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General Medical Services in England
Published in Arthur Newsholme, International Studies Volume 3, 2015
With the increasing utilisation of poor-law infirmaries by those seriously ill, and since the advent of the Sickness Insurance Act, the work of the D.M.O. has declined. Very often he is also public vaccinator for the union, and in this capacity is required to undertake the primary vaccination and sometimes the revaccination of all applicants, irrespective of social or economic position. He is paid a fee for each vaccination by the public assistance committee.
The Ministry of Health in Relation to Local Authorities
Published in Arthur Newsholme, The Ministry of Health, 2015
As a rule the local public vaccinators were also district medical officers under the Poor Law, while the local registrar of births who was also appointed by the Board of Guardians supplied the vaccination officer of the same authority with the names of infants born, thus starting the process for securing infantile vaccination. The public vaccinator who provides free infantile vaccination is still under the local jurisdiction of the Board of Guardians; but the Ministry of Health and its predecessors the Privy Council and Local Government Board have for many years inspected the work of these vaccinators by means of their medical inspectors, and thus ensured a fairly high standard of vaccination. Grants given by the Treasury to public vaccinators are made conditional on the achievement of this standard.
La Revolución Ciudadana and social medicine: Undermining community in the state provision of health care in Ecuador
Published in Emily E. Vasquez, Amaya Perez-Brume, Richard G. Parker, Social Inequities and Contemporary Struggles for Collective Health in Latin America, 2020
Karin Friederic, Brian J. Burke
Audit culture and the fetishisation of ‘production’ has transformed the provision of health care in Ecuador, much like it has in the field of global health more broadly (Adams, 2016; Brotherton, 2012). In recent years, teams of vaccinators have been hired and trained by the MOH on a short-term basis. They travel out to remote areas with low rates of vaccination coverage, like Las Colinas. In 2014, we travelled with one of the medical brigades to a community six hours from the health centre. Even before the doctors began to see patients, the vaccinator walked up to every adult present, including those participating in the soccer game beside the school, and began administering vaccines with little to no explanation. He barely mumbled which vaccine he was giving, he did not ask adults if they had received the vaccination before, and he failed to notify people if they needed follow-up booster shots. In most cases, they did. The vaccinator even pressured two of our students into getting yellow fever and tetanus vaccinations, diligently logging them into his notebook, despite the fact that these non-Ecuadorean students had already been immunised. The vaccinator was getting paid and evaluated per dose administered. If he did not administer all of the doses, he would be chastised, as valuable doses would have to be thrown out. Plus, as with medications in the health centre, the quantity used during this brigade would determine how many we would be given for future brigades. As the dentist noted when jumping onto her mule to leave the community, ‘the only thing the Ministry cares about is production, production, production, it’s all about the numbers.’
An exploration of vaccination in the 19th century through the eyes of Dr. Albert Mackey
Published in Baylor University Medical Center Proceedings, 2022
The vaccine fluid may be taken at any period, from the first appearance of the vesicle, till the areola beings to form, by small punctures; allowing it time to flow; or promoting the discharge by gentle pressure with the lancet. It is to be inserted, by a superficial puncture, into the middle of the arm, between the shoulder and the elbow; or, when the arm is likely to be much used, into the inside of the leg. It may be preserved, and conveyed, on the point of a vaccinator; that is, a bit of ivory, shaped like the tooth of a comb, and pointed like a lancet. This may be wrapped in paper; or a number of them may be inclosed in a quil, to be stopped with white wax. When they are used, a puncture is to be made with a lancet, then the point of the vaccinator is to be held in the puncture sometime; and afterwards repeatedly wiped on the part.8
Preferences for herpes zoster vaccination among adults aged 50 years and older in the United States: results from a discrete choice experiment
Published in Expert Review of Vaccines, 2021
Brandon J. Patterson, Kelley Myers, Alexandra Stewart, Brennan Mange, Eric M. Hillson, Christine Poulos
Our analysis showed that, within the African-American subgroup, there were three distinct groups of respondents with systematically different preferences suggesting heterogeneity in vaccine decision-making. More specifically, these three groups expressed different willingness to vaccinate and sensitivity to total OOP cost. Likely non-vaccinators were in one group (group 2) and likely vaccinators were in two groups (groups 1 and 3). The probability of belonging to the likely non-vaccinator group was one out of five and was lower than the probability of belonging in the other two groups. For the two likely vaccinator groups, respondents placed different levels of importance on OOP cost, where respondents in group 3 were less sensitive to changes in cost and had a predicted uptake that remained high even when OOP cost was at the highest levels. In contrast to group 3, predicted uptake for group 1 dropped by approximately 10% and 32% when total OOP cost increased from $0 to $15–$25 and $280–$300 respectively. The likely non-vaccinators had a predicted uptake of about 15%, even when the vaccine costs $0, vaccination had no ISR, and no days with FLS.
Hexavalent vaccines in infants: a systematic literature review and meta-analysis of the solicited local and systemic adverse reactions of two hexavalent vaccines
Published in Expert Review of Vaccines, 2021
Piyali Mukherjee, Essè Ifèbi Hervé Akpo, Anastasia Kuznetsova, Markus Knuf, Sven-Arne Silfverdal, Pope Kosalaraksa, Attila Mihalyi
Transposed in the daily practice of a vaccinator, these results mean that the administration of one DT3aP-HBV-IPV-Hib vaccine dose to 100 children would lead, on average, to three to seven fewer children experiencing a local reaction than with DT2aP-HBV-IPV-Hib. Likewise, on average four to ten fewer DT3aP-HBV-IPV-Hib vaccinated children would experience a systemic reaction when compared with DT2aP-HBV-IPV-Hib vaccinees. In other words, for every 100 children vaccinated with DT3aP-HBV-IPV-Hib, ten cases of fever, seven cases of redness, six cases of pain and four cases of grade 3 systemic reactions would be averted on average compared to those vaccinated with DT2aP-HBV-IPV-Hib. Therefore, when healthcare providers have to choose between hexavalent vaccines, they may want to take the higher frequency of local and systemic reactions observed after the use of DT2aP-HBV-IPV-Hib compared to DT3aP-HBV-IPV-Hib into account and consequently inform parents about this risk.