Vaccine
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Rotavirus infection causes severe gastroenteritis (RVGE) in children worldwide. Its disease burden has been reduced in countries where mass vaccination programs have been introduced. However, England and Wales have not yet implemented such a mass vaccination program. ⋯ Our calculations further show that herd protection accounts for about a quarter of the reduction in RVGE incidence. If vaccine-induced protection does not wane over three years, severe RVGE in children under five years of age could be eliminated within two years after the introduction of vaccination. This work lays the foundation for policy-makers to determine the impact of a mass vaccination program against rotavirus in England and Wales.
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Influenza A (H1N1) vaccination has been recommended for all frontline healthcare workers (HCWs) in the UK since October 2009, to protect individuals and their patients from infection. Understanding the factors influencing vaccine uptake by HCW may improve future vaccination programmes in current and subsequent years. ⋯ Vaccine uptake may be increased by addressing HCW knowledge and attitudes and access to vaccine. Future vaccination programmes should include targeted education and vaccine delivery, at the convenience of staff, and in their own department.
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The Public Health Center Vaccine Survey (PHCVS) examines the knowledge, attitudes, and beliefs about seasonal influenza and H1N1 vaccinations in a largely low-income, urban, public health clinic population in Los Angeles County, USA. ⋯ Study findings provide a useful risk profile of vulnerable groups in Los Angeles County, which may be generalizable to other urban jurisdictions in the United States. They also describe real world situations that can be used to forecast potential challenges that vaccine beliefs may pose to national as well as local influenza pandemic planning and response, especially for communities with limited access to these preventive services.
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Historical Article
The eradication of smallpox--an overview of the past, present, and future.
The 30th anniversary of the declaration of smallpox eradication is a propitious time to look back on the evolutionary history of the program, its execution, and its legacy for the future. The eradication of history's most feared disease culminated a decade-long World Health Organization campaign which began despite skepticism and doubt and succeeded despite a never ending array of obstacles occasioned by floods, civil war, famine, and bureaucratic inertia. ⋯ A definitive legacy for the future was the extension of the program into an "Expanded Program on Immunization", now functioning world-wide and resulting in dramatic improvements in health through control of vaccine-preventable diseases. No less important are the growing number of multi-national programs whose foundations rest on the development of active case surveillance to measure achievement and to guide progress - poliomyelitis, measles, guinea worm, and rubella.
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Following the rapid progress towards interrupting indigenous wild poliovirus transmission in the Americas in the early 1980s, the Global Polio Eradication Initiative (GPEI) was launched with a resolution of the World Health Assembly (WHA) in 1988. The GPEI built on many lessons learned from smallpox eradication, including the large-scale deployment of technical assistance, implementing agendas of innovation and research and the use of professionally planned and guided advocacy. By the year 2000, the incidence of polio globally had decreased by 99% compared with the estimated >350,000 cases reported from 125 endemic countries in 1988. ⋯ Uncontrolled WPV transmission appeared to be restricted to Chad and Pakistan, which increasingly represented the greatest risks to the GPEI. Although insufficient financing continued to be a major concern, political support for completing polio eradication in polio-infected countries was stronger than ever by mid-2011. While continued transmission in some areas, particularly in Pakistan and Chad, still had to be controlled as a matter of urgency, there were real opportunities to achieve new landmarks in polio eradication, especially in the key WPV reservoirs of India and Nigeria, setting the stage for polio to soon follow smallpox into the history books.