Systematic Vaccination Research Articles

Vaccination calendar of Catalonia 2016

The systematic vaccination calendar is a fundamental public health tool for the control of vaccine-preventable diseases, which benefits the entire population, both vaccinated and unvaccinated persons, equally. The vaccines used in the calendar, except tetanus, protect against diseases that are spread from person to person. Thus, when a critical number of immune persons is achieved (different for each disease), transmission is hindered due to the immunity phenomenon of group, since it reduces the risk of contracting the disease, even in people who cannot be vaccinated for medical reasons. In addition, it also contributes to the elimination (for example, poliomyelitis in Europe) and, even, to the eradication (for example, that of smallpox) of diseases preventable by vaccination.This article presents the Calendar of Systematic Vaccinations of Catalonia 2016. This is the fourteenth calendar for Catalonia since the first one was published in 1980 when the public health competences were assumed. Although vaccination is the responsibility of the autonomous communities, for years efforts have been made to harmonise the recommendations in the different communities, which culminated with the agreement adopted in January 2016 by the Interterritorial Council of the National Health System to establish a common calendar of vaccinations as of January 2017, which, in some communities such as Catalonia, was already applied during 2016.The calendar of Catalonia adopts all the recommendations of the common calendar. It also includes vaccination against hepatitis A, and systematic vaccinations for the adult population. The 2016 calendar protects against 15 diseases. The main novelties are the simplification of the vaccination scheme in the first year of life, with the use of hexavalent with a 2+1 vaccination schedule, the incorporation of the vaccination of the pneumococcal vaccination in the first year of life, and the vaccine against chickenpox at 15 months and 3 years.

Calendario vacunal de Cataluña 2016

The systematic vaccination calendar is a fundamental public health tool for the control of vaccine-preventable diseases, which benefits the entire population, both vaccinated and unvaccinated persons, equally. The vaccines used in the calendar, except tetanus, protect against diseases that are spread from person to person. Thus, when a critical number of immune persons is achieved (different for each disease), transmission is hindered due to the immunity phenomenon of group, since it reduces the risk of contracting the disease, even in people who cannot be vaccinated for medical reasons. In addition, it also contributes to the elimination (for example, poliomyelitis in Europe) and, even, to the eradication (for example, that of smallpox) of diseases preventable by vaccination.This article presents the Calendar of Systematic Vaccinations of Catalonia 2016. This is the fourteenth calendar for Catalonia since the first one was published in 1980 when the public health competences were assumed. Although vaccination is the responsibility of the autonomous communities, for years efforts have been made to harmonise the recommendations in the different communities, which culminated with the agreement adopted in January 2016 by the Interterritorial Council of the National Health System to establish a common calendar of vaccinations as of January 2017, which, in some communities such as Catalonia, was already applied during 2016.The calendar of Catalonia adopts all the recommendations of the common calendar. It also includes vaccination against hepatitis A, and systematic vaccinations for the adult population. The 2016 calendar protects against 15 diseases. The main novelties are the simplification of the vaccination scheme in the first year of life, with the use of hexavalent with a 2 + 1 vaccination schedule, the incorporation of the vaccination of the pneumococcal vaccination in the first year of life, and the vaccine against chickenpox at 15 months and 3 years.

Immunisation schedule of the Spanish Association of Paediatrics: 2018 recommendations

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines. Regarding funded immunisations, 2+1 strategy (2, 4, 11-12 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended. Administration of the 6-year booster dose with DTPa is recommended, and a poliomyelitis dose for children who had received the 2+1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy between 27 and 32 weeks' gestation. The two-dose scheme should be used for MMR (12 months and 2-4 years) and varicella (15 months and 2-4 years). MMRV vaccine could be applied as the second dose if available. Coverage of human papillomavirus vaccination in girls aged 12 with a two dose scheme (0, 6 months) should be improved. Information and recommendation for male adolescents about potential beneficial effects of this immunisation should be provided as well. The new 9 genotypes vaccine is now available, expanding the coverage for both gender. Regarding non-funded immunisations, Committee on Vaccines of the Spanish Association of Paediatrics recommends meningococcal B vaccination, with a 3+1 schedule, and requests to be included in the National Immunisation Program. Tetravalent meningococcal vaccine (MenACWY) is recommended to adolescents (14-18 years) who are going to live in countries with systematic vaccination against ACWY serogroups, and people >6 weeks of age with risk factors or travellers to countries with very high incidence. Vaccination against rotavirus is recommended in all infants.

The frequency of respiratory diseases in broiler chickens during 1992-2001

The respiratory diseases of broiler chickens are included among the very important problems in the poultry industry. The pathogenic causes of these diseases are viruses (NDV, IBV, ILTV, etc), bacteria (Mycoplasma spp, Haemophilus paragallinarum, E.coli, ORT, etc), fungi and parasites. These factors can act either alone, leading in complete disease or in combinations, causing respiratory syndromes. In broiler flocks the most frequent respiratory disease with considerable economic losses is Colibacillosis. It is either the result of primary infection of the birds with the pathogenic E.coli or secondary as complicated agent leading in the CDR syndrome. The evaluation of the respiratory diseases incidents in the Clinic of Avian Medicine showed that there has been a gradual decline in the number of the respiratory diseases during the last decade 1992 - 2001. More specifically, the percentages of the incidents of respiratory diseases were: 26,49% (1992), 22,14% (1993), 17,24% (1994), 18,00% (1995), 10,04% (1996), 9,93% (1997), 11,92% (1998), 7,79% (1999), 7,77% (2000) and 6,99% (2001). This significant reduction of the respiratory disease percentages was probably caused by factors relative with a series of measures applied in breeder flocks, in hatcheries and in poultry houses. These measures concern the continuous improvement of the poultry houses and equipment, the application of systematic vaccination programs in breeders and chicks, the good collaboration between farmers and veterinarians, the improvement of nutrition, the supplying of chicks free of bacteria, such as Mycoplasma spp, Salmonella spp, etc, and viruses, such as Reovirus, Chicken anemia virus, e.t.c, and the strict application of appropriate disinfections. The application of the above measures reduces the poultry stress, enhances their immunity, eliminates the presence and the spread of pathogens and secures better health and growth in the birds of the poultry industry. Keywords: Respiratory diseases, broilers, incidents' frequency, decade 1992-2001

Evaluation of the genetic variability found in Brazilian commercial vaccines for infectious bronchitis virus.

Infectious bronchitis virus (IBV) is currently one of the most important pathogens in the poultry industry. The H120 and Ma5 are the only viral strains approved by the Brazilian government as the constituent of vaccines. Despite the systematic vaccination in Brazil, IBV has not yet been controlled and diseases associated with this virus have been reported in vaccinated chickens. Here, we investigated the genetic variability of H120 and Ma5 strains present in the IBV vaccines from different Brazilian manufacturers. We performed DNA sequencing analyses of the S1 spike glycoprotein gene to investigate its genetic variability and the presence of viral subpopulations among vaccines, between batches, and also in each vaccine after a single passage was performed in chicken embryonated eggs. Our results revealed up to 13 amino acid substitutions among vaccines and some of them were localized in regions of the S1 glycoprotein that play a role in virus–host interaction. Secondary nucleotide peaks identified in the chromatogram for the S1 gene sequence revealed that all original vaccines (H120 and Ma5) were composed by different subpopulations of IBV. Moreover, new viral subpopulations were also found in vaccines after a single passage in chicken embryonated eggs. These findings indicate that H120 and Ma5 viral strains used in vaccines market in Brazil can still mutate very rapidly during replication, leading to amino acid substitutions in proteins involved in the stimulation of the immune response, such as the S1 glycoprotein. Therefore, our data suggest that the genetic variability of these viral strains should be taken into consideration to ensure an effective immune response against IBV.Electronic supplementary materialThe online version of this article (doi:10.1007/s11262-017-1515-2) contains supplementary material, which is available to authorized users.

25 years of systematic hepatitis B vaccination of pre-adolescents in Catalonia

A description is presented on the planning and evaluation of the hepatitis B vaccination program for pre-adolescents in Catalonia, 25 years after it was started in 1991. For the incorporation of the vaccine into the systematic vaccinations calendar an analysis was made of the criteria (disease burden, safety, immunogenicity and protection efficacy of the vaccine, effectiveness, efficiency, and potential impact of the vaccination, compatibility with other vaccines and likely limited potential impact of selective vaccination). This was followed by choosing the most convenient strategy for the universal vaccination of the child population (elevated risk of infection and illness during adolescence and young adult age, and low risk in newborns, infants and small children, rapid impact on the incidence of cases, efficiency of the intervention, and likely increased vaccine coverage in schools). Lastly, the evaluation of the results of the targets set for the Program in the Catalonia Health Plan.

Veinticinco años de vacunación sistemática frente a la hepatitis B de los preadolescentes en Cataluña

A description is presented on the planning and evaluation of the hepatitis B vaccination program for pre-adolescents in Catalonia, 25 years after it was started in 1991. For the incorporation of the vaccine into the systematic vaccinations calendar an analysis was made of the criteria (disease burden, safety, immunogenicity and protection efficacy of the vaccine, effectiveness, efficiency, and potential impact of the vaccination, compatibility with other vaccines and likely limited potential impact of selective vaccination). This was followed by choosing the most convenient strategy for the universal vaccination of the child population (elevated risk of infection and illness during adolescence and young adult age, and low risk in newborns, infants and small children, rapid impact on the incidence of cases, efficiency of the intervention, and likely increased vaccine coverage in schools). Lastly, the evaluation of the results of the targets set for the Program in the Catalonia Health Plan, are described.

Invasive meningococcal disease in Navarra in the era of a meningococcal C vaccine

Abstract Introduction Systematic childhood vaccination against meningococcus C has had a considerable impact on meningococcal invasive disease (MID). The aim of this study is to perform an analysis on the epidemiology, the clinical features, and the factors associated with a worse prognosis of MID, in the era of a meningococcal C vaccine. Material and methods The study included confirmed cases of MID in children less than 15 years of age in Navarra, Spain, between 2008 and 2014. The risk of death or permanent sequelae was evaluated according to the presence of clinical features and analytical parameters at diagnosis. Results The average annual incidence was 7.9 cases per 100 000 children, with the highest attack rate in children Conclusion The MID continues to be a significant cause of morbidity and mortality in children. Therefore, new advances are needed in the prevention, early diagnosis, and detection of the factors associated with poor prognosis.

Antigenic and immunogenic spectrum of foot-and-mouth disease vaccine strain O1 Campos against representative viruses of topotypes that circulated in Asia over the past decade

Identifying vaccine strains to control outbreaks of foot-and-mouth disease virus that could spread to new regions is essential for contingency plans. This is the first report on the antigenic/immunogenic relationships of the South American O1/Campos vaccine strain with representative isolates of the three currently active Asian type O topotypes. Virus neutralization tests using O1/Campos post-vaccination sera derived from cattle and pigs predicted for both species acceptable cross-protection, even after single vaccination, established by r1 values and by expectancy of protection using monovalent or polyvalent vaccines. The results indicate that effective oil vaccines containing the O1/Campos strain can be used against Asian isolates, expanding the scope of O1/Campos strain included in vaccine banks to control emergencies caused by Asian viruses, even on single-dose vaccination, and to cover the need of effective vaccines in Asia during systematic vaccination.

Management of Giant Ano-Vulvar Condyloma in a Structure with Limited Resources

Buschke-Lowenstein Tumor (BLT) or Giant Acuminate Condyloma (GAC) is an uncommon clinical entity rarely published in Cote d’Ivoire and Africa. It is a viral infection with increasing sexual transmission due to the resurgence of HIV infection. This observation is the first case recorded in our service in three decades. The treatment is resolutely surgical, in our context of sub-medicalization, in the absence of other therapeutic means. Most of the time the progression is favorable, but the prognosis can be aggravated by the HIV coinfection. Through this observation, the authors insist on the prevention of all sexually transmitted infections, particularly, with HPV and HIV, by sexual education (abstinence, fidelity, port of condom) and the systematic vaccination before any sexual activity.

More is not always better. Individual guideline or systematic vaccination against pneumococcus

More is not always better. Individual guideline or systematic vaccination against pneumococcus

Controlling bovine brucellosis in the state of São Paulo, Brazil: results after ten years of a vaccination program

A cross- sectional study was carried out, between May and November 2011, to estimate the situation of the bovine brucellosis in São Paulo State, 10 years after the commencement of the vaccination of the heifers with the S19 strain. The State was divided into seven regions and in each of them, 300 farms with reproductive activity were randomly chosen and considered as primary sample units. A fixed number of cows was randomly selected and tested for antibodies against Brucella spp. A farm was considered infected if at least one female tested positive. In the selected farms, an epidemiological questionnaire was administered which focused on herd traits as well as husbandry and sanitary practices that could be associated with the risk of infection. The prevalence (percentile, [95% confidence interval]) of infected herds was 10.2% [8.8-11.8] for the State, and for the regions, it varied from 7.3% [4.7-11.2] to 12.3% [8.8-16.8], not showing significant difference between different regions. The apparent prevalence of positive farms in the State and regions remained similar to the prevalence observed 10 years before. The prevalence of positive animals was 2.4% [1.8-3.1] in the State and varied from 1.1% [0.6-2] to 3.5% [1.7-7.1] in the regions, not showing significant difference between regions. Again, there was no difference in the prevalence of positive animals after 10 years of the vaccination program. The risk factors (odds ratio, 95% confidence interval) associated with bovine brucellosis in the State included number of cows ? 24 (3.08, 2.22-4.27) and the acquisition of breeding animals (1.33, 0.95-1.87). The São Paulo State should conduct systematic vaccination coverage of above 80% of the eligible heifers with the S19 strain vaccine annually. Moreover, the State should emphatically use RB51 strain vaccine in females above 8 months of age not vaccinated with S19 strain vaccine. An efficient animal health education program to orientate farmers to test replacement animals for brucellosis prior to introduction in their herds should also be implemented.

An update on the epidemiologic situation of bovine brucellosis in the State of Espírito Santo, Brazil

A cross-sectional study was carried out between January 2012 and May 2014 to estimate the prevalence of bovine brucellosis in the state of Espírito Santo, Brazil. This study was carried out 11 years after the implementation of the immunization program for heifers with a vaccine derived from the S19 strain of Brucella abortus. The state was divided into two regions. Three hundred farms from each region, with reproductive activity, were randomly chosen and included as primary sample units. A fixed number of cows were randomly selected and tested for antibodies against Brucella spp. A farm was considered to be infected when at least one female tested positive for Brucella spp. In the selected farms, an epidemiological questionnaire based survey, focused on herd traits as well as husbandry and sanitary practices, was conducted, to evaluate the factors associated with the risk of infection. The overall prevalence of infected herds was 9.3% (95% confidence interval, 95% CI = 7.1–11.8%), varying from 8.7% (95% CI = 5.7–12.6%) in region 2 to 9.7% (95% CI = 6.8–13.4%) in region 1. There was no significant difference in the prevalence between the regions. The apparent prevalence of Brucella spp. positive farms across the regions and the state was similar to the prevalence observed 11 years earlier. The prevalence of positive animals was 3.8% (95% CI = 0.9–10.1%), varying from 1.5% (95% CI = 0.8–2.4%) in region 1 to 7.9% (95% CI = 1.9–20.3%) in region 2, without a significant difference between the regions. There was no difference in the number of Brucella spp. positive animals after 11 years of the immunization program. The risk factors associated with brucellosis were (i) more than 10 cows per herd (OR = 5.0; 95% CI =2.5–11.1) and (ii) equipment, feedstock, or personnel sharing (OR = 2.2; 95% CI = 1.1–4.2). The state of Espírito Santo should seek systematic vaccination coverage targeting more than 80% of the eligible heifers. An efficient animal health program, which educates the farmers to test replacement animals for brucellosis before introducing them to their herds, to avoid equipment, personnel or feedstock sharing with farms of unknown sanitary conditions, and to increase awareness of the importance of good sanitary procedures during artificial insemination, should be implemented.

Protection against vaccine preventable diseases in children treated for acute lymphoblastic leukemia.

The objective of this retrospective study was to assess protection against vaccine preventable diseases (VPDs) in children treated for acute lymphoblastic leukemia (ALL). Clinical characteristics and vaccination records were collected. Antibodies against VPDs were measured after completion of chemotherapy and after a booster dose of vaccine. Immunization status of household members was evaluated. Sixty children were included. Median interval between the end of chemotherapy and enrolment in the study was 13 months (range 1-145). At ALL diagnosis, 81.3% of the children were up to date with their vaccination schedule. This proportion decreased to 52.9% at enrolment. Among the parents, 21% were up to date with their immunization schedule and 42% had received seasonal influenza vaccination. After chemotherapy, less than 50% of the patients were seroprotected against tetanus, diphtheria, polio 3, Haemophilus influenzae type b (Hib), and mumps and no more than 80% were seroprotected against polio 1 and 2, measles, rubella, and varicella. After a booster dose of vaccine, the rate of protection increased to over 90% for each of the following antigens: TT, DT, polio 1, Hib, measles, and rubella. Nevertheless, polio 3, mumps, and varicella-zoster virus antibodies titers/concentrations remained below seroprotective thresholds in over 20% of the patients. After chemotherapy for ALL, most of the children were not protected against VPDs. As the majority mounted a robust response to booster vaccines, efforts need to be done to improve protection against VPDs by implementing a systematic vaccine booster schedule. This could also be helped by reinforcing household members' immunization.

Discrepancies between general practitioners' vaccination recommendations for their patients and practices for their children

ObjectivesThe objectives of our study were to describe the vaccination recommendations by general practitioners (GPs) for their patients and practices for their children, and to identify any discrepancies between them. MethodsApplying multiple correspondence analysis and agglomerative hierarchical cluster analysis to data from a 2014 cross-sectional survey of a national sample of GPs, we constructed a typology based on the patterns of associations between GPs' vaccine recommendations to their patients and practices to their own children's vaccinations. ResultsThis study includes the 1038 GPs who reported that they had at least one child aged 2–25 years. Nearly half (47%, 482/1021) reported that all of their children were vaccinated against hepatitis B but that they did not always recommend that vaccine to patients; the same discordance was observed among 36% (369/1027) for the measles–mumps–rubella vaccine, 19% (194/1013) to 28% (290/1019) for routine and catch-up meningococcal C vaccination, and 27% (136/496) for the human papillomavirus vaccine. Cluster analysis showed that 37% (95% CI 33%–39%) of GPs reported an above-average rate of systematic vaccine recommendations for their patients, and most reported that all their children were vaccinated (low level of discordance), whereas 60% (95% CI 58%–64%) had a high level of discordance, that is, most reported that their children were vaccinated, but did not always recommend the same vaccines to their patients. ConclusionsMany GPs do not report the same attitude concerning the vaccination of their children and their patients. The reasons underlying these discrepancies, possibly including vaccine hesitancy, should be investigated.

Effectiveness of a systematic vaccination program in patients with autoimmune inflammatory disease treated with anti-TNF alpha drugs

ABSTRACTObjective: The objective of this is manuscript is to evaluate the impact of a vaccination protocol in the prevention of infection in autoimmune inflammatory disease (AUTID) patients treated with Anti-TNF-alpha therapies.Research design and methods: The authors conducted an observational study to test the effect of a vaccination program in AUTID patients that received anti-TNF-alpha therapies in hospital admissions related to infections. This effect was evaluated by comparing patients admitted before the program started (prevaccination period, 2009–2011) and after the program (postvaccination period, 2011–2014).Results: The study included 581 patients: 280 in the pre-vaccination group and 301 in the post-vaccination group. During the prevaccination period, 27.3% of patients treated with anti-TNF-alpha drugs were vaccinated before biological therapy. During the postvaccination period, this percentage increased to 97.0%. Statistically significant differences were detected in emergency room visits per 10.000 treatment days, in hospital admissions related to an infectious disease and in the rate of invasive pneumococcal disease due to Streptococcus pneumoniae infection per 10.000 days of treatment.Conclusions: This vaccination program decreases infectious complications and was associated with a lower amount of hospital admissions due to infections, emergency room visits and the rate of invasive pneumococcal disease.

Evolution of the incidence of hepatitis B virus infection and immunization rates in a large French cohort born between 1960 and 1994

In France, several successive changes in anti-hepatitis B virus (HBV) vaccination policies occurred since 1982. We estimated the incidence and prevalence of HBV infection according to years of birth 1960 to 1994 in a large sentinel cohort to evaluate the epidemiology of HBV during vaccination policy changes. A retrospective cohort study included data from all HIV, HBV and hepatitis C virus (HCV) screening facilities in Grand Lyon. From 2005 to 2010, all 57113 individuals with complete HBV serologic status were enrolled. Survival analyses modeled separately various ages in each birth cohort. The proportion of immunized individuals increased in birth cohorts 1978 to 1984 (up to 58.3% (95% confidence interval (CI), 43.3–68.2 at age 15). In post-1985 birth cohorts, this proportion decreased to 19.5% (95% CI, 15.5–24) in birth cohort 1987 at age 15. Probability of past or current HBV infection increased constantly in birth cohorts 1960 to 1967, up to 12% (95% CI, 10.4–14) at age 30, then decreased gradually in birth cohorts 1968 to 1991, down to 0.9% (95% CI, 0.7–1.2) at age 17.5. In post-1991 cohorts, the probability of HBV infection increased again, up to 2.5% (95% CI, 1.7–3.6) at age 17.5. HBV incidence fluctuated between 5 and 8 per 1000 person-years in pre-1986 birth cohorts, decreased to 2.1 (95% CI, 1.5–2.7) in birth cohorts 1986 to 1991 but rebounded to 5 (95% CI, 3.5–7.1) in post-1991 birth cohorts. HBV incidence was remarkably high in young adults with noticeable variations concomitantly to vaccination policy changes. A dramatic decline in immunization rate was temporally associated with a sharp rebound of infection after withdrawal of systematic adolescent vaccination in 1998.

Vaccination of stray dogs against rabies is an effective strategy to reduce the risk of human rabies

Background: Human Rabies is mainly infected through the dog bites in Sri Lanka. Mass vaccination against rabies and surgical sterilization are new strategies implemented for control of rabies in stray dogs after 2006 instead of mass culling. WHO recommends 70% vaccination coverage for eradication of rabies in dog population. Objectives were to survey stray dog population in Municipality, Dehiwala area (21 km2) and to assess the effect of two consecutive mass vaccination of them against rabies. Methods & Materials: 8 wards out of 29 wards were selected randomly as samples for surveillance. Counting was carried out five days between 6.30 am. and 9 am. in 8 wards.Road maps of the respective wards were utilized to identify the boundaries and to cover the entire roads of the respective ward. Dogs visible on the road at the time of counting were only considered. After completion of surveillance, vaccination was carried out ward by ward in a sequence to cover the entire 29 wards from October 2013 to March 2014 and from October 2014 to March 2015 for 1st and 2nd round vaccination respectively. Red and blue collars were used for identification of vaccinated dogs for 1st and 2nd round respectively. Dogs were caught with the aid of catching nets. After subcutaneous administration of vaccine (Rabisin®) dogs were released to same locality (Figure 1, Figure 2, Figure 3).Figure 2Image of a stray dog being worn a collar for identification after vaccination.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 3Image of vaccinating a stray dog.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Results: Estimated stray dog population is 1398 (CI±386). First and second round vaccination coverages were 97% (1364) and 88% (1231) respectively. 17 rabid dogs were reported in 2013. After vaccination commenced, the prevalence of rabid dogs in 1st, 2nd and 3rd quarters of 2014 was zero. 2 positive cases were reported only for 4th quarter of 2014. Positive rabid cases were not reported up to 3rd quarter of 2015. Conclusion: Pre- exposure vaccination with the phenomenon of ‘herd immunity’ has marked impact on prevalence of canine rabid cases. Making comprehensive multi year vaccination plans with reliable, high quality vaccine of prolong immunity can improve herd immunity of dog population to reduce the risk of human rabies. Follow up with systematic revaccination and vaccination of additions to dog population are also important to maintain herd immunity.

Herd Immunity Against Foot-and-Mouth Disease Under Different Vaccination Practices in India.

A systematic vaccination programme is ongoing in India to control the three prevailing serotypes (A, O, Asia1) of foot-and-mouth disease (FMD) virus. Under the programme, more than 120million bovine (term bovine applicable to both cattle and buffalo in this study) population of 221 of the 666 districts in the country are being bi-annually vaccinated with trivalent vaccine since 2010. Although clinical disease has reduced in these districts because of the systematic vaccinations, an abrupt increase in the number of FMD cases was recorded in 2013. Hence, a longitudinal field study was conducted in the year 2014 to estimate the serological herd immunity level in bovines, the impact of systematic vaccinations and field efficacy of the vaccines used. Serum samples (n=115963) collected from 295 districts of the 18 states of the country were analysed to estimate antibody titres against structural proteins of the three serotypes. The efficacy of the vaccine was demonstrated in the control group (group-D) where animals of the group were identified by ear tags for the purpose of repeated sampling after vaccination. Progressive building of the herd immunity in the field after systematic vaccination was demonstrated. The mean antibody titre against the serotypes O, A and Asia1 was estimated as log10 1.93 (95% CI 1.92-1.93), 2.02 (2.02-2.02) and 2.02 (2.02-2.02), respectively, in the states covered under the control programme. However, in other states herd immunity was significantly low [mean titre log10 1.68 (95% CI 1.67-1.69), 1.77 (1.76-1.78) and 1.85 (1.84-1.86) against the three serotypes]. Inverse relationship between the herd immunity and FMD incidences was observed the states following different vaccination practices. The study helped in demarcation of FMD risk zones in the country with low herd immunity. Estimation of herd immunity kinetics in the field helped in refining the vaccination schedule under the control programme.

Factors Influencing University Nursing Students' Measles Vaccination Rate During a Community Measles Outbreak

The purpose of this study was to survey the current state of measles vaccination in university nursing students during a measles outbreak and to identify factors influencing nursing students' vaccination rate. In 2014, this study used a self-administered questionnaire to survey 380 university nursing students. Factors influencing measles vaccination were identified through logistic regression analysis using variables between the vaccinated and nonvaccinated groups. Measles vaccination rate was 52.1%. The vaccination rate was significantly higher in juniors, seniors, and those who had heard about measles. In relation to health beliefs, the measles vaccination rate was higher when perceived benefits were high and perceived barriers were low. A systematic measles vaccination program targeting nursing students upon their entry to university is needed. In order to increase the measles vaccination rate, application of effective promotion campaigns and education programs is necessary.