Rozprawy doktorskie: „Vaccination of children”

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Miller, Julie A. "Factors Influencing Influenza Vaccination of Children". University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377872672.

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Baynam, Gareth. "Genetic influences on vaccine response in children". University of Western Australia. School of Paediatrics and Child Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0259.

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Vaccination is one of the most efficacious public health interventions1 and has been increasingly used to combat non-infectious diseases. Mechanisms underlying vaccine responses overlap with those regulating immune responses in health and disease. Therefore, an understanding of mechanisms underpinning these responses will have broad implications. Variation in immune response genes contributes to impaired vaccine responses2-4. Understanding the contribution of genetic variants to vaccine responses is likely to be particularly important in early life given the generalized functional immaturity of the immune system in infants and the highly variable kinetics of its maturation over the first few years of life5-7. However, studies of genetic influences on early childhood vaccine responses are scarce. Since a number of genes from several pathways are likely to be important, a targeted approach is necessary. This thesis explored the effects and interactions of genes associated with atopy, as atopy, or the genetic risk for it, has been associated with modulation of early childhood vaccine responses. This thesis aimed to: 1) investigate genetic variants associated with atopy on early childhood vaccine responses; 2) examine interactions between these genetic variants and non-genetic factors; 3) approach developmental genetic influences on genetic effects and their interactions; and 4) extend findings on vaccine responses to other immunological phenotypes and disease outcomes.

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Lau, Hiu-wan Leonia, i 劉曉蘊. "Indirect benefit of vaccinating children to protect the community frominfluenza". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48423919.

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Background Influenza causes annual, worldwide epidemics of respiratory disease that affects all segments of the population. Mass vaccination of healthy children, who are playing an important role in the transmission of influenza, is promoted to be a complementary approach in prevention and control of influenza. However, lack of published systemic review evidencing the indirect protection of vaccinating healthy children makes the implementation under uncertainty. Method A systemic review was conducted by computerized bibliographic searches in PubMed and the Cochrane Library identifying the published studies on the effectiveness and cost-effectiveness of vaccinating healthy children to control influenza epidemics by reducing transmission in the community. Any study design with vaccinating healthy children as the intervention versus control group with no influenza vaccine was included. Only outcomes measured on the contacts of children, either the community or household members were considered. Result Twenty-two articles were selected to be reviewed in this project, in which 17 of them covered the public health benefit of vaccinating healthy children to protect others in the community against influenza, and five of them were economic studies. Overall the result suggested that vaccinating health children produces a public health benefit in protecting others in the community against influenza and that it is a cost-effective measure. Discussion Targeting vaccines to healthy children should be promoted for optimal vaccine allocation, maximizing the vaccination effectiveness. Community planning on vaccine delivery infrastructure as well as educational and communicational strategies is necessary to improve influenza vaccine coverage. Further well-designed studies such as RCT with larger sample sizes, as well as studies in Hong Kong or other sub-tropical regions should be carried out and included. Moreover, large and population-based studies should be conducted to examine the overall impact of universal childhood influenza immunization.
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Public Health
Master
Master of Public Health

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Li, Jun. "Determinants of Bacillus Calmette-Guérin (BCG) vaccination among Québec children". Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=123110.

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ABSTRACTIntroduction:A province-wide non-mandatory tuberculosis prevention program offered free Bacillus Calmette-Guérin (BCG) vaccination to neonates and schoolchildren in the province of Québec (1949-1974). It has been suggested that BCG vaccination rates in Québec varied by geographical area, yet little is known about other determinants. Objectives:To identify determinants of BCG vaccination among Québec children born in 1974, considering separately vaccination occurring during the systematic vaccination program and after the program. Methods:A retrospective birth cohort, the Québec Birth Cohort on Immunity and Health (QBCIH), was assembled by including 81,496 subjects born in the province of Québec (Canada) in 1974 after at least 32 weeks of gestation. Analyses of potential determinants as documented in the Birth Registry and Healthcare Registration File were conducted among 71,658 individuals (88% of cohort) with complete data. Additional sociodemographic and other characteristics were assessed on 1643 subjects who participated in a telephone interview in 2012 (1154 interviewed individuals with complete information). Odds ratios (OR) and 95% confidence intervals (CI) were computed from logistic regression, with best models selected from backward elimination. For each of the two sources of data (administrative databases and interviews), separate regression models were constructed for the two outcomes: vaccination during and after the organized program. Finally, models considering the variables from both sources, as selected in previous steps, were estimated among 1320 interviewed participants with complete information for these variables.Results:Forty-six percent of the study subjects were BCG vaccinated, 42.8% within the program and 3.6% after it ended. During the vaccination program, children whose parents were born outside of Québec were less likely to be BCG vaccinated than those with Québec-born parents [OR=0.38, 95% CI: 0.20-0.75 for mothers; OR=0.25, 95% CI: 0.14-0.46 for fathers], and urban inhabitants had a lower likelihood of vaccination compared with rural dwellers [OR=0.50, 95% CI: 0.38-0.65]. When the mass BCG vaccination program was discontinued, children whose grandparents were not all of French ancestry were less likely to be BCG vaccinated than those whose grandparents were all of French ancestry [OR=0.40, 95% CI: 0.19-0.84]. Conclusion:This is the first study comprehensively investigating determinants of BCG vaccination in Québec, Canada. Different factors were identified as being related to vaccination within and after the organized program.
RÉSUMÉIntroduction :Un programme provincial de prévention de la tuberculose a été mis sur pied au Québec (1949-1974) et a permis d'offrir gratuitement aux nouveau-nés et aux enfants d'âge scolaire une vaccination au Bacille Calmette-Guérin (BCG) sur une base volontaire. Bien qu'il ait été suggéré que les taux de vaccination au BCG puissent varier par région au Québec, peu d'information est actuellement disponible quant aux autres déterminants de cette vaccination. Objectifs :Identifier les déterminants de la vaccination au BCG parmi les enfants québécois nés en 1974, en considérant séparément les vaccinations faites pendant le programme systématique ou après celui-ci.Méthodes :Une cohorte de naissance rétrospective, La Cohorte de Naissance Québécoise sur l'Immunité et la Santé (CNQIS), a été constituée et comprend 81,496 sujets nés en 1974 dans la province de Québec (Canada) après au moins 32 semaines de gestation. Les analyses des déterminants potentiels de la vaccination provenant du Registre des Naissances et du Fichier d'inscription des personnes assurées à l'assurance maladie ont été effectuées sur un échantillon de 71,658 individus (88% de la cohorte) pour qui les données étaient complètes. De plus, d'autres caractéristiques, dont certaines caractéristiques sociodémographiques, ont été étudiées chez 1643 individus qui ont participé à une entrevue téléphonique en 2012 (analyse de 1154 individus avec données complètes). Les rapports de cote (RC) et les intervalles de confiance (IC) à 95% proviennent de modèles de régression logistique issus d'une procédure de sélection descendante. Pour chaque source de données (bases de données administratives et entrevues), des modèles de régression distincts ont été élaborés pour la vaccination pendant et après le programme. Finalement, les variables sélectionnées précédemment et provenant des deux sources ont été considérées dans des modèles globaux. Ces analyses ont pris en compte 1320 individus ayant des données complètes pour les variables considérées.Résultats :Quarante-six pourcent des sujets ont été vaccinés au BCG, 42.8% pendant le programme de vaccination et 3.6% après celui-ci. Pendant le programme de vaccination, la probabilité d'être vacciné au BCG était plus faible pour les enfants dont les parents sont nés à l'extérieur du Québec, en comparaison à ceux dont les parents sont nés au Québec [RC=0.38, IC 95% : 0.20-0.75 pour les mères; RC=0.25, IC 95% : 0.14-0.46 pour les pères]. De plus, la probabilité d'être vacciné au BCG était plus faible pour les citadins en comparaison avec les sujets vivant en milieu rural [RC=0.50, IC 95% : 0.38-0.65]. Après la fin du programme de vaccination au BCG, les enfants dont les grands-parents n'étaient pas tous de descendance française avaient une plus faible probabilité d'être vaccinés, en comparaison avec les enfants dans les grands-parents étaient tous de descendance française [RC=0.40, IC 95% : 0.19-0.84].Conclusion :Cette étude est la première à s'intéresser de façon approfondie aux déterminants de la vaccination au BCG au Québec, Canada. Des déterminants différents ont été identifiés selon que la vaccination ait eu lieu pendant ou après le programme.

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Segraves, Laura J. "Improving Vaccination Compliance Among Amish Children in Knox County, Ohio". Otterbein University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1429908515.

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Dubuisson, Christy. "Hispanic Parents' Perceptions of Human Papillomavirus Vaccination for Male Children". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6993.

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Hispanic Americans experience a disparate burden of human papillomavirus vaccination (HPV)-related cancers. Despite vaccine availability, HPV vaccine uptake amid Hispanic American adolescent males in the United States is under the national goal. Furthermore, childhood vaccination compliance is driven by the parents; yet, there is little research on parents' perceptions of HPV vaccination of male children. The purpose of this phenomenological study was to explore the attitudes, beliefs, concerns, and decision- making factors of Hispanic American parents of male children aged 11- to 13- years-old surrounding HPV vaccination. The health belief model provided the framework for the study. Face-to-face interviews were conducted with 12 participants in a rural county in Colorado in which Hispanic Americans had a higher rate of reportable sexually transmitted infections than non-Hispanics. Data analysis included descriptive coding to summarize and synthesize the interview results. The results showed Hispanic parents had a positive attitude toward HPV vaccination, and parents believed that the vaccination would protect their child. Most of the parents were aware of the HPV vaccine. The parents believed in healthcare providers and would accept the vaccine if it was recommended by them. Despite several parents having concerns about HPV vaccinations, they still claimed they would vaccinate their child. The findings from the study can be used to inform educational offerings regarding HPV vaccination for Hispanic American boys.

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Koh, Naoko. "Cost-benefit analysis of influenza vaccination for children in Hong Kong". Thesis, Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971866.

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Kim, Mi-so, i 金美昭. "Parental characteristics towards child vaccination against pandemic influenza H1N1-2009". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hub.hku.hk/bib/B50561686.

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Background The pandemic of influenza A (H1N1-2009) virus was particularly widespread among children. Children and young adults were more likely to be infected than older adults, and infection among infants tended to lead to a higher risk of severe complications than among older children and adults. Vaccination against the virus was thus recommended as an effective countermeasure to protect these susceptible age strata from influenza infection and subsequent complications. Parental perception, attitudes and beliefs would thus play a major role in mitigating the pandemic influenza because these factors underlie the degree of vaccination uptake among children. Objective The primary aim of this study is to understand factors that are associated with parental acceptance of pediatric vaccination against influenza (H1N1-2009). The secondary aim is to consider the effective future vaccination campaign in the event of a pandemic and to increase child vaccination coverage. Methods We conducted a systematic literature search of the electronic databases, PubMed and the Web of Science. We identified and examined published literatures associated with parental acceptance dating back to the beginning of the 2009 pandemic. We extracted key datasets from these literatures, summarized the evidence systematically and determined the relationship amongst the aforementioned parental characteristics and acceptance of pandemic influenza vaccines. Results We included a total of 14 studies in this review. Our systematic review indicates that parents were more willing to accept H1N1 pandemic influenza vaccination if 1) their children had previous experience with seasonal influenza; 2) they have had the pandemic influenza vaccine themselves; or 3) they intended to have their children vaccinated against seasonal influenza vaccine. We also founded that parental perceptions and attitudes towards both the influenza pandemic itself and the pandemic influenza vaccine are significantly associated with acceptance. Our study identified misperceptions and distrust in vaccine safety as the main reason for parents to refuse pandemic influenza vaccination for their children. In addition, we found that parents usually received negative appraisal on pediatric influenza vaccination from the media and tended to regard health care workers as the most reliable source of information on pediatric influenza vaccination. . Conclusions Parental perceptions are influential on pandemic influenza vaccine acceptance of their children. We affirm the importance of the role of health care workers in delivering appropriate information on influenza vaccines to parents in increasing pediatric vaccination uptake. We recommend public health officials to employ effective strategies for risk communication regarding pediatric influenza vaccines in order to increase the coverage and hence effectiveness of vaccination program against a future influenza pandemic.
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Public Health
Master
Master of Public Health

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Mcnair, Chauntel Mckenzie. "Factors Influencing Vaccination Decisions in African American Mothers of Preschool Age Children". Scholar Commons, 2013. https://scholarcommons.usf.edu/etd/5073.

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Rates and coverage levels of immunizations of African-American children are reduced compared to other races. Few studies have identified factors that influence vaccination decisions of African-American mothers. This study assessed the mothers' vaccination decisions using a self-administered questionnaire and a screening instrument for determining health literacy. This instrument is called Rapid Estimate of Adult Literacy in Medicine (REALM). The sample was 92 African American mothers, recruited from a large metropolitan church in Jacksonville, Florida, who had at least one child under the age of seven. A cross-sectional research design was used to administer survey instruments to identify and interpret parental barriers and decision-making regarding childhood vaccination. The results of this study showed that the there was a decrease in scores across the levels of education which indicated that education had a significant impact on the parental perception for the vaccination of their children. Interventions can now be tailored to improve the childhood immunization rates and provide a foundation for developing effective childhood vaccination educational materials for this population.

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Jansson, Olivia, i Elin Magnusson. "Vilka anledningar finns till att föräldrar väljer att inte vaccinera sina barn? : En litteraturöversikt". Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-333217.

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Bakgrund: Vaccin skyddar både individen och samhället. Utan vaccin hotas flockimmuniteten och hälsan hos befolkningen. Runt om i världen finns hos vissa föräldrar en ovilja att vaccinera sina barn. Inspirationen till detta kommer ofta från internet. Syftet med detta arbete är att undersöka anledningar till att föräldrar avstår från att vaccinera sina barn. Detta är viktigt i sjuksköterskans arbetsroll då det i den ingår att stödja patienten i sin egenvård. Med hjälp av information från denna litteraturöversikt kan sjuksköterskor få en ökad förståelse för varför vissa väljer att tacka nej till vaccin. Metod: Genom en litteraturöversikt har artiklar angående föräldrar som inte vaccinerar sina barn granskats för att besvara syftet. Litteratursökningar gjordes i vetenskapliga databaser, vilket resulterade i att 13 vetenskapliga artiklar inkluderades i studien. Genom att noggrant granska dessa artiklar framkom många olika anledningar till varför föräldrarna väljer att avstå från att vaccinera sina barn. Resultat: Saker som föräldrar oroade sig för var biverkningar, följdsjukdomar och vaccinets innehåll. En del föräldrar tror inte på att sjukdomarna existerar längre eller tror att vaccinet inte fungerar. De allra flesta anledningarna syftade till att skydda barnet och berodde främst på okunskap eller för lite information. Slutsats: Slutsatsen är att mer pålitlig information måste bli tillgänglig för alla föräldrar att ta del av. Informationen bör komma från trovärdiga källor som gärna bör ge ut sin information via internet eller sociala medier, då föräldrar tenderar att söka sig dit. Sjuksköterskan kan med hjälp av bättre information hjälpa föräldrar att fatta ett bra beslut.
Background: Vaccine protects both individuals and the society in general. Without vaccines, both herd-immunity and public health are threatened. Around the world, some parents choose not to vaccinate their children. This decision is often based on information the parents have received from internet sources. This study aimed to investigate the reasons why parents refrain from vaccinating their children. This information is important in the nurse's profession as the role involves supporting the patient in his or her self-care. Method: Through a systematic review, articles regarding vaccine resistance and hesitancy have been examined to answer the purpose of this study. A literature search was made in scientific databases, and 13 articles were selected. The articles were reviewed and various reasons for the vaccine resistance were found. Result: Things that parents worried about were side effects, illnesses and the content of the vaccine. Some parents did not believe that the disease exists anymore or thought that the vaccine is not reliable. Most of the parents' decisions aimed to protect their child and were, in most cases, made by lack of information. Conclusion: The conclusion of this review is that more reliable information must be available for parents. The information should come from reliable sources, such as authorities. The authorities should also reach out with information through the internet and social media, as parents tend to rely on the internet whilst making decisions. With information from this study nurses can help the parents make an informed decision regarding vaccinations.

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Zúñiga, de Nuncio María Luisa. "A prospective randomized study to determine the effects of a prenatal immunization intervention on timeliness of infant immunization schedule initiation in two San Diego County community clinics /". Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 1999. http://wwwlib.umi.com/cr/ucsd/fullcit?p9943947.

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Nanyunja, Miriam. "Risk Factors for Measles among HIV-infected Children in Uganda". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2500.

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Measles remains a major global public health problem. Attainment of high population immunity to measles through vaccination is necessary to control this disease. Children infected with HIV infection often experience secondary measles vaccine failure by 2 years of age, making them susceptible to measles. It is not clear whether HIV-infected children on Highly Active Antiretroviral Treatment (HAART), older than 2 years, have a higher risk of measles than HIV-uninfected children. This retrospective cohort study, guided by the proximate determinants framework, was conducted to compare the risk of measles between HIV-infected children on HAART (exposed) and HIV-uninfected peers (unexposed). The age group with the highest measles susceptibility in the exposed children, which could inform timing for revaccination, was investigated. The role of age at initiation of HAART, low CD4+ count, and undernutrition as predictors of the risk of measles in the exposed children was examined. Univariate, bivariate, and binomial logistic regression analytical procedures were used in data analysis. Results showed no significant difference in the risk of measles between exposed and unexposed children. The age groups 5 to 9 years and 2 to 4 years were the first and second most affected by measles among the exposed children. Undernutrition (stunting) was a significant predictor of measles in exposed children (odds ratio of 4.14, p = 0.02), while age at initiation of HAART and CD4+ count prior to measles exposure were not. The study findings provide evidence to inform vaccination policy and nutrition care for HIV-infected children on HAART in Uganda, so as to reduce their risk of measles illness and mortality, thus contributing to positive social change for the children and the country.

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Xu, Hui, i 徐晖. "Review on global disease burden of pneumonia in young children and pneumococcal vaccination policy". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48426799.

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Pneumonia is one of the top causes of deaths in children younger than 5 years of age. According to WHO estimation, globally there are nearly 2 millions young children who die from pneumonia every year, and more than 70% of these deaths occurred in Africa and Southeast Asia. Pneumonia caused by Streptococcus pneumoniae (also called pneumococcus) is a vaccine preventable disease, accounting for 39% of community-acquired pneumonia. There are two types of pneumococcal vaccines that are pneumococcal polysaccharide vaccine (PPV) and pneumococcal conjugate vaccines (PCV). The latter one is routinely advised for children younger than five years. The aims of this paper are to review the global disease burden caused by Streptococcus pneumoniae in children younger than 5 years and to gather vaccine program information globally. For narrative review and policy analysis, WHO websites, other websites of health organizations or institutions, and literatures from Pubmed were reviewed, using key words “children pneumonia”, “Streptococcus pneumoniae”, “pneumonia vaccine”, “pneumococcal conjugate vaccine ”, “PCV-7”, “7-valent PCV”, “PCV-13”, “13-valent PCV”. Numerous literatures have reported that obvious incidence decrease of invasive pneumococcal diseases (IPD) in young children after PCV vaccination. In July 2000 PCV-7 (“7-valent pneumococcal conjugate vaccine”) was incorporated into National Immunization Program (NIP) in United States. Although since then the incidence of IPD caused by vaccine-covered serotypes markedly decreased, those caused by non-vaccine-covered serotypes were found substantially increased. In February 2010, PCV-13 (“13-valent pneumococcal conjugate vaccine”) replaced PCV-7 in NIP in United States. With a wider range of serotypes, PCV-13 was expected to be more effective than PCV-7 in children under 5. Using modeling method, many scholars estimated that PCV-13 was likely to be more cost-effective in reported settings when herd immunity was taken into consideration. Schedule of vaccine was another issue that needs to be investigated. There are three schedules commonly adopted by health authorities: 2 primary doses with 1 booster dose (2p+1), and 3 primary doses with 1 booster (3p+1) or without 1 booster dose (3p+0). In individual report, it seems three schedules were all effective. From result of systematic review, more evidence supported to use 3p+0 schedule (and 3p+1 schedule). However, emerging evidences are in support of 2p+1 schedule tool. WHO recommended both 3p+0 and 2p+1 schedule. If the country with high incidence rate in young infant (less than 32 weeks) 2p+1 schedule may not provide adequate protection for special individual serotype. In addition 2p+1 schedule may also lead to lower antibody level between the second primary dose and the booster dose, but the booster dose could induce higher antibody level, which is important for protecting certain serotypes. Countries should consider local factors and choose suitable vaccine schedule accordingly. In terms of global PCV programs, around 80 countries have already added PCV into their NIP, 58 countries (30%) were planning to introduce the program; nevertheless remaining 51 countries (26%) of countries have no schedule to introduce it yet. Most countries that have implemented PCV programs were western industrialized countries. With support from Global Alliance for Vaccines and Immunization (GAVI), 15 eligible African countries have had routine PCV programs. Comparatively, in Asia, India and China, two countries with the largest population and largest number of IPD cases in the world, have no PCV program to the children. Even industrialized economies like Japan and Taiwan have not implemented yet. Asia was lagging behind for decades. PCV program needs to be prioritized in Asian countries. Asian governments should consider investing more in PCV programs (high-income countries) and/or cooperating with other organizations such as GAVI (low-income countries) to increase the coverage of PCVs in children under 5 and to protect them from pneumococcal diseases.
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Public Health
Master
Master of Public Health

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Patel, SoonieRameshchandra. "Re-vaccination of children treated for haematological malignancies and after haematopoietic stem cell transplant". Thesis, St George's, University of London, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499046.

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Bröms, Margareta. "Attitudes among Swedish medical personnel towarduniversal varicella vaccination and other new vaccines for children". Thesis, Nordic School of Public Health NHV, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3639.

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Background: Thea ttitudes, knowledge, and experience of health personnel regarding vaccines and preventable diseases contribute importantlyto the success of vaccination programs. Aim: This study aimed to valuate the opinions of healthpersonnel involved in the care of children on the introduction of various new and older vaccines to the Swedish childhood vaccination. We particularly examined the knowledge of varicella diseaseas chickenpox and shingles and attitudes toward the varicellavaccine. Method: We created and administered aquestionnaire on vaccineprioritization forseveral vaccines, including hepatitis A and B,BCG(BacilleCalmette-Guérin) vaccine to preventtuberculosis, pneumococcal, meningococcal, HPV (human papilloma virus), rotavirus, influenza,respiratory syncytial virus,andTBE(tick bornencephalitis virus),and also explored health personnel’s knowledge about the VZV (varicella zoster virus) vaccine and its diseases. In 2006, the study targeted 600 nurses and physicians in Gothenburg, Sweden, whereas the current study in 2012 followed up with 160 school healthcare personnel. Results: The 2006 questionnaire generated 191/600 responses (32%), compared withthe 2012 follow-up questionnaire, which generated 40/160 (25%) responses from school health care personnel. Medical personnel ranked vaccination against hepatitis B highestin both studies. However, our data showed an important shift in attitude regarding HPV and rotavirus vaccination, which ranked lowestin 2006 but higher priority in 2012. Respondents also gave high priority to BCG. In 2006,only 34 of 138 respondents (25%) knew that a varicella vaccine was available, and universal varicella vaccination was generally ranked lower compared with other various vaccines. Additionally, pediatricians and personnel from infectious diseases department in the hospital having direct experience with these verity of varicella and zoster diseases were more likely to support universal varicella vaccination. Interestingly, in 2012 only one third of school healthcarepersonnel favored universal varicella vaccination.The health professionals xpressed a general demand for information and in-depth nowledge about the newer vaccines. Conclusion: If Swedish authorities decide to implement universal varicella vaccine into the current successful vaccination program for children, relevant healthcare personnel will require further education about VZV vaccineand disease

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Wong, Laura Elizabeth. "Effects of influenza vaccination and temperature screening of day care children a mathematical model /". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42997951.

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Li-Kim-Moy, Jean Patrick. "Influenza in Australian Children: burden of disease, advances in diagnosis, management and prevention through vaccination". Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/18257.

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Influenza is an almost universal respiratory viral infection which worldwide is reported to be responsible for 3 to 5 million cases of severe illness, and about 250,000 to 500,000 deaths per year. A systematic review I contributed to (Appendix #1) suggests an incidence of influenzaassociated influenza-like illness (ILI) of at least 1650 to 23400 (median 10180) per 100,000 globally per year. This indicates a substantial ongoing burden which is potentially amenable to vaccination strategies. In Australia, a targeted vaccination program exists aimed at individuals at higher risk of complications, including the elderly and individuals of all ages with co-morbid conditions. However internationally, increasing evidence from developed countries suggests a high burden in healthy young children, who contribute substantially to transmission in the community. This has led to a move towards universal vaccination strategies aimed at this group. Influenza, like other vaccine-preventable diseases, is a “moving” target affected by many factors including frequent mutation, changing epidemiology and control strategies such as vaccination; therefore, it requires constant re-evaluation to assess the success of interventions. The purpose of this thesis was to explore the current landscape of influenza in Australian children by establishing what is the extent of the problem and how can it be better managed. To this end, the questions being addressed were: 1. What is the current burden of influenza in Australian children? 2. In children who acquire infection, how can it be better diagnosed and how does earlier diagnosis help in managing children? 3. How well can influenza be prevented through vaccination in young children? 4. What are the safety issues surrounding influenza vaccination in children? 5. When children are vaccinated, how often does fever occur, and what is the pattern of fever and antipyretic use? How do these factors affect the vaccine’s immunogenicity in children? These issues are addressed through this thesis and the publications #1-7 contained within. Each publication is preceded by a brief overview of the issues and literature relevant to the publication and followed by a summary of the key findings and how it relates to the subsequent chapter of the thesis. Publications #1 and #2 examined the burden of influenza disease in children through analysis of administrative hospitalisation data (#1) and then through clinical review of influenza hospitalisations (#2). These found a substantial burden in young children, highest in infants, similar to other international developed countries. Publication #2 built upon findings in #1 and added clinical context showing the high proportion of hospitalised children with influenza who were previously healthy (~60%) and demonstrated that influenza was not a benign illness in hospitalised children (8.5% requiring intensive care unit admission). The same data helped show encephalitis to be an important neurological complication of influenza (Appendix #2). Vaccine uptake was too low, even in those at-risk children funded for vaccination (5%) and was much lower (0.7%) in unfunded healthy children. These findings support wider vaccination recommendations and funding to increase vaccine uptake. Appendix #3 and Publication #3 retrospectively investigated how children with influenza were investigated and managed through paediatric emergency departments. Appendix #3 showed that children with influenza had significantly higher rates of invasive investigations than children with other respiratory viruses, including lumbar punctures (LP, 18.3% vs 6.3% respectively) and blood cultures (71% vs 55.5%). Publication #3 then explored whether earlier diagnosis of influenza through rapid point-of-care testing (POCT) in this setting was beneficial. It found that early diagnosis was associated with reduced hospital admission and increased antiviral prescription. Rapid POCT, compared to standard influenza testing (multiplex respiratory virus panel), facilitated this earlier diagnosis (2.4 vs. 24.4 h, P<0.001), and had significant benefits in terms of reduced length of hospital inpatient stay (by 1 day, P=0.006) and increased antiviral prescription (odds ratio 4.54, P<0.001). These findings indicated POCT could have considerable utility in diagnosing influenza in a paediatric emergency department setting with impacts on hospitalisation rate and management approach. I then looked at vaccination to prevent infection. To advocate its use more widely in young children, vaccination must be shown to be efficacious in this population. Publication #4 confirmed the efficacy of influenza vaccination through a randomised controlled trial (RCT) in young children attending childcare. Vaccine efficacy of 100% (95%CI 16–100%) was demonstrated against laboratory-confirmed influenza in those aged 24-48 months. Vaccine safety concerns by parents limit vaccine uptake in children. It is a major ongoing concern especially in the context of a 2010 vaccine safety scare during which increased rates of febrile convulsions were detected after influenza vaccination in children aged <5 years. These occurred following vaccination with only one brand of vaccine, Fluvax® by bioCSL (now Seqirus). Publication #5 was a systematic review and meta-analysis of fever and febrile convulsions after inactivated influenza vaccine in children, conducted in the wake of these events. It found, reassuringly, that non-bioCSL brands of inactivated trivalent influenza vaccine (TIV) in RCTs had acceptable pooled fever estimates of 6.7% in young children (aged 6–35 months). Febrile convulsions were reported in 1.1 per 1000 vaccinated children in these RCTs. This contrasted with uncontrolled bioCSL studies, completed at that time, which reported fever rates between 22.5–37.1% for similarly aged children, though fortunately without increased febrile convulsions. Publication #6 reviewed the root cause analysis by bioCSL which identified the manufacturing process, virus-strain, and patient genetic factors as contributing to the increased risk of febrile convulsions seen with their vaccine. I critically analysed their conclusions, and discussed limitations in their analysis and why manufacturing issues, above others, should remain the key focus for increased reactogenicity with their TIV. Knowing determinants of vaccine immunogenicity in children could help improve vaccine efficacy/effectiveness. Publication #7 was the first study that used individual-level data from vaccine manufacturer clinical trials to explore fever, its patterns, frequency, and associated antipyretic use and how these affect immunogenicity in children. I documented evidence, from pooling three GlaxoSmithKline paediatric influenza trials (n=5902), of a 21-39% increase (p≤0.01) in adjusted post-vaccination geometric mean titre (GMT) when fever was experienced (versus no fever) after influenza vaccination (day 0-3) in children, and conversely a 13-20% decrease (p<0.0006) in adjusted GMT when antipyretic medication was used versus not used. In conclusion, this comprehensive thesis is derived of published original works of which I am the lead author. It demonstrates a high burden of influenza still exists in Australian children including those who are healthy. Early influenza diagnosis in young children, allowing more targeted management of those infected, may reduce the burden on hospital resources. Vaccination is efficacious at preventing infection but uptake is poor. Australian vaccination recommendations are not adequately covering those children most affected by influenza. Wider vaccine recommendations and funding are needed to considerably improve vaccination rates. One vaccine brand had significant safety concerns, due to manufacturing issues which are being addressed, but other brands have good evidence of safety. Increased understanding of post-vaccination fever and antipyretic use will be important to understanding immunogenicity in children and has the potential to further improve influenza vaccine efficacy in children.

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Подаваленко, А. П., Т. А. Лазуренко i Т. А. Хаблова. "Післявакцинальний імунітет проти дифтерії та правця у дітей м. Харкова". Thesis, Сумський державний університет, 2017. http://essuir.sumdu.edu.ua/handle/123456789/64476.

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Чинний календар щеплень в Україні (наказ МОЗ №551 від 11.08. 2014 р.) передбачає проведення дітям триразової вакцинації та ревакцинацій у 18 місяців, 6 та 16 років. В умовах нестійкої епідемічної ситуації з дифтерії та правця, через низький рівень охоплення щепленнями та реєстрацію правця серед дитячого населення актуальним є вивчення специфічного імунітету у дітей, які отримали профілактичні щеплення згідно з віком.
The antidiphtheria and antitetanus immunity studied in 122 children aged 1 to 17 years vaccinated according to current immunization schedule in Ukraine. Discovered by 24.6 % children non-immunity of diphtheria and 5.8 % of tetanus. Increasing the spacing between revaccination results in the formation of groups at risk of diphtheria and tetanus.

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Bingham, Bradley, Andrew Vo, Aaron Leyba i Sandra Leal. "Intent to Provide the Influenza Vaccination to Children ages 6-18: An Analysis of Law Implementation by Community Pharmacies". The University of Arizona, 2016. http://hdl.handle.net/10150/613980.

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Class of 2016 Abstract
Objectives: To determine the prevalence and incidence of community pharmacies not vaccinating children down to six years of age and to identify the reasons for non-compliance with Arizona State Board administrative rule R4-23-411. Subjects: 103 community retail pharmacies from six corporations in the Tucson metropolitan area established by December 2014. Methods: Funnel questionnaire administered via phone call to collect pharmacist response if he or she would vaccinate a six-year-old child; data for reasons why he or she would or would not vaccinate and gender of pharmacist was also collected. Results: Responses were collected from 103 pharmacists (male n = 55, female n = 48). 87% (n =90) of pharmacies stated they would not vaccinate a six-year-old, while 13% (n =13) would vaccinate. The rationale for not vaccinating varied from corporate policy (45%) to state law (37%). Conclusions: The majority of six retail pharmacy chains in Tucson, Arizona are not vaccinating down to six-years old, although Arizona administrative amendments allow pharmacists to do so. More pharmacies that would choose not to vaccinate may be related to a better understanding of corporate policies versus state administrative rule change.

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Jepsen, Linda, i Elin Toresdotter. "”Men visst känner man glädje när föräldrar beslutat sig för en vaccination som de varit tveksamma till” : Föräldrar som väljer att tacka nej till att vaccinera sina barn – Sjuksköterskans upplevelser och strategier i mötet". Thesis, Högskolan Väst, Avdelningen för omvårdnad - avancerad nivå, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-14299.

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Bakgrund: I mitten av 1900-talet började vaccin ges på rutin till barn för att förebygga sjukdom, vilket ses som den främsta medicinska insatsen som gjorts för folkhälsan. I Sverige är vaccinationstäckningen hög, men vissa föräldrar väljer att avstå från vaccinationer som det svenska barnvaccinationsprogrammet erbjuder. I tidigare forskning uppmärksammas det att mötet med föräldrar som avstår upplevs som svårt för sjuksköterskan. För att förstå varför föräldrar tackar nej samt hur sjuksköterskor kan bemöta dessa föräldrar behövs mer kunskap. Syfte: Att beskriva sjuksköterskans uppfattning om varför föräldrar tackar nej till att vaccinera sina barn samt hur sjuksköterskan bemöter dessa föräldrar. Metod: Webbaserad enkät med 15 frågor skickades ut till sjuksköterskor inom barnhälsovården samt elevhälsan. Enkäten som innehöll både öppna och slutna frågor har sammanställts med beskrivande statistik samt analyserats med kvalitativ innehållsanalys. Resultat: I resultatet framkom tre huvudkategorier: Påverkan på barnet, Misstro till vaccination och Sjuksköterskans strategier, vilka är uppbyggda av totalt 10 underkategorier. Slutsats: Resultatet visar att sjuksköterskan känner sig osäker vid dessa möten. För att minska osäkerhet belyser sjuksköterskorna vikten av att fråga om orsaken till föräldrarnas beslut och ta sig tid för samtal. Vikten av att hitta en struktur för samtalet belystes där motiverande samtal lyftes fram. Genom individanpassade samtal utifrån varje förälder kan en trygg miljö skapas och vården blir personcentrerad.
Background: In the mid-20th century, vaccines began to be routinely administered to children in order to prevent illness. This is seen as the foremost medical effort made for public health. The vaccination coverage in Sweden is high, but some parents choose to refuse the Swedish childhood vaccination program. Previous research shows that meeting with parents who refuse vaccination is perceived as difficult for nurses. In order to understand why parent´s refuse and how nurses best can meet them more knowledge is needed. Aim: To describe the nurse's idea of why parents refuse to vaccinate their children and how the nurse responds to these parents. Method: Web-based questionnaire with 15 questions, both open-ended and closed, was used and sent to nurses working in the child health care sector and in primary school. The questionnaire was analyzed with qualitative content analysis and descriptive statistics. Results: In the result, three main categories emerged: Influence on the child, Mistrust of vaccination and The specialist nurse's strategies. The main categories are made up of a total 10 subcategories. Conclusion: The result showed that nurses felt insecure meeting parents who refuse vaccinations. In order to reduce insecurity, nurses highlighted the importance of asking about the cause of the parents' decision and make time for these conversations. Finding a structure for the conversation was important and one example was motivational conversations. Individualizing the conversation and the questions after each parent created a safe environment and an approach of a person-centered care.

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Bengtsson, Victoria, i Emelia Bloom. "Det är inte bara att ge en spruta... : barnhälsovårdssjuksköterskors upplevelser av att vaccinera barn". Thesis, Högskolan Väst, Avdelningen för omvårdnad - avancerad nivå, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-9366.

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Background: In child health care immunization is a common task for the child health nurse. Often children are unprepared, afraid and preoccupied with pain in the vaccination situation. Most children experience the presence of the parents as important during the procedure. Parents who prepare their child reduce the child's stress during the vaccination situation. An interaction occurs between the child health nurse and the child where participation is a prerequisite for the experience to be a positive outcome. Aim: The aim of the study was to describe the child health nurses' experiences of vaccinating children aged 0-6 years.Method: Semi-structured qualitative interviews were performed with twelve child health nurses. Data was analyzed using a content analysis focusing in manifest content. Results: Child health nurses' experiences of vaccinating commuted between the sense of power and confident. The crucial experience was the support and cooperation that the child health nurses experienced with the parents. It emerged a theme: Participation, three main categories: Sense of power, sense of confidence and cooperation with parents and six subcategories: Abuse, powerlessness, experiences, strategies, common goals and approaches and different goals and approaches. Conclusion: The result indicates that the parents have a dominant role in the vaccination situations with the ability to affect the health nurse's experience. Child health nurse, child and parents must cooperate to vaccinations to be carried out and be perceived in a positive way

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Larsson, Caroline. "Topi - How can we ease allergy vaccination for children in the age of 5-12?" Thesis, Umeå universitet, Designhögskolan vid Umeå universitet, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-135760.

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30% of children and youths in Sweden have some form of allergy disease and for many people medicines are not sufficient. If so, there is a possibility of an allergy vaccination, a three to five-year process where the patients receive 50-80 injections. So what is the main problem? In fact, it is important to understand that the vaccination is something that affects the child in greater extent than just the moment when the syringe is provided. At present, the patient must stay to ensure that he/she does not get an allergic reaction and is feeling well enough to go home. They are constantly questioned about how they feel. But how does a child determine this? How good is good enough? Topi is a system that increases the involvement and transfer responsibilities from the child by keeping track of their well-being and surroundings - while making treatments more fun and safe. The project is funded by Swedish Asthma and Allergy Association´s Research Foundation

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Kinyanjui, Timothy Muiruri. "Modelling the transmission dynamics of RSV and the impact of routine vaccination". Thesis, Open University, 2013. http://oro.open.ac.uk/54676/.

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Introduction: Respiratory Syncytial Virus is the major viral cause of lower respiratory tract disease in young children worldwide, with the greatest burden of disease in infants aged 1-3 months. Consequently, vaccine development has centered on a vaccine to directly protect the infants in this age group. The fundamental problem is that these young infants are poor responders to candidate RSV vaccines. This thesis focuses on the use of mathematical models to explore the merits of vaccination. Methods: Following development and analysis of a simple non-age-structured ODE model, we elaborate this to a Realistic Age Structured model (RAS) capturing the key epidemiological characteristics of RSV and incorporating age-specific vaccination options. The compartmental ODE model was calibrated using agespecific and time series hospitalization data from a rural coastal Kenyan population. The determination of Who Acquires Infection From Whom (WAIFW) matrix was done using social contact data from 1) a synthetic mixing matrix generated from primarily household occupancy data and 2) a diary study that we conducted in the Kilifi Health and Demographic Surveillance System (KHDSS). The vaccine was assumed to elicit partial immunity equivalent to wild type infection and its impact was measured by the ratio of hospitalized RSV cases after to before introduction. of vaccination. Uncertainty and sensitivity analysis were undertaken using Latin Hypercube Sampling (LHS) and partial rank correlation respectively. Given the importance of households in the transmission of respiratory infections, an exploratory household model was developed to capture the transmission dynamics of RSV A and B in a population of households. Results: From the analytical work of the simple ODE model, we have demonstrated that the model has the potential to exhibit a backward bifurcation curve within realistic parameter ranges. Both the diary and the synthetic mixing matrices had similar characteristics i.e. strong assortative mixing in individuals less than 30 years old and strong mixing between children less than 5 years and adults between 20 and 50 years old. When the two matrices were jointly linearly regressed, their elements were well correlated with an R2 ~ 0.6. The RAS model was capable of capturing the age-specific disease and the temporal epidemic nature of RSV in the specified location. Introduction of routine universal vaccination at ages varying from the first month of life to the 10th year of life resulted in optimal long-term benefit at 7 months (for the diary contact model) and 5 months (for the synthetic contact model). The greatest benefit arose under the assumption of age-related mixing with the contact diary data with no great deal of effectiveness lost when the vaccine is delayed between 5 and 12 months of age from birth. Vaccination was also shown to change the temporal dynamics of RSV hospitalizations and also to increase the average age at primary infection. From the sensitivity analysis, we identified the duration of RSV specific maternal antibodies, duration of primary and tertiary infections as the most important parameters in explaining the imprecision observed in predicting both the age specific hospitalizations and the optimal month at vaccination. Results from the household model have demonstrated that the household epidemic profile may be different from the general population with strong interaction of the viruses in the household that do not necessarily reflect at the population level. Conclusion: The synthetic matrix method would be a preferable alternative route in estimating mixing patterns in populations with the required socio-demographic data. Retrospectively, the synthetic mixing data can be used to reconstruct contact patterns in the past and therefore beneficial in assessing the effect of demographic transition in disease transmission. Universal infant vaccination has the potential to significantly reduce the burden of RSV associated disease, even with delayed vaccination between 5 and 12 months. This age class represents the group that is being targeted by vaccines that are currently under development. More accurate data measuring the duration of RSV specific maternal antibodies and the duration of infections are required to reduce the uncertainty in the model predictions.

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Charles, Karen. "Parental Perspectives on Vaccinating Children Against Preventable Childhood Diseases". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3553.

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Childhood immunization has been one of the most important public health measures in the 20th century. In the United States, 95% of avoidable childhood diseases have been prevented through vaccinations. However, there have been growing concerns around the safety of vaccines, and this increased uncertainty has led to decreases in vaccination participation and increases in cases of preventable diseases. As such, is it important to understand why parents are not vaccinating their children. A qualitative approach was utilized to conduct this study. Flyers to recruit participants were distributed by healthcare providers and were posted in church facilities. Ten parents of children ages 3 to 8 years volunteered to participate to discuss their refusal to or delay in vaccinating their children. The health belief model functioned as the theoretical context to guide this phenomenological study approach in examining the reasons parents are not vaccinating or delaying vaccination of their children. Analysis included constructing a written description of the phenomenon as experienced by the research participants using their responses to the research question, followed by developing response coding schemes, identifying themes, justifying findings, and ensuring sound analysis and reporting of information. For example, word frequency and common phrases were the first steps of the analysis. Results showed that parents had a negative reaction towards childhood vaccination and felt that either the vaccine schedule was too aggressive or contained dangerous toxins that may have side effects. These findings can be used to assist healthcare providers in the way they provide outreach and education to parents as well as potentially helping develop tools that would encourage parents to vaccinate their children.

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Ritz, Nicole. "The influence of BCG vaccine strain on the immune response and protection against tuberculosis". Connect to thesis, 2009. http://repository.unimelb.edu.au/10187/8392.

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More than 100 million doses of Bacille-Calmette-Guérin (BCG) vaccine are given each year to protect infants against tuberculosis (TB). BCG is a live attenuated strain derived from Mycobacterium bovis. Subsequent to its development and first use in 1921, BCG was distributed to laboratories worldwide. Culture under dissimilar conditions led to the evolution of more than 20 BCG vaccine strains in different countries. Phenotypic differences between these BCG vaccine strains were first recognised in the 1920s and, more recently, molecular studies have defined their genomic differences. Although several animal and human studies suggest that the particular BCG vaccine strain used for immunisation influences the mycobacterial-specific immune response, there is currently insufficient data to favour or recommend one BCG vaccine strain.
The principal aim of this thesis was to investigate the influence of BCG vaccine strain on the mycobacterial-specific cellular immune response in infants. Related to this, three additional studies addressed questions that provided critical information for the design and interpretation of the main study. These studies investigated: (i) the BCG vaccine strains used in each country worldwide, (ii) the susceptibility of different BCG vaccine strains to antimycobacterial drugs; and (iii) the difference in the immune response induced by BCG immunisation in children and adults.
For the main study in this thesis, newborns were randomly allocated to be immunised soon after birth with one of the three BCG vaccine strains currently most commonly used worldwide (BCG-Denmark, BCG-Japan or BCG-Russia). Ten weeks after BCG immunisation, the mycobacterial-specific cellular immune response was investigated using a comprehensive panel of immunological assays. This comprised flow cytometric analysis of intracellular cytokines and cytotoxicity in T cells, as well as the measurement of cytokines and chemokines in supernatants, from in vitro whole blood stimulation assays.
Data from 167 BCG-immunised infants was included in the final analysis. Infants immunised with BCG-Denmark or BCG-Japan had significantly higher proportions of multifunctional CD4 T cells than infants immunised with BCG-Russia. Similarly, infants immunised with BCG-Japan had significantly higher levels of Th1 cytokines in supernatants than infants immunised with BCG-Denmark or BCG-Russia.
These findings are particularly important in the light of recent evidence from animal studies that the frequency of multifunctional CD4 T cells induced by immunisation correlates with protection against intracellular pathogens such as Mycobacterium tuberculosis. This suggests that immunisation with BCG-Denmark or BCG-Japan is associated with better protection against TB than immunisation with BCG-Russia. Until correlates of protection against TB are determined in humans, cautious interpretation of these findings is warranted. Nonetheless, the findings from this thesis have important implications. The use of a BCG vaccine strain with even a moderately higher protective efficacy would have a large effect on TB morbidity and mortality in infants on a global scale. This thesis may therefore inform future BCG immunisation policy worldwide.

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Pollock, Louisa Elizabeth. "Predictors of vaccine virus replication, immune response and clinical protection following oral rotavirus vaccination in Malawian children". Thesis, University of Liverpool, 2018. http://livrepository.liverpool.ac.uk/3022905/.

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Background: Current rotavirus vaccines are least effective in low-income, high-burden countries. Reduced vaccine response is likely to be multifactorial. The aim of this thesis was to determine whether passively-acquired maternal antibody levels, oral polio vaccine (OPV) response and histo-blood group antigen (HBGA) phenotype predict vaccine virus replication, immune response and clinical protection in Malawian infants following oral administration of the monovalent human rotavirus vaccine (RV1). Methods: In a longitudinal cohort study, infants received two doses of RV1 at 6 and 10 weeks of age. Stool was collected on alternate days for 10 days post-vaccine to detect RV1 and OPV vaccine virus shedding by RT-PCR. Pre and post-vaccine serum rotavirus(RV)-specific IgA and IgG were determined by ELISA, with seroconversion defined as change from seronegative (RV-specific IgA < 20 u/mL) to seropositive (RV-specific IgA > 20U/mL) or > 4x rise in concentration in infants seropositive at baseline. HBGA phenotype was determined by salivary ELISA and confirmed by FUT2 genotyping. Infants with detectable of A, B, or H antigens in saliva were defined as secretors. Infants with detectable Lewis a or b antigens in saliva were defined as Lewis positive and those with undetectable Lewis antigens as Lewis negative. In a separate cross-sectional case-control study, vaccinated infants < 12 months with rotavirus gastroenteritis (RVGE) were compared to age-matched, vaccinated community and non-RVGE controls. Rotavirus detection and genotyping were confirmed by RT-PCR. Results: Following rotavirus immunisation, 104/202 (52%) of infants had detectable vaccine virus shedding and 47/196 (24%) achieved RV-specific IgA seroconversion. Infants with the highest levels of maternal rotavirus-specific IgG antibody had reduced likelihood of vaccine virus shedding (RR 0.44, 95%CI 0.27-0.72, p=0.001) and lower RV-specific IgA response. Linear correlation between RV-specific IgG and vaccine response was weak, suggesting a threshold effect. There was no correlation between quantitative rotavirus and OPV vaccine virus shedding, but some evidence of common patterns of OPV and RV1 response. Protective poliovirus type 3 neutralizing antibody titres at 6 weeks were associated with RV1 shedding in the 1st RV1 dose period (RR 2.24, 95%CI 1.25-4.0, p=0.007). OPV shedding in the 2nd RV1 dose period was associated with RV1 shedding (RR 2.0, 95%CI 1.0-3.8, p=0.04). All 14 infants who failed to attain protective serotype 3 poliovirus-specific neutralizing antibody titres also failed to attain rotavirus vaccine seroconversion. There was no association observed between any HBGA phenotype and overall likelihood of vaccine virus shedding or seroconversion. In a sub-study of 186 infants, HBGA phenotype determined genotype-specific susceptibility to rotavirus infection: secretor phenotype was strongly associated with P[8] RVGE (OR 7.8, 95%CI 1.8-33.7, p=0.005) and P[4]RVGE (OR 5.8. 95%CI 1.3-25.2, p=0.02) and Lewis negative phenotype was associated with P[6] infection (OR 3.0, 85%CI 1.3-6.7, p=0.008). Comparing 119 RVGE cases to 119 age-matched community controls, non-secretor phenotype was associated with decreased risk of clinical rotavirus vaccine failure (OR 0.40, 95%CI 0.2-0.8, p=0.005). RV-specific IgA > 90U/mL at time of presentation was associated with a 75% decrease in the odds of clinical vaccine failure. Infants with vaccine failure mounted a robust convalescent RV-specific IgA response. Conclusions: A threshold inhibitory effect of maternal antibody, together with the strong association of low RV-specific IgA and vaccine failure, suggests that booster dosing regimens could potentially improve RV1 effectiveness in Malawi. Further research is required to determine the optimal schedule. There was no evidence of direct competitive inhibition observed between OPV of RV1 vaccine virus shedding patterns. Common factors may predict response to both vaccines. Contrary to our hypothesis, non-secretor infants were at decreased risk of clinical vaccine failure, due to relative protection against common rotavirus strains. HBGA phenotype is unlikely to contribute to reduced rotavirus vaccine effectiveness in Malawi. New non-P[8] based vaccines are therefore unlikely to confer additional benefit based on the HBGA hypothesis.

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Gosselin, Virginie. "Évaluation de l’efficacité du programme de vaccination contre le rotavirus chez les jeunes enfants vivant en Estrie". Mémoire, Université de Sherbrooke, 2016. http://hdl.handle.net/11143/8741.

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Résumé: Introduction : Le rotavirus est la principale cause de gastro-entérite aiguë (GEA) chez les tout-petits à travers le monde. En 2011, le vaccin antirotavirus monovalent (RV1) a été introduit dans le programme de vaccination universel du Québec afin de réduire la morbidité reliée à la gastro-entérite à rotavirus (GERV). Ce mémoire avait pour objectif de décrire les taux d’hospitalisation pour GEA et GERV avant et après l’implantation du programme chez les jeunes enfants estriens (étude d’impact) ainsi que la couverture vaccinale et d’évaluer l’efficacité vaccinale (EV) du RV1 (étude d’efficacité). Méthode : Le jumelage d’une banque de données hospitalières avec le registre régional de vaccination a permis d’extraire une cohorte d’enfants nés au Centre hospitalier universitaire de Sherbrooke (CHUS), vivant en Estrie et âgés de moins de cinq ans durant la période d’étude de juin 2004 à mai 2014 (n = 37 757). Cette cohorte a été suivie de façon rétrospective afin d’examiner les taux annuels d’hospitalisation pour GEA et GERV des années pré- (2004/2005-2010/2011) et post-implantation (2011/2012-2013/2014), globalement et selon diverses caractéristiques socioéconomiques. De plus, l’EV du RV1 a été calculée à l’aide de trois cohortes d’enfants : (1) les enfants vaccinés nés en 2011-2013 (n = 5 033), (2) les enfants non vaccinés nés en 2011-2013 (n = 1 239) et (3) les enfants non vaccinés nés en 2008-2010 (n = 6 436). Résultats : Le taux d’hospitalisation pour GEA a évolué de 81/10 000 enfants de moins de cinq ans en période pré-implantation à 46/10 000 en période post-implantation (réduction relative = 43 %, p < 0,001). Suite à l’implantation du programme, la couverture vaccinale a rapidement augmenté pour atteindre 81 %. Malgré une couverture vaccinale similaire parmi les différents groupes, les plus faibles réductions relatives ont été observées chez les groupes défavorisés. L’EV ajustée pour une série complète était de 62 % (intervalle de confiance [IC] 95 % : 37-77 %) et de 94 % (IC 95 % : 52-99 %) contre les hospitalisations pour GEA et GERV, respectivement. Les enfants vivant dans des quartiers ayant une proportion élevée de familles à faible revenu avaient une EV plus faible contre les hospitalisations pour GEA (30 % contre 78 %, p = 0,027). Conclusion : Trois ans après son introduction dans le programme universel, le RV1 a réduit de façon significative les gastro-entérites sévères chez les jeunes enfants estriens. Ce vaccin est très efficace pour prévenir les hospitalisations pour GERV, particulièrement chez les groupes plus aisés. D’autres études en contexte similaire sont nécessaires pour déterminer les facteurs reliés à une plus faible EV chez les groupes vulnérables.
Abstract: Introduction: Rotavirus is the main cause of acute gastroenteritis (AGE) among young children worldwide. In 2011, the monovalent rotavirus vaccine (RV1) was introduced into the Quebec universal immunization program to reduce morbidity related to rotavirus gastroenteritis (RVGE). This thesis aimed to examine AGE and RVGE hospitalization rates before and after implementation of the program in young children from the Eastern Townships (impact study) and the vaccine coverage, and to assess vaccine effectiveness (VE) of the RV1 (effectiveness study). Methods: The pairing of a tertiary hospital database with the regional immunization registry allowed to extract a cohort of children born at the Centre hospitalier universitaire de Sherbrooke (CHUS), living in Eastern Townships and aged less than five years during the study period from June 2004 to May 2014 (n= 37,757). This cohort was retrospectively followed-up to examine AGE and RVGE annual hospitalization rates of pre- (2004/2005-2010/2011) and post-program years (2011/2012-2013/2014), globally and according to several socioeconomic characteristics. Moreover, RV1 VE was calculated using three children cohorts: (1) vaccinated children born in 2011-2013 (n=5,033), (2) unvaccinated children born in 2011-2013 (n=1,239), and (3) unvaccinated children born in 2008-2010 (n=6,436). Results: AGE hospitalization rates evolved from 81/10,000 children aged less than five years in pre-program period to 46/10,000 in post-program period (relative reduction=43%, p<0.001). Following implementation of the program, vaccine coverage rapidly increased to reach 81%. Despite similar vaccine coverage among different groups, lowest relative reductions were observed in disadvantaged groups. Adjusted VE of a complete series was 62% (95% confidence interval [CI]: 37%-77%) and 94% (95% CI: 52%-99%) against AGE and RVGE hospitalizations, respectively. Children living in neighbourhoods with higher rates of low-income families had lower VE against AGE hospitalizations (30% vs. 78%, p=0.027). Conclusion: Three years following its introduction into the universal vaccination program, RV1 significantly reduced severe gastroenteritis in young children in the Eastern Townships. This vaccine was highly effective to prevent RVGE hospitalizations, particularly among the most well-off. Further studies in similar setting are needed to determine factors related to lower VE among vulnerable groups.

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Mashunye, Thandiwe Runyararo. "A systematic review and meta-analysis of fractional dose compared to standard dose inactivated polio vaccination in children". Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/30931.

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The World Health Organisation (WHO) recommends the introduction of at least one single dose of inactivated polio vaccine (IPV) in routine immunisation schedules to mitigate the risk of a polio virus type 2 reintroduction or re-emergence. As a result, there has been an increased demand and concurrent supply shortages of IPV worldwide resulting in poor access to IPV. With the phasing out of the oral polio vaccine and the pursuit of global eradication of polio, ensuring an adequate supply of IPV is of paramount importance. One of the strategies to improve access is the use of the fractional dose because of its dose sparing and cost reduction properties. This mini-dissertation presents a research protocol (Section A), scoping review (Section B) and journal formatted manuscript (Section C) for a systematic review and meta-analysis of fractional dose compared to standard dose inactivated polio vaccination in children. Section A describes the rationale for the review, eligibility criteria, the search strategy and methods for data extraction and analysis. Section B is a scoping review that details the journey towards eradication of polio, the current state of IPV demand and supply and further explains the rationale for performing the systematic review. Section C is a manuscript that gives the results of the review after performing the methods outlined in Section A. The results showed that as the number of IPV doses increased the seroconversion rates for fractional dose and full dose IPV approximated each other such that at three doses the rates were similar. In conclusion, there is no difference in seroconversion between three doses of fractional dose IPV and three doses of full dose IPV. With the current IPV shortages, using fractional dose IPV instead of the full dose IPV can stretch supplies and possibly lower the cost of polio vaccination.

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Carlson, Samantha Jennifer. "Attitudes about and access to influenza vaccination in Australia: experiences of parents of children hospitalised for acute respiratory infection". Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/23701.

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Influenza vaccination is the most effective tool to prevent influenza disease, however, uptake in children in Australia is low. Accordingly, this thesis asked: why is influenza vaccine coverage low, and how can it be increased to prevent children from being hospitalised for influenza? Methods include: 1) a systematic review of the known barriers and facilitators of influenza vaccination of children and pregnant women in Australia between 2004 and 2015, 2) qualitative interviews with parents of children hospitalised in two sites in Australia for influenza in 2017, and 3) a cross-sectional survey with parents of children who were hospitalised for acute respiratory infection (+/– laboratory-confirmed influenza) in five sites across Australia in 2019. To understand the complexities of behaviour, the Capability-Opportunity-Motivation-Behaviour model was used across the multiple studies. This thesis highlights the importance of receiving an influenza vaccination recommendation from a health care provider; the lack of such a recommendation was a strong variable associated with lack of influenza vaccination in children who had been hospitalised for acute respiratory infection. This thesis also highlights the importance of increasing influenza vaccination opportunities; motivation to vaccinate is low if influenza vaccination is difficult to remember, organise and access. By systematically mapping out the barriers to influenza vaccination of children in Australia, we were able to understand exactly where and how to practically target efforts to change behaviour, and thus increase uptake of influenza vaccine.

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Голяр, О. І., i А. В. Панчошак. "Проблема імунопрофілактики поліомієліту в Україні". Thesis, Сумський державний університет, 2016. http://essuir.sumdu.edu.ua/handle/123456789/45385.

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Дo тoго часy поки в свiтi залишається хоча б одна iнфiкована дитина, ризикy заражeння полiомiєлiтом пiддаються дiти всiх країн. Берyчи до yваги серйознi наслiдки захворювання, а також вiдсyтнiсть етiотропного лiкyвання, доцiльнiсть проведення вакцинацiї не залишає сумнiвiв. Вакцинацiя – це єдиний ефективний метод боротьби з полiомiєлiтом.

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Светличная, Е. В., i П. О. Трегуб. "Эффективность вакцинации детей против туберкулеза". Thesis, Сумский государственный университет, 2017. http://essuir.sumdu.edu.ua/handle/123456789/54166.

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Туберкулез – одно из самых распространенных заболеваний в мире, которое нередко приводит к смерти. Тем не менее, большинство родителей отказывается прививать своих детей вакциной БЦЖ, ссылаясь на множество осложнений возникающих после вакцинации. Целью данной работы является демонстрация того, как снизится показатель заболеваемости туберкулезом, при условии вакцинации.

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Lifalaza, Alice Njahi. "The perceptions of mothers and caregivers about the factors affecting low uptake of measles immunisation among children under 5 years in the Nangana District, Namibia". University of the Western Cape, 2016. http://hdl.handle.net/11394/4996.

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Magister Public Health - MPH
Immunisation is considered to be amongst the most successful and cost-effective disease prevention interventions available. The Expanded Programme on Immunisation (EPI) in Namibia was established in 1990 to ensure that the immunisation of children takes place within the prescribed age frame. However, continued measles outbreaks, particularly in the Kavango region, are evidence of poor EPI progress, with vaccination coverage being below80% per district. The reasons for the low uptake of measles immunisation in the Nyangana district in the Kavango region are not clearly understood. The aim of this study was, therefore, to investigate the perception of mothers/caregivers of factors that impact on the uptake of measles immunisation in the Nyangana Health District, with a view to improving measles immunisation coverage. Methodology: A qualitative exploratory study design was used to collect data from the study participants. In-depth interviews were conducted with 10 mothers of children under 5 years of age, for both children who received, and those who did not receive measles vaccination. Data was audio-taped and transcribed verbatim. The recorded interviews were translated from the Gciriku language to English. Data was analysed through the use of the Thematic Content Analysis approach. The transcribed interviews and narratives from the research assistant’s notes were organised into codes, sub-themes and main themes. In the final phase, themes were integrated and interpreted, by identifying facilitating factors for those who took their children for immunisation, and barriers for those who did not take theirs. The researcher facilitated assistance to children who did not receive their measles dose, to receive it. Ethical requirements were adhered to throughout the research study process. Results: The study showed that mothers had both positive and negative perceptions about immunisation. The findings revealed that information, and past experience of measles ,irrespective of the level of education, support from a spouse or family members, availabilityof services and convenience of time schedules, increased the uptake of immunisation on thepart of mothers/caregivers. However, it also emerged that supply-side factors, such as lack of information sharing between health care providers and mothers, hindered effective communication. Additionally, inconvenient time schedules and time constraints, staffshortages, health care providers’ attitudes, inaccurate data being kept of children immunisedat other health facilities, inadequate outreach services and perceived lack of supervision in the health facilties all contributed to the low uptake of immunisation. Demand-side factors that affected the uptake of immunisation included: socio-economic constraints that led to an inability to pay transport costs to access immunisation services; lack of support from a spouse; other family members and other support structures in the community also impacted on immunisation uptake, despite the reported awareness and willingness to use immunisation services. Conclusions and recommendations: The study concludes that the relationship between health care providers and mothers/caregivers, and support from other social structures, should be good, in order to motivate mothers to use immunisation services. The study recommends that the following aspects be addressed, as they have the potential to improve the low uptake of measles immunisation: patient/provider relationship, information sharing, and supervision in the health facility, access to services, availability of outreach services, improved data tracking and active involvement of all stakeholders. Laziness was overwhelmingly offered as an explanation for missing measles immunisation, although there are suggestions that there might be underlying causes for what is perceived as laziness, which require further exploration, especially in terms of socio-cultural barriers to immunisation. It is recommended that an in-depth look at the perceptions of health care providers and key informants should be conducted to search for further understanding of contributing factors.

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Kodituwakku, Aruna Poojitha. "Antigen specific B cells in the immune response to Haemophilus influenzae type b PRP conjugate vaccine /". Title page, table of contents and summary only, 2004. http://web4.library.adelaide.edu.au/theses/09PH/09phk769.pdf.

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Nunes, Sónia. "Epidemiological studies of Streptococcus pneumoniae carriage in the post-vaccination era among two risk groups: children and the elderly". Doctoral thesis, Universidade Nova de Lisboa. Instituto de Tecnologia Química e Biológica, 2012. http://hdl.handle.net/10362/8593.

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Dissertation presented to obtain the Ph.D. degree in Biology/ Molecular Biology
Streptococcus pneumoniae is a global cause of disease including pneumonia, otitis media, conjunctivitis, sepsis, and bacterial meningitis. These infections are not essential to the transmission or long-term survival of the bacterium; indeed, S. pneumoniae depends on asymptomatic colonization of the human nasopharynx for its dissemination to additional hosts. Considering this, colonization studies are a good way to monitor changes in the pneumococcal epidemiology that may result from the use of antibiotics and vaccines. The molecular characterization of pneumococci is crucial to assess these changes which highlight the need for the development and validation of easier and faster methods of molecular typing. Since 1996 our group has been monitoring the pneumococcal population colonizing children attending day care centers. However, for several years these studies have been confined to the Lisbon area. In this PhD we have addressed this situation by including other regions of Portugal in our study. In addition, we have started to study pneumococcal colonization in the elderly, the other age group where the incidence of pneumococcal infections is high. This thesis summarizes five studies conducted during this PhD. The first four studies were focused on the pneumococcal epidemiology among the two age groups where the rates of pneumococcal disease are highest: children up to six years old and adults older than 60 years. The fifth and last study describes the evaluation and validation of a new genotyping strategy for pneumococci.(...)
Financial support from Fundação para a Ciência e a Tecnologia, Portugal through grant SFRH/BD/40706/2007 awarded to Sónia Nunes.

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Larsson, Joar. "Etiska argument för och emot vaccination av barn i Sverige och Australien : - en argumentationsanalys". Thesis, Uppsala universitet, Folkhälsovetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-448619.

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Bakgrund: Immunisering är en vital del av folkhälsan. I Sverige är vaccinationstäckningenför barn hög och förtroende för immunisering god. I Australien är vaccinationsskepsisvanligare och både förtroendet och vaccinationstäckningen lägre än i Sverige, trots att bådaländerna har liknande policy kring vaccination. Den låga vaccinationstäckningen har lett tillatt nya åtgärder vidtagits för att öka vaccinationstäckningen i Australien.Syfte: Att analysera etiska argument för och emot barnvaccination genom att analyserapolicys, litteratur och samhällsdebatter samt undersöka de olika ståndpunkterna kringvaccination i Sverige och Australien.Metod: Deskriptiv argumentationsanalys och innehållsanalys används för att identifiera etiskaargument och innehåll i policydokument, vetenskaplig litteratur och debattartiklar. Dessaetiska argument analyseras sedan och jämförs med grundläggande etiska principer och teorier.Resultat: Det råder starka åsikter kring vaccinationsfrågan både från vaccinationsskeptikeroch förespråkare. De mest återkommande ämnena i litteratur och samhällsdebatt är autonomi,icke skada och tvångsvaccinering. Diskussionen kring dessa ämnen i den vetenskapligadiskussionen och i samhället pekar på komplexa frågor där argument kring vilka och varförolika beslut bör tas av beslutsfattande organ. I vetenskaplig litteratur beskrivs hur tvingandeåtgärder kan påverka samhället och i samhällsdebatten ligger stort fokus på föräldrarsrättigheter och vad som är bäst för barnen.Slutsats: Studien pekar på att en existerande etisk argumentation präglar både Sverige ochAustralien, där policyskapande kring vaccination av barn är en laddad och komplexsamhällsfråga.
Background: Immunization is a vital part of public health. In Sweden, vaccination coveragefor children is high and confidence in immunization is good. In Australia, vaccinationskepticism is more common and both confidence and vaccination coverage are lower than inSweden even though the countries have similar policies regarding vaccination. The lowvaccination coverage has led to implementation of measures to increase vaccination coveragein Australia.Purpose: To analyze ethical arguments for and against vaccination by analyzing scientificmaterial, policy documents on vaccination and debates in Sweden and Australia. As well asexamining the positions on vaccination that exist in these countries.Method: Descriptive argumentation analysis and qualitative text analysis have been used toidentify ethical arguments and content in policy documents, scientific literature and debatearticles. These ethical arguments are then analyzed and compared with basic ethicalprinciples.Results: The most recurring topics in the scientific literature and public debate are autonomy,the harm principle and compulsory vaccination. The discussion on these topics in thescientific discussion points out that it is difficult to answer these complex questions aboutvaccination. Where arguments about which and why different decisions should be made bydecision-making bodies and what is best for public health. The scientific literature alsodescribes how coercive measures can have a negative effect on public health. The publicdebate has a strong focus on parents' rights and mandatory vaccinations in preschools.Conclusion: The study demonstrates a prevailing ethical discussion that characterizes both Sweden and Australia, where policy-making regarding vaccination of children is complexsocietal issue and autonomy, mandatory vaccinations and the harm principle are central to thedebate.

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Claesson, Susanna, i Jannica Brännström. "Jämförelse av två olika vaccinationstekniker på spädbarn : Dubbelvaccinering eller en itaget?" Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-184790.

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Syfte: Syftet med denna studie var att jämföra BVC-sjuksköterskors och föräldrars upplevelse av vaccinationstillfället samt skattning av barns smärta i form av skriktid vid två typer av vaccinationstekniker, dubbelvaccinering respektive en injektion i taget, när barnet ska ha två sprutor vid samma vaccinationstillfälle. Metod: Studien är en jämförande deskriptiv studie med kvantitativ ansats. Från både Stockholm och Uppsala valdes 50 barn ut konsekutivt varav 25 barn från Stockholms län samt 25 barn från Uppsala län. Datainsamling skedde med hjälp av enkäter samt mätning av skriktid. Dataanalysen genomfördes med hjälp av chitvåtest samt t-test. Resultat: Det fanns signifikanta skillnader vad gäller både BVC-sjuksköterskors och föräldrars upplevelser av vaccinationsproceduren. Skillnader kunde även ses såväl hos både föräldrar (p=0,020) och BVC-sjuksköterskor (p=0,032) när de fick skatta sin upplevelse av barnets smärta i samband med vaccinationen. Skriktiden visade inte någon signifikant skillnad (p=0,051) mellan de olika vaccinationsteknikerna. Slutsats: Resultatet av denna studie visade att barn som fick dubbelvaccinering upplevdes ha mindre ont när deras smärta skattades av både föräldrar och BVC-sjuksköterskor. Barn som fick sprutorna samtidigt skrek/grät generellt kortare tid än de barn som fick en spruta i taget, skillnaden visade dock ingen signifikans. Flertalat föräldrar i denna studie föredrog dubbelvaccinering.
Aim: The aim of this study was to compare child health center nurses' and parents' experience of the immunization and the child's estimated pain in terms of cry duration when two types of vaccination techniques were used, simultaneous versus sequential immunization injections, when the child are given two shots at the same occasion. Methods: The study is a comparative descriptive study with quantitative approach. From both Stockholm and Uppsala 50 children were selected consecutively with 25 children from the Stockholm and 25 children from the Uppsala. Data collection was done by means of questionnaires and measurement of cry duration. Data analysis was performed using the chi-square test and t-test. Results: There were significant differences from both nurses' and parents' perceptions of the vaccination procedure. Differences could also be seen in terms of the child's pain when both parents' (p=0,020) and nurses' (p=0,032) rated the child's pain associated with the immunization. Cry duration did not show a significant difference (p=0,051) between the two vaccination techniques. Conclusions: The results of this study showed that the children who received two vaccinations simultaneously were experienced by both parents’ and nurses’ to have less pain. Children that received the two injections at the same time cried less in general then the children that received the two injections one by one, the difference was not however significant. Most of the parents in this study preferred that the injections should be given at the same time.

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Noguchi, Laura Kayoko. "The effect of music versus non-music on focus of attention in pediatric injection patients". Scholarly Commons, 2004. https://scholarlycommons.pacific.edu/uop_etds/593.

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Receiving vaccinations is a part of growing up in the United States; however, as necessary as vaccinations are, many children find the process to be frightening and painful. A review of literature indicates that non-pharmacological interventions, such as distraction, are generally effective in reducing pain and anxiety in children receiving injections. Music has been examined as a potential distraction during pediatric medical procedures, but research findings have been mixed, due, in part, to the way in which music was used: the children were primarily instructed to merely "listen to the music." It has been noted that individuals tend to maintain their attention on music more successfully when they are asked to listen for specific elements. The present study sought to determine if a focus of attention activity (pointing at pictures) involving music would affect levels of distress and perceptions of pain in pediatric injection patients. Sixty-four 4- to 6 1/2-year old children receiving routine immunizations were randomly assigned to one of three conditions: musical story, spoken story, or standard care control. Children in the two treatment conditions listened to a recorded story on headphones and pointed at corresponding pictures before, during, and after their injections. Observational data on distress and pain were collected, in addition to the child's self-rating of pain. Participants in the musical story condition tended to be less distressed and report less pain than participants in the spoken story and control conditions, although these differences were not statistically significant. Subsequent analysis indicated that children who received more injections tended to benefit more from the music intervention, in terms of their perceived pain. Implications of the findings are discussed, along with recommendations for future research in the area.

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Southern, Jo. "Evaluation of vaccination in the UK paediatric population : reactogenicity, immunogenicity and consideration of epidemiological need to protect children and the wider population". Thesis, Manchester Metropolitan University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.521029.

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Introduction Vaccination is accepted globally as the most effective preventative public health intervention against infectious disease. Rationalising vaccination schedules is key to ensuring optimal individual and population protection from potentially deadly diseases, with the most acceptable vaccines and schedules from economic and patient safety perspectives. Diseases for which vaccines are routinely recommended are identified through population level monitoring of cases and outcomes. Stringent assessment of vaccines in trials is required for licensure of novel products, usually with enhanced surveillance following introduction of a vaccination campaign to assess population impact and ongoing effectiveness. Method Testing novel vaccines with others that may be given concomitantly is not required for licensure. The UK Department of Health therefore commissions research to provide assurance that the addition of new vaccines is safe and does not compromise the existing routinely recommended schedule. A programme of trials recruiting infants and children was undertaken to provide such data. This body of published manuscripts describes trials that were undertaken for this purpose, to provide information both on novel antigens and novel delivery schedules. Data included in these manuscripts were provided to the Joint Committee for Vaccination and Immunisation (JCVI) to inform consideration of the addition of new antigens and or vaccines and refinement of existing schedules. Results: Studies described here contributed to the addition of meningococcal C conjugate vaccine to the programme and subsequent refinement of the schedule administered in early childhood; the addition of pneumococcal conjugate vaccine for infants; provided information for consideration about the use of conjugate booster campaigns in older children; the change to acellular pertussis and inactivated polio vaccine for infants and provided data to inform the future addition of pertussis vaccine for teenagers. Conclusion and impact: The information presented here would not have been available were it not for this Department of Health"funded programme of head to head comparison of products and evaluation of co-administration of products. Studies have contributed to the revision of the national schedule, which continues to be evaluated through further trials and routine surveillance activities.

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Venuto, Margaret M. "Health and economic burdens of norovirus disease and cost-effectiveness analysis of norovirus vaccination among school age children in the United States". Thesis, The University of Texas School of Public Health, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10126215.

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Background. Norovirus disease is of great public health significance as evidenced by the health and economic burdens each year in the United States. Although norovirus disease afflicts all ages in the general population, vulnerable segments of the population include the young and elderly. Currently there is no norovirus vaccine on the market to prevent norovirus infection nor is there prescribed medical treatment other than supportive care for self-limiting symptoms.

Methods. Surveillance data on norovirus outbreaks obtained from the Centers for Disease Control National Outbreak Reporting System, school enrollment data obtained from the National Department of Education, healthcare resource utilization data obtained from the Healthcare Cost and Utilization Project, and results from published research findings were used to estimate the health and economic burdens of norovirus disease among the school age population. Decision analysis was used to model the costs and benefits of norovirus vaccination. Cost effectiveness analysis was conducted from the societal and healthcare perspectives in order to determine the incremental cost-effectiveness ratios for the alternative health strategy compared to the current standard health strategy. Univariate and multivariate analyses were conducted in order to examine uncertainty associated with parameters and assess how the uncertainty affects the outputs of the decision model. Probabilistic sensitivity analysis was conducted in order to assess and quantify the impact of varying all parameters at the same time.

Results. Norovirus results in high numbers of illnesses and high direct medical, direct non-medical and indirect costs among school age children. In terms of health burden, there were a greater number of cases requiring supportive care than any other health outcome. The cost of supportive care is relatively inexpensive until indirect costs are factored in to the total cost of one episode of norovirus illness.

The results of the present study indicated that when comparing the standard health strategy of no norovirus vaccination to that of the alternative health strategy of norovirus vaccination, vaccination was found to be optimal. The results of probabilistic sensitivity analysis indicated that the alternative health strategy was marginally cost effective.

Conclusion. The results of the present study represent the first attempt to estimate the health and economic burdens of norovirus disease among the school age population with a focus on norovirus disease spread occurring in closed (schools) environments. The study findings will illustrate the uniqueness of closed environments in perpetuating norovirus spread and the feasibility of norovirus vaccination among school age children. The results of cost-effectiveness analysis indicated vaccination was an optimal strategy but is marginally effective.

Given the numerous limitations of using passive surveillance data, future research efforts should use higher quality and more accurate sources of data in order to estimate the health and economic burdens of norovirus disease and examine the other hidden costs of norovirus outbreaks such as environmental decontamination, school closure, student and staff absenteeism and other intangible costs. In addition, future research efforts should use the findings from this and other studies that have identified high prevalence of norovirus disease among younger age groups in order to establish priority age groups for vaccination when a vaccine becomes available on the market. Clinical trials are underway and development of a norovirus vaccine is expected within the next few years.

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Correia, Sara Fernandes. "REPRESENTAÇÕES SOCIAIS, ATITUDES E CRENÇAS DE PAIS ACERCA DA VACINAÇÃO CONTRA VARICELA". Pontifícia Universidade Católica de Goiás, 2015. http://localhost:8080/tede/handle/tede/3156.

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Made available in DSpace on 2016-08-10T10:57:45Z (GMT). No. of bitstreams: 1 Sara Fernandes Correia.pdf: 677309 bytes, checksum: cda15aca837ab723e31985abfe5f3cd7 (MD5) Previous issue date: 2015-08-14
Vaccination is one of the most effective ways to stop the chain of transmission of some vaccine-preventable diseases, and thus reduce infant mortality rates. Nevertheless, in many cases, there is controversy and resistance from the population to join the procedure. In the case of varicella vaccine, the World Health Organization recommends its inclusion in the childhood vaccination schedule, especially in countries where the injury is a major public health problem, and that can sustain a program with high vaccination coverage. In Brazil, only recently the inclusion of immunobiological in the calendar of the National Immunization Program, propitious occasion to investigate the representations, attitudes and parental beliefs about the implementation of the varicella vaccine in filhos.Com to investigate the social representations, attitudes and beliefs of the parents or guardians of children 12 to 24 months, about the varicella vaccine. Descriptive study with a qualitative approach, conducted from field research, using the theoretical framework of the Theory of Social Representations, made possible by the structural approach based on the Central Nucleus Theory. Data were collected in two stages, the first by the technique of free association of words from inducing presented theme. The database was processed in EVOC software. The second time was carried out semi-structured interviews with part of the first phase members, whose content obtained allowed to establish categories of análise. No together the elements that appear as social representations of the child varicella vaccination, point out its constitution in two axles, positive by important signs and immunity, and the relatively negative other, with the word pain. The highlighted categories were: Care revealed from different perspectives and multiple reasons to vaccinate or not the child. As mentioned care to prevent infectious diseases, suggest the vaccine as an important act of care for the child, as well as full screen hygiene practices. Check out some signs of popular attitudes and beliefs that contribute to some degree to justify certain behaviors considered as inadequate for science or unfounded. There is good acceptance parent or guardian to join the varicella vaccine. Despite the reference about the lack of information, they can understand that the benefits offered by immunization outweigh any inconvenience that may cause in children.
A vacinação é um dos meios mais eficazes para cessar a cadeia de transmissão de algumas doenças imunopreveníveis, e com isso reduzir os índices de morbimortalidade infantil. Apesar disso, em muitos casos, há controvérsia e resistência por parte da população à adesão ao procedimento. No caso da vacina contra varicela, a Organização Mundial de Saúde recomenda sua inclusão no calendário de vacinação infantil, principalmente nos países em que o agravo é um importante problema de saúde pública, e que podem sustentar um programa com alta cobertura vacinal. No Brasil, é recente a inclusão desse imunobiológico no calendário do Programa Nacional de Imunização, ocasião propícia para se investigar as representações, atitudes e crenças dos pais acerca da aplicação da vacina contra varicela nos filhos.Com o objetivo de investigar as representações sociais, atitudes e crenças dos pais ou responsáveis por crianças de 12 a 24 meses, acerca da vacina contra varicela. Estudo descritivo e exploratório, com abordagem qualitativa, realizado a partir de pesquisa de campo, com utilização do referencial teóricometodológico da Teoria das Representações Sociais, viabilizada pela abordagem estrutural com base na Teoria do Núcleo Central. Os dados foram coletados em dois momentos, o primeiro pela técnica de associação livre de palavras a partir de tema indutor apresentado. O banco de dados foi processado no software EVOC. No segundo momento, foi realizada entrevista semiestruturada com parte dos integrantes da primeira fase, cujo conteúdo obtido permitiu estabelecer categorias de análise.No conjunto, os elementos que aparecem como representações sociais sobre vacinação contra varicela no filho, apontam sua constituição em dois eixos, o positivo pelos signos importante e imunidade, e o outro relativamente negativo, com a palavra dor. As categorias evidenciadas foram: O cuidado revelado sob diferentes perspectivas e os múltiplos motivos para vacinar ou não a criança. Quanto aos cuidados mencionados para se evitar doenças infectocontagiosas, apontam a vacina como importante ato de cuidado para com a criança, assim como as práticas de higiene de modo ampliado. Verificam-se alguns sinais da presença de atitudes e crenças populares, que até certo ponto contribuem para justificar determinados comportamentos considerados pela ciência como inadequados ou infundados. Há boa aceitação dos pais ou responsável em aderir à vacina contra varicela. Apesar da referência quanto à falta de informação, conseguem entender que os benefícios oferecidos pela imunização superam algum incômodo que possa causar nas crianças.

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Кірсанова, Т. О., i С. В. Кузнєцов. "Вакцинація проти вірусу Varicella-zoster серед дитячого населення України". Thesis, Сумський державний університет, 2015. http://essuir.sumdu.edu.ua/handle/123456789/43103.

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Вітряна віспа (ВО) за останні роки має тенденцію до неухильного зростання захворюваності на різних територіях України, в першу чергу серед дитячого населення. Доведено, що найбільш ефективним способом боротьби з інфекційними захворюваннями є проведення масової вакцинації проти збудників цих хвороб.

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HAYDEN, DOMINIC JOHN. "A COMPARATIVE ANALYSIS OF POLICIES, INFRASTRUCTURE, AND INFLUENCES (INCLUDING PERSONAL INSIGHTS AND MISCONCEPTIONS) REGARDING THE VACCINATION OF CHILDREN IN MEXICO AND THE UNITED STATES". Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/614121.

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This analysis includes a diverse comparison of the infrastructure, policies, resources, and influences regarding the vaccination of children in Mexico and the United States. In order to portray my findings in a representative manner, I have utilized publiclyaccessible information provided by credible institutions in both countries. To fully understand the policies and procedures in Mexico, I conducted a trip to a rural community in Jalisco to collect information from medical professionals themselves in the form of questionnaires. personal correspondence, and local medical documentation. In doing this, I have included some personal insight and misconceptions that I possessed prior to the trip and how this has enlightened my knowledge on Mexican healthcare infrastructure. To conclude, I mention other political and ethical influences that can impact a country’s proper usage of vaccination. The overall intention of the paper is to educate the reader on these policies and procedures in place, influences that affect this essential medical advancement, and how personal prejudices can sometimes hinder the truth.

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Tocheva, Anna Stoyanova. "Carriage of Streptococcus pneumoniae in young children following pneumococcal conjugate vaccination and exploration of the role of human dendritic cells in causing between-serotype immunogenicity differences". Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/404046/.

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Piram, Maryam. "Epidémiologie de la vascularite à IgA (purpura rhumatoïde) : incidence, étiologie". Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLS185.

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Le purpura rhumatoïde, récemment renommé vascularite à IgA (IgAV) est, en Occident, la vascularite systémique la plus fréquente de l’enfant. Cette vascularite leucocytoclasique IgA-médiée des petits vaisseaux touche principalement la peau, les articulations, le tube digestif et les reins. L’évolution est le plus souvent favorable mais certains patients peuvent développer une pathologie rénale chronique. L’étiologie de l’IgAV étant inconnue, les études épidémiologiques sont importantes afin de générer des hypothèses étiologiques. La première partie de cette thèse consacrée à l’épidémiologie de l’IgAV, consiste en une revue de la littérature résumant l’ensemble des connaissances actuelles d’épidémiologie descriptive de l’IgAV ainsi que les facteurs de risque génétiques ou environnementaux rapportés. La seconde partie est une étude prospective sur 3 ans décrivant les caractéristiques épidémiologiques des cas incidents d’IgAV survenus chez les enfants habitant le département du Val de Marne, localisé au sud-est de Paris. Grâce à une analyse capture–recapture à 4 sources, nous avons estimé l’incidence annuelle de l’IgAV à 30/100 000 enfants < 15 ans. La faible variation de l’incidence de l’IgAV dans le temps et dans l’espace et l’existence d’une saisonnalité de la maladie suggèrent un facteur déclenchant infectieux ubiquitaire et non émergent. La troisième partie de cette thèse, s’intéresse à la question du rôle de la vaccination dans le déclenchement de l’IgAV. En l’absence d’études pharmaco-épidémiologiques robustes, nous avons réalisé une étude en case-crossover, qui est une variante d’une étude cas–témoin traditionnelle afin d’étudier l’effet de la vaccination sur le risque à court terme d’IgAV. Nos résultats indiquent que les vaccins communément réalisés chez l’enfant n’augmentent pas significativement le risque d’IgAV dans les 3 mois suivant la vaccination. Les résultats de cette thèse améliorent nos connaissances de l’épidémiologie de l’IgAV et suggèrent que les infections, mais pas les vaccins, jouent un rôle dans l’étiologie de la maladie. D’autres études épidémiologiques sont toutefois nécessaires, en particulier dans les populations non étudiées et multi-ethniques, afin de mieux cerner le rôle des facteurs génétiques dans la survenue de la maladie
Henoch-Schönlein purpura, recently renamed immunoglobulin A vasculitis (IgAV), is the most common systemic vasculitis in childhood in Western countries. The sites predominantly affected by this IgA-mediated, leukocytoclastic, small-vessel vasculitis are the skin, joints, gastrointestinal tract and kidneys. IgAV is often self-limiting, although chronic kidney disease can develop in some patients. Because the cause of IgAV is unknown, epidemiological studies are important to provide clues to understanding its etiology. The first part of this thesis, devoted to the epidemiology of IgAV, is a literature review summarizing the currently available knowledge on descriptive epidemiological aspects of IgAV and environmental and genetic risk determinants. The second part is a prospective survey describing the epidemiological characteristics of IgAV in Val de Marne, located in the southeast suburbs of Paris, France. With a 3-year study and 4-source capture–recapture analysis, we estimated the annual incidence of IgAV at 30/100,000 children (age ≤ 15 years). The few secular and geospatial variations in IgAV incidence and the observation of a seasonal pattern in IgAV incidence lend support to a role for a ubiquitous and communicable infectious trigger. The third part of the thesis addresses the concern suggested mainly by case reports of vaccination as a potential trigger of IgAV. In light of the lack of robust pharmacoepidemiological studies, we performed a case–crossover study, a variant of a traditional case–control study, to investigate the effect of vaccination on short-term risk of IgAV. The results indicated that vaccines commonly administered to children do not significantly increase the risk of IgAV in the 3 months after vaccine exposure. The results of this thesis enhance our knowledge of IgAV epidemiology and suggest that infections but not vaccines may play a role in the etiology of the disease. More epidemiological investigation is required, particularly in understudied areas and multiethnic populations, to gain insight in the burden of genetics in IgAV etiology

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Davila, Payan Carlo Stefan. "Cases of improvement to public health systems using mathematical modeling". Diss., Georgia Institute of Technology, 2013. http://hdl.handle.net/1853/50326.

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This work builds on the use of several Mathematical Modeling tools to develop approaches that address relevant, real and previously unanswered questions related to the improvement of Public Health Systems, in three particular instances. First, this thesis analyzes the variation in state-level vaccination coverage during the emergency response to the 2009 H1N1 pandemic influenza outbreak in the United States. The analysis considers the overall adults population and two priority sub-populations: children and high-risk adults. We focus on quantifying the association between vaccination coverage and the supply chain and distribution system decisions, during the vaccine shortage period, while controlling for other commonly recognized factors such as previous vaccinations, socio-economic characteristics, health seeking behavior and health infrastructure. The variables analyzed are generally correlated, and the problem has a limited sample size with a much larger number of independent variables. The findings of this research have been published in Vaccine and presented to the Centers for Disease Control and Prevention. Second, the research approaches the problem of estimating childhood obesity prevalence in small geographic areas in the U. S. Obesity is recognized as one of the major health problems in the country, and attending this condition in children is of major importance to deal with the sources of the overall problem. The ability to target interventions to the most affected children populations is necessary to achieve cost effective solutions. But local accurate obesity data is hard to obtain and missing for most of the small areas in the country. The research focuses on estimating prevalence of obesity and overweight status in children in small geographical areas in the absence of surveillance and detailed sampling. Our modeling approach is built in two stages. The first one uses a logistic regression model that links individual characteristics to high-BMI status, and generates samples of the empirical distribution of its coefficients though bootstrap re-sampling. The second uses simulation to generate virtual population samples of the small areas, which are then combined with the logistic model samples to estimate prevalence. Confidence intervals are built though re-sampling. A very important feature of our approach is that all of its inputs are from publicly available data, which gives availability for the replication of the methodology to any health stakeholder in the US. The model estimates were validated by using separate models for adults and children in a state with available data. Estimates obtained from our modeling approach were used by a large healthcare provider to geographically target interventions for pediatric obesity. Third, the thesis presents an introductory analysis of the possible effects of partial disruptions to critical supply chains due to absenteeism caused by a generalized flu-like illness in the US. For this analysis, we first construct a plausible national food supply chain for milk and then we simulate its disruption. To build the supply chain we used public information regarding production, consumption, and major milk processors and bottlers, and fitted it into a supply network though optimization. Then, to analyze the effects of flow disruptions of the supply chain, we built a simulation of the operation of the network and virtually generated absenteeism, mildly disrupting the supply chain flows by the proportional absences. We used information on potential absenteeism in work groups from an influenza simulator. Our initial analysis shows that absenteeism may create variations along the supply chain, similar to those described in the bullwhip effect analysis literature, even in the absence of supply shortages and without variations in pricing or demand, for which we find no prior reference in the literature.

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Adolfsson, Zandra, i Michaela Karlsson. "Barnvaccinationer : BHV-sjuksköterskans kommunikation och information till föräldrar". Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-78943.

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Bakgrund: Barnvaccinationsprogrammet är den mest framgångsrika medicinska insatsen för folkhälsan. Information kring barnvaccinationer sprids snabbt och lätt via media och informationskanaler, så som Facebook och YouTube. Denna information är inte alltid kritiskt granskad och misstänkta biverkningar kan då tendera att överskattas. Det finns en rad olika anledningar till att vissa föräldrar är tveksamma till barnvaccination. BHV-sjuksköterskans uppgift är att möta alla föräldrar med respekt och genom korrekt information ge föräldrarna ett beslutsunderlag inför vaccinationen. En bristande kommunikation mellan BHV-sjuksköterskan och föräldrarna kan bidra till ökad oro, vilket kan leda till att föräldrarna väljer att avstå vaccination. Syfte: Syftet var att beskriva BHV-sjuksköterskors erfarenheter av kommunikation med föräldrar inför barnvaccinationer. Metod: Semistrukturerade intervjuer med nio BHV-sjuksköterskor. Studien har analyserats med hjälp av en kvalitativ innehållsanalys. Resultat: I resultatet framkom att samtliga deltagare i studien upplevde att de flesta föräldrarna hade en positiv inställning till barnvaccination. Studien visade att BHV-sjuksköterskorna ansåg att de gav en bra och tydlig information till föräldrarna. Samtidigt menade deltagarna att spridningen av information kunde förbättras. Det framkom att det finns skillnader i när BHV-sjuksköterskorna ger information till föräldrarna. Deltagarna i studien kände sig trygga i mötet med föräldrar och kring kommunikation av information inför vaccination. Slutsats: Studien visar att BHV-sjuksköterskorna känner trygghet kring kommunikation, både med information inför vaccination och att bemöta tveksamma föräldrar. BHV-sjuksköterskorna beskriver att de inom organisationen har en bra och tydlig information.
Background: The childhood vaccination program is the most successful medical response to public health. Despite this, there have always been negative voices about vaccination. Information about childhood vaccinations is spread quickly and easily through media and information channels, such as Facebook and YouTube. This information is not always critically reviewed and suspected sideeffects may then be overestimated. Evidence shows that there is a variety of reasons why some parents have doubt about childhood vaccination. Child Health nurse's task is to meet all parents with respect and give correct information so the parents have a decision basis for vaccination. A lack of communication between the Child Health nurse and the parents can contribute to increased concern, which may lead to the parents choosing to abstain from vaccination. Aim: The aim was to describe Child Health nurse's experiences of communicating with parents before childhood vaccinations. Method: Semi-structured interviews with nine Child Health nurses. The study has been analyzed using a qualitative content analysis. Results: The result showed that all participants in the study felt that most parents had a positive attitude towards childhood vaccination. The study showed that the Child Health nurses felt that they provided a good and distinct information to the parents. At the same time, participants believed that the dissemination of information could be improved. It showed that there are differences in when Child Health nurses present information to the parents. The participants in the study felt safe in the meeting with parents and about communication of information prior to vaccination. Conclusion: The study showed that Child Health nurses felt secure about communication, both with information before vaccination and in meeting hesitent parents. Child Health nurses described that they had good and distinct information within the organization.

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Mills, Richael Odarkor [Verfasser], Sven [Akademischer Betreuer] Hammerschmidt, Sven [Gutachter] Hammerschmidt i Antje [Gutachter] Flieger. "Post-vaccination molecular epidemiology of pneumococcal carriage among children less than five years of age in Cape Coast, Ghana / Richael Odarkor Mills ; Gutachter: Sven Hammerschmidt, Antje Flieger ; Betreuer: Sven Hammerschmidt". Greifswald : Universität Greifswald, 2020. http://d-nb.info/1224047443/34.

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Mills, Richael Odarkor Verfasser], Sven [Akademischer Betreuer] [Hammerschmidt, Sven Gutachter] Hammerschmidt i Antje [Gutachter] [Flieger. "Post-vaccination molecular epidemiology of pneumococcal carriage among children less than five years of age in Cape Coast, Ghana / Richael Odarkor Mills ; Gutachter: Sven Hammerschmidt, Antje Flieger ; Betreuer: Sven Hammerschmidt". Greifswald : Universität Greifswald, 2020. http://nbn-resolving.de/urn:nbn:de:gbv:9-opus-41916.

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Lockwood, Lauren. "Introduction of pneumococcal conjugate vaccination in Ethiopia: a cross-sectional analysis of predictors of vaccine use in children aged 12-23 months using Demographic and Health Survey data from 2016". Thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-352902.

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Dias, Vania Ferreira Gomes. "Avaliação da dor em crianças de 0 a 23 meses: em busca de elementos para o aprimoramento das práticas durante a vacinação". Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/7/7141/tde-17082011-094918/.

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A vacinação ocupa um papel de destaque na prevenção de doenças e proteção da saúde, tanto no âmbito individual quanto coletivo. Contudo sua realização impõe uma série de condições desagradáveis, principalmente às crianças pequenas. Dentre os vários aspectos críticos que compõem os momentos de vacinação, destaca-se a dor provocada pela aplicação da vacina, por suas implicações para as crianças e seus familiares. Dado que o foco do atendimento nas Salas de Vacina está colocado, principalmente, sobre a vacina (preparação, aplicação, conservação, entre outros), outros aspectos críticos da vacinação das crianças não estão contemplados durante os atendimentos. Visando contribuir para a qualidade da assistência nas Salas de Vacina, este estudo busca levantar na literatura científica elementos que facilitem aos profissionais envolvidos no atendimento e na organização das Salas de Vacina, o reconhecimento da dor pela qual passam as crianças durante sua vacinação, através de instrumentos de avaliação. Para tal foi feita uma revisão da literatura, buscando instrumentos de avaliação de dor em crianças menores de dois anos. A busca foi estruturada a partir do acrônimo PICO em dez diferentes bases. Os descritores foram adaptados para atender às especificidades das mesmas e foi utilizado o Endnoteweb® para sistematização e compartilhamento das informações. Foram identificados 295 estudos entre 1993 e 2010 cujos resumos foram analisados e, aplicando-se os critérios de exclusão chegou-se a um conjunto de 24 artigos que foram lidos na íntegra. Tendo em vista a finalidade chegou-se a uma amostra final de 12 artigos que apresentavam 8 escalas. Constatou-se que as escalas mais adequadas para avaliação das crianças durante a vacinação são: MBPS, CHIPPS, NIPS e ABC. Estas escalas utilizam os parâmetros consagrados na literatura, em composições e especificações diferentes.
Vaccination has an important role to prevent diseases and protect health, both for individuals and for collectives. However its implementation requires a series of unpleasant conditions, especially to small children. Among several critical aspects that are present at the time of vaccination, there is the pain caused by the adistration of vaccine, because of its implications for children and their families. Since the focus of attention in the rooms vaccine is placed primarily on the vaccine (preparation, implementation, maintenance, etc.), other critical aspects of vaccination of children are not covered during the sessions. To contribute to the quality of care in rooms vaccine, this study raises some elements in the scientific literature to facilitate the professionals involved in care and organization of rooms vaccine, the recognition of pain that children may have during their vaccination, through assessment instruments. It was developed a review of the literature, searching for tools to evaluate pain in children under two years. The search was structured from the acronym PICO in ten different bases. The descriptors were adapted to meet the specific needs of these and Endnoteweb© was used to systematize and share information. Were identified 295 studies between 1993 and 2010 whose abstracts were reviewed and, applying the exclusion criteria was reached at a sample of 24 articles that were read in full. Given the goal was reached a final sample of 12 articles that presented eight scales. It was found that the most appropriate scale for assessing children for vaccination are: MBPS, CHIPPS, NIPS and ABC using the parameters established in the literature with compositions and different specifications.

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