Ethics Pertaining to the Legalities of Male Routine Infant Circumcision and Surrogate Consent to Non-Therapeutic Surgery

Abstract Background Herd immunity from pediatric pneumococcal conjugate vaccine (PCV) programs has resulted in substantial reductions in IPD due to PCV serotypes (ST). We assessed whether similar changes in ST distribution occur in non-bacteremic pneumococcal pneumonia (NBPP). Methods The Toronto Invasive Bacterial Diseases Network performs population-based surveillance for IPD and hospitalized, culture-confirmed NBPP in Toronto/Peel Region, Canada (Pop 4.5M). Patient data are collected by interview/chart review; illness associated with respiratory isolates is categorized using Musher criteria. Results Since 2002, 6627 episodes of IPD, and 7323 non-bacteremic episodes with a respiratory isolate of S. pneumoniae (2180 meeting modified Musher criteria for NBPP) have occurred in adults. Distributions of vaccine-type serotypes in IPD and NBPP pre-PCV7 (2002-2004), post-PCV7 (2006-2009) and late post-PCV13 (2014-2019) are shown in the Figure. There were no significant changes in distribution of vaccine serotype groups from 2014-2019 in IPD or NBPP. From 2014-2019, serotypes included in PCV13 and PCV20 were associated with 33% and 59% of IPD cases, and 29% and 49% of NBPP cases in adults.. Figure. distribution of serotype groups included in different pneumococcal vaccines in cases of IPD and non-bacteremic pneumonia Conclusion Eight years post routine infant PCV13 implementation, PCV13 type IPD and NBPP persists in adults. The distribution of vaccine-type strains is similar in IPD and NBPP; although non-vaccine-type strains are more common in NBPP. Disclosures Allison McGeer, MD, FRCPC, GlaxoSmithKline (Advisor or Review Panel member, Research Grant or Support)Merck (Advisor or Review Panel member, Research Grant or Support)Pfizer (Research Grant or Support)

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Agreement between routine and research measurement of infant height and weight

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-305970 ◽

2014 ◽

Vol 100 (1) ◽

pp. 24-29 ◽

Cited By ~ 11

Author(s):

M Bryant ◽

G Santorelli ◽

L Fairley ◽

E S Petherick ◽

R Bhopal ◽

...

Keyword(s):

Routine Data ◽

Research Data ◽

Data Sources ◽

School Age ◽

Methodological Issues ◽

Limits Of Agreement ◽

Born In Bradford ◽

Health Visitors ◽

Health And Illness ◽

Routine Infant

In many countries, routine data relating to growth of infants are collected as a means of tracking health and illness up to school age. These have potential to be used in research. For health monitoring and research, data should be accurate and reliable. This study aimed to determine the agreement between length/height and weight measurements from routine infant records and researcher-collected data.MethodsHeight/length and weight at ages 6, 12 and 24 months from the longitudinal UK birth cohort (born in Bradford; n=836–1280) were compared with routine data collected by health visitors within 2 months of the research data (n=104–573 for different comparisons). Data were age adjusted and compared using Bland Altman plots.ResultsThere was agreement between data sources, albeit weaker for height than for weight. Routine data tended to underestimate length/height at 6 months (0.5 cm (95% CI −4.0 to 4.9)) and overestimate it at 12 (−0.3 cm (95% CI −0.5 to 4.0)) and 24 months (0.3 cm (95% CI −4.0 to 3.4)). Routine data slightly overestimated weight at all three ages (range −0.04 kg (95% CI −1.2 to 0.9) to −0.04 (95% CI −0.7 to 0.6)). Limits of agreement were wide, particularly for height. Differences were generally random, although routine data tended to underestimate length in taller infants and underestimate weight in lighter infants.ConclusionsRoutine data can provide an accurate and feasible method of data collection for research, though wide limits of agreement between data sources may be observed. Differences could be due to methodological issues; but may relate to variability in clinical practice. Continued provision of appropriate training and assessment is essential for health professionals responsible for collecting routine data.

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Combination Vaccines for Routine Infant Immunization

New Generation Vaccines, Fourth Edition ◽

10.1201/9781439834404.ch33 ◽

2004 ◽

Author(s):

Myron Levine ◽

James Campbell ◽

Gregory Glenn ◽

Richard Kenney ◽

Margaret Rennels ◽

...

Keyword(s):

Combination Vaccines ◽

Routine Infant

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Over-diagnosis of Rotavirus Infection in Infants Due to Detection of Vaccine Virus

Clinical Infectious Diseases ◽

10.1093/cid/ciz1196 ◽

2019 ◽

Vol 71 (5) ◽

pp. 1324-1326 ◽

Cited By ~ 1

Author(s):

David M Whiley ◽

Suifang Ye ◽

Sarah Tozer ◽

Julia E Clark ◽

Cheryl Bletchly ◽

...

Keyword(s):

Clinical Management ◽

Diagnostic Testing ◽

Vaccine Virus ◽

Vaccine Effectiveness ◽

Wild Type ◽

Virus Shedding ◽

Rotavirus Infection ◽

Routine Infant ◽

Positive Results ◽

Active Disease

Abstract An accurate rotavirus diagnosis is important for clinical management and monitoring active disease and vaccine effectiveness. Between 2016–2018, rotavirus-positive results in our laboratory were from vaccine virus shedding in 71/152 (46.7%) infants with a request for rotavirus testing. Routine infant diagnostic testing should ideally distinguish vaccine from wild-type viruses.

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LACTIC ACID MILK AS A ROUTINE INFANT FOOD.

The Lancet ◽

10.1016/s0140-6736(01)30669-4 ◽

1927 ◽

Vol 210 (5419) ◽

pp. 63-65 ◽

Cited By ~ 1

Author(s):

JamesA Stephen ◽

EdwardR.C Walker

Keyword(s):

Lactic Acid ◽

Infant Food ◽

Lactic Acid Milk ◽

Routine Infant

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Cost-Effectiveness of Alternative Uses of Polyvalent Meningococcal Vaccines in Niger: An Agent-Based Transmission Modeling Study

Medical Decision Making ◽

10.1177/0272989x19859899 ◽

2019 ◽

Vol 39 (5) ◽

pp. 553-567

Author(s):

S. M. Niaz Arifin ◽

Christoph Zimmer ◽

Caroline Trotter ◽

Anaïs Colombini ◽

Fati Sidikou ◽

...

Keyword(s):

Cost Effectiveness ◽

Prediction Interval ◽

Cost Effective ◽

Sensitivity Analyses ◽

Transmission Model ◽

Agent Based ◽

Infant Vaccination ◽

Important Health ◽

Catch Up ◽

Routine Infant

Background. Despite the introduction of an effective serogroup A conjugate vaccine (MenAfriVac™), sporadic epidemics of other Neisseria meningitidis serogroups remain a concern in Africa. Polyvalent meningococcal conjugate (PMC) vaccines may offer alternatives to current strategies that rely on routine infant vaccination with MenAfriVac plus, in the event of an epidemic, district-specific reactive campaigns using polyvalent meningococcal polysaccharide (PMP) vaccines. Methods. We developed an agent-based transmission model of N. meningitidis in Niger to compare the health effects and costs of current vaccination practice and 3 alternatives. Each alternative replaces MenAfriVac in the infant vaccination series with PMC and either replaces PMP with PMC for reactive campaigns or implements a one-time catch up campaign with PMC for children and young adults. Results. Over a 28-year period, replacement of MenAfriVac with PMC in the infant immunization series and of PMP in reactive campaigns would avert 63% of expected cases (95% prediction interval 49%–75%) if elimination of serogroup A is not followed by serogroup replacement. At a PMC price of $4/dose, this would cost $1412 ($81–$3510) per disability-adjusted life-year (DALY) averted. If serogroup replacement occurs, the cost-effectiveness of this strategy improves to $662 (cost-saving, $2473) per DALY averted. Sensitivity analyses accounting for incomplete laboratory confirmation suggest that a catch-up PMC campaign would also meet standard cost-effectiveness thresholds. Limitations. The assumption that polyvalent vaccines offer similar protection against all serogroups is simplifying. Conclusions. The use of PMC vaccines to replace MenAfriVac in routine infant immunization and in district-specific reactive campaigns would have important health benefits and is likely to be cost-effective in Niger. An additional PMC catch-up campaign would also be cost-effective if we account for incomplete laboratory reporting.

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