Acute Laryngeal Infections
John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed in Paediatrics, The Ear, Skull Base, 2018
Routine infant immunization with conjugate Hib vaccine in the UK began in October 1992. Immunization is achieved by three primary doses followed by a late booster. The incidence of invasive Hib infections in children under 5 has fallen dramatically from an incidence of 35.5/100 000 for the year preceding vaccine implementation to 0.06/100 000 in 2012.29 A reduction in the incidence of acute epiglottitis of approximately 90% has been documented in countries in which an immunization programme has been established. In the UK there was a resurgence of cases in 2003 with over 230 cases of Hib infection, causing a booster programme to be launched.30 Vaccine failure does occur but in fewer than 10% of cases is there an identifiable clinical risk factor predisposing to infection. An increasing number of cases may be due to infection with an organism other than Haemophilus and continued vigilance among clinicians is required.27 There is evidence that a longer duration of breastfeeding (more than 13 weeks) is associated with a significantly enhanced antibody response to Hib in children aged between 18 months and 6 years.31
Autopsies of People With High-Risk Infections
Julian L Burton, Guy Rutty in The Hospital Autopsy, 2010
Immunisation is undoubtedly a public health success story in preventing disease, and – in the case of smallpox – eradicating a disease with a high fatality rate. However, it is not 100 per cent safe, and morbidity and some deaths inevitably follow. It is important that such deaths be evaluated with the utmost rigour in order to determine, as far as is possible, the contribution of the recent vaccination to death. Otherwise, political and public confidence in vaccination programmes may be lost, and herd immunity decline such that the disease that is intended to be reduced in incidence actually increases and causes many more deaths than the vaccine. Apart from the UK public loss of confidence in MMR vaccine through spurious association with autism, there has been concern over the safety of hexavalent immunisation and a possible association with unexpected deaths in infancy. Much criticism over the lack of proper autopsy protocol and investigative rigour has attended reports of such deaths in Germany (Schmidt et al., 2006).
Neurological events following immunizations
Avindra Nath, Joseph R. Berger in Clinical Neurovirology, 2020
However, some prevention measures have risks. The fact that immunizations, by their nature, are intended to stimulate the human immune system raises the possibility of adverse events. In the past, there have been situations in which the risk of GBS, ADEM, and other demyelinating disorders has appeared to be increased in the setting of specific vaccines. These events, however, have proven to be singularly unusual and, essentially, serve as the exception to the rule. Despite countless millions of doses of vaccine given to persons over the years, there are limited data suggesting any significant association of a particular vaccine with a specific neurologic adverse event. Many studies conducted over several decades support the safety of vaccination [140,145–149]. Nevertheless, as the occurrence of vaccine-preventable diseases significantly decreases within a population, certain untoward adverse events following vaccination become more apparent, resulting in the on-going need for reassurance of vaccine safety to the general public [150,151].
Influenza vaccine failure: failure to protect or failure to understand?
Published in Expert Review of Vaccines, 2018
Gregory A. Poland
While imperfect, influenza vaccines are a critical part of the influenza-prevention armamentarium. Unfortunately, physicians, nurses, pharmacists, the media, and others commonly use the term ‘vaccine failure’ without understanding the circumstances under which a vaccine did or did not fail in what it is expected to do. This can lead to false claims of ‘vaccine failure,’ increased mistrust in influenza vaccines, and a bias against receiving vaccine. Influenza vaccine can only provide maximum protection to the extent that the circulating and vaccine strains closely match; the vaccine is stored, handled, and administered properly and within a time frame that results in protective levels of immunity and is administered to an immunocompetent host in which genetic restriction does not prevent development of protective immune responses. In addition, development and use of a proper framework and nosology for describing and identifying vaccine failure can assist in efforts to study and identify actual mechanisms of documented vaccine failure that may be amenable to improvement.
Controlling pertussis: how can we do it? A focus on immunization
Published in Expert Review of Vaccines, 2018
Federico Martinón-Torres, Ulrich Heininger, Angus Thomson, Carl Heinz Wirsing von König
Our proposed ideal vaccination schedule is similar to that already used in many European countries (Figure 2). It incorporates early immunization of infants, preschoolers, adolescents, adults and pregnant women to provide maximum coverage of the population, and to increase the level of herd protection, thereby reducing the incidence of pertussis as much as possible. Outbreaks may arise not only from vaccine failure but also from failure to vaccinate. To achieve optimal uptake of vaccination there are a number of additional strategies that can be employed, such as strengthening government commitment to vaccination policies, securing public trust and acceptance in vaccines, and ensuring vaccinators are supported in their practice to foster acceptance of vaccination [30–32].
Influenza vaccine hesitancy and influencing factors among university students in China: a multicenter cross-sectional survey
Published in Annals of Medicine, 2023
Haiyan Zou, Yan Huang, Ting Chen, Luying Zhang
There is a gap between actual influenza vaccination rates and the probability of being willing to receive an influenza vaccine. Vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services [9], and has been listed by the WHO as one of the top 10 health threats [10]. Vaccine hesitancy may affect public confidence and acceptance of vaccines, reduce vaccination rates and herd immunity, and increase the likelihood of preventable disease outbreaks and epidemics [11,12]. A decline in the influenza vaccination rate due to vaccine hesitancy has been reported in many countries in recent years, such as in the United States [13], France [14] and Canada [15]. Therefore, in order to improve vaccination acceptance, it is necessary to study the influencing factors of influenza vaccine hesitancy.
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