Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prevention of disease by vaccination has been one of the major triumphs of medicine. Studies have been done on many vaccines to determine their benefits, risks, and costs. These studies have demonstrated that the benefits outweigh the risks and costs for many vaccines including polio, pertussis, measles, mumps and rubella. Thus, the use of these vaccines provides a net saving to society. Other vaccines such as those influenza and pneumococcal disease are cost-effective relative to other health expenditures. The value of benefit-risk, benefit-cost, and cost-effectiveness analyses lies not in providing the definitive basis for a decision on vaccine use or evaluation. Rather, these analytic techniques provide a structured framework which permits decision-makers to consider all relevant components of the decision in perspective to their relative contributions and subsequent effects. It forces key assumptions to be made explicit and identifies areas in which data are inadequate. The results of such analyses can assist in justifying a vaccination programme (poliomyelitis), in disseminating a programme more widely (measles), in changing health policy (smallpox), and in planning for how a vaccine might be used (hepatitis B). Cost analyses of vaccination may suggest the value of a vaccination programme, but the programme may not be widely adopted (influenza and pneumococcal vaccines). The reasons for this gap between study conclusions and application may be: disagreement with the estimates and assumptions used in the analysis; skepticism over the methodology itself; or subjective views of the vaccine or disease which remains resistant to analytical exercises.
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PMID:Benefits, risks and costs of immunization programmes. 392 21

Advances in immunology, microbial genetics, molecular biology and biochemistry are opening prospects for new purified and synthetic antigens against infectious diseases, cancers of viral origin and some immunodeficiencies. Immunization programmes against major childhood diseases with commonly used vaccines gave excellent results and are leading to their virtual eradication in developed countries. However some vaccines like the one against pertussis proved to be of considerably lower effectiveness. Results achieved in developing countries are in general lagging behind due to lower immunization coverage. While in some countries immunization strategies for eradication of measles are discussed, in others it is questionable whether immunization should continue due to failures of immunization programmes. Evaluation of the effectiveness of national immunization programmes by surveillance and various other methods including the use of epidemiological models point ot the deficiencies of vaccine potency and/or stability and the inadequacy of vaccination schemes and coverages. There is a need to determine optimal immunization programmes for control and possible eradication with currently available antigens and new ones. For newly developed vaccines, ever increasing in number, but with the uncertainty of their appropriate public health use, it is essential to study their optimal and most cost-effective uses e.g., pertussis vaccination is an old unsolved problem and that against hepatitis B a new one. Better results can be obtained with current vaccines by appropriate modification of immunization programmes. Some of the proposed strategies for using recently developed vaccines are questionable and need critical examination.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Problems and progress in immunization. 638 85

The seven major childhood infectious diseases-measles, mumps, rubella, polio, diphtheria, pertussis, and tetanus-can cause permanent disability and, in some cases, death. They all can be prevented by immunization, but prior to the National Childhood Immunization Initiative of 1977 more than a third of all children under age 15 were not properly protected. And even though vaccines are now available to reduce the risk of influenza, hepatitis B, and pneumococcal pneumonia, many high risk patients are not protected. Outbreaks of measles and pertussis, and occasionally of diphtheria and polio, during the mid-1970s indicate that immunization must be emphasized continually. With the combination of safe, effective vaccines, public and private programs, and a reliable disease surveillance and outbreak containment system, infectious diseases can be controlled. The Department of Health and Human Services has proposed a major initiative designed to eliminate the indigenous occurrence of measles.
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PMID:Preventive health services: Immunization. 641 18

This review discusses the indications for the routine immunizations covered by the Swiss "Immunization Schedule 1981" (diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella, BCG), as well as the indications for special immunizations (hepatitis B, influenza, pneumococci, rabies, tickencephalitis) and for the immunisations for travellers (cholera, yellow fever, meningococci, typhoid fever). Vaccination against measles, mumps and rubella should be given to girls and boys at the age of 18 (to 24) months as a combined injection. In view of the low prevalence of tuberculosis BCG vaccination is justifiable only at school leaving age, if at all. The indications for influenza and pneumococcal vaccines are still limited, the value of a general vaccination of all over 65 year old individuals is not proven for either vaccine. A nationwide vaccination campaign against hepatitis B was started early this year with a newly licensed vaccine for all population groups at risk. Only HDC-vaccines should be used for immunisation against rabies. The newly licensed, highly protective oral attenuated live typhoid vaccine will probably replace the parenteral typhoid vaccine.
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PMID:[Vaccination: 1982 status]. 713 94

Hospital employees are often exposed to infectious diseases, both within and outside of the hospital. Susceptible personnel are at risk of acquiring infection and are a possible source of infection for patients, other employees and members of their households. In recent years epidemics in hospitals due to rubella, pertussis, hepatitis B and Legionnaires' disease have included infection transmitted to and from personnel. A comprehensive plan for management of hospital personnel exposed to communicable diseases should include the following: (1) protocols for the management of each of the common infectious diseases; (2) protocols for employees who are at special risk (pregnant women) and employees who work in areas of risk for certain infectious diseases (newborn nursery, clinical and pathology laboratories, hemodialysis unit); (3) assessment of infectious disease experience of new employees by history, skin test (tuberculosis) and serology (rubella, hepatitis B), and a plan for subsequent tests during employment; (4) continuous program of education of employees in infection control; and (5) coordination of policies among administration, employee health service and infection control officer and committee.
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PMID:Management of infections in hospital employees. 721 27

To help the Children's Vaccine Initiative (CVI) achieve its goal of new and improved children's vaccines, we developed and applied a cost-effectiveness model to set priorities for vaccine development. The model measures the health benefits in additional Quality-Adjusted Life Years (QALYs) gained by the combined birth cohorts of all developing countries over an assumed useful life of a proposed vaccine (generally 10 years). It measures costs as the net cost of developing, procuring, and administering the vaccine to the same population and time frame compared to the status quo (the current vaccine, if any). It weights each dollar of in-kind allocation of the existing health infrastructure less heavily than a dollar cash outlay to purchase new vaccine to reflect severe constraints on foreign exchange and non-personnel costs. It expresses cost-effectiveness as the net cost per QALY. The model was applied to 13 candidate vaccines selected by the CVI for initial analysis on the basis of their near-term feasibility. The five most cost-effective improvements, each of which could generate a QALY inexpensively (below $25 per QALY), were an early-administration or an early two-dose measles vaccine, slow release tetanus toxoid (for women), improved typhoid vaccine, and hepatitis B combined with diphtheria-tetanus-pertussis vaccine.
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PMID:Setting priorities for the Children's Vaccine Initiative: a cost-effectiveness approach. 748 85

A vaccine combining hepatitis B with diphtheria, tetanus and whole-cell Bordetella pertussis (DTPwHBV) would facilitate the attainment of universal vaccination of infants against hepatitis B. A candidate vaccine was administered to 42 infants beginning at 7-15 weeks of age. Antibodies were measured from pre- and postvaccination blood samples. After three doses, at least 94.9% of the infants were protected against hepatitis B, diphtheria and tetanus. Responses to B. pertussis were considered adequate. No serious adverse events were reported. These results indicate that this candidate vaccine is safe and immunogenic when administered to infants according to a three-dose schedule, with doses 2 months apart.
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PMID:Evaluation of a combined tetravalent diphtheria, tetanus, whole-cell pertussis and hepatitis B candidate vaccine administered to healthy infants according to a three-dose vaccination schedule. 762 12

Inactivated and trivalent oral poliovirus vaccines contain either formalin-inactivated or live, attenuated poliovirus, respectively, of the three serotypes. Interference among the three attenuated poliovirus serotypes was minimized with a "balanced-formulation" vaccine, and serologic responses after IPV were optimized by adjusting the antigenic content of each inactivated poliovirus serotype. Seroconversion is dependent on both the relative content as well as the absolute quantity of virus in the vaccine. The "gold standard" method to assess humoral antibody responses following vaccination is the neutralization assay. Any detectable titer of neutralizing antibody against poliovirus is considered protective against clinical paralytic diseases. Recently, standard procedures were adopted for conducting neutralization assays. Efforts are being undertaken now to develop a combined diphtheria and tetanus toxoids and pertussis vaccine and IPV vaccine in the United States using a dual-chambered syringe that mixes the content of both vaccines at the time of injection; this approach is necessary to overcome the potential detrimental effect of thimerosal on IPV (the preservative in DTP). Other vaccines that combine DTP and/or Haemophilus influenzae type b and/or hepatitis B with IPV appear feasible but require further investigation. New combination vaccines should induce similar or superior levels of neutralizing antibody in serum for individual protection against paralytic disease and mucosal immunity that effectively decreases viral replication in the intestine and pharynx for population protection against transmission of poliovirus.
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PMID:Defining surrogate serologic tests with respect to predicting protective vaccine efficacy: poliovirus vaccination. 762 65

A recent analysis demonstrated a change in incidence approaching 100% for diseases against which we routinely immunize in the United States. At present, measles, mumps, rubella, invasive Haemophilus disease, poliomyelitis, diphtheria and tetanus are well-controlled but not eliminated. Diseases that now pose special problems include pertussis, hepatitis A and B and varicella. The incidence of pertussis surged in 1994, possibly in part because of waning immunity in the immunized population. Acellular pertussis vaccines are available for booster doses in children but are not now recommended for adults. Licensure of acellular pertussis vaccines for primary immunization of infants is eagerly awaited. Recombinant hepatitis B vaccine has been licensed for more than 10 years but there has been little change in disease incidence in the United States. Routine immunization of infants is now recommended but concerns exist about cost and persistence of immunity into adolescence. Inactivated hepatitis A vaccines appear to be highly effective in preventing clinical hepatitis and controlling epidemics. Potential target populations include military personnel, day-care attendees and travelers. Hepatitis A vaccine may be recommended for all children after approval by the United States Food and Drug Administration and if a combination vaccine becomes available. A live, attenuated varicella vaccine developed in 1974 and unlicensed in the United States is safe and highly effective in preventing varicella in healthy and immunocompromised populations. It also appears to reduce subsequent development of herpes zoster. Vaccines against pneumococci (conjugate vaccine), respiratory syncytial virus, rotavirus, tuberculosis and human immunodeficiency virus are needed. Research and technology to develop these vaccines must be developed, and efficient delivery mechanisms must be created and implemented.
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PMID:Present and future challenges of immunizations on the health of our patients. 763 35

New vaccines, anti-Haemophilus b and anti-hepatitis B, are now available in clinical practice. Specific recommendations have led to modifying the calendar. Practitioner has to explain these new vaccines to the families because they are not compulsory. Combined vaccines (like five valence) is useful to improve compliance. In the near future, new vaccines like the well tolerated acellular pertussis, and new combined vaccines will be available.
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PMID:[Vaccination in children]. 766 4


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