Vaccine
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Randomized Controlled Trial Clinical Trial
Effectiveness of Vi capsular polysaccharide typhoid vaccine among children: a cluster randomized trial in Karachi, Pakistan.
Typhoid fever is endemic in Karachi, with an incidence among children ranging from 170 to 450 per 100,000 child-years. Vaccination strategies are important for prevention, and the Vi capsular polysaccharide (ViCPS) vaccine has been shown to be effective in reducing the burden of typhoid fever. ⋯ The ViCPS vaccine did not confer statistically significant protection to children in the study areas, and there was a decline in antibody response 2 years post-vaccination. However, the ViCPS vaccine showed significant total protection in children 5-16 years of age, which is consistent with other studies of ViCPS vaccine conducted in India, Nepal, China and South Africa. These findings suggest that ViCPS vaccination of school-aged children will protect the children of urban, typhoid endemic areas against typhoid fever.
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The human papillomavirus (HPV) vaccination rate in Korea is very low because a school-based HPV vaccination program has not yet been introduced. This study was designed to assess HPV knowledge, compare the health beliefs toward HPV vaccination and intention to recommend HPV vaccination for girls and boys, and identify the factors influencing the intention to recommend HPV vaccination for girls and boys among Korean health teachers. A descriptive cross-sectional study design was employed, in which 757 health teachers who worked at elementary, middle, high, and special schools in Korea participated via an online survey. ⋯ Factors associated with the intention to recommend HPV vaccination for girls were the HPV vaccination status of the health teachers' children [odds ratio (OR)=4.24, 95% confidence interval (95% CI)=1.14-15.72], and the teachers' Pap-test experience (OR=2.50, 95% CI=1.05-5.91), perceived benefits (OR=3.30, 95% CI=1.26-7.40), perceived susceptibility (OR=3.25, 95% CI=1.58-6.68), and perceived barriers (OR=0.51, 95% CI=0.30-0.99); these factors for boys were the health teachers' career duration (OR=1.61, 95% CI=1.12-2.32), HPV knowledge (OR=1.45, 95% CI=1.01-2.09), perceived benefits (OR=3.46, 95% CI=2.27-5.26), perceived susceptibility (OR=1.55, 95% CI=1.04-2.29), and perceived severity (OR=1.71, 95% CI=1.15-2.56). General awareness of HPV should be increased and more specific information about HPV-including that related to vaccination of boys and men-should be provided for health teachers. Although a school-based HPV vaccine program has yet to be introduced in Korea, health teachers should possess general knowledge about HPV and HPV vaccination, and differences in attitudes and intentions related to HPV vaccination between girls and boys should be reduced.
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Pertussis is an acute infectious illness, caused by the bacteria Bordetella pertussis and commonly known as "whooping cough". Waning immunity after vaccination or after natural infection contributes significantly to the increasing incidence rates in adolescents and adults. Prevention of pertussis in industrialized countries is mainly based on immunization with acellular vaccines in combination with other antigens. A booster dose with an adult-formulation tetanus-diphtheria toxoid and acellular pertussis vaccine (Tdap) is now recommended for all adolescents by several countries, and replacement of the decennial Td dose with a single or more doses of Tdap is recommended for adults. ⋯ Despite the more recent position paper of WHO gives priority to infant and childhood vaccination against pertussis and leaves adolescent, adult and risk group immunization as an option for the future, data are quickly accumulating to support the need to consider pertussis vaccination as a crucial preventative intervention even in adolescents and special risk groups.
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Randomized Controlled Trial
The effect of an alternative reduced-dose infant schedule and a second year catch-up schedule with 7-valent pneumococcal conjugate vaccine on pneumococcal carriage: a randomized controlled trial.
The 7-valent pneumococcal conjugate vaccine (PCV7) was initially licensed for use as 3 infant doses and a booster (3+1). However, 2 infant doses plus a booster schedules only (2+1) are widely used. We compared the effect of these two schedules on pneumococcal carriage in young children. We also assessed the effect of a 2-dose schedule in the second year ("catch-up" schedule; 0+2). ⋯ Three infant doses seem to better protect against PCV7-serotype acquisition and carriage than two. However, after booster, most of these differences disappear. A 2-dose second year catch-up campaign may enhance the reduction of PCV7-serotype spread in the community.
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Mumps is easily preventable through vaccination. Investigation of a number of recent mumps outbreaks in universities in the North West of England, however, found that affected students were either not vaccinated or only partially vaccinated. An online survey of students (n=2456) attending five universities in the region was undertaken during 2010 to establish MMR vaccination status, knowledge of mumps and willingness to take up vaccination if offered. ⋯ Those least likely to take up vaccination included students not registered with a GP; mature students; and those who did not consider mumps to be a serious disease. The survey also highlighted that misconceptions remain about both the MMR vaccine safety and perceptions of risk/benefit of the vaccine. Encouraging registration with a GP and awareness raising should be a key part of campaigns to improve vaccination uptake among university students.