Vaccination of pentivalent, DTP, ADS vaccine for healthy and frequently sick children

Aim. To study the formation of anti-diphtheria post-vaccination immunity in practically healthy, and frequently sick children vaccinated with pentavalent, ADTP, and ADT vaccine.Material and methods. We observed 50 practically healthy and 92 frequently sick children. All children were vaccinated three times with a pentavalent vaccine, as well as revaccination with ADTP and ADT. The formation of specific anti-diphtheria immunity was detected for all children after 6 months, after 1 year, and after 5 years. The results were interpreted according to the final value of the optical density levels of protection: basic from -0,01 to 0,1; full protection -> 0.1; long-term protection -> 1.0.Results and discussion. After 6 months the intensity of post-vaccination immunity in both practically healthy and frequently sick children was the highest: full protection (> 0.1) (45,8%), basic protection (0,01 to 0,1) (31,0%). Statistical significance decreased after a year: full protection (45,8% versus 12,1%, p <0,001), and lack of protection increased (2,6% versus 55,7%, p <0,001), which indicated to the development of unstable immunity, therefore revaccination with ADTP and ADT vaccines were performed. 5 years after revaccination specific immunity tended to increase in both healthy and often-ill children.Conclusion. To create stable and long-term immunity when using “killed” vaccines and toxoids, revaccination vaccinations are required at various times after the course of vaccination for frequently ill children, as indicated by the data of basic and complete protection.

Immunogenicity and Complications of the Pentavalent Vaccine in Iranian Children

Objective: Vaccination is one of the most convenient and safe preventive care measures available for children. The Pentavalent vaccine which protects against five major infections including diphtheria, tetanus, pertussis, hepatitis B(HepB) and Haemophilus influenzae type b(Hib) was added to the Iranian national immunization program in November 2014. This study aimed to determine the Pentavalent vaccine adverse events and immunogenicity in an Iranian children population in Sari, northern Iran.Method: In this descriptive-analytical study, children who were vaccinated with three doses of the Pentavalent vaccine were studied. Two venous blood samples were obtained before the first dose and 4 weeks following the last booster dose. Possible local and systemic complications of the vaccine were recorded until 7 days following vaccination. Antibody titers were measured by quantitative ELISA kits and geometric mean titer(GMT) was calculated for each vaccine component before and after 3 doses of vaccine. Statistical analysis was performed by SPSS 20.0 software and Chi-square and Fisher's exact tests were used for analysis.Results: Immunogenicity of the Pentavalent vaccine for tetanus was 100%(GMT:2.52 Eu/mL, 95%CI: 2.22–2.88), Hib 98.7%(GMT:2.44 Eu/mL, 95%CI: 2.06–2.89), HepB 98.7%(GMT:153.54 Eu/mL, 95%CI: 133.73–176.29), diphtheria 93.1%(GMT:0.43 Eu/mL, 95%CI:0.37–0.51) and pertussis were 63.7% (GMT:19.44 Eu/mL, 95%CI:16.42–23.03). The most common systemic complication after vaccination was fever. Also, one infant cried for more than 3 hours after the second dose. Other serious side effects were not observed.Conclusion: The Pentavalent vaccine used in Iran can cause adequate antibody response against diphtheria, tetanus, pertussis, Hib and hepatitis B in most cases with minimal side effects. The immunogenicity of this vaccine is significantly lower for pertussis. In this study, no severe complication leading to contraindication to subsequent injections was reported. So, the present policy in replacing triple DTP vaccine with Pentavalent vaccine should be continued in Iran.

Immunization coverage of children aged 24–35 months in the Islamic Republic of Iran: a national cluster coverage survey

Background: Although vaccination coverage against a disease is not exactly the same as the community immunity against that disease, it is undoubtedly directly related to it and provides an estimate of the coherence and efficacy of community health infrastructure. Aims: To evaluate the vaccination coverage of children throughout the Islamic Republic of Iran in 2019. Methods: This was a cross-sectional study. A probability proportional to size cluster sampling method was used and the vaccination data of 8682 children aged 24–35 months were collected in the form of 1447 clusters, each composed of 6 participants. Only valid data, including vaccination card or electronic health files, were used. The results were reported in the form of descriptive tables. Results: Overall, 97.82% of Iranian participants (8068 of 8248) and 90.32% of non-Iranian participants (392 of 434) had received all necessary childhood vaccination by the time of interview. In total, 93.02% of all participants had presentable vaccination cards,; and the immunization history of 535 (6.16%) children was retrieved using their electronic health files. The dropout rate between receiving pentavalent vaccine 1 and pentavalent vaccine 3 was 0.01%. In 29 provinces, vaccination coverage was ≥ 95%. In the other 2 provinces, the figure was 93.30%. Conclusion: Immunization coverage of children aged 24–35 months fully complied with eradication/elimination goals of vaccine-preventable diseases. In 2019, measles and rubella elimination was certified in the Islamic Republic of Iran. However, non-Iranian people with immunization coverage < 95% constitute a high-risk group for possible outbreaks.

Impact evaluation of immunisation service integration to nutrition programmes and paediatric outpatient departments of primary healthcare centres in Rumbek East and Rumbek Centre counties of South Sudan

ObjectiveTo evaluate the impact of immunisation service integration to nutrition programmes and under 5-year-old paediatric outpatient departments of primary healthcare centres in Rumbek East and Rumbek Centre counties of South Sudan.DesignRetrospective intervention study.SettingThree primary healthcare centres in Rumbek East county and three primary healthcare centres in Rumbek Centre county of Lakes state in South Sudan.ParticipantWe extracted the data for the uptake of pentavalent vaccine (first, second and third dose) given to children aged between 6 weeks and 23 months from immunisation records for January–June 2019 before immunisation service integration and July–December 2019 after immunisation service integration from the District Health Information System 2 website to estimate the immunisation uptake ratios and drop-out rates.ResultsThe uptake of the first dose of the pentavalent vaccine improved from 61% to 96% (p<0.001) after immunisation service integration into the nutrition programmes of the primary healthcare centres in Rumbek Centre county. The uptake of the second pentavalent dose improved from 37% to 69% (p<0.001) and for the third pentavalent dose from 36% to 62% (p<0.001), while the drop-out rate reduced from 57% to 40% (p<0.001). While in Rumbek East county, the uptake of the first dose of the pentavalent vaccine improved from 55% to 77% (p<0.001) after immunisation service integration into the under 5-year-old paediatric outpatient departments. The uptake of the second dose improved from 36% to 62% (p<0.001) and for the third dose from 44% to 63% (p<0.001), while the drop-out rate reduced from 40% to 28% (p<0.001). Children were 23% more likely (RR 1.23, 95% CI 1.12 to 1.36, p<0.001) to be immunised with the first dose of the pentavalent vaccine on immunisation service integration into the nutrition programmes of primary healthcare centres of Rumbek Centre county in comparison to integration into under 5-year-old outpatient departments of Rumbek East county.ConclusionIntegration of immunisation service delivery to nutrition sites and children’s outpatient departments improved the immunisation coverage and decreased drop-out rates in the Rumbek East and Rumbek Centre counties of South Sudan. This evidence of positive impact should encourage the stakeholders of the Expanded Programme on Immunisation to focus on the sustainability and scale-up of this intervention to other counties in South Sudan, as logistically as possible.

Immune Response of Indian Preterm Infants to Pentavalent Vaccine Varies With Component Antigens and Gestational Age

Childhood vaccination plays critical role in protecting infants from several dreaded diseases. Of the global 15 million preterm (PT) infants with compromised immune system born annually, India contributes to &gt;3.5 million. Generation of adequate vaccine-induced immune response needs to be ensured of their protection. Immune response of Indian PT (n = 113) and full-term (FT, n = 80) infants to pentavalent vaccine administered as per the national recommendation was studied. Antibody titers against component antigens of pentavalent vaccine, immune cells profiling (T and B cells, monocytes and dendritic cells) and plasma cytokines were determined pre- and post-vaccination. Additionally, cell-mediated recall immune responses to pentavalent antigens were evaluated after short time antigenic exposure to infant PBMCs. Irrespective of gestational age (GA), all the infants developed adequate antibody response against tetanus, diphtheria, and protective but lower antibody levels for Haemophilus influenzae type-b and hepatitis B in preterm infants. Lower (~74%) protective antibody response to pertussis was independent of gestational age. PT-infants exhibited lower frequencies of CD4 T cells/dendritic cells/monocytes, increased plasma IL-10 levels and lower proliferation of central and effector memory T cells than in term-infants. Proliferative central memory response of FT-infants without anti-pertussis antibodies suggests protection from subsequent infection. Responder/non-responder PT-infants lacked immunological memory and could be infected with Bordetella. For hepatitis B, the recall response was gestational age-dependent and antibody status-independent. Humoral/cellular immune responses of PT-infants were dependent on the type of the immunogen. Preterm infants born before 32 weeks of gestation may need an extra dose of pentavalent vaccine for long lived robust immune response.