scholarly journals Vaccination coverage estimates and utilization patterns of inactivated enterovirus 71 vaccine post vaccine introduction in Ningbo, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lixia Ye ◽  
Jieping Chen ◽  
Ting Fang ◽  
Rui Ma ◽  
Jianmei Wang ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Vaccination Coverage ◽  
Eastern China ◽  
Multivariable Analysis ◽  
Enterovirus 71 ◽  
Information Management System ◽  
Simultaneous Administration ◽  
Childhood Immunization ◽  
Vaccine Introduction ◽  
Utilization Patterns

Abstract Background In China, enterovirus 71 (EV71) is the major etiological agents of hand foot mouth disease that poses severe risks to children’s health. Since 2015, three inactivated EV71 vaccines have been approved for use. Previous studies indicated the high willingness of EV71 vaccination in eastern China. However, few studies have assessed coverage and utilization patterns of EV71 vaccine in China. Methods Children born during 2012–2018 were sampled and their records were abstracted from Ningbo childhood immunization information management system. Descriptive statistics characterized the study population and assessed coverage and timeliness for EV71 vaccination. Simultaneous administration patterns as well as type of EV71 vaccine used were also evaluated. Bivariate and multivariable analysis was used to examine the relationship of socio-demographic characteristics with vaccination coverage and timeliness. Results Of 716,178 children living in Ningbo. One hundred seventy-two thousand two hundred thirty-six received EV71 vaccine with a coverage rate of 24.05% and only 8.61% received vaccination timely. 21.97% of children received the complete two dose EV71 series but only 6.49% completed timely. Vaccination coverage and timeliness increased significantly from 2012 birth cohort to 2018 birth cohort. Relatively higher coverage and timeliness were observed in resident children, Inner districts, high socioeconomic areas and large-scaled immunization clinics. Of 329,569 doses of EV71 vaccine, only 5853(1.78%) doses were administered at the same day as other vaccines. Conclusions There is a need for increasing EV71 vaccination coverage and timeliness as well as eliminating disparities among different populations. Our study highlights the importance of simultaneous administration to increasing coverage and timeliness of EV71 vaccination.

scholarly journals Effectiveness of Haemophilus influenzae Type b Conjugate Vaccine Introduction Into Routine Childhood Immunization in Kenya

JAMA ◽  
2006 ◽  
Vol 296 (6) ◽  
pp. 671 ◽  
Author(s):  
Karen D. Cowgill ◽  
Moses Ndiritu ◽  
Joyce Nyiro ◽  
Mary P. E. Slack ◽  
Salome Chiphatsi ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Childhood Immunization ◽  
Vaccine Introduction ◽  
Routine Childhood

Weight Gain Trajectory and Pain Interference in Young Adulthood: Evidence from a Longitudinal Birth Cohort Study

Pain Medicine ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 439-447 ◽  
Author(s):  
Dmitry Tumin ◽  
Adrianne Frech ◽  
Jamie L Lynch ◽  
Vidya T Raman ◽  
Tarun Bhalla ◽  
...  
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Birth Cohort ◽  
Transition To Adulthood ◽  
Multivariable Analysis ◽  
Normal Weight ◽  
Pain Interference ◽  
Birth Cohort Study ◽  
Bmi Trajectories ◽  
Bmi Trajectory

AbstractObjectiveObesity is associated with chronic pain, but the contribution of body mass index (BMI) trajectories over the life course to the onset of pain problems remains unclear. We retrospectively analyzed how BMI trajectories during the transition to adulthood were associated with a measure of pain interference obtained at age 29 in a longitudinal birth cohort study.MethodsData from the National Longitudinal Survey of Youth, 1997 Cohort (follow-up from 1997 to 2015), were used to determine BMI trajectories from age 14 to 29 via group trajectory modeling. At age 29, respondents described whether pain interfered with their work inside and outside the home over the past four weeks (not at all, a little, or a lot). Multivariable ordinal logistic regression was used to evaluate pain interference according to BMI trajectory and study covariates.ResultsAmong 7,875 respondents, 11% reported “a little” and 4% reported “a lot” of pain interference at age 29. Four BMI trajectory groups were identified, varying in starting BMI and rate of weight gain. The “obese” group (8% of respondents) had a starting BMI of 30 kg/m2 and gained an average of 0.7 kg/m2/y. On multivariable analysis, this group was the most likely to have greater pain interference, compared with “high normal weight” (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.14–1.88), “low normal weight” (OR = 1.45, 95% CI = 1.13–1.87), and “overweight” trajectories (OR = 1.33, 95% CI = 1.02–1.73).ConclusionsObesity and rapid weight gain during the transition to adulthood were associated with higher risk of pain interference among young adults.

scholarly journals P10.14 Factors associated with hpv vaccination coverage at school level during hpv vaccine introduction in thailand

2015 ◽  
Vol 91 (Suppl 2) ◽  
pp. A170.1-A170
Author(s):  
P Pensuk ◽  
N Wihantong ◽  
W Klinsupa ◽  
L Wechakul ◽  
S Pankhun ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
School Level ◽  
Factors Associated ◽  
Vaccine Introduction

scholarly journals Epidemiology and clinical significance of pLVPK-like virulence plasmid in KPC-2-producing Klebsiella pneumoniae infections in eastern China: a preliminary exploration

2020 ◽  
Author(s):  
Min Xu ◽  
Qing Yang ◽  
Yanchao Liu ◽  
Xiao Chen ◽  
Haishen Kong ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Clinical Characteristics ◽  
Eastern China ◽  
Multivariable Analysis ◽  
Tertiary Hospital ◽  
Multivariable Logistic Regression Analysis ◽  
Virulence Plasmid ◽  
Carbapenem Resistant ◽  
Epidemiological Trend ◽  
Wide Dissemination

Abstract Background: By acquiring a pLVPK-like virulence plasmid (pVir), Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-kp) evolves to a hypervirulent variant, with increasing cases reported worldwide. However, little is known about the epidemiological trend of pVir in KPC-kp, as well as clinical characteristics of infections caused by this novel strain (pVir+-KPC-kp). Methods: From 2014-2018, 662 carbapenem-resistant K. pneumoniae (CRKP) were consecutively collected from a tertiary hospital of eastern China. The confirmed KPC-kp were subjected to antimicrobial susceptibility testing, multilocus sequence typing and detection of pLVPK-related genetic loci (rmpA, rmpA2, iucA and iroN) to identify pVir+-KPC-kp strains. Then, the clinical characteristics and outcomes of KPC-kp infection patients with and without pVir were compared. Moreover, the risk factors for pVir+-KPC-kp infections also determined by a multivariable logistic regression analysis.Results: of the 662 CRKP, 86.6% (573/662) were KPC-kp including 285 (49.7%) pVir+-KPC-kp and 288 (50.3%) pVir--KPC-kp. Notably, the prevalence of pVir+-KPC-kp by year increased remarkably from 2014 (19.5%, 8/41) to 2018 (60.0%, 90/150). Sequence type (ST) 11 was the most predominant ST, accounting for 88.9% of all pVir+-KPC-kp. For the 352 KPC-kp infection cases (186 with pVir+-KPC-kp and 166 with pVir--KPC-kp), multivariable analysis indicated neurosurgery (Odds ratio [OR], 2.92; 95% confidence interval [CI], 1.48-5.75; P =0.002) was independently associated with pVir+-KPC-kp infections. Although patients with pVir+-KPC-kp infections had higher incidence of septic shock (31.2% vs. 21.1%, P =0.03), the two groups showed no significant differences in 7-day mortality (23.1% vs. 18.1%, P =0.24) or 28-day mortality (45.7% vs. 44.0%, P =0.75). Conclusions: Altogether, wide dissemination of pVir in ST11 KPC-kp has emerged in China. Neurosurgery is an independent risk factor for acquisition of pVir+-KPC-kp infections. The mortality rates were similar between patients infected with pVir+-KPC-kp or pVir--KPC-kp, suggesting uncertain impact of pVir in clinical outcome.

scholarly journals Health spending and vaccination coverage in low-income countries

2020 ◽  
Author(s):  
Francisco Castillo-Zunino ◽  
Pinar Keskinocak ◽  
Dima Nazzal ◽  
Matthew C Freeman
Keyword(s):  
Vaccination Coverage ◽  
Low Income ◽  
National Income ◽  
Health Spending ◽  
Gross National Income ◽  
Low Income Countries ◽  
Childhood Immunization ◽  
Government Health ◽  
Per Capita ◽  
The Impact

SummaryBackgroundRoutine childhood immunization is a cost-effective way to save lives and protect people from disease. Some low-income countries (LIC) have achieved remarkable success in childhood immunization, despite lower levels of gross national income or health spending compared to other countries. We investigated the impact of financing and health spending on vaccination coverage across LIC and lower-middle income countries (LMIC).MethodsAmong LIC, we identified countries with high-performing vaccination coverage (LIC+) and compared their economic and health spending trends with other LIC (LIC-) and LMIC. We used cross-country multi-year linear regressions with mixed-effects to test financial indicators over time. We conducted three different statistical tests to verify if financial trends of LIC+ were significantly different from LIC- and LMIC; p-values were calculated with an asymptotic χ2 test, a Kenward-Roger approximation for F tests, and a parametric bootstrap method.FindingsDuring 2014–18, LIC+ had a mean vaccination coverage between 91–96% in routine vaccines, outperforming LIC- (67–80%) and LMIC (83–89%). During 2000–18, gross national income and development assistance for health (DAH) per capita were not significantly different between LIC+ and LIC- (p > 0·13, p > 0·65) while LIC+ had a significant lower total health spending per capita than LIC- (p < 0·0001). Government health spending per capita per year increased by US$0·42 for LIC+ and decreased by US$0·24 for LIC- (p < 0·0001). LIC+ had a significantly lower private health spending per capita than LIC- (p < 0·012).InterpretationLIC+ had a difference in vaccination coverage compared to LIC- and LMIC that could not be explained by economic development, total health spending, nor aggregated DAH. The vaccination coverage success of LIC+ was associated with higher government health spending and lower private health spending, with the support of DAH on vaccines.

scholarly journals Noninvasive Pneumococcal Clones Associated with Antimicrobial Nonsusceptibility Isolated from Children in the Era of Conjugate Vaccines

2015 ◽  
Vol 59 (9) ◽  
pp. 5761-5767 ◽  
Author(s):  
Martha McElligott ◽  
Imelda Vickers ◽  
Mary Meehan ◽  
Mary Cafferkey ◽  
Robert Cunney ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Clonal Complex ◽  
Treatment Strategies ◽  
Significant Decline ◽  
High Rate ◽  
Immunization Schedule ◽  
Childhood Immunization ◽  
Conjugate Vaccines ◽  
Vaccine Introduction ◽  
Single Locus Variant

ABSTRACTCarriage and noninvasive pneumococcal isolates frequently have a higher prevalence of antimicrobial nonsusceptibility than invasive isolates. From 2009 to 2014, we determined the associated clones in 169 pediatric noninvasive nonsusceptible pneumococci from a total of 506 isolates collected after 7- and 13-valent conjugate vaccine introduction (PCV7/13) to the Irish childhood immunization schedule in 2008 and 2010, respectively. We compared our results to those from 25 noninvasive pediatric pneumococcal isolates collected in 2007, the year before introduction of conjugate vaccines. In 2007, England14-9 and Spain9V-3 accounted for 12% and 32% of nonsusceptible clones, respectively, but in 2009 to 2014, their prevalence fell to 0% and 2.4%. Furthermore, there was a significant decline in Spain6B-2 and its variants from 2009 to 2014 (P= 0.0024). Fluctuations occurred in clonal complex 320 associated with serotype 19A. The prevalence of Sweden15A-25 and its variants and ST558 (a single-locus variant of Utah35B-24) associated with nonvaccine serotypes (NVT) 15A and 35B increased from 0% and 8% in 2007 to 19% and 16% in 2013 to 2014, respectively. Pilus locus 1 (PI-1) is associated with the spread of some nonsusceptible pneumococcal clones. PI-1 was more frequently associated with PCV7/13 serotypes than NVT (P= 0.0020). Our data highlight the value of surveillance of noninvasive pneumococci following conjugate vaccine introduction. Importantly, emerging clones associated with NVT may limit the effectiveness of PCV7/13 in reducing the high rate of nonsusceptibility among pediatric noninvasive pneumococci, with implications for empirical treatment strategies.

scholarly journals New Vaccine Introduction and Childhood Vaccination Timeliness in Two Urban, Informal Settlements in Nairobi, Kenya

2021 ◽  
Author(s):  
Cara Bess Janusz ◽  
Martin K. Mutua ◽  
Abram L. Wagner ◽  
Matthew L. Boulton
Keyword(s):  
Urban Areas ◽  
Prevalence Ratio ◽  
Childhood Vaccination ◽  
Routine Immunization ◽  
Immunization Schedule ◽  
Childhood Immunization ◽  
African Countries ◽  
Vaccine Introduction ◽  
Routine Childhood ◽  
The Impact

New vaccine introduction accompanied by social mobilization activities could contribute to improved routine immunization timeliness. This study assesses the impact of Kenya’s introduction of pneumococcal conjugate vaccine (PCV) on the timeliness of routine childhood vaccination in two informal, urban settlements in Nairobi. Data collected from 2007 to 2015 as part of a demographic surveillance system were used to estimate annual vaccination delays of ≥ 4 weeks among children aged 12–23 months in the period before and after the introduction of PCV in Kenya. Binomial segmented regression models using generalized estimating equations examined the association between vaccine introduction and timeliness of routine immunization. Over half of all children vaccinated in the two urban areas received one or more doses ≥ 4 weeks after the recommended age. The timeliness of routine immunization showed slight improvements or nonsignificant changes during the years following PCV introduction compared with the preceding years (adjusted prevalence ratio [aPR]: 0.67, 95% CI: 0.45–0.99 for Bacille Calmette-Guerin receipt; aPR: 0.59, 95% CI: 0.41–0.83 for third dose Pentavalent receipt; aPR: 1.19, 95% CI: 0.99–1.42 for measles). However, as of 2015, delayed vaccination remained prevalent in children, particularly among the poorest residing in the settlements. Many sub-Saharan African countries have introduced new life-saving vaccines into their routine childhood immunization schedule. Additional evidence regarding the positive or neutral influence of new vaccine introduction on the performance of delivery systems provides further justification to sustain the inclusion of these more costly vaccines in the immunization schedule.

scholarly journals Written reminders increase vaccine coverage in Danish children - evaluation of a nationwide intervention using The Danish Vaccination Register, 2014 to 2015

2017 ◽  
Vol 22 (17) ◽  
Author(s):  
Camilla Hiul Suppli ◽  
Mette Rasmussen ◽  
Palle Valentiner-Branth ◽  
Kåre Mølbak ◽  
Tyra Grove Krause
Keyword(s):  
Confidence Interval ◽  
Birth Cohort ◽  
Vaccination Coverage ◽  
Marked Effect ◽  
Vaccine Coverage ◽  
Rubella Vaccine ◽  
Polio Vaccine ◽  
Percentage Points ◽  
Reference Cohort

We evaluated a national intervention of sending written reminders to parents of children lacking childhood vaccinations, using the Danish Vaccination Register (DDV). The intervention cohort included the full birth cohort of 124,189 children born in Denmark who reached the age of 2 and 6.5 years from 15 May 2014 to 14 May 2015. The reference cohort comprised 124,427 children who reached the age of 2 and 6.5 years from 15 May 2013 to 14 May 2014. Vaccination coverage was higher in the intervention cohort at 2.5 and 7 years of age. The differences were most pronounced for the second dose of the measles-mumps-rubella vaccine (MMR2) and the diphtheria-tetanus-pertussis-polio vaccine DTaP-IPV4 among the 7-year-olds, with 5.0 percentage points (95% confidence interval (CI): 4.5–5.4) and 6.4 percentage points (95% CI: 6.0–6.9), respectively. Among the 2.5 and 7-year-olds, the proportion of vaccinations in the preceding 6 months was 46% and three times higher, respectively, in the intervention cohort than the reference cohort. This study indicates a marked effect of personalised written reminders, highest for the vaccines given later in the schedule in the older cohort. In addition, the reminders increased awareness about correct registration of vaccinations in DDV.

scholarly journals Epidemiological characteristics of hand, foot, and mouth disease in Yunnan Province, China, 2008–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Jiang ◽  
Hongchao Jiang ◽  
Xin Tian ◽  
Xueshan Xia ◽  
Tian Huang
Keyword(s):  
Vaccination Coverage ◽  
Yunnan Province ◽  
Enterovirus 71 ◽  
Case Fatality ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Vaccination Coverage Rate ◽  
Foot And Mouth ◽  
Before And After ◽  
Epidemiological Characteristics

Abstract Background Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and little is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the epidemiological characteristics of HFMD before and after the introduction of EV71 vaccination in Yunnan Province. Methods Surveillance data collected between 2008 and 2019 were analyzed to produce epidemiological distribution on cases, etiologic composition, and EV71 vaccination coverage, as well as to compare these characteristics before and after EV71 vaccination. Results A total of 1,653,533 children received EV71 vaccines from 2016 through 2019 in Yunnan. The annual EV71 vaccination coverage rate ranged from 5.53 to 15.01% among children ≤5 years old. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1 and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province. Conclusions Non-EV71/non-CV-A16 enteroviruses became the predominant strain and led to a higher incidence in Yunnan. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and detect and monitor emerging enteroviruses.

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