Immunization History Research Articles

Meningococcal Carriage in Children with Atypical Hemolytic Uremic Syndrome Receiving Eculizumab Therapy.

Eculizumab is a first-line treatment for atypical hemolytic uremic syndrome (aHUS), and patients undergoing eculizumab therapy may become more susceptible to infection caused by Neisseria meningitidis (Nm). While meningococcal vaccination is required for patients undergoing eculizumab therapy, there is limited knowledge about meningococcal carriage in children with aHUS. We aimed to evaluate (1) the prevalence of Nm carriage, (2) serogroup distribution, and (3) the immunization status of children undergoing eculizumab treatment for aHUS. The Meningo-aHUS study is a prospective, multi-center study evaluating meningococcal carriage in children and adolescents in Türkiye receiving eculizumab for aHUS. We noted the age, gender, daycare, school, or university attendance, passive smoking status, previous infection and antibiotic use, and previous immunization history, including meningococcal vaccines, from the medical records of those children with aHUS. We collected nasopharyngeal samples, tested them for Nm using real-time polymerase chain reaction, and performed a serogroup analysis on the positive samples. We collected nasopharyngeal samples from 62 children with aHUS. Out of 62 children, 61 (98.4%) had received at least one dose of the meningococcal vaccine. The median time since the last meningococcal vaccine dose was 15 months (1-59 months). We detected meningococcal carriage in three (4.8%, 95% CI 1.0-13.5) children, and all three strains were non-groupable (NG). No other serogroups were detected. Almost all the children received their risk-group meningococcal immunization, including booster doses. A 4.8% of children with aHUS carried NG meningococci and, no vaccine serogroups were detected. Patients treated with eculizumab remain profoundly susceptible to IMD due to these NG meningococcal strains. The occurrence of breakthrough cases and carriage of Nm, especially NG strains, highlights the significance of maintaining a state of constant alertness, promptly seeking medical attention, and swiftly treating any symptoms that align with IMD, regardless of their vaccination status or antibiotic prophylaxis.

Varicella-Zoster Disease of the Central Nervous System in Immunocompetent Children: Case Series and a Scoping Review.

Varicella-Zoster Virus (VZV) is characterized by its ability to enter a dormant state within the body. When the wild or vaccine virus reactivates, it can lead to herpes zoster (HZ), which infrequently manifests as a neuroinfection. The aim of the study was to analyze the clinical manifestations and outcomes associated with VZV reactivation in the CNS in immunocompetent children. We searched medical databases for case reports using the keywords "zoster", "meningitis", "encephalitis", and "immunocompetent". The inclusion criteria were age below 18 years, any gender, race, and ethnicity, no features or history of immunodeficiency, and confirmation of VZV reactivation through the detection of VZV DNA in the CSF. Patients were categorized into two groups: children experiencing the reactivation of the wild virus and children with the vaccine strain virus. The cohort included six children hospitalized in our hospital and 49 children reported in the literature. In 37 (67%), a wild-type virus was detected, while in 18 (33%), an infection was caused by the vaccine strain. There were no differences in the clinical presentation between the two groups. A typical rash was observed in 32 (58%) children. Approximately 41 of the 55 children (75%) received antiviral treatment. Four patients experienced complications. Neither a history of VZV immunization nor the absence of a skin rash can definitively exclude VZV meningitis. It is important to note that any seemingly healthy child, regardless of recognized risk factors, could develop HZ meningitis.

Abstract A065: How accurate are parents' recalls? Factors affecting the concordance of parental and provider reports of HPV vaccination among African American adolescents

Abstract Objectives. Since the introduction of the human papillomavirus (HPV) vaccine in 2006, substantial efforts have been made at the national and state levels to monitor its uptake and understand the factors influencing vaccination. Most studies have focused on the acceptability and intent to vaccinate among adolescents and their parents, providing limited insights into how this understanding affects actual vaccine uptake and completion. A common method for measuring adolescents' vaccination status is parental recall. While some research has assessed the accuracy of parental recall, its implications have not been thoroughly explored. African Americans are disproportionately affected by HPV-related cancers, with higher mortality rates for cervical and oropharyngeal cancers compared to non-Hispanic whites. This study examined the accuracy of parents' reports of their adolescent children's HPV vaccination status and how this accuracy varied by socio-demographic characteristics within the Black/African American community. Methods. Data were taken from the 2015–2019 National Immunization Survey (NIS)-Teen, which includes a household interview and a provider-completed immunization history. We evaluated concordance between parents’ and providers’ reports of teens’ HPV vaccine initiation (at least 1 dose) and completion (3 doses) among Black/African American adolescents between the age of 13 to 17. We assessed bivariate associations of sociodemographic characteristics with having a concordant, false-positive (overreporting) or false-negative (underreporting) report, and used multinomial logistic regression to estimate the independent impact of each characteristic. Results: In a cohort of 68,205 adolescents (51.2% male, 95% CI: 50.4%-51.8%; 48.8% female, 95% CI: 48.2%-49.5%), parental reporting discrepancies in vaccination status were observed. Girls' parents were more likely to underreport (β=0.10, p=0.03) and overreport (β=0.10, p=0.03) vaccination status compared to boys' parents. Mothers with higher education levels were less likely to underreport, while single mothers were more likely to underreport (β=0.15, p=0.02) and overreport (β=0.17, p=0.008) vaccination status. Conclusions: Discrepancies between physician-reported and parental-reported HPV vaccination records among African American teenagers were observed, with parental reporting accuracy varying based on the child's gender and the mother's education level and marital status. Strategies to improve parental reporting accuracy and address disparities are needed to increase HPV vaccination rates and reduce HPV-related diseases in the African American community. Citation Format: Elaine Z. Liu, Philip Siu, Chun Pan, Grace X. Ma, Lin Zhu. How accurate are parents' recalls? Factors affecting the concordance of parental and provider reports of HPV vaccination among African American adolescents [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A065.

Study on Trend of Immunization Coverage in Mutum Biyu Ward "B" From 2016-2019 in Gassol Local Government Area, Taraba State, Nigeria

This study examines the trend of immunisation coverage for Bacille Calmette-Guerin (BCG), Oral Polio Vaccine (OPV), Measles, and Yellow Fever in Mutum Biyu Ward 'B' of Gassol local Government Area, Taraba State, Nigeria, from 2016 to 2019. The DHIS2 Nigeria platform was used to gather secondary data using a quantitative, cross-sectional approach. In order to analyse the completion and non-completion rates of Routine Immunisation (RI) schedules, vaccination cards and carer recollection were the main sources of immunisation histories. One-way ANOVA testing and descriptive statistics were used in the data analysis. The study's findings showed that vaccination coverage varied over time. The BCG coverage saw notable fluctuations, peaking in the years 2017 and 2019. In 2018, OPV coverage rose on average but somewhat decreased. Measles vaccination rates were steady at first, then they fell in 20l8 and then sharply recovered in 2019. The vaccination rate for yellow fever was low in 20l6, improved slightly in 2017, declined sharply in 2018, and then reached its peak in 2019. The study recommended localized use of geo-mapping to identify and map communities with low immunisation coverage in Mutum Biyu Ward "B" of Gassol LGA, Taraba State.

Eleven-Year Report of High Number of Diphtheria Cases in Children in East Java Province, Indonesia.

A high incidence of diphtheria cases in children in East Java province, Indonesia, has been observed since the beginning of this century. Despite many efforts, the outbreaks continue. This study aims to explain the high incidence of diphtheria in children in East Java province since 2013. This cross-sectional surveillance report-based study used data from 38 districts in East Java since 1 January 2013. Collected data included demographics, clinical information, additional examinations, immunization history, and close contact management. Over eleven years, there were 4009 diphtheria patients, of whom 2921 (72.86%) were under 18 years of age. Boys (59.77%) outnumbered girls, and the most common age category was >60-144 months (51.66%). Most cases had incomplete or zero immunization (76.16%). Tonsillopharyngeal diphtheria was the most common type (69.60%). The five top districts with the most cases were Surabaya, Sidoarjo, Kabupaten Blitar, Kota Malang, and Kabupaten Malang. The eleven-year case fatality rate (CFR) was 2.36% (69/2921). This study shows that diphtheria cases in children and adolescents in East Java have consistently been high, and low immunization coverage might still be the leading cause. There has also been a shift in the district distribution. Diphtheria outbreaks require complete and sustainable efforts, not just outbreak response immunizations.

Jenner's Legacy: How Edward Jenner's Smallpox Vaccine Changed Public Health.

Edward Jenner who discovered immunology and the smallpox vaccine conducted a smallpox vaccination test in 1796, which is considered a landmark in the history of modern immunization. This review focuses on describing Jenner and his accomplishments highlighting his discovery as a shift in the approaches toward disease control and prevention as well as the basis for further eradicating smallpox globally. Jenner's use of cowpox to protect people from smallpox was a revolution from other essential procedures such as variolation. His vaccine demonstrated how immunization could be used to combat diseases, and over the years the idea began to be deployed to other vaccines and other diseases. Besides the given medical profession, the work of Jenner was relevant to the changes or even enhancements of health policies and health systems globally. His vaccine provided not only the means to arrest a wide disease that could easily eliminate many human beings but also initiated procedures of disease prevention and control. Another important type of immunity, herd immunity, which determines an approach to managing specific diseases in the present, as well as knowledge of the degree of protection provided by the antigen in terms of the overall immune status of a population, was also achieved based on the actions taken after Jenner's procedure. As our society searches for vaccines for emergent diseases to date, this review reveals that Jenner's accomplishments are still relevant. In this article, analyzing Jenner's approach and the role of society and science at the time, along with the consequences of his work, the reader sees how Jenner changed the world of public health and laid a foundation for today's vaccination. Such an approach allows considering the changes and evolution of the topic that Jenner studied and contributed to and how people fight infections today.

The Stunting Determinants in Toddlers from Landak Regency, West Kalimantan: A Cross-Sectional Study

Background: Stunting is a nutrition problem that can slow down the growth. With prevalence at 32.5%, Landak Regency in West Kalimantan has been designated as a stunting hotspot. The lack of a maximum penalty for the stunting case in Landak Regency is not based on factors causing the stunting itself, because there is no identifiable factor causing the stunting in certain area due to narrow roads and sharp curves. Objectives: The objective of this study was to identify causes and distribution of the stunting case in Landak Regency. Methods: A total of 330 households in Meranti, Sebangki, and Senakin were included in this cross-sectional study because they were at a risk of the stunting. Toddlers, mothers, health care, and environmental factors were among the found variables. The researchers employed a basic random sampling strategy for the sampling and used the secondary health center data to find out whether or not toddlers were stunted. Researchers in this study collected data on the independent variables by observing and interviewing participants. Using the chi-square test, the data was analyzed. Results: The results showed that determinants of the stunting in Landak Regency were the history of early breastfeeding initiation (p-value=0.032), exclusive breastfeeding (p-value=0.042), frequency of exclusive breastfeeding (p-value=0.040), the continued breastfeeding (p-value=0.024), complementary feeding (p-value=0.042), immunization history (p-value=0.007), infectious disease history (p-value=0.000), maternal height (p-value=0.046), delivery assistance (p-value=0.000), access to health services (p-value=0.004), the role of health workers (p-value=0.002), and family latrine ownership (p-value=0.000). Conclusions: Several factors were found to be associated with incidence of the stunting among toddlers in Landak Regency.

Novel intervention based on an individualized bundle of care to decrease infection in kidney transplant recipients.

Infection remains a relevant complication after kidney transplantation (KT). A well-established strategy in modern medicine is the application of bundles of evidence-based practice in clinical settings. The objective of this study is to explore the application of a personalized bundle of measures aimed to reduce the incidence of infection in the first 12 months after KT. A single-center prospective cohort of 148 patients undergoing KT between February 2018 and September 2019 that received an individualized infection prevention strategy was compared to a preintervention cohort (n = 159). The bundle comprised a review of the patient's immunization history, infection risk by country of origin, screening for latent tuberculosis infection (LTBI), antimicrobial prophylaxis, and immunological assessment. Individualized recommendations were accordingly provided at a scheduled visit at day +30 after transplantation. The intervention cohort showed a higher compliance rate with the recommended vaccine schedule, screening for geographically restricted infections and LTBI, and intravenous immunoglobulin and vitamin D supplementation (p values <.001). The 1-year incidence rate of infection was lower in the intervention cohort (42.6% vs. 57.9%; p value =.037), as was the rate of infection-related hospitalization (17.6% vs. 32.1%; p value =.003) and the incidence of severe bacterial infection. There were no differences in graft rejection or mortality rates between groups. A multifaceted intervention, including a bundle of evidence-based practices, enhanced compliance with recommended preventive measures and was correlated with a reduction in the 12-month incidence of infection after KT.

Factors Causing Peritoneal Tuberculosis in Children with A Family Nursing Approach: Case Report

The morbidity rate of children due to tuberculosis (TB) including peritoneal TB is still high. It is very important to know the factors that cause Peritoneal Tuberculosis in children, so that it can prevent and reduce morbidity rates by using a family nursing approach that not only involves children, but also involves families so as to support the health of children and families holistically. This study aims to determine what factors cause cases of Peritoneal Tuberculosis in children using a family nursing approach. The method used is case report. This study examined 9 factors causing Peritoneal Tuberculosis, namely nutritional status, age, gender, residential density, air circulation at home, home lighting, BCG immunization history, economic background, and parental knowledge related to Peritoneal Tuberculosis. The study was conducted for 6 home visits with a family nursing care approach, namely the Friedman framework assessment, intervention, implementation, and evaluation and online follow-up 3 times. Each visit lasted 30 to 45 minutes. Factors causing Peritoneal TB in children include nutritional status, age of the child, housing density, house lighting and air circulation at home, gender, BCG immunization history, economic background, and parental knowledge. The main factors that caused An.Z to develop Peritoneal Tuberculosis were nutritional status and environmental conditions in the house, such as occupancy density, lighting, and air circulation in the house.

A Serological Survey of Measles and Rubella Antibodies among Different Age Groups in Eastern China.

Measles and rubella are vaccine-preventable diseases targeted for elimination in most World Health Organization regions, and China is considered to have momentum towards measles elimination. Therefore, this study aimed to assess the population immunity levels against measles and rubella in Zhejiang Province in China in order to provide valuable insights for informing future public health measures and contributing to the ongoing global campaign against these diseases. A cross-sectional serological survey was conducted in 2022. A total of 2740 blood samples were collected from healthy individuals spanning the age range of 0-59 years, representing diverse demographic strata across 11 prefectures in Zhejiang Province in China. The sera were tested for measles and rubella IgG antibodies to determine positivity rates and geometric mean concentrations (GMCs). The overall positivity rate for the measles IgG antibody was 85.3%, with a GMC of 588.30 mIU/mL. The positivity rate for the rubella IgG antibody was 70.9%, and the GMC was 35.30 IU/mL. Measles IgG antibody positivity rates across the 0-11 months, 12-23 months, 24-35 months, 3-5 years, 6-9 years, 10-14 years, 15-19 years, 20-29 years, and 30-59 years age groups were 63.1%, 92.5%, 97.0%, 94.0%, 85.8%, 77.3%, 86.9%, 84.9%, and 88.7%, respectively (trend χ2 = 118.34, p < 0.001). Correspondingly, rubella antibody positivity rates for these same age brackets were 55.9%, 87.9%, 94.7%, 88.2%, 69.9%, 54.2%, 72.6%, 67.5%, and 74.3% (trend χ2 = 199.18, p < 0.001). Both univariate and multivariate analyses consistently demonstrated that age, immunization history, and differing economic levels were significant factors contributing to variations in antibody levels. The seroprevalence of measles and rubella was lower than that required for herd immunity. Periodic vaccination campaigns should be launched to increase immunity.

Temporary Delayed Hypersensitivity Reaction to Botulinum Toxin-A After COVID-19 Vaccination: A Case Series.

The occurrence of a hypersensitivity reaction with the injection of botulinum toxin type A (BTX-A) in cosmetic use is a rare complication. We report the largest case series of temporary delayed hypersensitivity reaction (DHR) with BTX-A following COVID-19 vaccination and the first cases to incobotulinum toxin A (incoBTX-A). A retrospective multicentric case series of patients who developed a DHR to BTX-A after COVID-19 vaccination. Twelve patients were treated with BTX-A injections for the management of facial rhytids. The age range was between 29 and 45years. Ten (83.3%) were female. Ten (83.3%) patients received incoBTX-A, and two received onabotulinum toxin A (onaBTX-A). All patients had COVID-19 vaccination (mRNA vaccine) between 1 and 7months before. Within an average time of 24h after BTX-A injection, all patients developed progressive facial swelling and erythema that were more prominent at the injection points. Intradermal allergic tests to BTX-A were performed in six (50%) patients, and the results were all negative. Adequate clinical control was achieved with systemic corticosteroids and antihistamines. After 1year with no further vaccination, a new BTX-A treatment (provocation test) was performed in all patients with no secondary effects. Previous COVID-19 vaccination and the absence of new adverse events with further BTX-A injections suggest a temporary DHR. Clinicians should be aware of the importance of immunization history and its potential post-vaccine immunogenic effects with BTX-A. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Sero-epidemiological study and infection rate evaluation of pertussis in Henan Province

Objective: To analyze the epidemiological distribution characteristics, influencing factors, and infection rates of pertussis in the population of Henan Province. Methods: From 2022 to 2023, a cross-sectional survey was conducted to investigate the permanent population in Henan Province. Enzyme-linked immunosorbent assay (ELISA) was used to detect anti-pertussis toxin IgG (PT-IgG), analyze the antibody positivity rate (≥20 IU/ml) and median concentration (MC), and estimate the pertussis infection rate based on PT IgG ≥40 IU/ml. The rank sum test was used to compare antibody levels among groups, and the χ2 test was used to compare antibody positive rates and infection rates among groups. Results: A total of 4 810 research subjects were included in this study. The overall positive rate of PT-IgG was 12.10% and MC was 3.04 (0.35, 10.36) IU/ml. There were significant differences both in positive rates and antibody levels of PT-IgG among different regions or age groups (region positive rate: χ2=134.06, P<0.001, MC: H=337.74, P<0.001; age group positive rate: χ2=45.27, P<0.001, MC: H=134.49, P<0.001). Both the positive rate of PT-IgG (25.26%) and MC (8.01 IU/ml) were the highest within one year after completing a full course of vaccination. There were significant differences in positive rates and antibody levels among people receiving different types of pertussis vaccines (positive rate: χ2=12.38, P=0.006, MC: H=17.93, P<0.001). The antibody positivity rate (35.71%) and MC (8.88 IU/ml) of the people who received cell-free pertussis inactivated poliomyelitis influenza type b (combined) vaccine throughout the course were higher than those who received other types of vaccines. The natural infection rate of pertussis was evaluated for individuals aged≥3 years who had no history of pertussis vaccine immunization within the year prior to sampling. With a high vaccination rate, the estimated infection rate of pertussis in the population was 5 757.22/100 000. The infection rates in the 3-year-old (1 940.16/100 000) and 4-year-old (1 765.68/100 000) populations were at a low level among the entire population, reaching their peak at the age of 6 (12 656.71/100 000). Subsequently, although the infection rate continued to decline, it remained at a high level and peaked again at the age of 40-49 years (8 740.39/100 000). There was a statistically significant difference in the estimated infection rate of pertussis among different age groups (χ2=53.21, P<0.001). Conclusion: The PT-IgG level of pertussis in the population of Henan Province is generally at a low level. The estimated infection rate of pertussis is much higher than the reported incidence rate. A booster dose of pertussis vaccine is recommended at 6 years old.

PEMODELAN GEOGRAPHICALLY WEIGHTED NEGATIVE BINOMIAL REGRESSION (GWNBR) PADA KEJADIAN STUNTING DIiKABUPATEN BARITO KUALA TAHUN 2022

Stunting is a condition of malnutrition in toddlers that causes their height to be lower than other children their age. In 2022, South Kalimantan Province has a stunting prevalence of 24.6% and ranks fifteenth in Indonesia. Barito Kuala Regency, one of the regions in South Kalimantan Province, has the highest stunting rate at 33.6% which is included in the Chronic- Acute category (≥ 20%). This study uses the GWNBR model to characterize the factors that cause stunting in Barito Kuala Regency. The GWNBR model will make it easier for researchers to find out the factors that affect stunting in each sub-district. The weight matrix used is a fixed kernel function and an adaptive kernel function. The predictor variables used were the percentage of infant history of complete basic immunization, history of exclusive breastfeeding in infants &lt;6 months, history of low birth weight babies, new visits to pregnant women (K1), sixth antenatal care (ANC) visit (K6), history of pregnant women who received blood supplement tablets, history of infants 6-11 months who received vitamin A, active posyandu and households with access to appropate sanitary facilities.(healthy latrines). The best model results obtained with adaptive gaussian weighting with an AIC value of 167.25. Keywords: Stunting Cases, GWNBR model.

Knowledge Ottoman Turkish Medicine : From Methods of Immunization Traditional to Pioneer World Vaccine

This research explores the history of immunization "vaccination" which was known as the variation method during the Ottoman Turkish period. The method used is the historical method, with the stages of source collection, source criticism, interpretation and writing. Data were collected from conventional and non-conventional libraries (internet), sources collected in the form of books, journal articles, website articles and others printed or from the internet that support this research. Furthermore, the facts obtained are narrated diachronically so that the facts described are chronological. The results of this study show that the development of vaccines that is happening now is a great contribution from Ottoman Turkey. The history of vaccination was started by the Ottoman Turkish government, Ottoman (Ottoman Turkish) physicians created and developed the variolation (inoculation) method, a traditional vaccine method by taming and using viruses (germs) applied to human skin that had previously been scratched. In this way, the virus injected into the human body (smallpox sufferers or non-smallpox sufferers) will experience illness and during the illness the immune process is formed so that the patient will get immunity (antibody). The success of vaccination from Ottoman Turkey has spread to Europe which saved many human lives and eradicated smallpox, especially England which was brought by Lady Mary Montagu, traders, sailors, ambassadors and others who learned the variolation method from Ottoman Turkey.

Evaluation of the knowledge, attitudes and behavior of healthcare workers concerning influenza vaccination in a training and research hospital in Türkiye

Introduction and aim. Although increasing vaccination rates among healthcare workers (HCWs) is crucial for protecting their own health and preventing the spread of infections to patients, vaccination rates remain low. The purpose of this study is to evaluate the knowledge, attitudes, and behavior of healthcare workers concerning seasonal influenza vaccination in a training and research hospital in Türkiye. Material and methods. This cross-sectional descriptive study was conducted among 364 healthcare workers working in a training and research hospital in Ankara, Türkiye. A face-to-face questionnaire was completed by selected participants that included questions about their sociodemographic characteristics, receiving seasonal influenza vaccination, reasons for not receiving vaccination, attitudes and behavior towards seasonal influenza vaccination recommendations for their surroundings, knowledge of who should get the vaccine, and their immunization history. Results. Among the participants, 58.5% stated that they had never received an influenza vaccination, 35.7% mentioned not receiving the regular influenza vaccination, and only 5.8% reported receiving the influenza vaccination regularly every year. Reasons for not getting vaccinated included not trusting the influenza vaccine’s protection (60.1%), not believing they are in the risk group (38.9%), and not finding a suitable time to get vaccinated (36.1%). A total of 57.1% of the healthcare workers recommended the influenza vaccine for their surroundings. Conclusion. Influenza vaccination rates among healthcare workers are quite low. To maximize influenza vaccine uptake, awareness programs are needed to correct the misconceptions health care workers have about the vaccine, and diverse strategies should be implemented to encourage them to get vaccinated, thereby promoting influenza vaccination.

Polymyalgia Rheumatica Following Respiratory Syncytial Virus (RSV) Vaccination.

Polymyalgia rheumatica (PMR) is a chronic inflammatory disorder that causes stiffness and pain in the proximal joints, including the shoulders, hips and neck. The exact cause of polymyalgia rheumatica is yet to be fully understood, but research suggests that both genetic and environmental factors may contribute to it. Studies have previously linked the onset and relapse of polymyalgia rheumatica symptoms to the influenza and COVID-19 vaccines. The Food and Drug Administration approved the respiratory syncytial virus (RSV) vaccine, which is a recombinant protein vaccine for adults over 60, in May 2023. No previous reports of polymyalgia rheumatica onset or relapse have been linked to the RSV vaccine. The human proteome shares some peptides with the RSV F antigen, suggesting a high risk of cross-reactivity when using that antigen in vaccination formulations. A 72-year-old man experienced a new onset of bilateral shoulder pain and stiffness three days after receiving the Abrysvo® RSV vaccine. The symptoms lasted more than an hour (up until noon) and interfered with his activities of daily living. Inflammatory markers such as C-reactive protein were elevated. The patient's symptoms and inflammatory marker levels significantly improved with prednisone therapy. In patients with typical PMR symptoms, it is important for clinicians to carefully review immunisation history to rule out any potentially related adverse effects. Vaccines can trigger autoimmune diseases in some individuals.This case report suggests respiratory syncytial virus (RSV) vaccine is among the possible triggers for polymyalgia rheumatica.

Timeliness of Childhood Vaccinations Following Strengthening of the Second Year of Life (2YL) Immunization Platform and Introduction of Catch-Up Vaccination Policy in Ghana.

Strengthening routine immunization systems to successfully deliver childhood vaccines during the second year of life (2YL) is critical for vaccine-preventable disease control. In Ghana, the 18-month visit provides opportunities to deliver the second dose of the measles-rubella vaccine (MR2) and for healthcare workers to assess for and provide children with any missed vaccine doses. In 2016, the Ghana Health Service (GHS) revised its national immunization policies to include guidelines for catch-up vaccinations. This study assessed the change in the timely receipt of vaccinations per Ghana's Expanded Program on Immunizations (EPI) schedule, an important indicator of service quality, following the introduction of the catch-up policy and implementation of a multifaceted intervention package. Vaccination coverage was assessed from household surveys conducted in the Greater Accra, Northern, and Volta regions for 392 and 931 children aged 24-35 months with documented immunization history in 2016 and 2020, respectively. Age at receipt of childhood vaccines was compared to the recommended age, as per the EPI schedule. Cumulative days under-vaccinated during the first 24 months of life for each recommended dose were assessed. Multivariable Cox regression was used to assess the associations between child and caregiver characteristics and time to MR2 vaccination. From 2016 to 2020, the proportion of children receiving all recommended doses on schedule generally improved, the duration of under-vaccination was shortened for most doses, and higher coverage rates were achieved at earlier ages for the MR series. More timely infant doses and caregiver awareness of the 2YL visit were positively associated with MR2 vaccination. Fostering a well-supported cadre of vaccinators, building community demand for 2YL vaccination, sustaining service utilization through strengthened defaulter tracking and caregiver-reminder systems, and creating a favorable policy environment that promotes vaccination over the life course are critical to improving the timeliness of childhood vaccinations.

Evaluation and outcome of hearing in meningitis patients

Background: Meningitis remains the most common cause of acquired severe to profound SNHL in childhood. Likewise, deafness is the most common long-term neurological sequelae of the disease. Important consideration following meningitis is the development of labyrinthitis ossificans in which there is new bone formation within the lumen of the otic capsule. Ossification of the labyrinth can develop within a few days of meningitis which can make cochlear implantation difficult. Every newborn should be promptly screened for any hearing deficit along with the patients having meningitis. The most easily available investigation are OAE and BERA. Methods: Our ambispective study of 25 patients was undertaken in a duration of 2 years in ENT department of civil hospital, Ahmedabad. All the patients underwent a detailed clinical examination and all routine audiological, and radiological investigations. Results: The prevalence of hearing loss in post meningitis pediatric age group is 40%. Females are affected more than males. Median age group of presentation with hearing deficit is 4 years. Patients with complete immunization history have lower incidence of hearing loss associated with meningitis than incomplete immunization. Ossification of the cochlea can develop as early as 6 days from the development of first symptom. Conclusions: Ossification of the cochlea can develop as early as 6 days from the development of first symptom. These are the candidates who should be prioritized for cochlear implant surgery. Patients with mild hearing loss recovered completely whereas those with profound hearing loss underwent cochlear implant surgery and were benefited with it.

The Risk Factors for Stunting in Children Aged 6-59 Months: A Study of Case Control in A Sub Urban Area

Indonesia currently has a high incidence of stunting. The stunting prevalence in Bogor Regency is 28,6%, which is higher than the national stunting prevalence. Padasuka Village is categorized as sub-urban. Factors causing stunting can differ depending on the characteristics of the area. The objective of the study was to analyze the factors that cause stunting in children aged 6-59 months in sub-urban areas. Observational research method with case control design was conducted from December 2022 to June 2023. The research location was Padasuka Village, Bogor Regency. Data on children under five years old were weight, height, history of infectious diseases, exclusive breastfeeding, immunization, macro and micronutrient intake and maternal knowledge. Data were collected using a questionnaire with interview techniques. Nutrient intake data were obtained using a 2x24 hour food recall form. The study sample sizes were 41 cases and 41 controls, making a total of 82 subjects. Statistical analysis using SPSS 16 for Windows software used univariate analysis to see the description of each research variable and analysis of the relationship between variables (bivariate) using the Chi-Square test for characteristic data and independent t-test for intake data. The results of the analysis were birth weight (p-value=0,012), birth length (p-value=0,012), energy intake (p-value=0,002), carbohydrate intake (p-value=0,024), and protein intake (p-value=0,037) had significant differences between the stunting group and the normal group. Birth weight, birth length, energy intake, carbohydrate intake, and protein intake are risk factors for stunting in children under five years old in sub-urban areas.

Prevalence of anti-HLA antibodies in COVID-19 convalescent plasma donors: an Indian experience

BackgroundCOVID-19 convalescent plasma is one of the experimental therapies used widely in moderately sick COVID-19 patients. However, there are a few risks involved in plasma transfusion; notably, transfusion-related acute lung injury (TRALI) caused by antibodies against human leukocyte antigens (HLA). This study was designed to assess the prevalence of anti-HLA antibodies in convalescent plasma donors using the single antigen bead method. Study design and methodsThis was a hospital-based observational study of consecutive plasma donors. A total of 252 samples were screened for anti-HLA Class I and Class II antibodies using the microbead assay with the identification of anti-HLA Ab in positive samples being performed using a single antigen bead assay. Luminex-based normalized background cutoff ratios of 10.8 for Class I and 6.9 for Class II and mean fluorescence intensity cutoffs of 2500 for Class I and 1500 for Class II were used for screening and the single bead assay, respectively. ResultsOf 252 screened samples, 28 (11.1 %) were positive for Class I, Class II or both Class I and Class II anti-HLA antibodies in donors with no history of a previous immunizing event. Moreover, 20/252 (7.9%) donors without any history of prior immunization had specific anti-HLA antibodies of Class I or Class II or both by the single bead assay. ConclusionsThe high prevalence of anti-HLA antibodies in our cohort of donors raises an urgent and immediate need for anti-HLA antibody screening in all convalescent plasma donors for safe therapy of COVID-19 patients.