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Immunization Against Hepatitis A in Migrant Children: Three Vaccination Strategies, A Retrospective Study. Pediatr Infect Dis J 2020; 39:164-169. [PMID: 31929432 DOI: 10.1097/inf.0000000000002526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hepatitis A is endemic in many countries. Swiss guidelines recommend vaccinating patients native from endemic areas. In Geneva's Children's hospital, migrant children are screened and vaccinated if seronegative. Because hepatitis A's prevalence is decreasing worldwide, more children are seronegative at arrival, highlighting the need for immunization in medical centers and refugee camps and questioning the benefits of systematic serology. Other Swiss hospitals vaccinate regardless of serostatus. This study's aim is to assess migrant children's immunity according to origin and age, and the cost-effectiveness of different immunization strategies. METHODS We retrospectively analyzed 329 children's serostatus (1-16 years of age) between 2012 and 2015, using enzyme-linked fluorescent assay method. Serology and vaccine costs were based on local prices. Groups were compared with χ test and the age-seropositivity relationship was studied with linear regression. RESULTS The predominant regions were the Eastern Mediterranean and European Regions with mostly negative serologies (71% and 83%) and the African Region with mostly positive serologies (79%). Immunity varied depending on birth country. Regardless of region, seropositivity increased with age (P < 0.001). The most cost-effective vaccination strategy was an individualized approach based on age and origin, reducing costs by 2% compared with serology-guided immunization and by 17% compared with systematic vaccination. CONCLUSIONS Many migrant children >5 years old are seronegative and at risk of clinical infection. They need to be immunized. New guidelines according to age and origin should be defined to reduce immunization costs. We recommend systematic vaccination for patients <5 years old or native from low endemicity areas (≤25.7% of seropositivity). For the others, we propose serology-based vaccination.
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Early disappearance of maternal anti-measles, mumps, rubella, and varicella antibodies in Indian infants. Vaccine 2019; 37:1443-1448. [DOI: 10.1016/j.vaccine.2019.01.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 11/21/2022]
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Deyà-Martínez A, Esteve-Sole A, Giner MT, Aróstegui JI, Ruiz-Ortiz E, Yagüe J, Juan M, Plaza AM, Alsina L. Clues to management of neonatally diagnosed BTK deficiency. Pediatr Allergy Immunol 2016; 27:428-30. [PMID: 26844683 DOI: 10.1111/pai.12549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Angela Deyà-Martínez
- Department of Pediatric Allergy and Clinical Immunology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain
| | - Ana Esteve-Sole
- Department of Pediatric Allergy and Clinical Immunology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain
| | - Maria Teresa Giner
- Department of Pediatric Allergy and Clinical Immunology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain
| | - Juan I Aróstegui
- Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain.,Department of Immunology, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Estíbaliz Ruiz-Ortiz
- Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain.,Department of Immunology, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Jordi Yagüe
- Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain.,Department of Immunology, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Manel Juan
- Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain.,Department of Immunology, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Ana Maria Plaza
- Department of Pediatric Allergy and Clinical Immunology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain
| | - Laia Alsina
- Department of Pediatric Allergy and Clinical Immunology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain. .,Functional Unit of Immunology, Hospital Sant Joan de Déu-Clínic, Barcelona, Spain.
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