Inoculation Program Research Articles

Legionnaires' Disease Legacies

To the Editor.— The editorial comments by Samuel Vaisrub, MD, on historical aspects of Legionnaires' disease (243:1747, 1980) might well have included one additional legacy: its impact on the ill-fated swine influenza vaccination program. 1 It may be recalled that, in the spring of 1976 the American public had been warned of the strong probability of an impending epidemic of swine influenza. Indeed, the federal government had pushed for a massive inoculation program designed to vaccinate every person in the United States. However, by June 1976, the program stalled because vaccine manufacturers refused to accept liability that might result from injury or death caused by the vaccine. Private insurers also would not take the risk; therefore, legislation was proposed that would make the federal government liable for adverse effects caused by the vaccine. Members of the congressional committee reviewing the proposal questioned the wisdom of the government accepting this liability,

Participation of Senior Citizens in the Swine Flu Inoculation Program: An Analysis of Health Belief Model Variables in Preventive Health Behavior

Evidence is presented of statistically significant and strong relationships between Swine Flu Inoculation status and nine variables in the reformulated Health Belief Model with 122 randomly selected subjects, primarily Black and Portuguese-American, who are active members of two Providence, Rhode Island senior centers. No statistically significant relationship was discovered between inoculation status and previously having had the flu. The variables which were found related are: Efficacy, Safety, Knowledge of Side Effects, Prior Flu Shot Status, Proportion of Friends and Relatives Who Got the Shot, Sex, Race, Future Plans for Flu Shots, and Future Plans for Other Inoculations. The data were obtained through personal interviews in the Spring of 1977. It is suggested that the results provide some basis for optimism for successful intervention designed to change the future preventive health behaviors of nonparticipants in the Swine Flu Inoculation Program. Many nonparticipants had fears and doubts about the effectiveness and safety of the shot and are amendable to suggestions from physicians about future inoculation participation. Full information should be provided to high-risk groups such as senior citizens about the relative risks of suffering serious side effects, the effectiveness and safety of the procedure for persons their age with the typical health problems of senior citizens, and the relative risks and dangers to them of contracting the illness against which the shot is designed to protect them.

Optimal Control of Some Simple Deterministic Epidemic Models

Using control variables such as the level of medicare programme effort and the level of inoculation programme effort, three simple mathematical models of epidemics are transformed into optimal control problems. These are multi-state problems with the state variables as numbers of infectives and suspectibles and with the objective function being minimization of the total present value of the social or economic costs of infectives and medical controls. The problems are analysed with the framework of the maximum principle to obtain or, at least, partially characterize the optimal policies over time.

Optimal Control of Some Simple Deterministic Epidemic Models

Using control variables such as the level of medicare programme effort and the level of inoculation programme effort, three simple mathematical models of epidemics are transformed into optimal control problems. These are multi-state problems with the state variables as numbers of infectives and susceptibles and with the objective function being minimization of the total present value of the social or economic costs of infectives and medical controls. The problems are analysed with the framework of the maximum principle to obtain or, at least, partially characterize the optimal policies over time.

Utilization and acceptability of influenza A/New Jersey/76 virus vaccine in Oakland County, Michigan.

The program of mass inoculation of adults in Oakland County, Michigan, with monovalent influenza A/New Jersey/76 virus vaccine was monitored. A stratified random sample of participants was selected, and telephone interviews were conducted two days after inoculation. The group of vaccines differed from the overall county population in that it had a higher percentage of females and more of the vaccinees were older, better educated, and of higher income. Minor complaints following vaccination were relatively frequent, particularly sore arm. All complaints were significantly more frequent in females than in males, and among females, the group younger than 40 years reported these complaints most often. Since neither utilization of the vaccine nor complaints following vaccination were uniformly distributed, it was concluded that population-based studies are needed for proper assessment of vaccine-related effects.

Inoculation of pines with mycorrhizal fungi in natural soils—I.: Effects of density and time of application of inoculum and phosphorus amendment on mycorrhizal infection

On two soils lacking fungi capable of forming mycorrhizas with Pinus, the addition of superphosphate at 40 kgP/ha greatly increased mycorrhiza formation in Pinus radiata D. Don and P. elliottii Little and Dorman. Phosphorus could be partially replaced by increasing inoculum density or avoiding delay in inoculation after sowing. Chlamydospores were less effective than basidiospores as inoculum except at the highest density and in the presence of added P. At low available P concn such as are common in Australian soils, the normal pattern of infection of new short roots is interrupted and re-infection from the soil is of greater importance. Survival of mycorrhizal fungi in the soil in the absence of the host may therefore be a critical factor in inoculation programs.

Eliminating fainting by school children during mass inoculation clinics.

In a study of the influence of pre-inoculation instructions during a county-wide mass inoculation program for school children, fainting was virtually eliminated when the children were instructed not to faint or cry but to remain on their feet until they left the clinic. Several explanations for the results are discussed.

Outbreak of viral hepatitis in a municipal hospital

In a period of nine weeks, four private duty nurses at a municipal hospital developed viral hepatitis. As a result of the deaths of the first two of these, a state of near-panic developed among the employee population. A program of inoculation of personnel was instituted during which 1,900 employees received γ-globulin. A survey of 1,300 employees by means of serum glutamic pyruvic transaminase screening together with more intensive evaluation of those with abnormal levels proved useless in disclosing subclinical cases. Concepts of transmission of this disease are reviewed, including more recent studies which suggest the existence of a fecal-oral route in the spread of serum hepatitis.

Outbreak of Viral Hepatitis in a Municipal Hospital

In a period of nine weeks, four private duty nurses at a municipal hospital developed viral hepatitis. As a result of the deaths of the first two of these, a state of near-panic developed among the employee population. A program of inoculation of personnel was instituted during which 1,900 employees received γ-globulin. A survey of 1,300 employees by means of serum glutamic pyruvic transaminase screening together with more intensive evaluation of those with abnormal levels proved useless in disclosing subclinical cases. Concepts of transmission of this disease are reviewed, including more recent studies which suggest the existence of a fecal-oral route in the spread of serum hepatitis.

Use of the organic integrity test (OIT) with children who cannot read.

The OIT has led the author to conclude that the human brain can better be understood and treated as a cross-correlation pattern recognition system in the cybernetic sense. With this view, he has attempted to unify the diverse phenomena of chromaphilia, reading disabilities, phonetic therapy and the processes of perception with a summarizing mathematical theory of pattern recognition by identity, which states that "an unknown form f is recognized as a known form g, if their cross-correlation pattern recognition index (PRI) is unity," that is: If PRI (f, g) = 1, then f ≅ g. This theorem can be proved by the Swartz inequality.1 This PRI theory requires a huge memory storage of known forms g, in order to recognize incoming unknown forms f, by cross-correlation pattern recognition. Practically, the PRI theory may be applied to biomedical engineering to build a pattern recognition system to solve computer pattern recognition problems—for automatic brain wave interpretation, as an example. Of course, the best all-purpose computer, a human brain with its ten billion neurons, can fill this order. The PRI theory is fundamental enough, relating to the all-or-none law of neurophysiology, to explain the manner in which the human brain perceives patterns whether in health or in disease. It therefore not only explains reading disabilities but also unifies the basic concept of brain damage, schizophrenia, mental deficiency and other neuropsychiatric disorders as one of decreased ability to perceive form, revealed as chromaphilia on the OIT. With the PRI theory as a guide and the OIT as a diagnostic technique and finally the A E I O U & Y as a method of teaching reading, it is now feasible to initiate carefully a pilot program of early detection and inoculation against reading disabilities as vaccines are given to prevent polio and smallpox in children of any community.

Organizing Mass Gamma Globulin Clinics in Three North Carolina Counties

SOME 30,000 children were inoculated with gamma globulin on a mass basis in three western North Carolina counties during the period from July 6 to August 7, 1953. Inoculations were given in Caldwell County on July 6, 7, and 8, and 12,800 children were processed in the 3 days. Catawba County was the site of a 3-day inoculation program on July 15, 16, and 17, at which time 14,761 children were given gamma globulin. In Avery County, during a 2-day program on August 6-7, 3,092 children were inoculated. The pattern developed for operating the mass gamma globulin clinics in North Carolina has proved to be highly effective. This discussion outlines the purely administrative aspects of formulating and operating a globulin mass inoculation clinic. The criteria which must be fulfilled by a county prior to receiving globulin from the Office of Defense Mobilization varied according to the amount of globulin available, and these, accordingly, are not included.