study of children born between 2006 and 2014 used administrative health data to assess coverage and timeliness of the first routine dose of MMR vaccine administered at age 12-24 months for children who received an early dose of the vaccine due to a disease outbreak. We compared this group to children who received an early dose due to travel to a measles-endemic region and to children who did not receive an early dose. RESULTS Only 5.5% of 366 351 children received an early dose. Coverage for the routine dose at age 24 months was 96.5% for children receiving an outbreak dose, 92.2% for those travelling to measles-endemic regions and 86.6% for those without an early dose (p<0.0001). The multivariable Cox proportional hazard analysis, controlling for neighbourhood income, place of residence and interaction effects, determined that, as compared to the general cohort, the outbreak group was most likely to obtain the first routine dose (adjusted HR (aHR): 1.52, 95% CI 1.44 to 1.60), followed by the travel group (aHR: 1.26, 95% CI 1.18 to 1.34). CONCLUSIONS It is reassuring that the majority of children who received an early dose returned for their routine dose and did so in a timely manner.
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Affiliation(s)
- Xiaoyan Guo
- Analytics and Performance Reporting Branch, Alberta Ministry of Health, Edmonton, Alberta, Canada
| | - Kimberley A Simmonds
- Strategic Planning and Policy Division, Alberta Ministry of Health, Edmonton, Alberta, Canada
| | - Jill Svenson
- Health and Wellness Promotion Branch, Alberta Ministry of Health, Edmonton, Alberta, Canada
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Reagan-Steiner S, Yankey D, Jeyarajah J, Elam-Evans LD, Curtis CR, MacNeil J, Markowitz LE, Singleton JA. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2015. MMWR Morb Mortal Wkly Rep 2016; 65:850-8. [PMID: 27561081 DOI: 10.15585/mmwr.mm6533a4] [Citation(s) in RCA: 283] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents aged 11-12 years routinely receive vaccines to prevent diseases, including human papillomavirus (HPV)-associated cancers, pertussis, and meningococcal disease (1). To assess vaccination coverage among adolescents in the United States, CDC analyzed data collected regarding 21,875 adolescents through the 2015 National Immunization Survey-Teen (NIS-Teen).* During 2014-2015, coverage among adolescents aged 13-17 years increased for each HPV vaccine dose among males, including ≥1 HPV vaccine dose (from 41.7% to 49.8%), and increased modestly for ≥1 HPV vaccine dose among females (from 60.0% to 62.8%) and ≥1 quadrivalent meningococcal conjugate vaccine (MenACWY) dose (from 79.3% to 81.3%). Coverage with ≥1 HPV vaccine dose was higher among adolescents living in households below the poverty level, compared with adolescents in households at or above the poverty level.(†) HPV vaccination coverage (≥1, ≥2, or ≥3 doses) increased in 28 states/local areas among males and in seven states among females. Despite limited progress, HPV vaccination coverage remained lower than MenACWY and tetanus, diphtheria, and acellular pertussis vaccine (Tdap) coverage, indicating continued missed opportunities for HPV-associated cancer prevention.
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Abstract
The recent decrease in public confidence in the measles, mumps and rubella vaccine has important implications for individuals and public health. This article presents moral arguments relating to conflicts between individual autonomy and collective responsibilities in vaccination decisions with a view to informing and advising health professionals and improving the effectiveness of education policies in avoiding resurgence of endemic measles. Lower population immunity, due to falling uptake, is hastening the need for greater public awareness of the consequences for the population. Vaccination refusals go hand in hand with responsibilities owed to future generations and society in not knowingly contributing to preventable harms. Issues such as parents’ rights are considered and balanced against: collective responsibilities for public health; permissibility of ‘free-riding’; conflicting duties of health professionals; and possible enforcement of vaccination. It is suggested that the arguments may form a persuasive tool for the practice of health professionals involved in informing and supporting parents’ vaccination decisions.
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Affiliation(s)
- Janice Wood-Harper
- School of Community Health Sciences and Social Care, University of Salford, Greater Manchester, M6 6PU, UK.
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Albertson JP, Clegg WJ, Reid HD, Arbise BS, Pryde J, Vaid A, Thompson-Brown R, Echols F. Mumps Outbreak at a University and Recommendation for a Third Dose of Measles-Mumps-Rubella Vaccine - Illinois, 2015-2016. MMWR Morb Mortal Wkly Rep 2016; 65:731-4. [PMID: 27467572 DOI: 10.15585/mmwr.mm6529a2] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Mumps is an acute viral disease characterized by fever and swelling of the parotid or other salivary glands. On May 1, 2015, the Illinois Department of Public Health (IDPH) confirmed a mumps outbreak at the University of Illinois at Urbana-Champaign. IDPH and the Champaign-Urbana Public Health District (C-UPHD) conducted an investigation and identified 317 cases of mumps during April 2015-May 2016. Because of sustained transmission in a population with high 2-dose coverage with measles-mumps-rubella (MMR) vaccine, a third MMR dose was recommended by IDPH, C-UPHD, and the university's McKinley Health Center. No formal recommendation for or against the use of a third MMR dose has been issued by the Advisory Committee on Immunization Practices (ACIP) (1). However, CDC has provided guidelines for use of a third dose as a control measure during mumps outbreaks in settings in which persons are in close contact with one another, where transmission is sustained despite high 2-dose MMR coverage, and when traditional control measures fail to slow transmission (2).
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Bednarczyk RA, Orenstein WA, Omer SB. Estimating the Number of Measles-Susceptible Children and Adolescents in the United States Using Data From the National Immunization Survey-Teen (NIS-Teen). Am J Epidemiol 2016; 184:148-56. [PMID: 27338281 DOI: 10.1093/aje/kwv320] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/10/2015] [Indexed: 11/13/2022] Open
Abstract
Despite high measles vaccination rates in the United States, imported measles cases have led to outbreaks in the United States. These outbreaks have not led to sustained measles transmission; however, with each birth cohort of children not fully vaccinated against measles, measles-susceptible individuals accumulate in the population. The total number of measles-susceptible children and adolescents in the United States is unknown. We used age-specific measles vaccination data from the National Immunization Survey-Teen (2008-2013) to estimate the number of measles-susceptible children aged 17 years or younger, accounting for vaccine effectiveness, infant protection from maternal antibodies, and loss of immunity following childhood cancer treatment. Approximately 12.5% of US children and adolescents are susceptible to measles, with the highest levels of susceptibility being observed in children aged 3 years or younger (24.7% are susceptible to measles). In sensitivity analyses, we found that a sustained decrease in measles vaccination coverage from 91.9% (2013 level) to 90.0% (2009 level) would add nearly 1.2 million susceptible children and adolescents (thus making 14.2% of those aged 17 years or younger susceptible to measles). This reemphasizes the need for high measles vaccination coverage to support population-level immunity and prevent reestablishment of indigenous measles transmission in the United States.
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93
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Diana A. [Review of the 2016 Swiss immunization schedule and technology update for improving vaccine management]. Rev Med Suisse 2016; 12:949-953. [PMID: 27352591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The 2016 immunization schedule published by the Swiss Federal Office of Public Health includes three new clauses: reimbursement of the additional Human Papillomavirus (HPV) vaccination in young males (11-26 years) as recommended by local canton programs, the end of franchise exemption for the measles, mumps and rubella (MMR) vaccination, and the creation of a new system of indemnities and moral compensation in the event of personal injury resulting from vaccinations. This article presents the main features of the 2016 immunization schedule with details of the technology available to physicians to improve vaccine management.
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Hutchings HA, Evans A, Barnes P, Healy MA, James-Ellison M, Lyons RA, Maddocks A, Paranjothy S, Rodgers SE, Dunstan F. Does frequent residential mobility in early years affect the uptake and timeliness of routine immunisations? An anonymised cohort study. Vaccine 2016; 34:1773-7. [PMID: 26923454 PMCID: PMC4820086 DOI: 10.1016/j.vaccine.2016.02.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/12/2016] [Accepted: 02/17/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND There are conflicting findings regarding the impact of residential mobility on immunisation status. Our aim was to determine whether there was any association between residential mobility and take up of immunisations and whether they were delayed in administration. METHODS We carried out a cohort analysis of children born in Wales, UK. Uptake and time of immunisation were collected electronically. We defined frequent movers as those who had moved: 2 or more times in the period prior to the final scheduled on-time date (4 months) for 5 in 1 vaccinations; and 3 or more times in the period prior to the final scheduled on-time date (12 months) for MMR, pneumococcal and meningitis C vaccinations. We defined immunisations due at 2-4 months delayed if they had not been given by age 1; and those due at 12-13 months as delayed if they had not been given by age 2. RESULTS Uptake rates of routine immunisations and whether they were given within the specified timeframe were high for both groups. There was no increased risk (odds ratios (95% confidence intervals) between frequent movers compared to non-movers for the uptake of: primary MMR 1.08 (0.88-1.32); booster Meningitis C 1.65 (0.93-2.92); booster pneumococcal 1.60 (0.59-4.31); primary 5 in 1 1.28 (0.92-1.78); and timeliness: primary MMR 0.92 (0.79-1.07); booster Meningitis C 1.26 (0.77-2.07); booster pneumococcal 1.69 (0.23-12.14); and primary 5 in 1 1.04 (0.88-1.23). DISCUSSION Findings suggest that children who move home frequently are not adversely affected in terms of the uptake of immunisations and whether they were given within a specified timeframe. Both were high and may reflect proactive behaviour in the primary healthcare setting to meet Government coverage rates for immunisation.
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Affiliation(s)
- Hayley A Hutchings
- Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
| | - Annette Evans
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Heath Park, Cardiff, UK.
| | - Peter Barnes
- Abertawe Bromorgannwg University Health Board (ABM UHB), Singleton Park, Swansea, UK.
| | - Melanie A Healy
- Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
| | | | - Ronan A Lyons
- Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
| | - Alison Maddocks
- Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
| | - Shantini Paranjothy
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Heath Park, Cardiff, UK.
| | - Sarah E Rodgers
- Patient and Population Health and Informatics (PPHI), Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
| | - Frank Dunstan
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Heath Park, Cardiff, UK.
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Kato H, Mori M, Oba M, Kawahara H, Kaneko T. Persistence and Half-lives of Anti-measles and Anti-rubella Antibodies in Japanese Hospital Workers: A Longitudinal Study. Intern Med 2016; 55:2587-94. [PMID: 27629951 DOI: 10.2169/internalmedicine.55.6762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Antibody testing for endemic viruses in healthcare workers is used as an index of immunoprotection in Japan. However, it remains unclear how these antibody titers chronologically change and how they should be interpreted. Methods We retrospectively collected two sets of antibody titers to measles and rubella, measured in 2013 and within the preceding 5 years, in adult hospital workers by an enzyme-linked immunoassay and calculated in international units. Subjects infected with, or vaccinated against, these viruses over this period were eliminated. Seropositivities and geometric mean titers were analyzed. Decay rates and half-lives of antibodies were calculated using a mixed-effect model according to the subjects' ages and antibody titers. Results We analyzed 469 subjects for measles and 439 for rubella. Comparison with previous data revealed a mean measurement interval of 1,026 days between the previous and present tests, with seropositivity rates of 98.0% (previous) vs. 99.3% (present) for measles; 974 days and 90.7% vs. 94.9%, respectively, for rubella. For measles and rubella, 97.4% and 86.1%, respectively, of previously seropositive subjects remained positive in the present test. The geometric mean titers in the present and previous tests were 924.3 IU/mL and 853.2 IU/mL (measles) and 46.23 IU/mL and 40.78 IU/mL (rubella), respectively. In the mixed-effect model, measles and rubella antibody titers showed an increasing trend with age. Conclusion Seropositivities against measles and rubella can remain high for more than 5 years. Among adult hospital workers in Japan, the antibody titers against measles and rubella have a sufficient lifetime persistence.
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Affiliation(s)
- Hideaki Kato
- Infection Control Department, Yokohama City University Medical Center, Japan
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Shah GL, Shune L, Purtill D, Devlin S, Lauer E, Lubin M, Bhatt V, McElrath C, Kernan NA, Scaradavou A, Giralt S, Perales MA, Ponce DM, Young JW, Shah M, Papanicolaou G, Barker JN. Robust Vaccine Responses in Adult and Pediatric Cord Blood Transplantation Recipients Treated for Hematologic Malignancies. Biol Blood Marrow Transplant 2015; 21:2160-2166. [PMID: 26271191 PMCID: PMC4672874 DOI: 10.1016/j.bbmt.2015.08.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/05/2015] [Indexed: 01/04/2023]
Abstract
Because cord blood (CB) lacks memory T and B cells and recent decreases in herd immunity to vaccine-preventable diseases in many developed countries have been documented, vaccine responses in CB transplantation (CBT) survivors are of great interest. We analyzed vaccine responses in double-unit CBT recipients transplanted for hematologic malignancies. In 103 vaccine-eligible patients, graft-versus-host disease (GVHD) most commonly precluded vaccination. Sixty-five patients (63%; engrafting units median HLA-allele match 5/8; range, 2 to 7/8) received protein conjugated vaccines, and 63 patients (median age, 34 years; range, .9 to 64) were evaluated for responses. Median vaccination time was 17 months (range, 7 to 45) post-CBT. GVHD (n = 42) and prior rituximab (n = 13) delayed vaccination. Responses to Prevnar 7 and/or 13 vaccines (serotypes 14, 19F, 23F) were seen in children and adults (60% versus 49%, P = .555). Responses to tetanus, diphtheria, pertussis, Haemophilus influenzae, and polio were observed in children (86% to 100%) and adults (53% to 89%) even if patients had prior GVHD or rituximab. CD4(+)CD45RA(+) and CD19(+) cell recovery significantly influenced tetanus and polio responses. In a smaller cohort responses were seen to measles (65%), mumps (50%), and rubella (100%) vaccines. No vaccine side effects were identified, and all vaccinated patients survived (median follow-up, 57 months). Although GVHD and rituximab can delay vaccination, CBT recipients (including adults and those with prior GVHD) have similar vaccine response rates to adult donor allograft recipients supporting vaccination in CBT recipients.
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Affiliation(s)
- Gunjan L Shah
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Leyla Shune
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Duncan Purtill
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sean Devlin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Emily Lauer
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marissa Lubin
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Valkal Bhatt
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Courtney McElrath
- Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nancy A Kernan
- Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andromachi Scaradavou
- Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sergio Giralt
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Miguel A Perales
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Doris M Ponce
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - James W Young
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Monica Shah
- Department of Medicine, Weill Cornell Medical College, New York, New York; Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Genovefa Papanicolaou
- Department of Medicine, Weill Cornell Medical College, New York, New York; Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Juliet N Barker
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
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Hill HA, Elam-Evans LD, Yankey D, Singleton JA, Kolasa M. National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19-35 Months - United States, 2014. MMWR Morb Mortal Wkly Rep 2015; 64:889-96. [PMID: 26313470 DOI: 10.15585/mmwr.mm6433a1] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The reduction in morbidity and mortality associated with vaccine-preventable diseases in the United States has been described as one of the 10 greatest public health achievements of the first decade of the 21st century. A recent analysis concluded that routine childhood vaccination will prevent 322 million cases of disease and about 732,000 early deaths among children born during 1994-2013, for a net societal cost savings of $1.38 trillion. The National Immunization Survey (NIS) has monitored vaccination coverage among U.S. children aged 19-35 months since 1994. This report presents national, regional, state, and selected local area vaccination coverage estimates for children born from January 2011 through May 2013, based on data from the 2014 NIS. For most vaccinations, there was no significant change in coverage between 2013 and 2014. The exception was hepatitis A vaccine (HepA), for which increases were observed in coverage with both ≥1 and ≥2 doses. As in previous years, <1% of children received no vaccinations. National coverage estimates indicate that the Healthy People 2020 target* of 90% was met for ≥3 doses of poliovirus vaccine (93.3%), ≥1 dose of measles, mumps, and rubella vaccine (MMR) (91.5%), ≥3 doses of hepatitis B vaccine (HepB) (91.6%), and ≥1 dose of varicella vaccine (91.0%). Coverage was below target for ≥4 doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP), the full series of Haemophilus influenzae type b (Hib) vaccine, hepatitis B (HepB) birth dose,† ≥4 doses pneumococcal conjugate vaccine (PCV), ≥2 doses of HepA, the full series of rotavirus vaccine, and the combined vaccine series.§ Examination of coverage by child's race/ethnicity revealed lower estimated coverage among non-Hispanic black children compared with non-Hispanic white children for several vaccinations, including DTaP, the full series of Hib, PCV, rotavirus vaccine, and the combined series. Children from households classified as below the federal poverty level had lower estimated coverage for almost all of the vaccinations assessed, compared with children living at or above the poverty level. Significant variation in coverage by state¶ was observed for several vaccinations, including HepB birth dose, HepA, and rotavirus. High vaccination coverage must be maintained across geographic and sociodemographic groups if progress in reducing the impact of vaccine-preventable diseases is to be sustained.
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Hofstetter AM, DuRivage N, Vargas CY, Camargo S, Vawdrey DK, Fisher A, Stockwell MS. Text message reminders for timely routine MMR vaccination: A randomized controlled trial. Vaccine 2015; 33:5741-5746. [PMID: 26424607 PMCID: PMC5863911 DOI: 10.1016/j.vaccine.2015.09.042] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 09/16/2015] [Accepted: 09/18/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Measles-mumps-rubella (MMR) vaccination is important for preventing disease outbreaks, yet pockets of under-vaccination persist. Text message reminders have been employed successfully for other pediatric vaccines, but studies examining their use for MMR vaccination are limited. This study assessed the impact of text message reminders on timely MMR vaccination. STUDY DESIGN Parents (n=2054) of 9.5-10.5-month-old children from four urban academically-affiliated pediatric clinics were randomized to scheduling plus appointment text message reminders, appointment text message reminder-only, or usual care. The former included up to three text reminders to schedule the one-year preventive care visit. Both text messaging arms included a text reminder sent 2 days before that visit. Outcomes included appointment scheduling, appointment attendance, and MMR vaccination by age 13 months, the standard of care at study sites. RESULTS Children of parents in the scheduling plus appointment text message reminders arm were more likely to have a scheduled one-year visit than those in the other arms (71.9% vs. 67.4%, relative risk ratio (RRR) 1.07 [95% CI 1.005-1.13]), particularly if no appointment was scheduled before randomization (i.e., no baseline appointment) (62.1% vs. 54.7%, RRR 1.14 [95% CI 1.04-1.24]). One-year visit attendance and timely MMR vaccination were similar between arms. However, among children without a baseline appointment, those with parents in the scheduling plus appointment text message reminders arm were more likely to undergo timely MMR vaccination (61.1% vs. 55.1%, RRR 1.11 [95% CI 1.01-1.21]). CONCLUSION Text message reminders improved timely MMR vaccination of high-risk children without a baseline one-year visit.
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Affiliation(s)
- Annika M Hofstetter
- Department of Pediatrics, Columbia University, New York, NY, USA; NewYork-Presbyterian Hospital, New York, NY, USA.
| | | | | | - Stewin Camargo
- Department of Pediatrics, Columbia University, New York, NY, USA.
| | - David K Vawdrey
- NewYork-Presbyterian Hospital, New York, NY, USA; Department of Biomedical Informatics, Columbia University, New York, NY, USA.
| | - Allison Fisher
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Melissa S Stockwell
- Department of Pediatrics, Columbia University, New York, NY, USA; NewYork-Presbyterian Hospital, New York, NY, USA; Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Kamali A, Bagchi CP, Mendoza E, Wilson D, Schwartz B, Mascola L. Measles in a Patient with Presumed Immunity - Los Angeles County, 2015. MMWR Morb Mortal Wkly Rep 2015; 64:1123. [PMID: 26447803 DOI: 10.15585/mmwr.mm6439a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
On February 14, 2015, patient A, aged 17 years, was seen in an emergency department for evaluation of reactive airway disease. In the waiting room at the same time were two siblings, aged 6 months, presenting with fever and rash; these two children (patients B and C) were later confirmed to have measles. Patient A began a 5-day course of oral prednisone (50 mg per day); however, symptoms continued, and patient A returned to the emergency department the next day and received 125 mg of intravenous (IV) methylprednisolone. Patient A had documentation of receipt of 2 doses of measles, mumps, and rubella (MMR) vaccine at ages 12 months and 4 years.
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Florescu L, Rugina A, Temneanu OR, Paduraru DTA, Matei MC, Safta C, Mindru DE. VACCINATION--COLLECTIVE RESPONSIBILITY OR VIOLATION OF RIGHTS? Rev Med Chir Soc Med Nat Iasi 2015; 119:1098-1105. [PMID: 26793855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Vaccination is considered to be the most effective and the cheapest medical intervention through which individual and collective immunisation is achieved. Statistics show that, at present, immunisation annually saves 400 million lives and protects approximately 750,000 children against disabilities of varying degrees. Approximately 80% of worldwide children are vaccinated against diphtheria, tetanus, pertussis, polio, measles, etc.; these diseases used to be considered incurable in the past. Vaccines help the body to produce antibodies; they help the immune system to detect germs and inactivate their cells. The immunological protection is installed after a variable period of time following the inoculation and is long lasting. Immunisations can be achieved in several ways: through national immunisation campaigns with general recommendation--they may be compulsory, optional or prophylactic (for the diseases for which a vaccine is available); vaccinations not included in the compulsory immunisation programmes; they may also be targeted to the contagious infectious outbreaks or to groups of population in certain situations. There is no guarantee that a vaccine will provide 100% protection. However, it will significantly reduce the risk of getting an infection. Vaccines have side effects which can be divided into reactions triggered by the vaccine or reactions exacerbated by it, without a causal relationship to the vaccine.
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