Vaccine
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Immunizing pregnant women is a promising strategy to reduce infectious disease-related morbidity and mortality in pregnant women and their infants. Important pre-requisites for the successful introduction of new vaccines for immunization in pregnancy include political commitment and adequate financial resources: trained, committed and sufficient numbers of healthcare workers to deliver the vaccines; close integration of immunization programs with antenatal care and Maternal and Child Health services; adequate access to antenatal care by pregnant women in the country (especially in low and middle-income countries (LMIC)); and a high proportion of births occurring in health facilities (to ensure maternal and neonatal follow-up can be done). The framework needed to advance a vaccine program from product licensure to successful country-level implementation includes establishing and organizing evidence for anticipated vaccine program impact, developing supportive policies, and translating policies into local action. International and national coordination efforts, proactive planning from conception to implementation of the programs (including country-level policy making, planning, and implementation, regulatory guidance, pharmacovigilance) and country-specific and cultural factors must be taken into account during the vaccines introduction.
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Human papilloma virus (HPV) is the most common sexually transmitted infection in the USA with some strains increasing the risk of certain cancers. The HPV vaccine, introduced in 2006, has reduced the infection rate, although racial/ethnic disparities in vaccination exist. Asian college students are among those with the lowest vaccination rates, however there has been little exploration as to why. ⋯ Older students, those without a primary care provider, and those who completed the survey in English had more negative attitudes about the HPV and vaccine. Participants who were younger, female, had a higher level of knowledge, had more positive attitudes, and completed the survey online were associated with better vaccination status. Findings from this study provide insight into Chinese college students' knowledge and attitudes about HPV and HPV vaccination and may be used to develop culturally sensitive programs that address the risk of HPV and the benefits of HPV vaccine.
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Clinical and post-licensure data have demonstrated that AS03-adjuvanted inactivated split virion vaccines, many with reduced antigen content, are effective against influenza infection. The objective of this review is to provide a comprehensive assessment of the safety of trivalent seasonal, monovalent pre-pandemic and pandemic AS03-adjuvanted influenza vaccines, based on non-clinical, clinical and post-licensure data in various populations. Non-clinical studies on local tolerance, toxicology and safety pharmacology did not raise any safety concerns with AS03 administered alone or combined with various influenza antigens. ⋯ Approximately 90 million doses of A/H1N1pdm09 pandemic influenza vaccines (Pandemrix and Arepanrix H1N1) were administered worldwide, which contributed post-licensure data to the collective safety data for AS03-adjuvanted influenza vaccines. An association between Pandemrix and narcolepsy was observed during the A/H1N1pdm09 pandemic, for which a role of a CD4 T cell mimicry sequence in the haemagglutinin protein of A/H1N1pdm09 cannot be excluded. Provided that future AS03-adjuvanted influenza vaccines do not contain this putative mimicry sequence, this extensive safety experience supports the further development and use of AS03-adjuvanted inactivated split virion candidate vaccines against seasonal and pandemic influenza infections.
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Vellore district in southern India was selected for intensified immunization efforts through India's Mission Indradhanush campaign based on 74% coverage in the National Family Health Survey in 2015. As rural households rely almost entirely on the Universal Immunization Program (UIP), we assessed routine immunization coverage and factors associated with vaccination status of children in rural Vellore. ⋯ We found higher UIP antigen coverage and proportion of fully vaccinated children than previously reported from rural Vellore. However, adherence to the recommended schedule was still not optimal. Our study highlights the potential of improving parental awareness of vaccination schedule and targeting health education interventions at pregnant women during antenatal visits to sustain and improve routine immunization coverage.
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To prevent the spread of infectious diseases, governments have implemented a number of policies, including a range of mandatory vaccination policies. In addition, some governments have implemented no fault vaccine injury compensation schemes as a legal mechanism of recourse for individuals experiencing adverse events following vaccination. We aimed to identify countries with mandatory vaccination policies that also have no fault compensation schemes. ⋯ No-fault compensation schemes are one government approach to address unintended consequences of vaccination. Few countries have implemented these schemes, including those with mandatory vaccination policies. Mandatory vaccination invokes a strong need to protect those who fall victim to extremely rare cases of provable no-fault vaccine injury. Countries that mandate childhood vaccination without providing no fault compensation schemes could be seen as abrogating the social contract. This is particularly important when public policies limit parental choice regarding whether to vaccinate.