Extended Program Of Immunization Research Articles

Knowledge, Beliefs, and Behaviors of Turkish Parents about Childhood Vaccination.

Vaccination is critical to the prevention and control of infectious disease outbreaks and is also one of the most important public health successes. When it comes to childhood vaccinations, parents' consent is very important. For this reason, childhood vaccination rates are directly related to the knowledge, beliefs, and behaviors of the parents. Therefore, this study aimed to evaluate the knowledge, beliefs, and behaviors of parents of children aged 0-5 regarding childhood vaccinations and how these beliefs affect their vaccination behaviors. This descriptive, cross-sectional study was conducted on 302 parents from February to June 2020. Data were collected using a questionnaire form with 26 questions. Sociodemographic characteristics were reported as frequencies, means, and percentages. Multiple regression analysis was utilized to evaluate vaccination behaviors and affective factors. About 87.1% of the parents know that vaccines protect their children from infectious diseases, and 76.8% know that vaccines can have side effects. Although 97.7% of the parents had their children fully vaccinated according to the Extended Immunization Program, 2.3% did not vaccinate their children. Moreover, 98% of the parents trust the information given by healthcare professionals about vaccination. The parents' beliefs explain 53% (R2 = 0.53) of the parents' child vaccination behavior. This study found that although the knowledge level of parents about vaccines is quite good, negative knowledge and beliefs that may affect vaccination also exist. Considered by parents as a reliable source of information, healthcare professionals should impart their knowledge, beliefs, and concerns regarding immunization.

Trends of expenditure on Immunization in Pakistan since 2000.

World health organization started Expanded Program on Immunization in 1974. At that time only 5% of the children were covered globally in the first year on pro-gram. In Pakistan 16.34% of the total population is under five years’ children. In 2000 Global Alliance for Vaccines and Immunizations (GAVI) was introduced in Paki-stan. Since 2000 by the finance and HR support from GAVI, additional 370 million children have been vaccinated from deadly disease. It has been noticed that the expenditure on immunization remained inconsistent over the time period. Since 2000 the massive change is seen in the pattern of expenditure on immunization both routine and campaigns to meet the goals. In Pakistan, expenditure on immun-ization has reached to $240 million annually but still the fully immunized children are between 43-62% of all the under-five population of the country. Immunization services needed to be on time and efficiently provided to the communities. The growth in fiscal gap and need for expenditure competition in financing, has subju-gated policymaking. There is a need for reviewing the current policies for budgeting immunization program and needful risk assessment will support future financial crisis.Key Words: Immunization, Global Alliance for Vaccines and Immunization,Extended Program of Immunization,

STUDY OF PREVALENCE OF HEPATITIS B SURFACE ANTIGEN (HBSAG) IN BLOOD DONOR POPULATION BORN PRIOR TO AND AFTER IMPLEMENTATION OF HBV VACCINATION IN KERALA, SOUTH INDIA

BACKGROUND: Since 1995 Hepatitis B vaccination became a part of Extended immunization Program (EIP) in India, neonates started getting immunoprophylaxis against Hepatitis B virus. Since vaccination started recently, exact prevalence of immunized persons were not available, but anyway vaccinated blood donors over 18 years old are progressively increasing MATERIALS AND METHODS: In this study 2400 blood donors were screened for HBsAg by enzyme linked immunosorbent assays, among the donor blood samples which are positive for HBsAg were noted. Various demographic patterns of blood donor were analyzed. To know about impact of vaccination on prevalence HBV infection among donors who born after the implementation of mandatory HBV vaccination schedule was compared with blood donors those who are born before HBV vaccination schedule RESULTS: Among the blood donors overall prevalence of HBV infection was 0.75% HBsAg. HBV vaccinated blood donor were protected from getting disease ,showing P value of 18 years (0.07), 19 years(0.01), 20 years(0.02) CONCLUSION: Young blood donors born after implementation of universal HBV vaccination in lndia presented higher prevalence of HBsAg but lower incidence of HBsAg seroconversion than older. HBV vaccine boosting for adolescents at 15–17 years old prior to reaching blood donor age may improve blood safety.

Health System Barriers and Facilitators to Delivering Additional Vaccines through the National Immunisation Programme in China: A Qualitative Study of Provider and Service-User Perspectives.

In China, there are two categories of vaccines available from the Chinese Center for Disease Control and associated public health agencies. Extended Program of Immunization (EPI) vaccines are government-funded and non-EPI vaccines are voluntary and paid for out-of-pocket. The government plans to transition some non-EPI vaccines to EPI in the coming years, which may burden public health system capacity, particularly in terms of budget, workforce, supply chains, and information systems. Our study explored vaccinator and caregiver perspectives on introducing non-EPI vaccines into routine immunization and perceived facilitators and barriers affecting this transition. We conducted a qualitative study from a realist perspective, analysing semi-structured interviews with 26 vaccination providers and 160 caregivers in three provinces, selected to represent regional socioeconomic disparities across Eastern, Central, and Western China. Data were analysed thematically, using deductive and inductive coding. Most participants were positive about adding vaccines to the national schedule. Candidate EPI vaccines most frequently recommended by participants were varicella, mumps vaccine, and hand–foot–mouth disease. Providers generally considered existing workspaces, cold-chain equipment, and funding sufficient, but described frontline staffing and vaccine information systems as requiring improvement. This is the first qualitative study to explore interest, barriers, and facilitators related to adding vaccines to China’s national schedule from provider and caregiver perspectives. Findings can inform government efforts to introduce additional vaccines, by including efforts to retain and recruit vaccine programme staff and implement whole-process data management and health information systems that allow unified nationwide data collection and sharing.

A Serological Survey of Selected Papua New Guinea Blood Donors for Hepatitis B and Related Co-Infections.

Hepatitis B virus (HBV) infection is a serious problem and earlier studies in Papua New Guinea have reported a high prevalence of hepatitis B virus infection. These studies were undertaken using insensitive tests and before an expanded immunization program. The current HBV status is therefore uncertain. A retrospective study to investigate the HBV status was carried out using blood donor data at Nonga General Hospital, East New Britain Province, Papua New Guinea, from January 2003 to December 2018. Additional data for Human Immunodeficiency Virus, syphilis and hepatitis C virus were also collected. Data were analysed using NCSS statistical software. The mean hepatitis B antigen (HBsAg) sero-prevalence was 21% for the period of study and showed a downward trend over the period of the study, which may reflect the effect of the extended immunization program. HBsAg prevalence in male donors (23%) was significantly higher than females (16%). Donors living in Pomio district had a significantly lower proportion of sero-positive HBsAg donors (7%) than Gazelle (22%), Kokopo (22%) and Rabaul (20%), which was attributed to this district’s geographical isolation. Ethnically, Pomios donors (8%) had significantly lower HBsAg prevalence than the Taulils, (29%), Bainings (21%) and Tolais (21%). Fifteen to nineteen year olds (23%) were the predominant age group affected, and vertical or perinatal transmission was probably the primary transmission route. Our findings call for greater awareness on the part of public policy makers and should be considered when planning future public health campaigns.

Gebe ve Emziren Kadınlarda Bağışıklama

Immunization in our country as part of the Extended Immunization Program (GBP) since 1981 services are offered. The purpose of the program can be prevented by vaccinating babies, children and adultsimmunization by vaccinating before the period when the risk of getting diseases is highest and to prevent injury and death from these diseases.In this review, before pregnancy according to the adult vaccination schedule, pregnant women whose vaccines are missing; current vaccines applications It is aimed to provide sensitivity on the subject by examining in the light of current information.

Why are Children Less Affected by COVID-19 ? Could there be an Overlooked Bacterial Co-Infection?

As it is known, there is a pandemic that is growing rapidly and affecting almost the entire world, including Turkey. Following the announcement of the isolation of a new type of Coronavirus (SARS CoV-2) by the Chinese government on January 7, 2020, as of March 15, 2020, 168 834 Verified cases and 6492 deaths were reported due to this pandemic (COVID-19 pandemic) (1,2). However, it is noteworthy that children are less affected by this viral pandemic in terms of both the number of cases and the incidence of serious illnesses. So far, it has been shown that children aged 0-9 years generally have a mild infection, but there are no reported fatalities (2,3). It is not new for children to experience some viral diseases mildly (4). However, given the seriousness of the current pandemic, clarifying the cause of this situation may reveal crucial information regarding the outbreak control. The fact that the clinical picture in children is seriously different from adults may be that their immune system responds more quickly than adults, or it may depend on the immunity they have gained through the extended immunization program. In other words, some antibodies that exist in children thanks to vaccination but disappear in adults over the years may protect children. In a study conducted in 2008, the measles vaccine has been shown to provide neutralizing antibodies against SARS CoV (5). In addition, studies revealed that whooping cough outbreaks have been observed in China in recent years (6,7). In one study, Bordetella spp. were isolated in 4.51% of pediatric patients followed for respiratory tract infection (8). There are similarities between SARS CoV-2 and transmission dynamics of Bordetella species. Both pathogens are transmitted at a high secondary attack rate via respiration and droplet. The incubation and clinical time of both pathogens are similar. Prior antibiotic use facilitates the placement of Bordetella species. Bordetella species actively interact with other pathogens or flora members (9,10). In the clinic of both pathogens, there are asymptomatic carrier cases, cough is dominant, as well as the complaint of dry cough. It is noteworthy that the number of CD4 T lymphocytes has decreased in the laboratory findings of whooping cough, and that some medicines used in treatment (Chloroquine, erythromycin) can also be used in Bordetella species. The absence of death in the 0-9 age group who with a strong titer of whooping cough antibodies also brought to mind the possibility of an overlooked co-infection in the pandemic (7). Pathogens that may co-infect with SARS CoV-2 such as whooping cough and different clinical manifestations seen among children and adults are considered to be examined in this respect. In this sense we developed two hypotheses: <b>Hypothesis 1:</b> Could childhood vaccines be the reason for a milder infection in children? <b>Hypothesis 2:</b> In cases of severe pneumonia and ARDS, can there be a bacterial co-infection, such as bordatella pertussis, that has been vaccinated in childhood but whose antibody titer has declined over the years?

Measles seroprevalence after reactive vaccination campaigns during the 2015 measles outbreak in four health zones of the former Katanga Province, Democratic Republic of Congo

BackgroundMeasles continues to circulate in the Democratic Republic of Congo, and the country suffered from several important outbreaks over the last 5 years. Despite a large outbreak starting in the former province of Katanga in 2010 and the resulting immunization activities, another outbreak occurred in 2015 in this same region. We conducted measles seroprevalence surveys in four health zones (HZ) in the former Katanga Province in order to assess the immunity against measles in children 6 months to 14 years after the 2015 outbreak.MethodsWe conducted multi-stage cluster surveys stratified by age group in four HZs, Kayamba, Malemba-Nkulu, Fungurume, and Manono. The age groups were 6–11 months, 12–59 months, and 5–14 years in Kayamba and Malemba-Nkulu, 6–59 months and 5–14 years in Manono and Fungurume. The serological status was measured on dried capillary blood spots collected systematically along with vaccination status (including routine Extended Program of Immunization (EPI), and supplementary immunization activities (SIAs)) and previous self-reported history of suspected measles.ResultsOverall seroprevalence against measles was 82.7% in Kayamba, 97.6% in Malemba-Nkulu, 83.2% in Manono, and 74.4% in Fungurume, and it increased with age in all HZs. It was 70.7 and 93.8% in children 12–59 months in Kayamba and Malemba-Nkulu, and 49.8 and 64.7% in children 6–59 months in Fungurume and Manono. The EPI coverage was low but varied across HZ. The accumulation of any type of vaccination against measles resulted in an overall vaccine coverage (VC) of at least 85% in children 12–59 months in Kayamba and Malemba-Nkulu, 86.1 and 74.8% in children 6–59 months in Fungurume and Manono. Previous measles infection in 2015-early 2016 was more frequently reported in children aged 12–59 months or 6–59 months (depending on the HZ).ConclusionThe measured seroprevalence was consistent with the events that occurred in these HZs over the past few years. Measles seroprevalence might prove a valuable source of information to help adjust the timing of future SIAs and prioritizing support to the EPI in this region as long as the VC does not reach a level high enough to efficiently prevent epidemic flare-ups.

Vaccination of infants aged 0 to 11\xa0months at the Yaounde Gynaeco-obstetric and pediatric hospital in Cameroon: how complete and how timely?

BackgroundVaccination is a major, but simple and cost effective public health intervention in the prevention of infectious diseases, especially in children. Nowadays, many children still miss scheduled vaccines in the Extended Program of Immunization (EPI) or are being vaccinated after the recommended ages.This study was aimed at assessing vaccination completeness and timeliness in children aged 0 to 11 months attending the vaccination clinic of the Yaounde Gynaeco-Obstetric and Pediatric Hospital.MethodsThis was an observational cross-sectional study over a period of 3 months (1st February to 30th April 2016). 400 mothers were interviewed and their children’s vaccination booklets analyzed. Information on the children and the parents was collected using a pretested questionnaire. Data analysis was done using SPSS version 20 software. Bivariate and multivariate analysis with logistic regression was done to assess the determinants of completeness and timeliness.ResultsA total of 400 mother-infant pairs were sampled. The vaccination completeness rate was 96.3%. This rate varied between 99.50% for BCG and 94.36% for IPV. Most of the children were born at the Yaounde Gynaeco-Obstetric and Pediatric hospital where they were regularly receiving their vaccines. The proportion of correctly vaccinated infants was 73.3%. The most differed vaccines were BCG, PCV13 and IPV. Factors influencing immunization completeness were the father’s profession and the mother’s level of education.ConclusionsDespite the high immunization coverage, some children did not complete their EPI vaccines and many of them took at least one vaccine after the recommended age.

The Trend of the Extended Program of Immunization (EPI) in Iran from the Beginning (1984) to 2013

Introduction The extended program of immunization (EPI) in Iran is started in 1984, and it played an important and effective role in controlling many infectious diseases in community. The objective of this study was to determine the time trends of vaccination coverage by the type of vaccine among children, in the age group of 0-24 months, in Iran from the beginning of EPI (1984) to 2013. Materials and Methods This study has been conducted as a descriptive analytical research to evaluate the vaccines of extended program of immunization in Iran from 1984 to 2013. The data of this study have been obtained from the World Health Organization and UNICEF. The data of this study included the percentage of coverage for routine vaccines in Iran National immunization program in children, aged 0-24 months. The data analysis has been done by STATA, Version12. Results The coverage of all vaccines has been continuously increased from 1984 to 2013, and now the coverage for all of them is about 99 percent. All coefficients in the regression models are positive and statistically significant (P <0.05). Birth dose of Hepatitis B (HepBB) and third dose of diphtheria–tetanus–pertussis containing vaccine (DPT3) variables with coefficients of 1.52 and 1.34 had the highest rate of increasing during this period, respectively. The first dose of diphtheria–tetanus–pertussis containing vaccine (DPT1) with a coefficient of 0.65 had the lowest coefficient among other variables. Conclusion According to the findings, maintaining the wide coverage, monitoring and updating the program can play an important role to improve children's health, contagious disease prevention, and health promotion.

Level of Knowledge and Practice of Extented Program of Immunization Among Medical Students

Objectives:To determine the level of knowledge&amp; practice regarding extended program of immunization (EPI) in Pakistan among medical students.Design:A questionnaire based survey done amongst the students of a medical college of Peshawar.Methodology:A questionnaire was developed in the line with study objectives and circulated among students of third, fourth and final year of a medical college of Peshawar .Fifty students were selected from each class randomly. They were provided the assurance regarding the confidentiality of their response.Results:Total of 150 students was interviewed .All students were in age group 20-25 yrs. Males were 42.6% and female were 57.4%. Good knowledge was observed in 27.3% of students, average knowledge was observed in 56.6% while 16% had poor level of knowledge. Regarding practice 78% used to recommend immunization to other while 22% did not give any advice regarding immunization to anyone .Most of the students having good knowledge were from final year class (16%).Conclusion:Efforts towards ensuring adequate exposure to immunization education during training years are need to eliminate one of the barriers to adequate immunization in children.

Hepatitis B Virus Infection; A Vanishing Disease in Iranian Children

Hepatitis B virus (HBV) infection is the main cause of chronic liver disease (1) and at least 2 billion people are infected worldwide, while 350 million are chronic HBV carriers (1). The prevalence rate of HBV infection differs in various countries. In areas with a high prevalence (8% or more), the lifetime risk of exposure to the infection is around 60 and it typically occurs in infancy or childhood periods. China, South-East Asia, most of Africa and some parts of the Middle East have a high prevalence of HBV infection and the rate ranges from 8% to 15% (1, 2). Inter-mediate prevalence areas (2-7%) of infection occur across all age groups and most areas of Middle East countries, Eastern and Southern parts of Europe are in this category. There are also areas with low endemicity, i.e. lower than 2% prevalence in adults. These areas include North Amer-ica and Western Europe (1).HBV infection is still the main cause of chronic liver dis-ease in Iran (3), although the seroprevalence of HBV in-fection in Iran has decreased during the last two decades (4). The main risk factor for HBV transmission was pre-viously related to maternal-infantile transmission and high coverage infantile vaccination is the main cause for changes in the epidemiology of HBV infection (5). Given the importance of this interruption to HBV transmission in Iran, the HBV vaccination has been included in the ex-tended program of immunization (EPI) since 1993 (6, 7).Adibi

An overview of the National Consultative Council of Immunization in Honduras

The State of Honduras instituted its technical advisory committee on immunization in response to recommendations made by the Pan-American Health Organization (PAHO) and the National Extended Program of Immunization (EPI). On 9 October 1999, the “National Consultative Council of Immunization” (NCCI) was established to provide support and recommendations to the EPI program for the eradication, elimination and control of vaccine-preventable diseases. The seven permanent members of the Council are all paediatricians. Additionally, there are liaison members (from PAHO, the national EPI team, and others) who participate in NCCI meetings when required. Meetings take place three times per year. The high quality of Council recommendations is demonstrated by the fact that the health authorities have adopted all of them.

Recent advances in Hepatitis B vaccination

Hepatitis B virus is a microorganism formed in the excess of surface antigen which is devoid of nucleic acid. Surface antigen of HBV was from the beginning the natural candidate for the vaccine which was thus produced by isolation of plasma HBsAg and later substituted by recombinant protein(s). The Extended Program of Immunization was beneficial for the reduction of HBV incidence in the populations of many participating countries. It is further postulated that HCC incidence in the world was also reduced at least in the portion caused by hepatitis B virus. Persistence of anti-HBV immunity was first measured by quantitative anti-HBs assay determined at 1 month post vaccination cycle, and then at different time points, even up to 12-15 years. The frontier of 10 IU/L (mIU/ml) is a mark of sustained immunity. However, cellular immunity studies revealed that this kind of response is very important in the defense against the virus and may last longer than the detectable antibodies. It was shown that 'full' surface vaccines, i.e. preS+S, may give stronger immunity and are good even for neonates. The next generation vaccines are DNA-based and plant-based HBV vaccines. This last category raises many hopes and with sufficient immunogenicity could ensure the most comfortable route of administration.

Changing Pattern of Hepatitis Viral Infection in Saudi Arabia in the Last Two Decades

Information on the epidemiology of viral hepatitis B, C and A in the Kingdom of Saudi Arabia (KSA) has accumulated over the last two decades. We review the changing epidemiology of these infections and suggest possible strategies for eradication. We screened Saudi medical journals and Medline for reports dealing with hepatitis B, C and A, and analyzed official of blood donor screening data from the Ministry of Health (MOH) Central Blood Bank and the King Khalid University Hospital (KKUH) Blood Bank. Several studies from the 1980s found a high endemicity for HBV, with 5% to 10% of the population infected and prevalence varying from one region to another. In children (age 1 to 12 years), the prevalence was almost 7% in 1989, just before the addition of the HBV vaccine to the Extended Program of Immunization (EPI). By 1997, the prevalence of HBV infection in children had declined to 0.3%. Blood donor results have also shown a steady decrease in HBV infection. At KKUH, prevalence declined from 3.7% in 1987 to 1.7% in 2000. Hepatitis C infection has also shown a marked decline among Saudi blood donors at KKUH, HAV infection among children has declined from 50% in 1989 to 25% in 1997, but the infection rate is still high, reaching 50% in a few regions. Hepatitis B, C, and A infection has declined in KSA in the last two decades by more than 50%. The reasons for this marked decline are multifactorial. An important reason is the adoption in the last two decades of the MOH strategy for prevention of viral hepatitis infection, which needs to continue. Improvements in the economic status of the population and the decline in illiteracy have also contributed to the decline in viral hepatitis infection.