Successful Control of Streptococcus pneumoniae 19A Replacement With a Catch-up Primary Vaccination Program in Taiwan

2019 ◽  
Vol 69 (9) ◽  
pp. 1581-1587 ◽  
Author(s):  
Chun-Yi Lu ◽  
Chuen-Sheue Chiang ◽  
Cheng-Hsun Chiu ◽  
En-Tzu Wang ◽  
Ying-Yan Chen ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Incidence Rate ◽  
Primary Vaccination ◽  
Vaccination Schedule ◽  
Incidence Rates ◽  
Vaccination Programs ◽  
Catch Up ◽  
Rate Ratios ◽  
National Programs ◽  
The Impact

Abstract Background Streptococcus pneumoniae infections in Taiwan mostly occur in children aged 2–4 years. Because of a significant increase in the incidence of serotype 19A-related infections, the 13-valent pneumococcal conjugate vaccine (PCV13) was initially introduced in the national immunization program for children 2–5 years of age, prior to the national programs for infants. We have assessed the impact of such vaccination programs in reducing the incidence of invasive pneumococcal disease (IPD) in Taiwanese children. Methods We analyzed the national data on IPDs from the Taiwan Centers for Disease Control between 2008 and 2017. We calculated the incidence rates of IPD and incidence rate ratios (IRRs) between years for different serotypes to estimate the effectiveness of the vaccination programs. Results The national catch-up primary vaccination schedule successfully reduced the incidence rate of IPD from 17.8/100 000 in 2012 to 5.5/100 000 in 2017 among children aged 0–5 years. The IRR (2017 over 2012) was 0.31, corresponding to a 69% reduction. A modest herd effect was also observed, with a 37% reduction in the incidence of IPD in elderly people (≥70 years) from 2012 to 2017. The incidence of IPD caused by serotype 19A in children aged 0–5 years was reduced by 32.6–44.3% yearly from 2012 to 2017. In 2015, serogroup 15 outnumbered 19A, to become the leading serotypes in children 0–5 years old. Conclusions Special catch-up vaccination programs starting from children 2–5 years of age with PCV13 have been highly effective in reducing the incidence of IPD, especially as caused by serotype 19A, in Taiwanese children.

scholarly journals Impact of the herpes zoster vaccination programme on hospitalised and general practice consulted herpes zoster in the 5 years after its introduction in England: a population-based study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e037458
Author(s):  
Nick Andrews ◽  
Julia Stowe ◽  
Galena Kuyumdzhieva ◽  
Bersabeh Sile ◽  
Ivelina Yonova ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Incidence Rate ◽  
Vaccination Programme ◽  
Vaccine Coverage ◽  
Ecological Impact ◽  
Population Based ◽  
Age Cohorts ◽  
Catch Up ◽  
Rate Ratios ◽  
The Impact

ObjectivesTo assess the impact of herpes zoster vaccination in the 5 years after introduction for 70- to 79-year-olds in England in September 2013.DesignPopulation based ecological impact assessment.SettingHospitals covering the whole English population for the period 2008 to 2018 and 293 general practices (GP) for the period 2005 to 2018, in England.ParticipantsOver the period the population contributed 117·5 million person-years for hospitalisation events and 6.96 million person-years for GP events in individuals aged 60 to 89.InterventionsLive attenuated herpes zoster vaccination (Zostavax), first used on 1st September 2013, in 70- and 79-year-olds with continued use in new 70 year-olds and with a staged catch-up of those aged 71 to 78 years in 2013.Outcome measuresHerpes zoster and postherpetic neuralgia (PHN) consultation and hospitalisation rates in age-cohorts according to vaccine eligibility. Incidence rate ratios in age-cohorts eligible for vaccination compared with those non-eligible were calculated by Poisson regression. This was used to estimate prevented cases and, along with vaccine coverage, to estimate vaccine effectiveness.ResultsLarge and prolonged reductions in herpes zoster and PHN consultations and hospitalisations were observed in the 5 years post-implementation. For example, in 79 year-olds first eligible in 2013, the incidence rate ratio for consultations 5 years later was 0·65 (95% CI: 0·52 to 0·81). Over the whole period an estimated 40 500 fewer zoster consultations and 1840 fewer zoster hospitalisations occurred because of the vaccination programme. These reductions were consistent with effectiveness in the routine cohorts (vaccinated aged 70) of between 37% (for hospitalised zoster) and 75% (for PHN consultations) and, in catch up cohorts (vaccinated aged 78 to 79) of between 49% (for hospitalised PHN) and 66% (for PHN consultations).ConclusionGiven the clear and sustained impact of herpes zoster vaccination over the 5-year period since introduction, optimising vaccination coverage is important to attain maximum benefit.

scholarly journals COVID-19 among the inhabitants of the slums in the city of Buenos Aires: a population-based study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e044592
Author(s):  
Alejandro Macchia ◽  
Daniel Ferrante ◽  
Gabriel Battistella ◽  
Javier Mariani ◽  
Fernán González Bernaldo de Quirós
Keyword(s):  
Incidence Rate ◽  
Buenos Aires ◽  
Reporting System ◽  
Incidence Rates ◽  
Health Reporting ◽  
Rt Pcr ◽  
Slum Dwellers ◽  
Integrated Health ◽  
The Impact ◽  
The City

ObjectiveTo summarise the unfolding of the COVID-19 epidemic among slum dwellers and different social strata in the city of Buenos Aires during the first 20 weeks after the first reported case.DesignObservational study using a time-series analysis. Natural experiment in a big city.SettingPopulation of the city of Buenos Aires and the integrated health reporting system records of positive RT-PCR for COVID-19 tests.ParticipantsRecords from the Argentine Integrated Health Reporting System for all persons with suspected and RT-PCR-confirmed diagnosis of COVID-19 between 31 January and 14 July 2020.OutcomesTo estimate the effects of living in a slum on the standardised incidence rate of COVID-19, corrected Poisson regression models were used. Additionally, the impact of socioeconomic status was performed using an ecological analysis at the community level.ResultsA total of 114 052 people were tested for symptoms related with COVID-19. Of these, 39 039 (34.2%) were RT-PCR positive. The incidence rates for COVID-19 towards the end of the 20th week were 160 (155 to 165) per 100 000 people among the inhabitants who did not reside in the slums (n=2 841 997) and 708 (674 to 642) among slums dwellers (n=233 749). Compared with the better-off socioeconomic quintile (1.00), there was a linear gradient on incidence rates: 1.36 (1.25 to 1.46), 1.61 (1.49 to 1.74), 1.86 (1.72 to 2.01), 2.94 (2.74 to 3.16) from Q2 to Q5, respectively. Slum dwellers were associated with an incidence rate of 14.3 (13.4 to 15.4).ConclusionsThe distribution of the epidemic is socially conditioned. Slum dwellers are at a much higher risk than the rest of the community. Slum dwellers should not be considered just another risk category but an entirely different reality that requires policies tailored to their needs.

scholarly journals Vaccine impact and effectiveness of meningococcal serogroup ACWY conjugate vaccine implementation in the Netherlands: a nationwide surveillance study

2021 ◽  
Author(s):  
Milou Ohm ◽  
Susan J M Hahné ◽  
Arie van der Ende ◽  
Elizabeth A M Sanders ◽  
Guy A M Berbers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Incidence Rate ◽  
Vaccination Programme ◽  
Screening Method ◽  
Age Groups ◽  
Incidence Rates ◽  
Age Group ◽  
Mass Campaign ◽  
Conjugate Vaccination ◽  
The Impact

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.

scholarly journals Injury Incidence Across the Menstrual Cycle in International Footballers

2021 ◽  
Vol 3 ◽  
Author(s):  
Dan Martin ◽  
Kate Timmins ◽  
Charlotte Cowie ◽  
Jon Alty ◽  
Ritan Mehta ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Incidence Rate ◽  
Luteal Phase ◽  
Incidence Rates ◽  
Follicular Phase ◽  
Tendon Injuries ◽  
Cycle Phase ◽  
Injury Incidence ◽  
Rate Ratios ◽  
Late Follicular Phase

Objectives: This study aimed to assess how menstrual cycle phase and extended menstrual cycle length influence the incidence of injuries in international footballers.Methods: Over a 4-year period, injuries from England international footballers at training camps or matches were recorded, alongside self-reported information on menstrual cycle characteristics at the point of injury. Injuries in eumenorrheic players were categorized into early follicular, late follicular, or luteal phase. Frequencies were also compared between injuries recorded during the typical cycle and those that occurred after the cycle would be expected to have finished. Injury incidence rates (per 1,000 person days) and injury incidence rate ratios were calculated for each phase for all injuries and injuries stratified by type.Results: One hundred fifty-six injuries from 113 players were eligible for analysis. Injury incidence rates per 1,000 person-days were 31.9 in the follicular, 46.8 in the late follicular, and 35.4 in the luteal phase, resulting in injury incidence rate ratios of 1.47 (Late follicular:Follicular), 1.11 (Luteal:Follicular), and 0.76 (Luteal:Late follicular). Injury incident rate ratios showed that muscle and tendon injury rates were 88% greater in the late follicular phase compared to the follicular phase, with muscle rupture/tear/strain/cramps and tendon injuries/ruptures occurring over twice as often during the late follicular phase compared to other phases 20% of injuries were reported as occurring when athletes were “overdue” menses.Conclusion: Muscle and tendon injuries occurred almost twice as often in the late follicular phase compared to the early follicular or luteal phase. Injury risk may be elevated in typically eumenorrheic women in the days after their next menstruation was expected to start.

scholarly journals Descriptive Epidemiology of Injuries in Professional Ultimate Frisbee Athletes

2020 ◽  
Vol 55 (2) ◽  
pp. 195-204 ◽  
Author(s):  
Matthew C. Hess ◽  
David I. Swedler ◽  
Christine S. Collins ◽  
Brent A. Ponce ◽  
Eugene W. Brabston
Keyword(s):  
Incidence Rate ◽  
Epidemiologic Study ◽  
Incidence Rates ◽  
Thigh Muscle ◽  
Surveillance Program ◽  
Injury Incidence ◽  
Descriptive Epidemiology ◽  
Injury Rates ◽  
Ultimate Frisbee ◽  
Rate Ratios

Context Injuries in professional ultimate Frisbee (ultimate) athletes have never been described. Objective To determine injury rates, profiles, and associated factors using the first injury-surveillance program for professional ultimate. Design Descriptive epidemiology study. Setting American Ultimate Disc League professional ultimate teams during the 2017 season. Patients or Other Participants Sixteen all-male teams. Main Outcome Measure(s) Injury incidence rates (IRs) were calculated as injuries per 1000 athlete-exposures (AEs). Incidence rate ratios were determined to compare IRs with 95% confidence intervals, which were used to calculate differences. Results We observed 299 injuries over 8963 AEs for a total IR of 33.36 per 1000 AEs. Most injuries affected the lower extremity (72%). The most common injuries were thigh-muscle strains (12.7%) and ankle-ligament sprains (11.4%). Running was the most frequent injury mechanism (32%). Twenty-nine percent of injuries involved collisions; however, the concussion rate was low (IR = 0.22 per 1000 AEs). Injuries were more likely to occur during competition and in the second half of games. An artificial turf playing surface did not affect overall injury rates (Mantel-Haenszel incidence rate ratio = 1.28; 95% confidence interval = 0.99, 1.67). Conclusions To our knowledge, this is the first epidemiologic study of professional ultimate injuries. Injury rates were comparable with those of similar collegiate- and professional-level sports.

scholarly journals Effects of introducing a walk-in clinic on ambulatory care sensitive hospitalisations among asylum seekers in Germany: a single-centre pre–post intervention study using medical records

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e027945
Author(s):  
Celina Lichtl ◽  
Kayvan Bozorgmehr
Keyword(s):  
Ambulatory Care ◽  
Incidence Rate ◽  
Asylum Seekers ◽  
Time Trends ◽  
Intervention Study ◽  
Post Intervention ◽  
Rate Ratios ◽  
The Impact ◽  
Reception Centre ◽  
Ambulatory Care Sensitive

ObjectiveMeasuring the effect of introducing a walk-in clinic on ambulatory care sensitive (ACS) hospitalisations among asylum seekers in a large state reception- and registration centre.Design and settingPre–post intervention study using anonymous account data from a university hospital functioning as referral facility for a state reception- and registration centre in the third largest German federal state.ParticipantsWe included all asylum seekers residing in the reception centre and admitted to the referral hospital between 2015 to 2017.InterventionsEstablishment of an interdisciplinary walk-in clinic in the reception centre (02/2016).Main outcome measuresInternational lists for ACS conditions for both adults and children were adapted and used to calculate the prevalence of ACS conditions among the population (primary outcome measure). The impact of the intervention on the outcome was analysed using a segmented Poisson regression to calculate incidence-rate ratios with respective 95% CIs, adjusted for age, sex and admission.ResultsThe prevalence of ACS hospitalisations changed over time, as did the effect of age, sex and quarter of admission. Introducing the walk-in clinic reduced the prevalence of ACS hospitalisations among asylum seekers compared with the period before establishment of the clinic (incidence-rate ratios (IRR)=0.80 (0.65 to 1.00), p=0.054), but the effect was attenuated after adjustment for time trends. The average difference in prevalence of ACS hospitalisations compared with the period before establishment of the clinic, corrected for pre-existing time trends, age and sex of asylum seekers was IRR=1.03 ((0.69 to 1.55), p=0.876).ConclusionsA walk-in clinic in reception centres may be effective to reduce ACS hospitalisations, but our study could not prove evidence for a measurable effect after full adjustment for time trends. Further research, ideally with parallel control groups, is required to establish evidence for the effectiveness of walk-in clinics in reception centres on reducing ACS hospitalisations.

scholarly journals Incidence of extra-articular manifestations in ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis: results from a national register-based cohort study

Rheumatology ◽  
2020 ◽  
Author(s):  
Karin Bengtsson ◽  
Helena Forsblad-d'Elia ◽  
Anna Deminger ◽  
Eva Klingberg ◽  
Mats Dehlin ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Incidence Rates ◽  
The Other ◽  
Population Register ◽  
Swedish Population ◽  
National Patient Register ◽  
National Patient ◽  
Rate Ratios ◽  
Strength Of Association

Abstract Objectives To estimate the incidence and strength of association of extra-articular manifestations [EAMs, here: anterior uveitis (AU), IBD and psoriasis] in patients with AS, undifferentiated SpA (uSpA) and PsA, compared with controls. Methods Three mutually exclusive cohorts of patients aged 18–69 years with AS (n = 8517), uSpA (n = 10 245) and PsA (n = 22 667) were identified in the Swedish National Patient Register 2001–2015. Age-, sex- and geography-matched controls were identified from the Swedish Population Register. Follow-up began 1 January 2006, or six months after the first SpA diagnosis, whichever occurred later, and ended at the first date of the EAM under study, death, emigration, 70 years of age, and 31 December 2016. Incidence rates (IRs) and incidence rate ratios were calculated for each EAM, and stratified by sex and age. Results Incidence rate ratios for incident AU, IBD and psoriasis were significantly increased in AS (20.2, 6.2, 2.5), uSpA (13.6, 5.7, 3.8) and PsA (2.5, 2.3, n.a) vs controls. Men with AS and uSpA had significantly higher IRs per 1000 person-years at risk for incident AU than women with AS (IR 15.8 vs 11.2) and uSpA (IR 10.1 vs 6.0), whereas no such sex difference was demonstrated in PsA or for the other EAMs. Conclusions AU, followed by IBD and psoriasis, is the EAM most strongly associated with AS and uSpA. Among the SpA subtypes, AS and uSpA display a largely similar pattern of EAMs, whereas PsA has a considerably weaker association with AU and IBD.

scholarly journals The impact of Australia's measles control programme over the past decade

2004 ◽  
Vol 133 (1) ◽  
pp. 99-105 ◽  
Author(s):  
H. F. GIDDING
Keyword(s):  
Vaccination Schedule ◽  
Control Programme ◽  
Childhood Vaccination ◽  
Mmr Vaccine ◽  
School Aged Children ◽  
Measles Elimination ◽  
Source Case ◽  
Catch Up ◽  
The Impact ◽  
Control Campaign

We reviewed measles surveillance data for 1993–2002 to determine the impact of Australia's measles control initiatives. The introduction of a second dose of measles–mumps–rubella (MMR) vaccine for 10- to 16-year-olds in 1993 was followed by marked reductions in measles notifications and hospitalizations, especially in the targeted age group. Further rate reductions were achieved following the Measles Control Campaign (MCC) in 1998, which involved a catch-up campaign for primary-school-aged children and lowering the age for the second dose of MMR vaccine to 4 years. Since the MCC, outbreaks have continued to occur, but most had a source case who was infected overseas, which suggests that indigenous transmission has been interrupted. In addition, a greater proportion of cases have been in adults although infants aged <5 years still had the highest rates. In conclusion, Australia is making good progress towards measles elimination. However, as in other countries, this progress can be sustained only by maintaining high vaccination coverage with the routine childhood vaccination schedule.

scholarly journals Higher COVID-19 vaccination rates are linked to decreased county-level COVID-19 incidence across USA

2021 ◽  
Author(s):  
Arjun Puranik ◽  
AJ Venkatakrishnan ◽  
Colin Pawlowski ◽  
Bharathwaj Raghunathan ◽  
Eshwan Ramudu ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Vaccine Efficacy ◽  
Vaccine Dose ◽  
The United States ◽  
Vaccination Rate ◽  
Incidence Rates ◽  
P Value ◽  
County Level ◽  
Vaccination Rates ◽  
The Impact

Real world evidence studies of mass vaccination across health systems have reaffirmed the safety1 and efficacy2,3 of the FDA-authorized mRNA vaccines for COVID-19. However, the impact of vaccination on community transmission remains to be characterized. Here, we compare the cumulative county-level vaccination rates with the corresponding COVID-19 incidence rates among 87 million individuals from 580 counties in the United States, including 12 million individuals who have received at least one vaccine dose. We find that cumulative county-level vaccination rate through March 1, 2021 is significantly associated with a concomitant decline in COVID-19 incidence (Spearman correlation ρ = −0.22, p-value = 8.3e-8), with stronger negative correlations in the Midwestern counties (ρ = −0.37, p-value = 1.3e-7) and Southern counties (ρ = −0.33, p-value = 4.5e-5) studied. Additionally, all examined US regions demonstrate significant negative correlations between cumulative COVID-19 incidence rate prior to the vaccine rollout and the decline in the COVID-19 incidence rate between December 1, 2020 and March 1, 2021, with the US western region being particularly striking (ρ = −0.66, p-value = 5.3e-37). However, the cumulative vaccination rate and cumulative incidence rate are noted to be statistically independent variables, emphasizing the need to continue the ongoing vaccination roll out at scale. Given confounders such as different coronavirus restrictions and mask mandates, varying population densities, and distinct levels of diagnostic testing and vaccine availabilities across US counties, we are advancing a public health resource to amplify transparency in vaccine efficacy monitoring (https://public.nferx.com/covid-monitor-lab/vaccinationcheck). Application of this resource highlights outliers like Dimmit county (Texas), where infection rates have increased significantly despite higher vaccination rates, ostensibly owing to amplified travel as a “vaccination hub”; as well as Henry county (Ohio) which encountered shipping delays leading to postponement of the vaccine clinics. This study underscores the importance of tying the ongoing vaccine rollout to a real-time monitor of spatio-temporal vaccine efficacy to help turn the tide of the COVID-19 pandemic.

scholarly journals The initial impact of a national BNT162b2 mRNA COVID-19 vaccine rollout

2021 ◽  
Author(s):  
Ahmed Zaqout ◽  
Joanne Daghfal ◽  
Israa Alaqad ◽  
Saleh A.N. Hussein ◽  
Abdullah Aldushain ◽  
...  
Keyword(s):  
Protective Effect ◽  
Incidence Rate ◽  
Confidence Intervals ◽  
Poisson Regression ◽  
Incidence Rates ◽  
Post Vaccination ◽  
Time Periods ◽  
Rate Ratios ◽  
Vaccination Period

AbstractObjectiveWe herein report the initial impact of a national BNT162b2 rollout on SARS-CoV-2 infections in Qatar.MethodsWe included all individuals who by 16 March 2021 had completed ≥14 days of follow up after the receipt of BNT162b2. We calculated incidence rates (IR) and their 95% confidence intervals (CI), during days 1–7, 8–14, 15–21, 22–28, and >28 days post-vaccination. Poisson regression was used to calculate incidence rate ratios (IRR) relative to the first 7-day post-vaccination period.ResultsWe included 199,219 individuals with 6,521,124 person-days of follow up. SARS-CoV-2 infection was confirmed in 1,877 (0.9%), of which 489 (26.1%) were asymptomatic and 123 (6.6%) required oxygen support. The median time from first vaccination to SARS-CoV-2 confirmation was 11.9 days (IQR 7.7–18.2). Compared with the first 7-day post-vaccination period, SARS-CoV-2 infections were lower by 65.8–84.7% during days 15–21, days 22–28, and >28 days (P <0.001 for each). For severe COVID-19, the incidence rates were 75.7– 93.3% lower (P <0.001 for each) during the corresponding time periods.ConclusionOur results are consistent with an early protective effect of BNT162b2 against all degrees of SARS-CoV-2 severity.

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