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1

SHERJIL, AHMAD, and COL JAVAID IQBAL. "ABSENCE OF SCAR FORMATION IN INFANTS AFTER BCG VACCINATION." Professional Medical Journal 13, no. 04 (December 16, 2006): 637–41. http://dx.doi.org/10.29309/tpmj/2006.13.04.4942.

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Objective: To determine proportion of infants who do not developBCG scar after vaccination. To highlight importance of evaluation and follow up for these infants. Study Design:Observational Cross-sectional study. Setting: In Vaccination Centre Military Hospital Rawalpindi. Duration: From 1stJanuary 2003 to 15th March 2003. Materials & Methods: 50 to 70 infants are vaccinated in the hospital every day.Infants fulfilling the inclusion criteria averaged ten per day during this study. It took two and a half month, to completea random sample of 250 infants. Sample Size: 250 vaccinated infants. Results: Of all the infants, first 250 infants whofulfilled the laid down criteria were documented. Two hundred and one infants, males and females showed presenceof scar. Forty-nine infants, males and females showed no response to BCG vaccination. Conclusion: This descriptivestudy concludes that a significant proportion of infants does not show tuberculin reactivity after vaccination and needmonitoring and evaluation for causes of poor reactivity e.g. poor technique, quality of vaccine, improper storage as wellas underlying undiagnosed immunological disorders.
2

Yin, Hui-Chu, Shao-Wen Cheng, Chun-Yuh Yang, Ya-Wen Chiu, and Yi-Hao Weng. "Comparative Survey of Holding Positions for Reducing Vaccination Pain in Young Infants." Pain Research and Management 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/3273171.

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Background. Infant holding position may reduce vaccination pain. However, the optimal position for young infants remains controversial. Objectives. To compare the effectiveness of holding infants in the supine position and the effectiveness of holding infants in upright position for relieving acute pain from vaccine injection. Methods. This prospective cohort study enrolled 6–12-week-old healthy infants. We examined infant pain responses by evaluating the following three categories: (1) crying, (2) irritability, and (3) facial expression. Results. In total, 282 infants were enrolled, with 103 and 179 held in the supine and upright positions, respectively. At 30 s after vaccination, the infants in the supine position showed a larger decrease in crying (p<0.001), irritability (p=0.002), and pained facial expression (p=0.001) than did those in the upright position. However, there was no significant difference in pain response between two groups at 180 s after intervention. Conclusion. In 2-month-old infants, the supine position may reduce acute pain more effectively than does the upright position. Our findings provide a clinical strategy for relieving vaccination pain in young infants.
3

Rahman, Mahbubur, Miho Sekimoto, Isamu Takamatsu, Kenji Hira, Takuro Shimbo, Kyoichiro Toyoshima, and Tsuguya Fukui. "Economic evaluation of universal BCG vaccination of Japanese infants." International Journal of Epidemiology 30, no. 2 (April 2001): 380–85. http://dx.doi.org/10.1093/ije/30.2.380.

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4

Sandmann, Frank, Mark Jit, Nick Andrews, Hannah L. Buckley, Helen Campbell, Sonia Ribeiro, Bersabeh Sile, et al. "Infant Hospitalizations and Fatalities Averted by the Maternal Pertussis Vaccination Program in England, 2012–2017: Post-implementation Economic Evaluation." Clinical Infectious Diseases 71, no. 8 (February 25, 2020): 1984–87. http://dx.doi.org/10.1093/cid/ciaa165.

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Abstract In October 2012, a maternal pertussis vaccination program was implemented in England following an increased incidence and mortality in infants. We evaluated the cost-effectiveness of the program by comparing pertussis-related infant hospitalizations and deaths in 2012–2017 with nonvaccination scenarios. Despite considerable uncertainties, findings support the cost-effectiveness of the program.
5

Kim, Grace, Jay G. Berry, Jessica L. Janes, Abe Perez, and Matt Hall. "Association of Maternal Tdap Recommendations With Pertussis Hospitalizations of Young Infants." Hospital Pediatrics 12, no. 3 (February 8, 2022): e106-e109. http://dx.doi.org/10.1542/hpeds.2021-006323.

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BACKGROUND It is well established that young infants have the highest risk of severe pertussis, which often results in hospitalization. Since the 2012 recommendation of administering tetanus toxoid, diphtheria toxoid, and acellular pertussis (Tdap) vaccine for every pregnancy, evaluation of pertussis hospitalizations among young infants in the United States has been limited. METHODS In this ecological study, we used the Kids’ Inpatient Database, the largest all-payer pediatric inpatient database in the United States, to study pertussis hospitalizations among infants &lt;1 month of age from 2000 to 2016. RESULTS The overall rate of pertussis hospitalizations before the Tdap vaccination recommendation was 5.06 per 100 000 infants (95% confidence interval, 4.36–5.76) and 2.15 per 100 000 infants (95% confidence interval, 1.49–2.81) afterward. CONCLUSIONS This study supports maternal vaccination against pertussis as an important strategy in protecting young infants, and continued evaluation is needed to assess the long-term trends in hospitalization.
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MO, Taiwo, Adebari HO, Adebayo OS, Sakariyau AO, Akinde OO, and Adegoke OO. "Declining Maternally-Derived Measles Antibodies in Infants and Nursing Mothers in Nigeria: A Review." SOJ Immunology 6, no. 1 (January 2, 2018): 1–7. http://dx.doi.org/10.15226/2372-0948/6/1/00164.

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Measles, also reffered to as rubeolais an endemic respiratory disease caused by a virus. It is a highly contagious infection which typically begins with a mild to moderate fever, often accompanied by a persistent cough, runny nose, conjunctivitis and sore throat. Today, despite the availability of a safe, effective and relatively inexpensive vaccine for more than 40 years, measles still kills more than any other vaccines preventable disease among children. In Pregnant women, IgG immunoglobulin antibody is produced and crosses the placenta to developing fetus’ blood circulation; thereby conferring primary protection against infections in the early life of newborns. The presence or absence of Maternal Measles Antibody (MMA) in infants is therefore a factor to be considered in immunization of infants against measles. In Nigeria, the recommended age for routine measles vaccination for infants is at 9 month of age. However, it has been severely reported that the present-day civilized mothers are more measles vaccine-immuned contrary to been natural measles virus-immuned and as such, produce low titer anti-measles virus antibody which consequently decays or clears from their respective infants earlier than 9 months of age when measles vaccine is routinely administered. Early immunization against measles may potentially minimize the duration of the period between the loss of maternal antibodies transferred via the placenta and the administration of the recommended measles vaccination for infants, hence the need for the re-evaluation of the measles immunization schedule. Keywords: Vaccination; Maternal Measles Antibody; Infant, Virus;
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Channon-Wells, Samuel William, Emily Tough, Neda So, Daniel O'Connor, and Matthew D. Snape. "Differentiating vaccine reactions from invasive bacterial infections in young infants presenting to the emergency department in the 4CMenB era: a retrospective observational comparison." BMJ Paediatrics Open 6, no. 1 (October 2022): e001559. http://dx.doi.org/10.1136/bmjpo-2022-001559.

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BackgroundDifferentiating infants with adverse events following immunisation (AEFIs) or invasive bacterial infection (IBI) is a significant clinical challenge. Young infants post vaccination are therefore often admitted to the hospital for parenteral antibiotics to avoid missing rare cases of IBI.MethodsDuring a service evaluation project, we conducted a single-centre retrospective observational study of infants with IBI, urinary tract infection (UTI) or AEFI from two previously published cohorts. All patients presented to hospital in Oxfordshire, UK, between 2011 and 2018, spanning the introduction of the capsular group-B meningococcal vaccine (4CMenB) into routine immunisation schedules. Data collection from paper and electronic notes were unblinded. Clinical features, including National Institute for Health and Care Excellence (NICE) ‘traffic light’ risk of severe illness and laboratory tests performed on presentation, were described, and comparisons made using regression models, adjusting for age and sex. We also compared biochemical results on presentation to those of well infants post vaccination, with and without 4CMenB regimens.ResultsThe study included 232 infants: 40 with IBI, 97 with probable AEFI, 24 with possible AEFI, 27 with UTI and 44 post vaccination ‘well’ infants. C-reactive protein (CRP) was the only discriminatory blood marker, with CRP values above 83 mg/L only observed in infants with IBI or UTI. NICE risk stratification was significantly different between groups but still missed cases of IBI, and classification as intermediate risk was non-differential. Fever was more common in probable AEFI cases, while seizures and rashes were equally frequent. Diarrhoea and clinician-reported irritability or rigours were all more common in IBI.ConclusionsClinical features on presentation may aid risk stratification but cannot reliably differentiate IBI from AEFI in infants presenting to the emergency department. Blood results are generally unhelpful due to post vaccination inflammatory responses, particularly in children receiving 4CMenB vaccination. Improved biomarkers and clinical prediction tools are required to aid management in febrile infants post vaccination.
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Galvao, Tais F., Marcus T. Silva, Ivan R. Zimmermann, Luiz Antonio B. Lopes, Eneida F. Bernardo, and Mauricio G. Pereira. "Influenza Vaccination in Pregnant Women: A Systematic Review." ISRN Preventive Medicine 2013 (November 7, 2013): 1–8. http://dx.doi.org/10.5402/2013/879493.

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Objective. To assess the effects of the inactivated influenza virus vaccine on influenza outcomes in pregnant women and their infants. Methods. We performed a systematic review of the literature. We searched for randomized controlled trials and cohort studies in the MEDLINE, Embase, and other relevant databases (inception to September 2013). Two researchers selected studies and extracted the data independently. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the quality of the evidence. Results. We included eight studies out of 1,967 retrieved records. Influenza vaccination in pregnant women significantly reduced the incidence of influenza-like illness in mothers and their infants when compared with control groups (high-quality evidence) and reduced the incidence of laboratory-confirmed influenza in infants (moderate-quality evidence). No difference was found with regard to influenza-like illness with fever higher than 38°C (moderate-quality evidence) or upper respiratory infection (very-low-quality evidence) in mothers and infants. Conclusions. Maternal vaccination against influenza was shown to prevent influenza-like illness in women and infants; no differences were found for other outcomes. As the quality of evidence was not high overall, further research is needed to increase confidence and could possibly change these estimates.
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Peltola, Heikki, Assad Safary, Helena Käyhty, Viena Karanko, and Francis E. André. "Evaluation of Two Tetravalent (ACYW135) Meningococcal Vaccines in Infants and Small Children: A Clinical Study Comparing Immunogenicity of O-Acetyl-Negative and O-Acetyl-Positive Group C Polysaccharides." Pediatrics 76, no. 1 (July 1, 1985): 91–96. http://dx.doi.org/10.1542/peds.76.1.91.

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Two different tetravalent polysaccharide vaccines against group A, C, Y, and W135 meningococci were given to 118 infants aged 6 to 23 months; the same vaccines were administered in a second dose 12 months later to those infants aged 6 to 11 months at first vaccination. Forty of the infants received vaccine containing the nonacetylated group C polysaccharide C(OAc-) and 78 the acetylated group C polysaccharide C(OAc+) together with group A, Y, and W135 polysaccharides. All polysaccharides, at a dose of 30 µg, induced antibody responses after administration of both vaccines in all age groups although the responses were better in the older infants. Acetylation of the sialic acid of the group C polysaccharide did not significantly influence the response. Rapid decreases in the antibody titers after the first vaccination stressed the need for one or more revaccinations. Vaccination elicited mild local and systemic reactions. Elevated temperatures were more common in the youngest infants but only four developed fever exceeding 38.5°C (101.3°F). We conclude that tetravalent (ACYW135) meningococcal vaccine is safe and immunologically effective in children younger than age 2 years. However, revaccinations may be required to maintain immunity.
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Kang, Hye-Young, Ki Hwan Kim, Ji Hong Kim, Hwang Min Kim, Jinkyung Kim, Mi-Sun Kim, Antoine C. El Khoury, and Dong Soo Kim. "Economic Evaluation of the National Immunization Program of Rotavirus Vaccination for Children in Korea." Asia Pacific Journal of Public Health 25, no. 2 (January 10, 2012): 145–58. http://dx.doi.org/10.1177/1010539511416806.

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The authors assessed the cost-effectiveness of rotavirus vaccination to develop an evidence-based national immunization program in Korea. A Markov model was constructed to compare the costs and clinical outcomes of vaccination versus no vaccination. The birth cohort of 493189 infants in 2007 was followed until the age of 5 years. Korea-specific data for epidemiological characteristics and economic burden of rotavirus diarrhea were used for the modeled estimation. Efficacy of RotaTeq® was based on a recent clinical trial. Rotavirus vaccination would prevent 181238 symptomatic cases (reduction rate = 63.2%) over 5 years after birth. From the societal perspective, at a vaccination cost of 100000 Korean won (KW; 1 US$ ≈ 1200 KW) per dose, universal vaccination would cost 375 620 KW per case averted. The breakeven price of vaccine was 56061 KW. Rotavirus vaccination would reduce the burden of the disease substantially and be a cost-effective strategy to prevent rotavirus diarrhea in Korea.
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Matvienko-Sikar, Karen, Elaine Toomey, Michelle Queally, Caragh Flannery, Kate O Neill, Ted G. Dinan, Edel Doherty, et al. "Choosing Healthy Eating for Infant Health (CHErIsH) study: protocol for a feasibility study." BMJ Open 9, no. 8 (August 2019): e029607. http://dx.doi.org/10.1136/bmjopen-2019-029607.

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IntroductionChildhood obesity is a public health challenge. There is evidence for associations between parents’ feeding behaviours and childhood obesity risk. Primary care provides a unique opportunity for delivery of infant feeding interventions for childhood obesity prevention. Implementation strategies are needed to support infant feeding intervention delivery. The Choosing Healthy Eating for Infant Health (CHErIsH) intervention is a complex infant feeding intervention delivered at infant vaccination visits, alongside a healthcare professional (HCP)-level implementation strategy to support delivery.Methods and analysisThis protocol provides a description of a non-randomised feasibility study of an infant feeding intervention and implementation strategy, with an embedded process evaluation and economic evaluation. Intervention participants will be parents of infants aged ≤6 weeks at recruitment, attending a participating HCP in a primary care practice. The intervention will be delivered at the infant’s 2, 4, 6, 12 and 13 month vaccination visits and involves brief verbal infant feeding messages and additional resources, including a leaflet, magnet, infant bib and sign-posting to an information website. The implementation strategy encompasses a local opinion leader, HCP training delivered prior to intervention delivery, electronic delivery prompts and additional resources, including a training manual, poster and support from the research team. An embedded mixed-methods process evaluation will examine the acceptability and feasibility of the intervention, the implementation strategy and study processes including data collection. Qualitative interviews will explore parent and HCP experiences and perspectives of delivery and receipt of the intervention and implementation strategy. Self-report surveys will examine fidelity of delivery and receipt, and acceptability, suitability and comprehensiveness of the intervention, implementation strategy and study processes. Data from electronic delivery prompts will also be collected to examine implementation of the intervention. A cost–outcome description will be conducted to measure costs of the intervention and the implementation strategy.Ethics and disseminationThis study received approval from the Clinical Research Ethics Committee of the Cork Teaching Hospitals. Study findings will be disseminated via peer-reviewed publications and conference presentations.
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Cevigney, Rachel, Christopher Leary, and Bernard Gonik. "Adjustable Algorithmic Tool for Assessing the Effectiveness of Maternal Respiratory Syncytial Virus (RSV) Vaccination on Infant Mortality in Developing Countries." Infectious Diseases in Obstetrics and Gynecology 2021 (May 24, 2021): 1–7. http://dx.doi.org/10.1155/2021/5536633.

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Acute lower respiratory infection (ALRI) due to RSV is a common cause of global infant mortality, with most cases occurring in developing countries. Using data aggregated from priority countries as designated by the United States Agency for International Development’s (USAID) Maternal Child Health and Nutrition (MCHN) program, we created an adjustable algorithmic tool for visualizing the effectiveness of candidate maternal RSV vaccination on infant mortality. Country-specific estimates for disease burden and case fatality rates were computed based on established data. Country-specific RSV-ALRI incidence rates for infants 0-5 months were scaled based on the reported incidence rates for children 0-59 months. Using in-hospital mortality rates and predetermined “inflation factor,” we estimated the mortality of infants aged 0-5 months. Given implementation of a candidate maternal vaccination program, estimated reduction in infant RSV-ALRI incidence and mortality rates were calculated. User input is used to determine the coverage of the program and the efficacy of the vaccine. Using the generated algorithm, the overall reduction in infant mortality varied considerably depending on vaccine efficacy and distribution. Given a potential efficacy of 70% and a maternal distribution rate of 50% in every USAID MCHN priority country, annual RSV-ALRI-related infant mortality is estimated to be reduced by 14,862 cases. The absolute country-specific reduction is dependent on the number of live births; countries with the highest birth rates had the greatest impact on annual mortality reduction. The adjustable algorithm provides a standardized analytical tool in the evaluation of candidate maternal RSV vaccines. Ultimately, it can be used to guide public health initiatives, research funding, and policy implementation concerning the effectiveness of potential maternal RSV vaccination on reducing infant mortality.
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Williams, J. R., D. J. Nokes, G. F. Medley, and R. M. Anderson. "The transmission dynamics of hepatitis B in the UK: a mathematical model for evaluating costs and effectiveness of immunization programmes." Epidemiology and Infection 116, no. 1 (February 1996): 71–89. http://dx.doi.org/10.1017/s0950268800058970.

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SummaryComplex hepatitis B (HBV) epidemiology makes it difficult to evaluate and compare effectiveness of different immunization policies. A method for doing so is presented using a mathematical model of HBV transmission dynamics which can represent universal infant and adolescent vaccination strategies and those targeted at genito-urinary (GU) clinic attenders and infants born to infectious mothers. Model structure, epidemiological underpinning, and parameterization, are described. Data from the UK National Survey of Sexual Attitudes and Lifestyles is used to define patterns of sexual activity and GU clinic attendance; data deficiencies are discussed, in particular that of UK seroprevalence of HBV markers stratified by age, sex, and risk factors. General model predictions of endemic HBV marker prevalence in homosexual and heterosexual populations seem consistent with published UK data. The simulations exhibit non-linearities in the impact of different vaccination strategies. Estimated number of carriers prevented per vaccine dose for each strategy provides a measure of costs and benefits, varying temporally over the course of a programme, and with level of vaccine coverage. Screening before vaccination markedly increases payback per dose in homosexuals but not in heterosexuals; mass infant vaccination gives the poorest effectiveness ratio and vaccination of infants after antenatal screening the best; in general, increasing vaccine coverage yields lower pay-back per dose. The model provides a useful framework for evaluating costs and benefits of immunization programmes, but for precise quantitative comparison more UK epidemiological data is urgently needed.
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Mahoney, Francis J., Margaret Lawrence, Cathy Scott, Quan Le, Steve Lambert, and Thomas A. Farley. "Continuing Risk for Hepatitis B Virus Transmission Among Southeast Asian Infants in Louisiana." Pediatrics 96, no. 6 (December 1, 1995): 1113–16. http://dx.doi.org/10.1542/peds.96.6.1113.

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Objective. Implementation and evaluation of a hepatitis B vaccination program for Southeast Asian infants in Louisiana. Methods. A baseline seroprevalence survey of hepatitis B virus (HBV) infection in US-born Southeast Asian children was conducted in 1991 before the implementation of a vaccination program. Hepatitis B vaccination and postvaccination serologic testing of survey participants 10 years of age and younger was performed. Eighteen months after the hepatitis B vaccine was integrated into infant immunization schedules in July 1993, a vaccination coverage survey was performed. Results. Baseline serologic testing was conducted on 96% of persons from 225 randomly selected households in a Southeast Asian community in Louisiana. Of 676 US-born children, 28 (4.1%) had chronic HBV infection; 61% of children with chronic HBV infection were born to hepatitis B surface antigen (HBsAg)-negative women. Among children born to HBsAg-negative women, the prevalence of chronic HBV infection increased with age, reaching 7.3% for children 13 to 16 years of age. Children born to HBsAg-negative women and living with carriers were 5.4 times more likely to have evidence of HBV infection than were children who did not live with carriers. Before the survey, only one child had received three doses of hepatitis B vaccine. In July 1993, 43% of Southeast Asian infants 9 to 18 months of age born in Louisiana had received three doses of hepatitis B vaccine. Infants who received immunizations from private providers were more likely to be fully vaccinated than were infants who received services from public sector clinics (prevalence ratio, 2.1; 95% confidence interval, 1.4,3.1). Conclusions. HBV transmission occurs throughout childhood in US-born Southeast Asian children, and the prevalence of chronic HBV infection approaches that of the country of origin. Few US-born Southeast Asian children have received hepatitis B vaccine. Because of the high rates of early childhood HBV transmission and the high risk of chronic infection in Asian and Pacific Islander communities, prevention efforts should be enhanced to ensure that all Asian and Pacific Islander infants receive hepatitis B vaccine in the first 12 months of life and that older children are vaccinated.
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Fleury, Juliette, Pauline Scherdel, Eric Frampas, Nathalie Vabres, Caroline Rey-Salmon, Marie Blot, Elise Launay, Martin Chalumeau, and Christèle Gras-Le Guen. "Evaluation of a Temporal Association between Vaccination and Subdural Hematoma in Infants." Journal of Pediatrics 209 (June 2019): 134–38. http://dx.doi.org/10.1016/j.jpeds.2019.01.044.

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Leino, Tuija, Jukka Ollgren, Nina Strömberg, and Ulpu Elonsalo. "Evaluation of the Intussusception Risk after Pentavalent Rotavirus Vaccination in Finnish Infants." PLOS ONE 11, no. 3 (March 7, 2016): e0144812. http://dx.doi.org/10.1371/journal.pone.0144812.

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Rinta-Kokko, Hanna, Arto A. Palmu, Esa Ruokokoski, Heta Nieminen, Marta Moreira, Lode Schuerman, Dorota Borys, and Jukka Jokinen. "Evaluation of the indirect impact of the 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine in a cluster-randomised trial." PLOS ONE 17, no. 1 (January 5, 2022): e0261750. http://dx.doi.org/10.1371/journal.pone.0261750.

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Background In the nation-wide double-blind cluster-randomised Finnish Invasive Pneumococcal disease trial (FinIP, ClinicalTrials.gov NCT00861380, NCT00839254), we assessed the indirect impact of the 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against five pneumococcal disease syndromes. Methods Children 6 weeks to 18 months received PHiD-CV10 in 48 clusters or hepatitis B/A-vaccine as control in 24 clusters according to infant 3+1/2+1 or catch-up schedules in years 2009―2011. Outcome data were collected from national health registers and included laboratory-confirmed and clinically suspected invasive pneumococcal disease (IPD), hospital-diagnosed pneumonia, tympanostomy tube placements (TTP) and outpatient antimicrobial prescriptions. Incidence rates in the unvaccinated population in years 2010―2015 were compared between PHiD-CV10 and control clusters in age groups <5 and ≥5 years (5―7 years for TTP and outpatient antimicrobial prescriptions), and in infants <3 months. PHiD-CV10 was introduced into the Finnish National Vaccination Programme (PCV-NVP) for 3-month-old infants without catch-up in 9/2010. Results From 2/2009 to 10/2010, 45398 children were enrolled. Vaccination coverage varied from 29 to 61% in PHiD-CV10 clusters. We detected no clear differences in the incidence rates between the unvaccinated cohorts of the treatment arms, except in single years. For example, the rates of vaccine-type IPD, non-laboratory-confirmed IPD and empyema were lower in PHiD-CV10 clusters compared to control clusters in 2012, 2015 and 2011, respectively, in the age-group ≥5 years. Conclusions This is the first report from a clinical trial evaluating the indirect impact of a PCV against clinical outcomes in an unvaccinated population. We did not observe consistent indirect effects in the PHiD-CV10 clusters compared to the control clusters. We consider that the sub-optimal trial vaccination coverage did not allow the development of detectable indirect effects and that the supervening PCV-NVP significantly diminished the differences in PHiD-CV10 vaccination coverage between the treatment arms.
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Ogokeh, Constance E., Manish Patel, Joana Y. Lively, Mary A. Staat, Geoffrey A. Weinberg, Julie A. Boom, Janet A. Englund, et al. "2738. Influenza Vaccination During Pregnancy Among Mothers of Infants with Acute Respiratory Illness, United States, 2016–2018." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S963—S964. http://dx.doi.org/10.1093/ofid/ofz360.2416.

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Abstract Background Influenza vaccination has been shown to reduce influenza risk in pregnant women and their infants who are not yet age-eligible for vaccine. Ascertainment of vaccination history is important for vaccine safety and effectiveness evaluations. Our goals were to (a) determine coverage, location, and timing of maternal influenza vaccination and (b) compare a subset of self-reported influenza vaccinations with documented vaccine records. Methods We enrolled children < 18 years. with acute respiratory illness in 7 pediatric hospitals and emergency departments in the New Vaccine Surveillance Network from December 1, 2016 to October 31, 2018. We interviewed all mothers of enrolled infants < 1 year, and obtained mother’s influenza vaccine information while pregnant. As an option, sites obtained maternal influenza vaccine records from reported sources (e.g., registries, provider records, pharmacies). Results Among 5,458 mothers, 2,944 (54%) self-reported receiving influenza vaccine during pregnancy (57% in 2016–2017; 51% in 2017–2018), varying from 49% to 74% by site. Among self-reported vaccinees, 17%, 36%, and 47% received vaccine during their first, second, and third trimester, respectively. Most women (76%) were vaccinated at their OB/GYN or midwife office, 7% at their primary care provider, 7% at their workplace, and 5% at a retail pharmacy. Among 1,338 infants < 6 months. during early influenza season (i.e., born from June to August) and thus ineligible for vaccination, only 46% of mothers reported receiving vaccine during pregnancy (42% reported not receiving it, 12% were unsure). Of 2,242 women for whom vaccine verification was attempted, 1,491 (67%) self-reported receiving influenza vaccine during pregnancy; of those, documentation of vaccine receipt was found for 901 (60%). Conclusion Influenza vaccination coverage among pregnant women was suboptimal, potentially increasing the risk of influenza in unvaccinated pregnant women. Infants born to unvaccinated women, particularly those born from June to August, may also be at higher risk since they are not age-eligible to receive vaccine before influenza season. The optimal approach to ascertainment of maternal vaccination history with accuracy and completeness merits further investigation. Disclosures All authors: No reported disclosures.
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Hartati, Edim, Ismoedijanto Ismoedijanto, and Soegeng Soegijanto. "Comparison of Neutralizing Antibody Response to Type 1 Polio Virus on Healthy Infants Receiving either Oral Monovalen Polio Vaccine Type 1 or Oral Trivalen Polio Vaccine Given with Basic DTP/Hb Immunization." Indonesian Journal of Tropical and Infectious Disease 1, no. 1 (April 1, 2010): 5. http://dx.doi.org/10.20473/ijtid.v1i1.3715.

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In March 2005, there was outbreak of Polio-1 and expanded throughout Java and Sumatera island. Oral monovalent polio vaccinetype 1 (mOPV1) had succeeded in evereeming polio outbreak in Indonesia in 2005. This study aimed to compare neutralizing antibodyresponse to type 1 polio virus in healthy infants receiving either mOPV1 or oral trivalent Polio Vaccine (tOPV), given with other basicvaccination (DTP/HB). Randomized controlled singel blind clinical trial on healthy infants range age 42 to 80 days who had receivedfirst oral polio vaccine before 1 month of age. Trial group received mOPV1 and control group tOPV, each had 3 times of vaccination.Blood samples were taken three times (pre vaccination, post second and third vaccination) for measurement of neutralizing antibody topolio virus. Thirty subjects from mOPV1 group and 29 from tOPV group were analyzed. Post second vaccination, mOPV1 group (456)had more increase in geometric mean titer of neutralizing antibody than tOPV group (317) but not significant (p=0.514). Post thirdvaccination the level of neutralizing antibody titer was almost equal in both groups. Proportion of seroconversion to type 1 polio virusin mOPV1 group 53.9%, 57.7% and tOPV group 25.9%, 41.7% (on second and third evaluation respectively), both were statisticallyinsignificant. Antibody response measured by neutralizing antibody titer and proportion of seroconversion on antibody to type 1 poliovirus in healthy infants receiving mOPV1 vaccination was similar to they receiving tOPV.
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Sun, Mei, Chengyue Li, Dan Wu, Pingping Li, Jun Lu, Ying Wang, Fengshui Chang, Xiaohong Li, and Mo Hao. "Impact evaluation of the routine hepatitis B vaccination program of infants in China." Journal of Public Health 41, no. 1 (January 27, 2018): 158–63. http://dx.doi.org/10.1093/pubmed/fdy015.

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H.R., Teni, Wisnu Barlıanto, I. Wayan Arsana Wıyasa, H. M. S. Kusuma, Tita Sari, and Novilia Bachtıar. "Analysis of specific antibody and cellular immune response to first-dose measles vaccine Edmonston-Zagreb (EZ) in 9-month-old infants." Allergologia et Immunopathologia 49, no. 3 (May 1, 2021): 193–201. http://dx.doi.org/10.15586/aei.v49i3.6.

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Background: Measles vaccinations have been suggested to provide immune protection and decreased measles incidence. However, there was a limited study evaluating how the measles vaccine elicits specific immune responses.Objective: This study aimed to evaluate both humoral and cellular immunity to first-dose measles vaccine Edmonston-Zagreb (EZ) in 9-month-old Indonesian infants.Methods: A cohort study was conducted on 9-month-old infants who got the first-dose of measles vaccine EZ. Measles-specific immunoglobulin G (IgG) antibody serum levels were measured using plaque-reduction microneutralization assay. Peripheral blood mononuclear cells were stimulated with a measles-specific peptide to identify a cellular immune response. Quantification of CD4+ and CD8+ T-cells producing interferon-gamma (IFN-ɣ) and interleu-kin 17-A (IL-17A) were conducted by flow cytometry. Humoral and cellular immune response parameters were analyzed over time.Results: The prevalence of seropositivity rates was 85.8% at 1-month after vaccination and 16.67% at 6-months postvaccination. Measles-specific IgG antibodies increased significantly at 1-month after measles vaccination. However, they decreased significantly 6-months after vaccination. IFN-ɣ and IL-17A secreting T-cells increased significantly at 1-month after measles vaccination. Interestingly, a significant decrease of IFN-ɣ and IL-17A secreting CD4+ T cells was noticed 6-months postvaccination compared to IFN-ɣ and IL-17A secreting CD8+ T cells. Conclusion: Our study suggests that the first-dose measles vaccine on 9-months-old infants seems to induce both humoral and cellular immune responses that decline 6-months after vaccination.
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Skinner, Julie, Lani Indrawati, Michael Winters, John MacNair, Walter Manger, Hari Pujar, Jeffrey Blue, Joseph Antonello, Jon Heinrichs, and Michael Caulfield. "Preclinical evaluation of a 15-valent pneumococcal polysaccharide-protein conjugate vaccine in infant rhesus monkeys (52.20)." Journal of Immunology 184, no. 1_Supplement (April 1, 2010): 52.20. http://dx.doi.org/10.4049/jimmunol.184.supp.52.20.

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Abstract The incidence of invasive pneumococcal disease (IPD) caused by the 91 serotypes of Streptococcus pneumoniae (PN) varies geographically and temporally as a result of changing epidemiology and vaccination. Prevnar® (Pfizer), the first licensed pneumococcal conjugate vaccine (PCV), comprises polysaccharides (PS) from 7 serotypes conjugated to the mutant diphtheria toxin carrier protein, CRM197. In the United States, this vaccine has been highly efficacious in reducing the incidence of IPD caused by vaccine serotypes, however, the incidence of non-vaccine serotypes (e.g., 19A, 22F, and 33F) has increased resulting in the need for vaccines with higher valencies. Indeed, 10- and 13-valent PCVs have recently been licensed. For expanded coverage, we have developed a 15-valent PCV containing PS from serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F and 33F conjugated to CRM197 and formulated on aluminum phosphate adjuvant. The vaccine was tested in infant rhesus monkeys since they, like human infants, do not respond to unconjugated PN PS. Infant (2-3 month old) rhesus monkeys were vaccinated 3 times with PCV-15 or Prevnar® at 2 month intervals, and serotype-specific IgG antibodies were measured using a multiarray electrochemiluminescence (ECL) assay. The results indicate that antibody responses to PCV-15 and Prevnar® were comparable for the 7 common serotypes and that post-vaccination responses to PCV-15 were &gt; 10-fold higher than baseline for the 8 added serotypes.
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Roduit, Caroline, Paola Bozzotti, Nathalie Mielcarek, Paul-Henri Lambert, Giuseppe del Giudice, Camille Locht, and Claire-Anne Siegrist. "Immunogenicity and Protective Efficacy of Neonatal Vaccination against Bordetella pertussis in a Murine Model: Evidence for Early Control of Pertussis." Infection and Immunity 70, no. 7 (July 2002): 3521–28. http://dx.doi.org/10.1128/iai.70.7.3521-3528.2002.

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ABSTRACT A significant resurgence of early cases of pertussis is being observed in infants too young to have yet completed their three-dose vaccination schedule. In this study, murine models of immunization and Bordetella pertussis challenge were adapted to early life. This allowed comparative evaluation of immunogenicity and protective efficacy of immunization initiated in the neonatal period (7-day-old mice) or in infancy (3-week-old mice) with diphtheria-tetanus-whole-cell pertussis (DTPw) and diphtheria-tetanus-acellular pertussis (DTPa) vaccines. Neonatal DTPa vaccination induced strong pertussis-specific antibody and memory responses. Patterns of bacterial clearance were similar in both age groups. In contrast, as observed in human neonates, neonatal DTPw priming did not induce significant antibody responses to pertussis toxin (PT) and filamentous hemagglutinin (FHA) and even interfered with subsequent antibody responses. However, this did not reflect induction of permanent neonatal tolerance, as antigen-specific antibodies could be elicited by subsequent exposure to DTPa. Furthermore, despite these blunted PT and FHA antibody responses, the protective efficacy of DTPw in neonatal mice proved similar to that in infant mice, resulting in complete bacterial clearance at day 8 after B. pertussis challenge. Thus, neonatal priming with antipertussis vaccines should be considered to reduce the window of vulnerability to pertussis at the time of its greatest severity.
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Asiado, Annabelle Joy, Sweet Zerlyn Cabuntucan, and Cereneo Jr Santiago. "Routine Vaccine Simulation for Infants in a Mobile Environment." International Journal of Computing Sciences Research 6 (January 1, 2022): 763–80. http://dx.doi.org/10.25147/ijcsr.2017.001.1.73.

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Purpose–Thisstudy aimed to develop and evaluate the Routine Vaccine Simulation for Infants. The routine vaccine simulation application was developed for the health workers and parents to provide basic information and press the importance of the vaccination to infants.Method–The researchers used the fourth-generation technique (4GT) for the software development life cycle of the application. The technique adapted contains four major parts namely, requirements gathering, design strategy, implementation, and testing.Results–The application was tested and evaluated by health workers, parents, and IT practitioners from the academe and the industry. The evaluation was based on criteria for core app quality. Descriptive and inferential statistics were employed for data presentation and interpretation. As a whole, the evaluation of the android-based routine vaccine simulation application was found excellent in most of its features. The finding asserts the adherence to the standards of android developmentapplicationsand conforms to the expectations of the app’s potentialusers. Conclusion–The development of a routine vaccine app for infants serves as a new platform for immunization awareness and education. Once information given in the app is taken earnestly, infants will be protected against diseases. Thus, controversies surrounding vaccination hesitancies can be decreased.Recommendations–A thorough information dissemination and education campaign regarding vaccine safety can be initiated in the local communities to address the issues on vaccine safety and hesitancy.Research Implications–The healthcare system in the communities through the local government unit (LGU) willbe able to benchmark and implement the information dissemination and education to mothers and health workers using the app.
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Su, Jiang, Mark J. Ferson, Alan E. Stark, and Peter W. Robertson. "Evaluation of the neonatal hepatitis B vaccination program in infants born to Chinese mothers." Medical Journal of Australia 166, no. 8 (April 1997): 446–47. http://dx.doi.org/10.5694/j.1326-5377.1997.tb123205.x.

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Vazquez-Pagan, Ana, and Stacey Schultz-Cherry. "Serological Responses to Influenza Vaccination during Pregnancy." Microorganisms 9, no. 11 (November 6, 2021): 2305. http://dx.doi.org/10.3390/microorganisms9112305.

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Pregnant women, newborns, and infants under six months old are at the highest risk of developing severe and even fatal influenza. This risk is compounded by the inability to vaccinate infants under six months, highlighting the importance of vertically transferred immunity. This review identifies novel insights that have emerged from recent studies using animal models of pregnancy and vaccination. We also discuss the knowledge obtained using existing clinical trials that have evaluated influenza-specific serological responses in pregnant women and how these responses may impact early life immunity. We delineate the mechanisms involved in transferring specific maternal antibodies and discuss the consequences for early life immunity. Most importantly, we highlight the need for continued research using pregnant animal models and the inclusion of pregnant women, a commonly neglected population, when evaluating novel vaccine platforms to better serve and treat communicable diseases.
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Callahan, Emily A., Talal Chatila, Richard J. Deckelbaum, Catherine J. Field, Frank R. Greer, Olle Hernell, Kirsi M. Järvinen, et al. "Assessing the safety of bioactive ingredients in infant formula that affect the immune system: recommendations from an expert panel." American Journal of Clinical Nutrition 115, no. 2 (December 4, 2021): 570–87. http://dx.doi.org/10.1093/ajcn/nqab346.

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ABSTRACT Bioactive ingredients for infant formula have been sought to reduce disparities in health outcomes between breastfed and formula-fed infants. Traditional food safety methodologies have limited ability to assess some bioactive ingredients. It is difficult to assess the effects of nutrition on the infant immune system because of coincident developmental adaptations to birth, establishment of the microbiome and introduction to solid foods, and perinatal environmental factors. An expert panel was convened to review information on immune system development published since the 2004 Institute of Medicine report on evaluating the safety of new infant formula ingredients and to recommend measurements that demonstrate the safety of bioactive ingredients intended for that use. Panel members participated in a 2-d virtual symposium in November 2020 and in follow-up discussions throughout early 2021. Key topics included identification of immune system endpoints from nutritional intervention studies, effects of human milk feeding and human milk substances on infant health outcomes, ontologic development of the infant immune system, and microbial influences on tolerance. The panel explored how “nonnormal” conditions such as preterm birth, allergy, and genetic disorders could help define developmental immune markers for healthy term infants. With consideration of breastfed infants as a reference, ensuring proper control groups, and attention to numerous potential confounders, the panel recommended a set of standard clinical endpoints including growth, response to vaccination, infection and other adverse effects related to inflammation, and allergy and atopic diseases. It compiled a set of candidate markers to characterize stereotypical patterns of immune system development during infancy, but absence of reference ranges, variability in methods and populations, and unreliability of individual markers to predict disease prevented the panel from including many markers as safety endpoints. The panel's findings and recommendations are applicable for industry, regulatory, and academic settings, and will inform safety assessments for immunomodulatory ingredients in foods besides infant formula.
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Teljeur, Conor, Patrick S. Moran, Patricia Harrington, Karina Butler, Brenda Corcoran, Joan O’Donnell, Cara Usher, Darina O’Flanagan, Kevin Connolly, and Máirín Ryan. "Economic Evaluation of Selective Neonatal Bacillus Calmette-Guérin Vaccination of High-risk Infants in Ireland." Pediatric Infectious Disease Journal 37, no. 8 (August 2018): 759–67. http://dx.doi.org/10.1097/inf.0000000000001891.

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Panda, Bijoy Kumar, Raveena Bajaj, Deepika Surve, and Ruma Deshpande. "Safety evaluation following immunization of pentavalent vaccine (multi-dose vial): experiences and comparative study." International Journal of Contemporary Pediatrics 8, no. 2 (January 22, 2021): 243. http://dx.doi.org/10.18203/2349-3291.ijcp20210107.

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Background: Combination vaccines have many benefits but sometimes may result in unexpected side effects which may make the vaccine unfit for administration particularly with multidose vials.Methods: Healthy infants aged 6-8 weeks who came for routine immunization of liquid pentavalent vaccine were included in the study. All infants were observed for 30 minutes, post vaccination. Telephonic interview was conducted to detect AEFIs at 1 week and 1 month post vaccination.Results: The common AEFIs were found to be fever and pain at injection site. A comparison of the incidence (per 100 doses) of AEFIs after 1st, 2nd and 3rd dose of pentavalent vaccine showed that AEFIs goes on reducing with dose. Incidence (per 100 doses) of fever and local AEFIs was more (statistically significant) with multi-dose vial pentavalent vaccine.Conclusions: The multi-dose vial liquid pentavalent vaccine was found to be equally tolerable compared to single-dose vial liquid pentavalent vaccine.
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Buchwald, Andrea G., Ibrahima Teguete, Moussa Doumbia, Fadima C. Haidara, Flanon Coulibaly, Fatoumata Diallo, Samba O. Sow, William C. Blackwelder, and Milagritos D. Tapia. "Clinical Evaluations Have Low Sensitivity for Identifying Preterm Infants in a Clinical Trial in a Limited Resource Setting." Global Pediatric Health 6 (January 2019): 2333794X1985740. http://dx.doi.org/10.1177/2333794x19857402.

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Preterm birth is a primary outcome of interest in maternal vaccination trials but determination of gestational age is challenging in limited-resource settings. This study compares the New Ballard Score and fundal height measurements with the current standard of early ultrasound for sensitivity of predicting preterm birth. A trial of maternal influenza vaccination was conducted in Bamako, Mali. The New Ballard Score and fundal height were collected on 4038 infants born in the trial, ultrasound data were available for 1893 of those infants. New Ballard Score and fundal height were compared, consecutively, to all ultrasound results, early ultrasound results from the first trimester, and the date of last menstrual period for estimation of gestational age. Sensitivity of the New Ballard Score for identifying preterm infants was 0.33 compared with early ultrasound and 0.1 compared with the last menstrual period based estimates of gestational age. Sensitivity of low birth weight alone was 0.43 compared with early ultrasound. New Ballard Score estimated gestational age within 1 week of ultrasound more frequently than fundal height (53% compared with 7.6%, respectively) yet New Ballard Score identified few infants as preterm (1.8% vs 5.8% by early ultrasound), and was biased toward categorizing low birth weight infants and infants requiring hospitalization as preterm. New Ballard Score is not an ideal measure for identifying preterm births in low-resource settings. Despite the time and cost of training required for correct measurement of New Ballard Score, measurement of low birth weight alone performed better than New Ballard Score for identifying preterm infants.
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Silé Souam Nguélé, Haoua Démadji Béléti, Djidita Hagré Youssouf, Kanezouné Gongnet, Ildjima Ousmane Kadallah, Adrienne Ngaringuem, Séraphin Nguefack, and Avoksouma Djona Atchénémou. "Explanatory factors of the psychomotor development of infants aged 1-24 months in N'Djamena (Chad)." World Journal of Advanced Research and Reviews 13, no. 1 (January 30, 2022): 019–26. http://dx.doi.org/10.30574/wjarr.2022.13.1.0750.

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Introduction: Psychomotor development (PMD) reflects the cerebral maturation through sensory, motor and psychological acquisitions of an individual. Its evaluation allows an early diagnosis of delays in order to take care of them. The objective of this study was to determine the profile and explanatory factors of PMD of infants in N'Djamena. Methods: This was a cross-sectional study conducted at the “Notre Dame des Apôtres” Hospital in N'Djamena. It involved 428 infants aged 1 to 24 months received in preventive consultation between October 2017 and June 2018. The Denver II scale was used for the assessment of PMD. Data were analyzed with SPSS 21.0 software. Results: the sex ratio was 1.06. The most represented age group was under 3 months (35.5%). The items of gross motor skills were 95% completed, fine motor skills 93.8%, language 84.6% and sociability 68.8% at the 90th percentile. Development was advanced in 56.8% normal in 32.1% and delayed in 2.1%. Statistically significant differences in PMD were observed according to age group (p= 0.000), vaccination status (p= 0.002), feeding mode (p= 0.000), maternal exchange (p= 0.000) and pregnancy follow-up (p= 0.03). Conclusion: The psychomotor development of N'Djamenese infants is similar to that of other African children, although some variations are noted. It is influenced by certain factors related to the infant and the mother.
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Groome, Michelle J., Jacqueline E. Tate, Marion Arnold, Milind Chitnis, Sharon Cox, Corné de Vos, Mari Kirsten, et al. "Evaluation of Intussusception After Oral Monovalent Rotavirus Vaccination in South Africa." Clinical Infectious Diseases 70, no. 8 (May 24, 2019): 1606–12. http://dx.doi.org/10.1093/cid/ciz431.

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Abstract Background Postlicensure studies have shown an association between rotavirus vaccination and intussusception. We assessed the risk of intussusception associated with Rotarix (RV1) administration, at 6 and 14 weeks of age, in an upper-middle-income country, South Africa. Methods Active prospective surveillance for intussusception was conducted in 8 hospitals from September 2013 through December 2017. Retrospective case enrollment was done at 1 hospital from July 2012 through August 2013. Demographic characteristics, symptom onset, and rotavirus vaccine status were ascertained. Using the self-controlled case-series method, we estimated age-adjusted incidence rate ratios within 1–7, 8–21, and 1–21 days of rotavirus vaccination in children aged 28–275 days at onset of symptoms. In addition, age-matched controls were enrolled for a subset of cases (n = 169), and a secondary analysis was performed. Results Three hundred forty-six cases were included in the case-series analysis. Post–dose 1, there were zero intussusception cases within 1–7 days, and 5 cases within 8–21 days of vaccination. Post–dose 2, 15 cases occurred within 1–7 days, and 18 cases within 8–21 days of vaccination. There was no increased risk of intussusception 1–7 days after dose 1 (no cases observed) or dose 2 (relative incidence [RI], 1.71 [95% confidence interval {CI} .83–3.01]). Similarly, there was no increased risk 8–21 days after the first (RI, 4.01 [95% CI, .87–10.56]) or second dose (RI, .96 [95% CI, .52–1.60]). Results were similar for the case-control analysis. Conclusions The risk of intussusception in the 21 days after the first or second dose of RV1 was not higher than the background risk among South Africa infants. Clinical Trials Registration South African National Clinical Trial Register (DOH-27-0913-4183).
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Papp, Kim A., Boulos Haraoui, Deepali Kumar, John K. Marshall, Robert Bissonnette, Alain Bitton, Brian Bressler, et al. "Vaccination Guidelines for Patients With Immune-Mediated Disorders on Immunosuppressive Therapies." Journal of Cutaneous Medicine and Surgery 23, no. 1 (November 21, 2018): 50–74. http://dx.doi.org/10.1177/1203475418811335.

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Background:Patients with immune-mediated diseases on immunosuppressive therapies have more infectious episodes than healthy individuals, yet vaccination practices by physicians for this patient population remain suboptimal.Objectives:To evaluate the safety and efficacy of vaccines in individuals exposed to immunosuppressive therapies and provide evidence-based clinical practice recommendations.Methods:A literature search for vaccination safety and efficacy in patients on immunosuppressive therapies (2009-2017) was conducted. Results were assessed using the Grading of Recommendation, Assessment, Development, and Evaluation system.Results:Several immunosuppressive therapies attenuate vaccine response. Thus, vaccines should be administered before treatment whenever feasible. Inactivated vaccines can be administered without treatment discontinuation. Similarly, evidence suggests that the live zoster vaccine is safe and effective while on select immunosuppressive therapy, although use of the subunit vaccine is preferred. Caution regarding other live vaccines is warranted. Drug pharmacokinetics, duration of vaccine-induced viremia, and immune response kinetics should be considered to determine appropriate timing of vaccination and treatment (re)initiation. Infants exposed to immunosuppressive therapies through breastmilk can usually be immunized according to local guidelines. Intrauterine exposure to immunosuppressive agents is not a contraindication for inactivated vaccines. Live attenuated vaccines scheduled for infants and children ⩾12 months of age, including measles, mumps, rubella, and varicella, can be safely administered as sufficient time has elapsed for drug clearance.Conclusions:Immunosuppressive agents may attenuate vaccine responses, but protective benefit is generally maintained. While these recommendations are evidence based, they do not replace clinical judgment, and decisions regarding vaccination must carefully assess the risks, benefits, and circumstances of individual patients.
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Calvo-Lerma, Joaquim, Pierre Bueno-Llamoga, Christine Bäuerl, Erika Cortés-Macias, Marta Selma-Royo, Francisco Pérez-Cano, Carles Lerin, Cecilia Martínez-Costa, and Maria Carmen Collado. "Persistence of Anti SARS-CoV-2 Antibodies in Breast Milk from Infected and Vaccinated Women after In Vitro-Simulated Gastrointestinal Digestion." Nutrients 14, no. 10 (May 19, 2022): 2117. http://dx.doi.org/10.3390/nu14102117.

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Breastfeeding is key for infant development and growth. Breast milk contains different bioactive compounds including antibodies. Recent studies have demonstrated the presence of breast milk SARS-CoV-2 antibodies after maternal infection and vaccination. However, the potential impact on the infant has not been explored yet. As a first step, we aimed at assessing the potential persistence of SARS-CoV-2 IgA and IgG antibodies from infected and vaccinated women in the gastrointestinal tract of the infants by means of an in vitro-simulated gastrointestinal digestion approach. Breast milk samples from 10 lactating women receiving mRNA vaccination against SARS-CoV-2 (n = 5 with BNT162b2 mRNA and n = 5 with mRNA-1273) and also, COVID-19 infected (n = 5) were included. A control group with women with no exposure to the virus (n = 10 pre-pandemic) were also studied. The presence of IgA and IgG SARS-CoV-2 antibody levels was determined by ELISA after the gastric and intestinal stages. The impact of digested antibodies on infant gut microbiota was tested by simulating colonic fermentation with two different fecal inoculums: infants from vaccinated and non-vaccinated mothers. Specific gut microbial groups were tested by targeted qPCR. In vitro infant gastrointestinal digestion significantly decreased the levels of both anti-SARS-CoV-2 IgA and IgG. However, both remained resistant in all the study groups except in that evaluating breast milk samples from infected women, in which IgG was degraded below the cut-off values in the intestinal phase. No effect of the antibodies on microbiota were identified after digestion. In conclusion, antibody levels against SARS-CoV-2 are reduced after in vitro-simulated gastrointestinal tract but remain present, so a positive biological effect could be expected from this infant immunization pathway.
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Pieri, Myrtani, Maria-Arsenia Maniori, Lucy Shahabian, Elie Kanaan, Irene Paphiti-Demetriou, Spyros Pipis, Kyriakos Felekkis, Vicky Nicolaidou, and Christos Papaneophytou. "Survival of Vaccine-Induced Human Milk SARS-CoV-2 IgG, IgA and SIgA Immunoglobulins across Simulated Human Infant Gastrointestinal Digestion." Nutrients 14, no. 16 (August 17, 2022): 3368. http://dx.doi.org/10.3390/nu14163368.

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Breastfeeding can be a vital way of acquiring passive immunity via the transfer of antibodies from the mother to the breastfeeding infant. Recent evidence points to the fact that human milk contains immunoglobulins (Ig) against the SARS-CoV-2 virus, either after natural infection or vaccination, but whether these antibodies can resist enzymatic degradation during digestion in the infant gastrointestinal (GI) tract or indeed protect the consumers remains inconclusive. Herein, we evaluated the levels of IgG, IgA, and secretory IgA (SIgA) antibodies against the spike protein of SARS-CoV-2 in 43 lactating mothers who received at least two doses of either an mRNA-based vaccine (Pfizer/BioNTech, Moderna; n = 34) or an adenovirus-based vaccine (AstraZeneca; n = 9). We also accessed the potential persistence of SARS-CoV-2 IgA, IgG, and secretory IgA (SIgA) antibodies from vaccinated women in the GI tract of the infants by means of a static in vitro digestion protocol. Our data depict that, although slightly reduced, the IgA antibodies produced after vaccination resist both the gastric and intestinal phases of infant digestion, whereas the IgGs are more prone to degradation in both phases of digestion. Additionally, SIgA antibodies were found to greatly resist the gastric phase of digestion albeit showing some reduction during the intestinal phase. The evaluation of the vaccine induced Ig profile of breastmilk, and the extent to which these antibodies can resist digestion in the infant GI tract provide important information about the potential protective role of this form of passive immunity that could help decision making during the COVID-19 pandemic and beyond.
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Insulander, Mona, Ingegerd Hökeberg, Gudrun Lind, Madeleine von Sydow, Susanne Lindgren, Ingvor Petersson, and Björn Fischler. "Evaluation of a new vaccination program for infants born to HBsAg-positive mothers in Stockholm County." Vaccine 31, no. 40 (September 2013): 4284–86. http://dx.doi.org/10.1016/j.vaccine.2013.06.065.

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Martinón-Torres, Federico, Javier Diez-Domingo, Emmanuel Feroldi, Emilia Jordanov, Siham B’Chir, and Xavier Da Costa. "Evaluation of a Hexavalent-Pentavalent-Hexavalent Infant Primary Vaccination Series Followed by a Pentavalent Booster Vaccine in Healthy Infants and Toddlers." Pediatric Infectious Disease Journal 38, no. 3 (March 2019): 317–22. http://dx.doi.org/10.1097/inf.0000000000002231.

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Esa Putra Tugiyono, Muhammad Mahafada, and Rita Kusuma Astuti. "REVIEW OF THE EVALUATION OF COMMUNITY SERVICE ACTIVITIES BY IMMIGRATION POLYTECHNIC CADETS FOR THE PURPOSE OF VACCINATING IN TANGERANG CITY." Jurnal Abdimas Imigrasi 2, no. 1 (February 25, 2021): 63–69. http://dx.doi.org/10.52617/jaim.v2i1.239.

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The purpose of the vaccination program organized by the government is to reduce the possibility of transmission of the Corona virus. If given in bulk, the Covid-19 vaccine can encourage the formation of herd immunity in society. So, people with vulnerable ages such as the elderly and infants or people with autoimmunity and people who can't get vaccinated can still get protection from those around them. Community Service Activities by Immigration Polytechnic Cadets in the context of Vaccination in the Tangerang City area received a positive response in the form of appreciation and thanks delivered directly by the Covid-19 Task Force. It is hoped that this activity is a form of concern and involvement in supporting the government's program to suppress the spread of Covid-19 in Indonesia so that herd immunity can be formed and the pandemic can be ended immediately.
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Rivin, Beth E., Douglas S. Diekema, Anna C. Mastroianni, John N. Krieger, Jeffrey D. Klausner, and Brian J. Morris. "Critical Evaluation of Adler’s Challenge to the cdc’s Male Circumcision Recommendations." International Journal of Children’s Rights 24, no. 2 (July 23, 2016): 265–303. http://dx.doi.org/10.1163/15718182-02402004.

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We evaluate Peter Adler’s challenge to the Centers for Disease Control and Prevention (cdc) draft recommendations on male circumcision (this issue, see pp. 237–262). Thecdcadvocates elective male circumcision (mc) to improve public health in theusabased on strong scientific evidence. In marked contrast to thecdc, Adler’s criticisms depend on speculative claims and obfuscation of the scientific data. Adler’s central argument that circumcision in infancy should be delayed to allow a boy to make up his own mind as an adult fails to appreciate that circumcision later in life is a more complex operation, entails higher risk, is more likely to involve general anaesthesia and presents financial, psychological and organisational barriers. These limitations are avoided by circumcision early in infancy, when it is convenient, safe, quick, low risk, usually involves local anaesthesia and provides benefits immediately. Benefits of male circumcision include: protection against: urinary tract infections that are ten times higher in uncircumcised infants; inflammatory skin conditions; other foreskin problems; sexually transmitted infections and genital cancers in the male and his female sexual partners. Circumcision during infancy is also associated with faster healing and improved cosmetic outcomes. Circumcision does not impair sexual function or pleasure. Some authorities regard the failure to offer circumcision as unethical, just as it would be unethical to fail to encourage paediatric vaccination. Since the benefits vastly outweigh the risks, each intervention is in the best interests of the child. In conclusion, Adler’s criticisms of thecdc’s evidence-based male circumcision policy are flawed scientifically, ethically and legally, and should be dismissed as endangering public health and individual well-being.
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Laryea, Eunice Baiden, Joseph Asamoah Frimpong, Charles Lwanga Noora, John Tengey, Delia Bandoh, George Sabblah, Donne Ameme, Ernest Kenu, and Kwame Amponsa-Achiano. "Evaluation of the adverse events following immunization surveillance system, Ghana, 2019." PLOS ONE 17, no. 3 (March 1, 2022): e0264697. http://dx.doi.org/10.1371/journal.pone.0264697.

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Background With over 80% of children worldwide vaccinated, concerns about vaccine safety continues to be a public health issue. Ghana’s Adverse Events Following Immunization surveillance started in 1978 with the objective to promptly detect and manage AEFI cases either real or perceived. Periodic evaluation of the surveillance system is critical for optimal performance; hence we evaluated the system to assess its attributes, usefulness and system’s performance in meeting its objectives. Methods A case of AEFI was defined as any untoward medical event occurring within 28 days after vaccination and may not necessarily have causal relationship with the vaccine use. We reviewed surveillance data and procedures for the period 2014 to 2018 and interviewed key stakeholders. Adapting the CDC’s Updated Guidelines for Evaluating Public Health Surveillance Systems, we assessed the system’s attributes and usefulness. We performed summary descriptive statistics on quantitative data and directed content analysis on information gathered from interviews. Results In all, 2,282 AEFI cases including 476 (21%) serious cases (life threatening events) were reported for the period. The highest case detection rates of 61.45 AEFIs per 100,000 surviving infants was recorded in 2018. Reporting forms were modified to accommodate new indicators without any disruption in the function of the system. At the national level, completeness of 100 randomly sampled reporting forms (100%) and was higher than the region (27%) but timeliness (50%) was lower than the region (83%). All (16/16) Community Health Nurses interviewed indicated “fear of being victimized” as the reason for underreporting, nonetheless, the system was useful as it made them cautious when vaccinating children to prevent reactions. Data on AEFI surveillance was also useful in guiding training needs and provision of vaccination logistics. Conclusion The AEFI surveillance system is useful at all levels but partially meeting its objective due to underreporting. We recommend training and supportive supervision to improve timeliness of reporting, data completeness and acceptability.
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Donald, Peter, Stefan Kaufmann, Stephanie Thee, Anna Maria Mandalakas, and Christoph Lange. "Pathogenesis of tuberculosis: the 1930 Lübeck disaster revisited." European Respiratory Review 31, no. 164 (June 28, 2022): 220046. http://dx.doi.org/10.1183/16000617.0046-2022.

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During the 1930 Lübeck Mycobacterium bovis bacille Calmette–Guérin (BCG) disaster, 251 neonates received three oral BCG doses accidentally contaminated by virulent Mycobacterium tuberculosis; 67 (26.7%) infants died of tuberculosis. BCG reversion to pathogenicity did not occur. Detailed post mortem examinations clarified contested aspects of tuberculosis pathogenesis. Gastrointestinal infection was seldom “silent” and did not cause typical primary pulmonary lesions. In 15 infants, primary pulmonary foci were found but these resulted from vaccine ingestion and aspiration and were not caused by gastrointestinal infection spreading to the lungs without trace of its journey, as claimed by prominent researchers such as Calmette and von Behring. Further, among 60 infants in whom post mortem evaluation was completed, a “silent” gastrointestinal infection without an intestinal primary focus was found in only one. Lymphohaematogenous-disseminated tuberculosis caused death in 24/67 (35.8%) infants and tuberculous meningitis in a further 17/67 (25.4%). Gastrointestinal tuberculosis complications caused death in 26/67 (38.8%) infants. Half of the tuberculosis-attributed deaths had occurred by 3 months, 93% by 6 months and 100% by 12 months; remarkably no further deaths or tuberculosis recurrences occurred within 5 years post-vaccination/infection. These findings provide graphic confirmation that the early introduction of chemoprophylaxis in recently M. tuberculosis-infected young children is critical and urgent.
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Abd-Alabass, Zainalabideen, and Raad Faraj. "Evaluation of Health Care Workers’ Knowledge about Immunity and Vaccination at Primary Health Care Centers in Al-Hilla City." Kufa Journal for Nursing Sciences 11, no. 1 (June 28, 2021): 1–7. http://dx.doi.org/10.36321/kjns.vi20211.445.

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Background: Immunizations are one of the most effective health initiatives of the twentieth century, but many people do not receive sufficient immunizations in several parts of the world. Every year, about three million people around the world die from diseases that can be prevented by vaccines; half of the dead were infants and children. However, community health care workers have become increasingly recognized and acknowledged as an important and efficient intervention essential for increasing community-centered health services, especially in deprived areas. Aims of the study: To evaluate the level of health care workers' knowledge about immunity and vaccination at primary health care centers. Methodology: A cross-sectional descriptive study design conducted for the periods 27 \ September \ 2020 to 25 \ April \ 2021, among (315) health care workers who are selected by non-probability sampling (convenience sample), self-administered questionnaire, the scores obtained for answers to closed-ended questions were used to determine the level of knowledge, reverse questions were used, several statistical measures were used by using Statistical Package of Social Sciences version 24, in order to analyze and evaluate the results of the study. Results: The findings showed that health care workers have a moderate level of knowledge about immunity and vaccination. Conclusion: There was a moderate level of knowledge about immunity and vaccination among health care workers. In addition, the greatest part of participants in this study is medical assistants and nurses. Recommendations: The researcher recommends implementing an educational program designed for health care workers about immunity and vaccination in all primary health care centers
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Kmeid, Maria, Hayat Azouri, Racha Aaraj, Elissa Bechara, and Diane Antonios. "Vaccine coverage for Lebanese citizens and Syrian refugees in Lebanon." International Health 11, no. 6 (May 15, 2019): 568–79. http://dx.doi.org/10.1093/inthealth/ihz023.

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Abstract Article History Following the refugee crisis in Lebanon, the on-going inflow of Syrian refugees presented new challenges to optimal immunization coverage for all the children living in the country. Healthcare facilities have been overburdened during this period and the country witnessed outbreaks of many infectious diseases. Thus, the evaluation of vaccine compliance for mandatory and non-mandatory vaccines as well as the factors affecting the vaccination rate among Lebanese residents and Syrian refugees is fundamental. Background Since 2012, Lebanon has hosted around 1.2 million Syrian refugees, a high number in a country whose population does not exceed 4.4 million. Healthcare facilities have been overburdened during this period, which has led to the spread of many infectious diseases, including outbreaks of measles, mumps and hepatitis. At the appearance of such outbreaks, it becomes essential to evaluate vaccine compliance and the factors influencing the vaccination rate among Lebanese residents and Syrian refugees in infants and children up to 15 y of age. Methods A total of 571 infants and children were recruited in Beirut and Mount Lebanon, two governorates that together host half of the Lebanese population. Results A very high rate of vaccine compliance was seen for mandatory vaccines, whereas an intermediate to very low rate of compliance was found for non-mandatory vaccines. Both bivariate and multiple regression analyses indicated that age group and regular consultation of a pediatrician were independently associated with immunization coverage. Bivariate analysis indicated that parental age, occupational and educational status of parents, family size and vaccine price were also independently associated with immunization coverage. Incomplete vaccination coverage was associated with socioeconomic factors. Conclusions From these results, it becomes apparent that it may be necessary to reassess vaccination priorities considering the current socioeconomic situation.
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Bektur, C. R., and T. S. Nurgozhin. "Evaluation of health outcomes and cost-effectiveness of 13-valent Pneumococcal Conjugate Vaccination for infants in Kazakhstan." Clinical Therapeutics 37, no. 8 (August 2015): e76. http://dx.doi.org/10.1016/j.clinthera.2015.05.219.

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SA, Idrissi, Elbazi K, Ait Boucetta B, Gennouni M, El Anssari S, Brahim I, Hazime R, and Admou B. "Post-vaccine immunity against hepatitis B in Moroccan children." Journal of Advanced Pediatrics and Child Health 5, no. 1 (September 2, 2022): 028–32. http://dx.doi.org/10.29328/journal.japch.1001049.

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Background: Hepatitis B is a major public health issue worldwide. Immunization of infants against this disease has been effective in Morocco since 1999. However, evaluation of post-vaccination response is rarely performed in our setting. The purpose of this study was to evaluate immunity against HBV in fully vaccinated children in the city of Marrakech in Morocco and to investigate the factors influencing the level of post-vaccination immunity. Methods: A descriptive cross-sectional study was conducted on fully vaccinated children who have medical and vaccination records, from three primary healthcare centers in Marrakech. Children with anti-HBs antibody levels between 10 and 100 IU/L were considered moderately immune, and those with antibody levels above 100 IU/L as highly immune, while those with antibody levels below 10 IU/L were considered non-immune. Results: Of the 123 children recruited, 114 (92.7%) had protective anti-HBs antibody titers, of which 37 (30%) were moderately immunized and 77 (62.7%) were highly immunized, and nine (7.3%) were non-immune. Age, birth weight, vaccine type, and time since the previous dose have all been significantly associated with the degree of post-vaccination immunity. Anti-HBs antibody levels were not significantly related to factors potentially linked to post-vaccination non-response, such as chronic disease, immunosuppressive medication and others. Conclusion: Our findings denote that the HBV vaccine used in The Moroccan Expanded Program on Immunization (EPI) is effective against HBV. Nevertheless, in non-responders, corrective actions such as re-vaccination and monitoring of post-vaccination anti-HBs antibody levels should be implemented.
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MARKEY, P., V. KRAUSE, J. W. BOSLEGO, P. M. COPLAN, J. M. DARGAN, and K. M. KAPLAN. "The effectiveness of Haemophilus influenzae type b conjugate vaccines in a high risk population measured using immunization register data." Epidemiology and Infection 126, no. 1 (February 2001): 31–36. http://dx.doi.org/10.1017/s0950268801005155.

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The Northern Territory of Australia has had historically very high incidence rates of invasive Haemophilus influenzae type b disease in children less than 5 years of age, with the burden of disease greatest among Aboriginal infants less than 12 months. This study documents the impact of conjugate Hib vaccines introduced in 1993. Immunization rates were monitored using an existing immunization register, and case finding was done retrospectively using hospital and laboratory records. Following the vaccine introduction, the incidence fell abruptly to a seventh of its pre-vaccination level, in both Aboriginal and non-Aboriginal children. The effectiveness of PRP-OMPC (PedvaxHIBTM) was 97·5% and the overall effectiveness of the vaccination programme was 86·3%. The study shows Hib immunization as an effective intervention while discussing continuing needs for Hib control in high risk populations. It also illustrates the benefit of immunization registers in the evaluation of immunization programmes and assessment of vaccine effectiveness.
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Boccalini, Sara, Beatrice Zanella, Paolo Landa, Daniela Amicizia, Angela Bechini, Maddalena Innocenti, Mariasilvia Iovine, et al. "Why the Anti-Meningococcal B Vaccination during Adolescence Should Be Implemented in Italy: An Overview of Available Evidence." Microorganisms 8, no. 11 (October 29, 2020): 1681. http://dx.doi.org/10.3390/microorganisms8111681.

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Although meningococcal disease has a low incidence in Italy, it is a public health concern owing to its high lethality rate and high frequency of transitory and/or permanent sequelae among survivors. The highest incidence rates are recorded in infants, children and adolescents, and most of the cases are due to Neisseria meningitidis B. In Italy, anti-meningococcal B (anti-MenB) vaccination is free for infants but, despite the considerable disease burden in adolescents, no national recommendation to vaccinate in this age-group is currently available. The aim of this study was to assess the main available scientific evidence to support the Italian health authorities in implementing a program of free anti-MenB vaccination for adolescents. We conducted an overview of the scientific literature on epidemiology, disease burden, immunogenicity and safety of available vaccines, and economic evaluations of vaccination strategies. Each case of invasive meningococcal disease generates a considerable health burden (lethality rate: 9%; up to 60% of patients experience at least one sequela) in terms of impaired quality of life for survivors and high direct and indirect costs (the mean overall cost of acute phase for a single case amounts to about EUR 13,952; the costs for post-acute and the long-term phases may vary widely depending of the type of sequela, reaching an annual cost of about EUR 100,000 in cases of severe neurological damage). Furthermore, vaccination against meningococcus B in adolescence proved cost-effective. The study highlights the need to actively offer the anti-MenB vaccination during adolescence at a national level. This would make it possible to avoid premature deaths and reduce the high costs borne by the National Health Service and by society of supporting survivors who suffer temporary and/or permanent sequelae.
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Lee, Kenneth K. C., Fiona Rinaldi, Mia K. U. Chan, Shirley T. H. Chan, Thomas M. T. So, Ellis K. L. Hon, and Vivian W. Y. Lee. "Economic Evaluation of Universal Infant Vaccination with 7vPCV in Hong Kong." Value in Health 12 (November 2009): S42—S48. http://dx.doi.org/10.1111/j.1524-4733.2009.00626.x.

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49

Doroshenko, Alexander, Weicheng Qian, and Nathaniel D. Osgood. "Evaluation of outbreak response immunization in the control of pertussis using agent-based modeling." PeerJ 4 (August 18, 2016): e2337. http://dx.doi.org/10.7717/peerj.2337.

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BackgroundPertussis control remains a challenge due to recently observed effects of waning immunity to acellular vaccine and suboptimal vaccine coverage. Multiple outbreaks have been reported in different ages worldwide. For certain outbreaks, public health authorities can launch an outbreak response immunization (ORI) campaign to control pertussis spread. We investigated effects of an outbreak response immunization targeting young adolescents in averting pertussis cases.MethodsWe developed an agent-based model for pertussis transmission representing disease mechanism, waning immunity, vaccination schedule and pathogen transmission in a spatially-explicit 500,000-person contact network representing a typical Canadian Public Health district. Parameters were derived from literature and calibration. We used published cumulative incidence and dose-specific vaccine coverage to calibrate the model’s epidemiological curves. We endogenized outbreak response by defining thresholds to trigger simulated immunization campaigns in the 10–14 age group offering 80% coverage. We ran paired simulations with and without outbreak response immunization and included those resulting in a single ORI within a 10-year span. We calculated the number of cases averted attributable to outbreak immunization campaign in all ages, in the 10–14 age group and in infants. The count of cases averted were tested using Mann–WhitneyUtest to determine statistical significance. Numbers needed to vaccinate during immunization campaign to prevent a single case in respective age groups were derived from the model. We varied adult vaccine coverage, waning immunity parameters, immunization campaign eligibility and tested stronger vaccination boosting effect in sensitivity analyses.Results189 qualified paired-runs were analyzed. On average, ORI was triggered every 26 years. On a per-run basis, there were an average of 124, 243 and 429 pertussis cases averted across all age groups within 1, 3 and 10 years of a campaign, respectively. During the same time periods, 53, 96, and 163 cases were averted in the 10–14 age group, and 6, 11, 20 in infants under 1 (p< 0.001, all groups). Numbers needed to vaccinate ranged from 49 to 221, from 130 to 519 and from 1,031 to 4,903 for all ages, the 10–14 age group and for infants, respectively. Most sensitivity analyses resulted in minimal impact on a number of cases averted.DiscussionOur model generated 30 years of longitudinal data to evaluate effects of outbreak response immunization in a controlled study. Immunization campaign implemented as an outbreak response measure among adolescents may confer benefits across all ages accruing over a 10-year period. Our inference is dependent on having an outbreak of significant magnitude affecting predominantly the selected age and achieving a comprehensive vaccine coverage during the campaign. Economic evaluations and comparisons with other control measures can add to conclusions generated by our work.
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Delgleize, E., and B. Standaert. "Allocating Vaccine Funds for Pneumococcal Vaccination of Infants and Older Adults: A Method for Strategic Evaluation in the Netherlands." Value in Health 17, no. 7 (November 2014): A676. http://dx.doi.org/10.1016/j.jval.2014.08.2510.

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