DTP Vaccine Research Articles

Impact of a Free Health Care Policy in the Democratic Republic of the Congo During an Ebola Outbreak: An Interrupted Time-Series Analysis

Background: During past outbreaks of Ebola Virus Disease (EVD) and other infectious diseases, health service utilization declined among the general public, delaying health seeking behavior and affecting population health. In 2018, the Democratic Republic of Congo (DRC) announced a free health care policy during an EVD outbreak in affected and neighboring areas. We evaluated the impact of this policy on health service utilization. Methods: Using monthly data from the national Health Management Information System from January 2017 to January 2019, we examined rates of the use of nine health services at primary health facilities: total visits; first and fourth antenatal care visits; institutional deliveries; postnatal care visits; DTP vaccinations; and visits for uncomplicated malaria, pneumonia, and diarrhea. We used controlled interrupted time series analysis with a mixed effects model to estimate changes in the rates of services use during the policy (June -September 2018) and afterward. Findings: Use of most services increased, including EVD affected zones. Total visits and visits for pneumonia and diarrhea increased more than two-fold relative to the control areas (p<0·001), while institutional deliveries and first antenatal care increased between 20-50% (p<0·01). Visits for DTP, fourth antenatal care visits and postnatal care visits were not significantly affected. Most increases did not persist after the policy ended. Interpretation: The free care policy was effective at rapidly increasing the use of health services, but this effect was not sustained post-FCP. Such policies may mitigate the impact of infectious disease outbreaks on health service utilization. Funding Statement: This project received funding from the Rapid Research Fund for Ebola supported by the International Development Research Centre, Social Sciences and Humanities Research Council, and Canadian Institutes of Health Research, and AXA Research Fund. Dr. Law received salary support through a Canada Research Chair and a Michael Smith Foundation for Health Research Scholar Award. Dr. Grepin also received salary support through a Canada Research Chair. Declaration of Interests: Dr. Law has consulted for Health Canada, the Health Employees’ Union, the Conference Board of Canada, and provided expert witness testimony for the Attorney General of Canada. All other authors report no potential conflicts of interest. Ethics Approval Statement: The research protocol was approved by the Ethics Committees at Wilfrid Laurier University and Kinshasa School of Public Health.

Trust collapse caused by the Changsheng vaccine crisis in China

BackgroundThe public acceptance and implementation of vaccination programs is essential to prevent infectious diseases. However, vaccine adverse events may cause public panic and eventually lead to an increasing number of populations who were hesitant or refuse to participate in these vaccination programs. In 2018, the Changsheng vaccine crisis broke out in mainland China, and 252,600 unqualified DTP vaccines were reported to be used for child vaccination. In this study, we observed media and public reactions toward the vaccine crisis. MethodsThis study conducted Internet surveillance by four mainstream indicators from July 15th to August 7th, including social media (WeChat, Sina Weibo), online news and Baidu search index. We also analyzed the emotional perceptions of people in crisis through an online questionnaire survey. ResultsDuring the crisis, huge number of articles emerged on Internet, 125,882,894 articles (including forwarding) on WeChat friends circle, 1,877,660 Sina Weibo posts, 648,265 online news and 4,986,521 Baidu search indexes. Most of these articles were negative and expressed the public’s weak confidence to the China-made vaccines. Public confidence in vaccines was undermined by the actions of the manufacturer and the government. ConclusionsThe DTP vaccine crisis led to panic about immunization and eroded trust in the immunization program and in the government. Restoring public confidence in Chinese-made vaccines will take a long time, and meticulous management in vaccine production, and strict government regulation will help to alleviate public anxiety about vaccine safety and ultimately restore confidence.

Febrile seizures: what pediatricians should know

Febrile seizures are the age-dependent and predictively favorable condition, which is observed in children under 6 years. All febrile seizures are divided into simple (2/3 of all cases), complex and febrile status. Complicated seizuresinclude attacks with focalsymptoms, prolonged and recurring throughout the day. Simple febrile seizures are short, generalized, not repeated. Simple seizures do not harm the child’s neuropsychic development, they do not transform into epilepsy, and do not need chronic prescription of anticonvulsant therapy. A child with normal development and simple febrile seizures does not need an obligatory EEG and MRI of the brain. All the patients of 18 months old or less with the first episode of febrile seizures need to be hospitalized. The risk of recurrence of seizures and their transformation into epilepsy is higher in a child with complex seizures. There is a small group of children with prolonged seizures and / or febrile status, often with neuropsychiatric developmental delay, which needs to be monitored by a neurologist and further examination. Sometimes doctor prescribes long-term anticonvulsant therapy for the children of this group. Febrile seizures can be prevented with special dosage of anticonvulsant drugs quickly reaching a therapeutic concentration in the child’s brain. Febrile seizures are not a contraindication to vaccination and revaccination, attention should be paid in case of DTP vaccination in children with repeated prolonged seizures and / or febrile status.Conflict of interest: The author of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Estimation of Consistency of Production of the Pertussis Component of DTP Vaccine in Terms of Immunogenic Activity and Specific Safety Using Shewhart Charts

WHO experts attribute the resurgence of whooping cough to the wide use of acellular pertussis vaccines (aPs) as components of combination products. In this regard, WHO encourages countries that have not yet switched to the use of aPs to continue to use whole-cell pertussis vaccines (wPs) for primary vaccination. The experience of using pertussis vaccines has shown that companies do not always produce highly efficacious products. The use of statistical methods of samples quality control helps to ensure consistency of the technological process, which results in the production of more homogeneous products, and rules out the possibility of producing low-quality products. This paper presents the results of retrospective evaluation of the consistency of the wP (as a pertussis component of the DTP vaccine) production using Shewhart control charts. It was shown that at some points in time during the analyzed period from January 2017 until March 2018 the technological process of the company lacked proper statistical control. This increased the risk of producing non-uniform and defective products. In order to improve the quality and consistency of pertussis component batches, the company’s quality control and quality assurance services should make extensive use of Shewhart charts on a real-time basis.

Seroprevalence of diphtheria and pertussis immunoglobulin G among children with pneumonia in Ji\u2019nan, China

BackgroundVaccination is still one of the most important methods to control and prevent childhood infections including diphtheria and pertussis. This study evaluated the level of diphtheria (DT) and pertussis (PT)-related antibodies among children with pneumonia in Ji’nan, China.MethodsA total of 484 sera of children from 1 day to 13 years of age were collected from 2014 to 2015 in Ji’nan. Children with recent history of pertussis were excluded from this study. Anti-DT and PT IgG concentrations were measured by ELISA (Euroimmun, Lübeck, Germany).ResultsOf the 484 subjects tested, the overall positivity rate of anti-DT IgG (≥0.1 IU/ml) was 48.97%, and the highest positivity rate of anti-DT IgG (68.55%) and proportion with long term protection (23.27%) were observed in children aged 6 m- < 3 y. For anti-PT IgG, 334 subjects (69.01%) had anti-PT IgG levels below the lower limit of detection (5 IU/ml). Even with detectable anti-PT antibodies, the majority (115/150, 76.67%) of them had antibody levels of 5- < 40 IU/ml. The highest proportion of subjects with detectable anti-PT IgG (≥5 IU/ml) was observed in children aged < 6 m (44.36%), then the proportion continually decreased to 15.0% at 3 y- < 6 y (χ2 = 24.05, p < 0.0001). The highest positivity rate (≥40 IU/ml) was only 8.27% in children aged < 6 m. Subjects with an anti-PT IgG ≥100 IU/ml were observed in all the groups and there were no significant differences in the proportions of subjects with a level ≥ 100 IU/ml among these age groups (χ2 = 2.572, p = 0.4624). A total of 5 subjects had anti-PT IgG ≥100 IU/ml (≥1 years post pertussis vaccination) which was considered to be indicative of a recent pertussis infection.ConclusionsWe demonstrated low antibody levels and protection against pertussis in our study population. The anti-PT IgG maintained a low level throughout all age groups, and even no immune responses were observed after the basic immunization and booster. Our study supported the need to reevaluate the immune response of DTP vaccine which was used in Shandong province after 2010.

Analysis of clinical characteristics in 857 patients with pediatric pertussis in Xi′an

Objective To analyze the clinical characteristics in children with pertussis, and to provide a scientific basis for treatment of pertussis. Methods Retrospective analysis of general data, symptoms, signs, auxiliary examinations, treatment and prognosis was performed on the patients with pediatric pertussis in Xi′an from January 2015 to December 2016; the epidemiological data were analyzed by using descriptive approach. Results In a total of 857 patients with pertussis, there were 469 males and 388 females (the gender ratio of 1.211.00), 183 cases (21.3%) from the urban areas and 674 cases (78.7%) from the rural areas.The cases were reported throughout the year, indicating 2 peak times of onset: 355 cases (41.5%) from July to September and 218 cases (25.4%) from February to April.And 473 cases (55.2%) were younger than 6 months; 479 cases (55.9%) were inoculated with diphtheria, tetanus and pertussis combined vaccine(DTP) vaccine; 492 cases (57.4%) were exposed to their family members who coughed at that time.Cough was the main symptom, and the median duration of pertussis from onset to diagnosis was 20 days.Concomitant symptoms included spasmodic cough was relieved in 836 cases (97.5%), facial suffusion in 806 cases (94.0%), peri-oral cyanosis in 308 cases (35.9%), asthma in 269 cases (31.4%), crow-like echo in 248 cases (28.9%), and apnea in 46 cases (5.4%); pulmonary moist rale was found by check-up in 761 cases (88.8%), and fever was observed in 159 cases (18.5%). The increased proportion of the peripheral blood lymphocytes was found in 702 cases (81.9%), the increased total count of leukocytes in 505 cases (58.9%), the increased procalcitonin(PCT) in 36 cases (4.2%) and the elevated level of high sensitivity C reactive protein(hsCRP) in 17 cases (2.0%); pneumonia was suggested by chest radiography in 673 cases (78.5%); in the blood-gas analysis, hypoxemia was suggested in 50 cases (5.8%) and respiratory failure in 9 cases (1.1%). In the 857 patients with pertussis, 59 cases (6.9%) were with severe-type pertussis.At 1 week of the treatment, no spasmodic cough was reported in 515 cases (60.1%) and obviously relieved spasmodic cough in 198 cases (23.1%), and no deaths occurred. Conclusions The cases of pertussis occur throughout the year in Xi′an, predominately from July to September and February to April.A higher incidence is reported in the rural areas, compared with the urban areas, particularly in those younger than 6 months with incomplete DTP vaccination, who usually have severe conditions.In many cases, those with pediatric pertussis are infected by family members; most of them have spasmodic cough with good prognosis, without typical clinical signs. Key words: Pertussis; Epidemiologic characteristics; Clinical characteristics

PERTUSSIS INCIDENCE AND THE EFFECT OF REVACCINATION OF PRESCHOOL AND SCHOOL CHILDREN

The review is devoted to the analysis of pertussis incidence of children in the age group of 5–7, as well as strategies of DTP immunization with the help of the drugs in foreign countries. Mass vaccination against pertussis began in the middle of the 20th century, which contributed to a reduction in incidence and mortality rate from this infection. However, in the last decade, there has been an opposite tendency of increasing incidence of patients among children under school age, school age and adults. Atypical forms of the disease and complications due to ARVI, respiratory mycoplasmosis and cytomegalovirus infections are described in the review. Various strategies for the use of whole-cell and acellular pertussis vaccines as part of DTP drugs are described, as well as the epidemiological effect of introducing an additional booster dose of vaccine to children under school age. The expediency of revaccination of children aged 6–7 in Russia is argued, which can help to reduce the overall incidence of pertussis. The research materials related to the study of the properties of acellular anti-pertussis vaccine, such as immunogenicity and safety in comparison with whole-cell vaccine, are analyzed. The main drugs and their composition, which are used to vaccinate children against pertussis, are described in the review. It is assumed, that the increase in the incidence among children and teenagers, with the appearance of atypical forms of pertussis, is associated with a number of factors, such as the spread of new genotypes of Bordetella pertussis bacterium, emerged from mutations, as well as short duration of immunity after vaccination with acellular drugs, in comparison with whole-cell, and the use of more modern methods of detecting the pathogen. The mechanisms of the immune response due to different types of pertussis vaccines are also reviewed. It is concluded, that revaccination of children aged 6–7 with an additional fifth dose of an acellular vaccine against pertussis, as part of the DTaP instead of the Td drug, which is regulated in the National Calendar of preventive vaccinations, will have a favorable effect on the epidemic situation with pertussis infection in Russia.

Identifying vulnerable population groups: On-time infant vaccination coverage in Australia

IntroductionImmunisation coverage is a good measure of immunisation program effectiveness. Coverage of the 3-dose infant schedule in Australia assessed at age 12 months is &gt;90%. Timeliness is an important goal for population immunity, but on-time coverage of the 2-4-6 month schedule and coverage in specific populations is rarely reported.&#x0D; Objectives and ApproachWe conducted a retrospective population-based cohort study of 1.9 million Australian births, 1996-2012 (approximately 42% of Australia’s population). Individual data from state-held birth and perinatal records were combined with Commonwealth-held immunisation and death records, through probabilistic linkage. We assessed on-time coverage across 13 demographic and perinatal characteristics of diphtheria-tetanus-pertussis vaccines (DTP) defined as vaccination 14 days prior to the scheduled due date, to 30 days afterwards.&#x0D; ResultsOn-time DTP vaccination coverage in non-Aboriginal infants was 88.1% for the 2-month dose, 82.0% for 4-month dose, and 76.7% for 6-month dose; 3-dose coverage was 91.3% when assessed at 12 months. On-time DTP coverage for Aboriginal infants was 77.0%, 66.5%, and 61.0%; 3-dose coverage at 12 months was 79.3%. Appreciable differences in on-time coverage were observed across population subgroups. On-time coverage in non-Aboriginal infants born to mothers with ≥3 previous pregnancies was 62.5% for the 6-month dose (47.9% for Aboriginal infants); up to 23.5% lower than for first-borns. Infants born to mothers who smoked during pregnancy had coverage 8.7-10.3% lower than infants born to non-smoking mothers for the 4- and 6-month dose. A linear relationship was apparent with increasing socio-economic disadvantage and decreasing on-time coverage.&#x0D; Conclusion/ImplicationsOn-time vaccination coverage of the 2-4-6 month schedule is only 50-60% across specific population subgroups representing a significant avoidable public health risk. Australian Aboriginal infants, multiparous mothers, and those who are socio-economically disadvantaged are key groups most likely to benefit from targeted programs addressing vaccine timeliness.

Immune response to a Tdap booster in vertically HIV-infected adolescents

BackgroundPertussis cases have increased worldwide and knowledge on immune response and cytokine profile after Tdap vaccine in immunodeficient adolescents is scarce. ObjectiveTo evaluate the immune response after Tdap in HIV-infected (HIV) and in healthy adolescents (CONTROL). MethodologyThirty HIV adolescents with CD4 cell counts >200 and 30 CONTROLs were immunized with Tdap, after a prior whole-cell DTP vaccine primary scheme. Blood samples were collected immediately before and after vaccine. Lymphocyte immunophenotyping was performed by flow cytometry; tetanus, diphtheria and pertussis toxin antibodies were assessed by ELISA; whole blood was stimulated with tetanus toxoid and Bordetella pertussis and supernatants were assessed for cytokines by xMAP. ResultsMean age of HIV and CONTROL groups were 17.9 e 17.1 years, respectively. Pain at injection site was more intense in CONTROL group. HIV group had similar increase in tetanus antibodies at 28 days (geometric mean concentration, GMC, 15.6; 95% CI, 7.52–32.4) than CONTROL group (GMC, 23.1; 95% CI, 15.0–35.5), but lower diphtheria antibodies at 28 days (GMC, 2.3; 95% CI, 0.88–6.19) than CONTROL group (GMC, 16.4; 95% CI, 10.3–26.2); for pertussis, the percentage of individuals who seroconverted was lower in HIV than CONTROL group (HIV, 62.1% versus CONTROL, 100%; p = .002). Both groups built a cellular immune response to tetanus, with a Th2 (IL-4, IL-5 and IL-13) and Th1 (IFN-γ) response, with lower cytokine levels in HIV than in CONTROL group. Especially for pertussis, cellular and humoral responses were less intense in HIV adolescents, with a lower Th1 and Th17 profile and higher IL-10 levels. HIV-infected adolescents on viral suppression showed an enhanced immune response to all the three vaccine antigens, although still at lower levels if compared to CONTROL group. ConclusionsBoth groups tolerated well and built an immune response after Tdap. However, HIV-infected adolescents would probably benefit from more frequent booster doses.

Population Immunity to Diphtheria and Tetanus in the Republic of Belarus Following Long-Standing Vaccination

Study results of IgG to diphtheria and tetanus in 785 residents aged from 1 to 76 years old from different regions of the Republic of Belarus (in 2017) in long-term (since 1996) immunization schedule: at 3, 4, 5 and at 18 months old – DTP vaccine, at 6 years old – DT, at 11 years old – Diphtheria toxoid, at 16 years old, 26 years old and every following 10 years –Td or Diphtheria toxoid are presented. The antibody concentration was measured by Virion/Serion kits (Germany) and evaluated in accordance with the international standard: less than 0.01 IU/ml – individual is susceptible, 0.01–0.09 IU/ml – levels of antitoxin giving some degree of protection, 0.1 – &lt; 1 IU/ml – protective level of circulating antitoxin, ≥ 1.0 IU/ml – a level of antitoxin giving long-term protection. It was shown that the proportion of immune individuals against diphtheria and tetanus (with antibodies ≥ 0.01 IU/ml) was 96.7% (CI 95.4 ÷ 97.9) and 99.5% (CI 99.0 ÷ 100,0), respectively, and was quite high in all the population age groups – from 87.7 to 100% for diphtheria and from 96.5 to 100% for tetanus. In seropositive individuals IgG were presented mainly in protective and highly protective (≥ 0.1 IU/ml) titers: for diphtheria 93.7% – in 1–14 years old; 88.7% – in 15–19 years old; 78.4% – in 20–76 years old and for tetanus 100.0% – in 1–14 years old; 100.0% – in 15–19 years old; 99.3% – in 20–76 years old. Comparison of the current and previous studies results (in 1989–1994 – during the outbreak of diphtheria, in 1998–2001 – after the mass immunization campaign, in 2004 – in the context of continuous single cases of diphtheria registration in adults) had shown that the data of 2017 demonstrated the highest population immunity level to diphtheria and to tetanus in the last 30 years of observation.

Assessment of on-time vaccination coverage in population subgroups: A record linkage cohort study

Reported infant vaccination coverage at age 12 months in Australia is >90%. On-time coverage of the 2–4–6 month schedule and coverage in specific populations is rarely reported. We conducted a population-based cohort study of 1.9 million Australian births, 1996–2012, combining individual birth and perinatal records with immunisation records through probabilistic linkage. We assessed on-time coverage across 13 demographic and perinatal characteristics of diphtheria-tetanus-pertussis vaccines (DTP) defined as vaccination 14 days prior to the scheduled due date, to 30 days afterwards. On-time DTP vaccination coverage in non-Aboriginal infants was 88.1% for the 2-month dose, 82.0% for 4-month dose, and 76.7% for 6-month dose; 3-dose coverage was 91.3% when assessed at 12 months. On-time DTP coverage for Aboriginal infants was 77.0%, 66.5%, and 61.0% for the 2–4–6 month dose; 3-dose coverage at 12 months was 79.3%. Appreciable differences in on-time coverage were observed across population subgroups. On-time coverage in non-Aboriginal infants born to mothers with ≥3 previous pregnancies was 62.5% for the 6-month dose (47.9% for Aboriginal infants); up to 23.5 percentage points lower than for first-borns. Infants born to mothers who smoked during pregnancy had coverage 8.7–10.3 percentage points lower than infants born to non-smoking mothers for the 4- and 6-month dose. A linear relationship was apparent between increasing socio-economic disadvantage and decreasing on-time coverage. On-time coverage of the 2–4–6 month schedule is only 50–60% across specific population subgroups representing a significant avoidable public health risk. Aboriginal infants, multiparous mothers, and those who are socio-economically disadvantaged are key groups most likely to benefit from targeted programs addressing vaccine timeliness.

Serum anti-tetanus and measles antibody titres in Ugandan children aged 4 months to 6 years: implications for vaccine programme.

To study the antibody response to tetanus toxoid and measles by age following vaccination in children aged 4 months to 6 years in Entebbe, Uganda. Serum samples were obtained from 113 children aged 4-15 months, at the Mother-Child Health Clinic (MCHC), Entebbe Hospital and from 203 of the 206 children aged between 12 and 75 months recruited through the Outpatients Department (OPD). Antibodies to measles were quantified by plaque reduction neutralisation test (PRNT) and with Siemens IgG EIA. VaccZyme IgG EIA was used to quantify anti-tetanus antibodies. Sera from 96 of 113 (85.0%) children attending the MCHC contained Measles PRNT titres below the protective level (120 mIU/ml). Sera from 24 of 203 (11.8%) children attending the OPD contained PRNT titres 0.15 IU/ml by EIA, a level considered protective. The overall concentration of anti-tetanus antibody was sixfold higher in children under 12 months compared with the older children, with geometric mean concentrations of 3.15 IU/ml and 0.49 IU/ml, respectively. For each doubling in age between 4 and 64 months, the anti-tetanus antibody concentration declined by 50%. As time since the administration of the third DTP vaccination doubled, anti-tetanus antibody concentration declined by 39%. The low measles antibody prevalence in the children presenting at the MCHC is consistent with the current measles epidemiology in Uganda, where a significant number of measles cases occur in children under 1 year of age and earlier vaccination may be indicated. The consistent fall in anti-tetanus antibody titre over time following vaccination supports the need for further vaccine boosters at age 4-5 years as recommended by the WHO.

Evaluation of Immunobiological Properties of Bordetella pertussis Vaccine Strains

The study performed as part of evaluation of immunobiological properties of Bordetella pertussis vaccine strains offered an opportunity to standardize pertussis bacterial mass based on the content of surface antigens — agglutinogens 1, 2 and 3. Certain levels of agglutinogens in seed lots were found to be capable of modifying the protective activity of pertussis vaccine. The heterogeneity of the bacterial strain population was reduced by applying selection criteria for colonies based on expression of agglutinogens. B. pertussis seed lots derived from vaccine strains that had undergone selection were sent to manufacturers of the pertussis component of DTP vaccine. Production of pertussis vaccine using a more homogenous bacterial mass that actively expresses agglutinogens 1, 2 and 3 made it possible to enhance immunogenic activity of the pertussis component of DTP vaccine. The safety of the whole-cell pertussis vaccine produced from the standardized seed lot was not compromised.

Inquérito da cobertura vacinal de tríplice bacteriana e tríplice viral e fatores associados à não vacinação em Santa Maria, Distrito Federal, Brasil, 2012

INTRODUCAO: A vacinacao e uma intervencao segura que propicia imunidade individual e coletiva, se utilizados os esquemas corretamente. A vacina triplice bacteriana (DTP) protege contra difteria, tetano e coqueluche e a triplice viral (SCR) contra sarampo, caxumba e rubeola. As doses de reforco sao indicadas para corrigir possiveis falhas vacinais primarias e garantir a imunidade. OBJETIVOS: Estimar a cobertura vacinal do segundo reforco da DTP e da segunda dose da SCR em criancas de 7 a 9 anos de idade, e identificar os possiveis fatores associados a nao vacinacao. MATERIAIS E METODOS: Foi realizado um estudo transversal do tipo inquerito domiciliar, com amostra probabilistica por conglomerados 30x7, resultando em 206 criancas residentes na Regiao Administrativa de Santa Maria, Distrito Federal, Brasil, entre junho e julho de 2012. A analise dos dados foi realizada calculando-se as medidas de frequencia, tendencia central e dispersao, assim como a razao de prevalencia associadas a vacinacao. RESULTADOS: Houve baixa cobertura vacinal para o segundo reforco de DTP (72,3%; IC95%: 66-78) e segunda dose de SCR (76,7%; IC95%: 71-83). Os fatores relacionados a nao vacinacao foram significativos quando os cuidadores das criancas nao eram os pais; familias com tres filhos ou mais; ser a partir do quarto filho; e nao receber visita domiciliar de profissionais de saude. CONCLUSAO: As condicoes socioeconomicas das familias e a baixa adesao a vacinacao das criancas levam a baixas coberturas vacinais e a maior suscetibilidade ao adoecimento.

Vaccination and GDP Growth Rates: Exploring the Links in a Conditional Convergence Framework

Summary Vaccination rates vary significantly across countries, and the intensity of vaccination programs is a matter of public choice, infrastructure limitations, budget constraints, and many other factors. The link between better health and better economic performance is by now well established, and many vaccines have been shown to generate significant ROI in a classical cost-benefit framework. To our knowledge, the longer term macroeconomic benefits of improved vaccination programs have not been estimated. We modify the standard conditional convergence model to account for changes in vaccination rates across time and countries, and use the modified model to estimate the macroeconomic gains from improved vaccination rates, using the DTP vaccine as a proxy for vaccination programs generally. We find evidence to suggest economically and statistically significant and sustained increases in the GDP growth rate associated with lagged increases in vaccination rates; furthermore, we find these effects increasing over time. We find that investments of the sort made by the Global Alliance for Vaccination and Immunization (Gavi) are linked to measurably higher DTP rates, and we estimate the returns to such investments as at least 12:1. For countries on the threshold of graduating from Gavi, these results suggest that much is at stake: reducing investment in vaccination could reverse both the public health improvements and tangible economic benefits associated with ongoing improvements in vaccination rates.

Disseminated induced pseudolymphoma DTP vaccine

Disseminated induced pseudolymphoma DTP vaccine

Combined DTP-HBV vaccine versus separately administered DTP and HBV vaccines for primary prevention of diphtheria, tetanus, pertussis, and hepatitis B

Reason for withdrawal from publication This protocol has been withdrawn from the Cochrane Library as the authors were not able to complete the review.

Mathematical modeling of diphtheria transmission in Thailand

In this work, a mathematical model for describing diphtheria transmission in Thailand is proposed. Based on the course of diphtheria infection, the population is divided into 8 epidemiological classes, namely, susceptible, symptomatic infectious, asymptomatic infectious, carrier with full natural-acquired immunity, carrier with partial natural-acquired immunity, individual with full vaccine-induced immunity, and individual with partial vaccine-induced immunity. Parameter values in the model were either directly obtained from the literature, estimated from available data, or estimated by means of sensitivity analysis. Numerical solutions show that our model can correctly describe the decreasing trend of diphtheria cases in Thailand during the years 1977–2014. Furthermore, despite Thailand having high DTP vaccine coverage, our model predicts that there will be diphtheria outbreaks after the year 2014 due to waning immunity. Our model also suggests that providing booster doses to some susceptible individuals and those with partial immunity every 10 years is a potential way to inhibit future diphtheria outbreaks.

Safety of Combination Vaccines with Whole Cell Pertussis Component

We consider the safety of domestic products combined (DTP, Bubo Kok) containing whole-cell pertussis vaccine. DTP and Bubo Kok safety vaccines meet WHO requirements, EF and more rigid in some cases, the requirements of Russian regulatory documents. Thus, in assessing the safety of specific pertussis vaccine and complete neutralization of diphtheria and tetanus toxins, are administered to laboratory animals much larger doses of test products in comparison with the requirements of the WHO and the EP. In contrast to the WHO and the EP in the domestic requirements have stringent requirements for quantitative content in the non-adsorbed toxoids vaccine. Compared with foreign counterparts, domestic vaccines are significantly less anti-genetic load, that is responsible for their low reactivity, at the same time they possess the desired immunogenic activity.

Carrier priming to improve pneumococcal disease control and reduce the international program’s cost in children

Pneumococcal conjugate vaccine (PCV) has the potential to interact with other vaccines containing diphtheria toxin-like antigens (such as those found in the DTP vaccine) upon sequential administration. This is attributed to the similarity of the diphtheria toxoid antigen to the carrier protein used to make PCV, (known as cross reactive material [CRM]) to diphtheria toxin 197 or CRM197. The interaction could lead to enhanced immunogenicity of PCV as a result of a phenomenon called carrier priming, whereby DTP is given some weeks before the first dose of PCV. This phenomenon could be implemented in the immunisation schedule in developing countries and among vulnerable populations to enhance the immunogenicity of PCV, reduce the number of doses required, and produce a more cost-effective immunisation program in developing countries.