Vaccine
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Introduction of new vaccines in low- and lower middle-income countries has accelerated since Gavi, the Vaccine Alliance was established in 2000. This study sought to (i) estimate the costs of introducing pneumococcal conjugate vaccine, rotavirus vaccine and a second dose of measles vaccine in Zambia; and (ii) assess affordability of the new vaccines in relation to Gavi's co-financing and eligibility policies. ⋯ While the introduction of new vaccines is justified by expected positive health impacts, long-term affordability will be challenging in light of the current economic climate in Zambia. The government needs to both allocate more resources to the health sector and seek efficiency gains within service provision.
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High rates of nonmedical exemptions (NMEs) from required childhood vaccinations have contributed to outbreaks of vaccine-preventable diseases, such as measles and pertussis. Understanding the parental decision to obtain an NME could help health professionals and public health programs improve vaccination rates in areas with high vaccine refusal. Using a 2002-2003 multi-state survey of parents of school age children (n=2445), this study found that parental distrust of the government and of healthcare providers is a significant factor related to a number of vaccine-related beliefs and behaviors. ⋯ Distrustful parents had increased odds of thinking government sources of information about vaccines were unreliable, categorizing the CDC, the Food and Drug Administration (FDA), or local and state health departments as poor or very poor sources (distrust government vs trust government: 25.2% vs 11.7%; OR, 2.39; 95% CI, 1.70-3.36; P<0.01; distrust healthcare providers vs trust healthcare providers: 24.4% vs 11.4%; OR, 2.44; 95% CI, 1.75-3.38; P<0.01). These findings indicate that distrustful parent populations may need to be reached through modalities outside of traditional government and healthcare provider communications. Research into new and more effective techniques for delivering pro-vaccine messages is warranted.
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Randomized Controlled Trial
Delayed BCG immunization does not alter antibody responses to EPI vaccines in HIV-exposed and -unexposed South African infants.
Bacille Calmette-Guérin (BCG) is routinely given at birth in tuberculosis-endemic settings due to its protective effect against disseminated tuberculosis in infants. BCG is however contraindicated in HIV-infected infants. We investigated whether delaying BCG vaccination to 14 weeks of age affected vaccine-induced antibody responses to Haemophilus influenzae type b (Hib)-conjugate, pertussis, tetanus and Hepatitis B (HBV) vaccines, in HIV-exposed uninfected (HEU) and -unexposed uninfected (HUU) infants. ⋯ DOH-27-1106-1520.
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The World Health Organization (WHO), and European Agencies recommend influenza vaccination for individuals at-risk due to age (≥65 years), underlying diseases, pregnancy and for health care workers (HCWs) in Europe. Pneumococcal vaccine is recommended for those at-risk of pneumococcal disease. In Ireland, vaccination uptake among at-risk adults is not routinely available. ⋯ Influenza vaccination coverage among individuals ≥65 years was moderate. Influenza vaccination status was associated with GP vaccination recommendation and free access to vaccination services. Doctors should identify and recommend vaccination to at-risk patients to improve uptake.