Bronchiolitis
Samar Razaq in Difficult Cases in Primary Care, 2021
Which of the following statements regarding vaccinations are true? Diphtheria, tetanus and pertussis vaccine may be associated with an increased mortality from infections other that diphtheria, tetanus and pertussis in high-mortality areas.The child’s response to vaccines may differ depending on the vaccinations and infections they may have had in the past.The measles vaccine has been associated with a reduced mortality from infections other than measles.Vaccination of pregnant mothers with the pertussis vaccine to prevent neonatal infections is not recommended, because of the risk of Arthus’s reactions.Vaccinating close household contacts of young infants against pertussis does not reduce the risk of pertussis acquisition by the infant.
Measles and its neurological complications
Avindra Nath, Joseph R. Berger in Clinical Neurovirology, 2020
Attenuated live vaccines prevent measles. Because they can be neutralized by transplacentally transmitted maternal antibodies that persist during the first year of life [51], initial administration of the vaccine in the industrialized countries is recommended at the age of 12 months. In countries with ongoing measles virus transmission in which the risk of measles mortality among infants is high, earlier immunization at the age of 9 months has been recommended [24]. Usually, measles vaccine is given in combination with mumps and rubella vaccine. One dose of the vaccine leads to seroconversion in more than 90% of the recipients. A second dose of measles vaccine is recommended for all children to protect nonresponders to the first vaccination. The second dose may be given as early as 4 weeks after the first [24]. The measles vaccines in use today have an excellent safety record. Some recipients develop a transient rash or low-grade fever 5–12 days after the vaccination, but they remain otherwise asymptomatic; complications are extremely rare. Acute encephalitis after vaccination has been reported with a frequency of less than 1 per million doses administered compared to 1 per 1000 children with natural measles. Vaccination also significantly reduced the occurrence of SSPE and other complications associated with measles [5,52,53].
Age and lifecourse transitions in health
Kevin McCracken, David R. Phillips in Global Health, 2017
Vaccinations for measles, polio and other common infections have certainly played an important part in the MDG 4 target for reducing child mortality. The WHO report that in 2014, about 85 per cent of the world's children had received one dose of measles vaccine by their first birthday (two doses are usually needed), provided mainly though routine health care. Measles deaths fell by 79 per cent from 546,800 (2000) to 114,900 in 2014 (WHO, 2016q). However, Measles and Rubella Initiative (M&R) (2016) note that 20 million people are still affected by measles annually, and 315 children are killed daily by measles complications. Also, in 2014 there were fewer countries than in 2012 meeting the one-dose vaccination target (The Lancet, 2016a). It is therefore crucial to maintain vaccinations as measles deaths in Sub-Saharan Africa (96,000) and Southern Asia (39,800) accounted for 93 per cent of the estimated measles deaths worldwide during 2013. However, social and political upheavals and insecurity can disrupt these programmes. Indeed, 60 per cent of the 21.5 million children in 2013 who did not receive any measles vaccination came from just six countries, three in Africa and three in South Asia/Southeast Asia (M&R, 2016).
Current perspectives in assessing humoral immunity after measles vaccination
Published in Expert Review of Vaccines, 2019
Iana H. Haralambieva, Richard B. Kennedy, Inna G. Ovsyannikova, Daniel J. Schaid, Gregory A. Poland
To prevent persisting measles endemicity and target measles for global eradication, achieving and sustaining herd immunity of at least 90–95% is required [13–17]. It is generally accepted that the live attenuated measles vaccine has a high protective efficacy, particularly after two vaccine doses (although it may be lower and not life-long compared to the wild-type virus infection), and a field effectiveness of 94.1% (IQR, 88.3%-98.3%) after two doses [18]. Accordingly, measles mainly affects unvaccinated individuals. It is also indisputable that a two-dose measles vaccination program must be implemented and sustained globally to reduce measles morbidity/mortality and achieve measles eradication. What is still a subject of debate is the ability of the current measles vaccine to sustain long-term protective immunity and adequate herd immunity in settings with no wild-type virus exposure (i.e., no boosting of immunity resulting from asymptomatic infection).
The second fifty years: A history of the American College Health Association
Published in Journal of American College Health, 2020
Michael J. Huey, Connie Crihfield, Devin Jopp
HIV was not the only virus with a significant impact on college campuses in the 1980s. In 1983, ACHA adopted and published its first set of Prematriculation Immunization Requirements recommendations. This publication was largely fueled by outbreaks of measles on colleges campuses in the 1980s. In the 11-year period from 1980-1990, CDC received reports of nearly 4,000 college measles cases. The proportion of measles cases occurring on college campuses during this period ranged from approximately 2% to 20% of the total measles cases in the United States, with a peak (20%) in 1983. At the time, as many as one-half to two-thirds of college students could not document adequate vaccination against measles.11 In 1980, the CDC’s Advisory Council on Immunization Practices (ACIP) recommended that all college and university students complete a series of immunization requirements prior to matriculation and in 1983-84 ACHA “seconded” that recommendation. In 1988, ACHA became a partner in the new National Coalition for Adult Immunization. By 1989, both ACHA and CDC/ACIP recommended that all college students receive two doses of measles vaccine prior to matriculation. ACHA’s involvement with ACIP grew in subsequent decades.
Influenza vaccine programs for children in low- and middle-income countries: current status and way forward
Published in Expert Review of Vaccines, 2019
Justin R Ortiz, Kathleen M Neuzil
The first EPI schedule included only 1 dose of measles vaccine for children to be given after 9 months of age. In 2009, WHO recommended that countries add MCV2 once systems for MCV1 delivery were established [34]. As measles is a highly contagious disease, vaccine coverage >93% is necessary to ensure sufficient herd protection to protect communities from sustained outbreaks. To accomplish this, many developing countries provided MCV1 within routine immunization programs augmented with Supplemental Immunization Activities (SIAs). SIAs are mass immunization campaigns to provide vaccines to children that had not been reached through routine immunization programs. SIAs are resource intensive and time-consuming, but necessary to ensure optimal vaccine coverage for measles elimination. In 2017, WHO expanded the recommendation to all countries to provide MCV2, irrespective of MCV1 coverage [30]. In making its recommendation for a second dose of measles vaccine, WHO argued that such a program would ‘slow the accumulation of susceptible children and thereby allow a lengthening of the interval between SIAs’, decrease a country’s reliance on SIAs, and provide a well-child visit during the second year of life to provide additional health interventions. As of 2019, countries without MCV2 policies are mostly low-income countries from sub-Saharan Africa (Figure 3) [35].
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