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Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The immunization guidelines for the prevention of hepatitis B virus, pneumococcal pneumonia, and Haemophilus influenza type b, have undergone revision in recent years. The indications, efficacy, and safety of hepatitis B virus vaccine, hepatitis B immune globulin, pneumococcal vaccine, and Haemophilus influenzae type b vaccine are reviewed. The current recommendations for immunization from the Centers for Disease Control's Immunization Practices Advisory Committee are also included in the article. While these products have contributed to decreases in disease, the antibody responses elicited are not always adequate to provide extended protection to the populations at greatest risk of disease. By reviewing the current status and immunizing guidelines, it is hoped that the P & T Committee's task of selecting efficacious, safe, and cost-effective preparations will be made easier.
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PMID:Recent advances in communicable disease prevention: hepatitis B, pneumococcus, and H influenzae type b. 1031 80

An increasing number of new and improved vaccines to prevent childhood diseases are being introduced. Combination vaccines represent one solution to the problem of increased numbers of injections during single clinic visits. This statement provides general guidance on the use of combination vaccines and related issues and questions. To minimize the number of injections children receive, parenteral combination vaccines should be used, if licensed and indicated for the patient's age, instead of their equivalent component vaccines. Hepatitis A, hepatitis B, and Haemophilus influenzae type b vaccines, in either monovalent or combination formulations from the same or different manufacturers, are interchangeable for sequential doses in the vaccination series. However, using acellular pertussis vaccine product(s) from the same manufacturer is preferable for at least the first three doses, until studies demonstrate the interchangeability of these vaccines. Immunization providers should stock sufficient types of combination and monovalent vaccines needed to vaccinate children against all diseases for which vaccines are recommended, but they need not stock all available types or brand-name products. When patients have already received the recommended vaccinations for some of the components in a combination vaccine, administering the extra antigen(s) in the combination is often permissible if doing so will reduce the number of injections required. To overcome recording errors and ambiguities in the names of vaccine combinations, improved systems are needed to enhance the convenience and accuracy of transferring vaccine-identifying information into medical records and immunization registries. Further scientific and programmatic research is needed on specific questions related to the use of combination vaccines.
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PMID:Combination vaccines for childhood immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) 1032 51

In contrast to the 1980s, immunization rates increased dramatically in the United States in the mid-1990s. Three-quarters of all 2-year-olds had received all recommended immunizations in 1997 as compared to just over one-half in 1992. Immunization rates for individual vaccines have reached 90 percent for three of the vaccines--measles, mumps, rubella; pollo; and Haemophilus influenzae type b (Hib). The vaccine for diphtheria, tetanus and pertussis, however, and the newer vaccine for hepatitis B have not yet reached 90 percent of 2-year-olds. The rising immunization levels in young children have resulted in declining incidence of almost all of the vaccine-preventable illnesses. Cases of measles and Hib have declined 95 percent and the incidence of rubella and congenital rubella, hepatitis B and mumps has also declined. Pertussis (whooping cough), however, continued its pattern of periodic increases and decreases. This lack of improvement is probably due to a combination of lower immunization levels for pertussis and waning immunity in previously immunized adolescents and young adults. Federal efforts such as the President's Childhood Immunization Initiative along with its Vaccines for Children program have been credited for a great deal of this improvement. These programs increased public awareness of the need for and access to immunizations, better tracking of immunizations and vaccine-preventable illnesses and have also removed cost barriers to receipt of such protection. At the same time, new vaccines (against chickenpox and rotavirus) and safer versions of older vaccines (pertussis) have been brought into widespread use. Children can now be vaccinated against increasing varieties of childhood diseases. While progress in immunization has been good, areas in need of improvement remain. Pertussis continues to be a problem both in terms of incidence and immunization levels. Also, immunization levels differ significantly by poverty level and race and ethnicity. Black, Hisparic, American Indian and Asian children are less likely to be fully immunized than non-Hispanic white children and poor children are less likely to be fully immunized than nonpoor children.
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PMID:Immunization and vaccine-preventable illness, United States, 1992 to 1997. 1032 22

Eradication is the permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts; intervention measures are no longer needed. To date, the only infectious disease that has been eradicated is smallpox. Poliomyelitis is targeted for eradication by the year 2000, and the eradication initiative is well under way, with the Western Hemisphere certified as being polio-free and more than one year having passed since polio cases occurred in the Western Pacific Region of the World Health Organization. A review of the technical feasibility of eradicating other diseases preventable by vaccines currently licensed for civilian use in the United States indicates that measles, hepatitis B, mumps, rubella, and possibly disease caused by Haemophilus influenzae type b are potential candidates. From a practical point of view, measles seems most likely to be the next target. Global capacity to undertake eradication is limited, and care must be taken to ensure that a potential measles eradication effort does not impede achievement of polio eradication. Even in the absence of eradication, major improvements in control are both feasible and necessary with existing vaccines. New and improved vaccines may give further possibilities of eradication in the future. Eradication represents the ultimate in sustainability and social justice.
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PMID:Eradication of vaccine-preventable diseases. 1035 57

An increasing number of new and improved vaccines to prevent childhood diseases are being introduced. Combination vaccines represent one solution to the problem of increased numbers of injections during single clinic visits. This statement provides general guidance on the use of combination vaccines and related issues and questions. To minimize the number of injections children receive, parenteral combination vaccines should be used, if licensed and indicated for the patient's age, instead of their equivalent component vaccines. Hepatitis A, hepatitis B, and Haemophilus influenzae type b vaccines, in either monovalent or combination formulations from the same or different manufacturers, are interchangeable for sequential doses in the vaccination series. However, using acellular pertussis vaccine product(s) from the same manufacturer is preferable for at least the first three doses, until studies demonstrate the interchangeability of these vaccines. Immunization providers should stock sufficient types of combination and monovalent vaccines needed to vaccinate children against all diseases for which vaccines are recommended, but they need not stock all available types or brandname products. When patients have already received the recommended vaccinations for some of the components in a combination vaccine, administering the extra antigen(s) in the combination is often permissible if doing so will reduce the number of injections required. To overcome recording errors and ambiguities in the names of vaccine combinations, improved systems are needed to enhance the convenience and accuracy of transferring vaccine-identifying information into medical records and immunization registries. Further scientific and programmatic research is needed on specific questions related to the use of combination vaccines.
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PMID:Combination vaccines for childhood immunization. 1035 68

Taking into account the global status of polio, it seems evident that the continuing use of oral poliovaccine in all countries is the most obvious and prudent public health policy for the foreseeable future. Possible exceptions might include those countries which are not troubled by the added cost of the inactivated vaccine; whose health services are able to guarantee high levels of vaccine coverage; and which can expect to experience comparatively few importations of wild poliovirus. An important question is whether it is warranted at this time to recommend a combined schedule of inactivated vaccine followed by live vaccine. This implies the addition of at least two inoculations of inactivated vaccine to an already complex vaccination schedule. In most countries, this now includes the administration of three inoculations each of DTP and Haemophilus influenzae as well as one of measles-mumps-rubella vaccine by approximately 12 months of age. Some countries also routinely vaccinate young children against hepatitis B (three additional inoculations). Because most physicians and clinics, as a policy, do not give more than two inoculations at one visit, it implies the need for scheduling additional well-child visits. In the United States, this is a principal factor in the greatly increased estimated costs of such a programme. Experience also shows that as the number of routine visits which are required for vaccination increases, overall vaccination coverage diminishes. The schedule recommended in the United States possesses yet a further problem. Children there would not receive the second dose of oral vaccine until five years of age, thus permitting the accumulation of a large number of preschool children with limited intestinal immunity-a potentially explosive problem were wild virus to be introduced. The inactivated polio vaccine is useful and certainly indicated for the small numbers of persons for whom the live, oral vaccine is contraindicated. However, to use it routinely implies accepting the potential of substantial penalties while reducing but not eliminating, an already extremely small risk of vaccine-associated paralytic illness. From the public health perspective, I therefore argue against the proposition. Copyright 1997 John Wiley & Sons, Ltd.
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PMID:Developed countries should not use inactivated polio vaccine for the prevention of poliomyelitis. 1039 73

Studies of immune function in human immunodeficiency virus (HIV)-infected children are important, because functional abnormalities can precede CD4+ T-cell loss and are associated with the development of opportunistic and bacterial infections. We sought to correlate clinical parameters and immunological function with HIV RNA plasma levels in 20 children. HIV RNA levels were measured by a polymerase chain reaction assay. We analyzed T-cell responses to mitogens (phytohemagglutinin, concanavalin A, and pokeweed [PWM]) and antigens (tetanus toxoid and Candida albicans); T-cell suppressor activity; and humoral immunity to Haemophilus influenzae, hepatitis B, tetanus, and diphtheria vaccines. The median age of the children was 6 years. Eight children had HIV RNA levels less than 200 to 9621 copies per milliliter (group I). Four children had 37,970 to 82,630 copies per milliliter (group II). Eight children had 102,100 to 191,200 copies per milliliter (group III). There were no differences in the HIV-related complications between group I and II children. Group I/II children had significantly higher CD4+ T-cell counts (P = 0.02), less symptomatic HIV disease (P = 0.005), and more detectable protective vaccine immunity (P = 0.014) compared with group III children. Responses to mitogens were conserved in most children. Group I children tended to have higher responses to tetanus toxoid than group II children and significantly higher responses than group III children (P = 0.01). Group I had significantly higher responses to C. albicans than groups II (P = 0.016) and III (P = 0.001). Group I/II children tended to have lower suppressor activity compared with group III children (median, 0 vs 64%). We demonstrated that humoral and cellular immune dysfunction exists at all stages of disease in HIV-infected children but was most severe in children with greater than or equal to 100,000 HIV RNA copies per milliliter. Function was the most intact in children with less than 10,000 copies per milliliter.
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PMID:Correlation of clinical parameters and immunological function with human immunodeficiency virus plasma viremia in children. 1041 60

To investigate the incorporation of oral rhesus-human reassortant rotavirus tetravalent (RRV-TV) vaccine into a routine immunization programme, RRV-TV or oral placebo was coadministered with a pentavalent diphtheria-tetanus-whole-cell pertussis-Haemophilus influenzae b (Hib)-inactivated polio vaccine and hepatitis B vaccine following a 3-4-5-mo schedule in a double-blind trial involving 249 infants. Seroconversion rates after 3 doses of rotavirus vaccine were 80% for rotavirus immunoglobulin A (IgA) and 93% for RRV neutralizing antibodies. Rotavirus vaccine did not interfere with the immune responses to diphtheria, tetanus, pertussis, Hib, poliovirus 1, 2 and 3, or hepatitis B. Following the first, second and third doses of vaccine, fever >38 degrees C on the day of vaccination was seen in 31%, 24% and 24%, respectively, with no difference between RRV-TV- and placebo-vaccinated children. This fever was presumably due to the whole-cell pertussis vaccine. Those vaccinees who received concomitant RRV-TV vaccine had another peak of fever around d 4 after the first dose, when 25% of them had fever >38 degrees C and 3% >39 degrees C. It is concluded that RRV-TV rotavirus vaccine can be given concurrently with other childhood immunizations following a 3-4-5-mo vaccination schedule. However, febrile reactions to RRV-TV rotavirus vaccine are common when the first dose is given at the age of 3 mo.
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PMID:Concurrent administration of rhesus rotavirus tetravalent (RRV-TV) vaccine with pentavalent diphtheria-pertussis-tetanus-Haemophilus influenzae beta-inactivated polio and hepatitis B vaccines. 1050 75

Antibody avidity to Haemophilus influenzae type b (Hib) polysaccharide (PS) was assessed in infants vaccinated with diphtheria-tetanus-acellular pertussis (DTaP) combined with Hib-PS conjugated to tetanus toxoid (PRP-T) and hepatitis B (HB) (DTaP-PRP-T-HB) and after a PRP-conjugate (CRM197-OS) booster 3-7 months later. Avidity differed between infants with anti-Hib-PS IgG antibody <1 or >1 microg/mL postprimary series (avidity index [AI], 42%, 95% confidence interval [CI], 35%-49%, and 68% and 63%-72%, respectively; P<.0001). For infants with <1 microgram/mL anti-Hib-PS IgG antibody, mean AI rose by the time of preboost immunization to 61% (95% CI, 57%-65%), even though total IgG antibody levels fell. Spontaneous Hib-PS antibody rises after primary series DTaP-PRP-T-HB vaccination were followed by high postboost anti-Hib-PS IgG antibody levels and avidity. The DTaP-PRP-T-HB combination vaccine studied elicits high avidity antibody, and affinity maturation appears to occur in the absence of further antigen exposure even in those with very low anti-Hib-PS antibody.
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PMID:Avidity maturation of antibody to Haemophilus influenzae type b (Hib) after immunization with diphtheria-tetanus-acellular pertussis-hib-hepatitis B combined vaccine in infants. 1047 80

The first scientific attempts to control an infectious disease can be attributed to Edward Jenner, who, in 1796 inoculated an 8-year-old boy with cowpox (vaccinia), giving the boy protection against subsequent challenge with virulent smallpox. Thanks to the successful development of vaccines, many major diseases, such as diphtheria, poliomyelitis and measles, are nowadays kept under control, and in the case of smallpox, the dream of eradication has been fulfilled. Yet, there is a growing need for improvements of existing vaccines in terms of increased efficacy and improved safety, besides the development of completely new vaccines. Better technological possibilities, combined with increased knowledge in related fields, such as immunology and molecular biology, allow for new vaccination strategies. Besides the classical whole-cell vaccines, consisting of killed or attenuated pathogens, new vaccines based on the subunit principle, have been developed, e.g. the Hepatitis B surface protein vaccine and the Haemophilus influenzae type b vaccine. Recombinant techniques are now dominating in the strive for an ideal vaccine, being safe and cheap, heat-stable and easy to administer, preferably single-dose, and capable of inducing broad immune response with life-long memory both in adults and in infants. This review will describe different recombinant approaches used in the development of novel subunit vaccines, including design and production of protein immunogens, the development of live delivery systems and the state-of-the-art for nucleic acids vaccines.
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PMID:Production of recombinant subunit vaccines: protein immunogens, live delivery systems and nucleic acid vaccines. 1048 12


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