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Increasing numbers of immigrants from the former Soviet Union are settling in the United States each year, making it imperative for clinicians to know how to find and interpret immigrant children's immunization records. Records show that these children have usually received immunizations against tetanus, diphtheria, pertussis, poliomyelitis, measles, mumps and tuberculosis (BCG). They are occasionally vaccinated against influenza, smallpox and tularemia, but never against rubella, hepatitis B or H. influenzae meningitis. The Soviet immunization schedule differs significantly from the U.S. schedule only in BCG vaccine and polio immunization. Contrary to widespread belief in the United States, BCG vaccination does not necessarily render a child's tuberculin skin test positive, and it certainly does not confer total immunity to tuberculosis. MMR vaccination is essential for all Soviet immigrant children. A single update of all the other immunizations may be a wise approach when handling Soviet children's immunizations.
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PMID:Clinical management of immigrants' immunization histories: a focus on Soviet health records and BCG. 157 76

The situation of viral vaccines used in Asian countries is reviewed, focusing on the following vaccines: smallpox, rabies, polio, measles, rubella, mumps, influenza, Japanese encephalitis, hepatitis B, varicella, dengue, and rotavirus. Vaccinations are among the most important strategies to combat communicable diseases caused by bacteria, fungi, parasites, and viruses. Active immunizations are more preferable in most instances than passive ones. It has taken almost 2 centuries to eradicate the highly contagious infection of smallpox from the world. In 1979 the World Health Organization (WHO) announced the global eradication of smallpox. Smallpox vaccination was 1st practiced in 1840 by Dr. Dan Beach Bradley, with the last 2 cases of smallpox reported in Thailand in 1962. Despite the achievement for many years of more ideal rabies vaccine, Semple vaccine continues to be used in developing countries. Attempts should be intensified to produce newer tissue culture vaccines in developing countries themselves and to eradicate vectors. Instances of poliomyelitis were reported in Indonesia, the Philippines, Sri Lanka, India, and Thailand as late as 1983-84, but only a few sporadic cases have occurred in Malaysia since 1980. This mixed record results from polio vaccine having been incorporated into national Expanded Program on Immunization (EPI) programs in many countries. Measles remains 1 of the most common viral infections in children in most developing nations, but morbidity and mortality rates are not accurately obtainable in these countries. Rubella outbreaks have been reported from many countries in Southeast Asia with congenital rubella syndromes due to maternal rubella on the increase in many countries, including Thailand. Children who receive the mumps vaccination are those receiving the combined MMR vaccines. Monovalent mumps vaccine is not obtainable in developing countries. Influenza vaccine is impracticable in most developing countries. Japanese encephalitis vaccine has been used in Japan since 1954. Because of the high cost of Hepatitis B vaccine, mass immunization cannot be practiced in any developing country. Current data suggest that OKA strain of varicella vaccine will be a useful vaccine to protect against chickenpox in immunocompromised children as well as normal children living in some settings. More years are needed to determine the feasibility of dengue immunization. At present, only rotaviruses are the enteric viral agents causing human diarrhea for which vaccination is indicated and feasible. Requirements for vaccines used in developing countries are outlined.
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PMID:Vaccine requirements and priorities for developing countries. 379 67

Recent additions to the immunization schedule include acellular pertussis vaccine, and hepatitis B vaccine for all infants and selected adolescents. The third dose of OPV is recommended at 6 months of age and the first dose of MMR vaccine at 12 to 15 months. A new vaccine against Haemophilus influenzae type b has been licensed. Children aged 6 months and older with asthma, diabetes, or heart disease should receive influenza vaccine. Children aged 2 years and older with asplenia, immunosuppression, and nephrotic syndrome may be candidates for pneumococcal immunization.
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PMID:Childhood immunization guidelines: current and future. 785 58

The Childhood Immunization Initiative (CII) was initiated to increase vaccination coverage among 2-year-old children. The 1996 objective is to have at least 90% coverage for four of the five critical vaccines routinely recommended for children (i.e., one dose of measles-mumps-rubella vaccine [MMR] and at least three doses each of diphtheria and tetanus toxoids and pertussis vaccine [DTP], oral poliovirus vaccine, and Haemophilus influenzae type b vaccine [Hib]), and at least 70% coverage for three doses of hepatitis B vaccine (Hep B) (1). These objectives are an interim step toward the year 2000 goal of at least 90% coverage for the recommended series of vaccinations and are being monitored on an ongoing basis. This report presents national estimates of vaccination coverage among 2-year-old children derived from provisional data from the National Health Interview Survey (NHIS) for the first quarter of 1994 and compares these with the last two quarters of 1993.
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PMID:Vaccination coverage of 2-year-old children--United States, January-March, 1994. 786 81

The primary goal of the Childhood Immunization Initiative (CII) is to increase, by 1996, vaccination levels for 2-year-old children to at least 90% for the most critical doses in the vaccination series (i.e., one dose of measles-mumps-rubella vaccine [MMR] and at least three doses each of diphtheria and tetanus toxoids and pertussis vaccine [DTP], oral poliovirus vaccine, and Haemophilus influenzae type b vaccine [Hib]) and to at least 70% for three or more doses of hepatitis B (Hep B) vaccine (1). This report presents estimates, based on the National Health Interview Survey (NHIS), of the annual national vaccination coverage levels for children aged 19-35 months (median: 27 months) for 1993, compares estimates for 1993 with those for 1992, and compares estimates for the first 6 months of 1993 with third and fourth quarter 1993 estimates.
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PMID:Vaccination coverage of 2-year-old children--United States, 1993. 809 Jan 58

The principal goal of the Childhood Immunization Initiative (CII) is to increase, by 1996, vaccination levels for 2-year-old children to at least 90% for the most critical doses in the vaccination series (i.e., one dose of measles-mumps-rubella vaccine [MMR] and at least three doses each of diphtheria and tetanus toxoids and pertussis vaccine [DTP], oral poliovirus vaccine [OPV], and Haemophilus influenzae type b vaccine [Hib]) and to at least 70% for at least three doses of hepatitis B vaccine (Hep B). Since 1991, annual national estimates of vaccination coverage levels of preschool-aged children have been available through the National Health Interview Survey (NHIS) conducted by CDC. This report presents vaccination coverage levels of children aged 19-35 months for 1992 and provisional estimates of vaccination coverage for the combined first and second quarters of 1993 (Table 1).
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PMID:Vaccination coverage of 2-year-old children--United States, 1992-1993. 816 35

Some major modifications of the recommended Swiss vaccination schedule have been introduced in spring 1996: 1. The vaccination against pertussis using the new acellular vaccines, which cause fewer side-effects. This allows the administration of a fourth and a fifth dose at the age of 2 and 4-7 years, respectively. 2. The consideration of combination vaccines, which contain the vaccinations against diphtheria, tetanus and pertussis as well as the vaccine against invasive diseases caused by Haemophilus influenzae type b. 3. In order to increase the individual vaccination protection, a second dose of MMR vaccine is recommended, preferably at the age of 4-7 years. A general recommendation for hepatitis B vaccination during adolescence may be expected in 1998.
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PMID:[Routine vaccination in childhood]. 949 11

It is imperative that pediatric nephrologists monitor the immunization status of pediatric chronic renal insufficiency, dialysis and transplantation patients closely to reduce the risk of vaccine-preventable disease. Pediatric patients with chronic renal insufficiency and those on dialysis should receive all the standard immunizations according to the schedule as deliniated by the Red Book. In addition to these standard vaccines, these patients will also benefit from influenza and pneumococcal vaccine. Pediatric renal transplant recipients should also be immunized with standard and special vaccines; however, all live viral vaccines should be avoided in this population. Because patients with renal disease may not respond optimally to all immunizations, it is important to study antibody response to MMR and varicella in patients before transplantation. If these patients are unprotected, they should be immunized before transplantation. It seems that pediatric dialysis and transplantation patients may not respond optimally to hepatitis B vaccine. Therefore, if at all possible, this vaccine should be administered before these therapies. Doubling the recommended dose of hepatitis B vaccine may improve response. Antibody levels to hepatitis B should be monitored every other year, and this vaccine should be readministered when the antibody level decreases to less than 10 mIU/mL. Hopefully the morbidity and mortality associated with vaccine-preventable disease can be reduced in this population by ensuring that pediatric patients with chronic renal disease are adequately immunized.
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PMID:Immunization guidelines for pediatric renal disease. 961 66

There are concerns in Australia about inadequate rates of childhood immunisation, an important preventive measure to reduce infectious diseases. The population passing through the Melbourne Juvenile Justice Centre (MJJC) comes from a background at high risk for inadequate immunisation and outbreaks can occur in residential institutions. MJJC residents were invited to participate in a study by completing a medical officer-administered risk behaviour questionnaire and/or giving a blood sample. Ninety residents completed the questionnaire; 83 gave blood samples. Sera were tested for measles, mumps, rubella and hepatitis A, B and C markers using standard commercial assays. Diphtheria and tetanus were tested with an ELISA in a public health laboratory familiar in the technique. Sixty four per cent (53/83) of participants were non-immune to at least one component of MMR and 44.6% (37/83) non-immune to either tetanus or diphtheria. Despite 61.1% of participants reporting injecting drug use, only 28.2% had protective levels of anti-HBs, 6.1% were positive for anti-HBc (2.4% equivocal), 22.9% were anti-HCV positive and 9.6% had markers of exposure to hepatitis A virus. These results show suboptimal levels of immunity in this institutional setting with the potential for disease outbreaks. Many residents miss adolescent school-based programs for immunisation because of truancy and early school leaving. Despite considerable risk of blood-borne viruses, many MJJC residents are inadequately vaccinated against hepatitis B.
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PMID:Serostatus for vaccine-preventable diseases in residents at Melbourne Juvenile Justice Centre. 974 12

The aim of these sectional studies was to find out current mass immunisation rates of school beginners. The study was carried out in the administrative district of Dingolfing-Landau in 1999, also to examine to what extent the recommendations to the STIKO (Established Immunisation Committee at the Robert Koch-Institute) for the corresponding age-group had been complied with. To this end, the vaccination documents submitted at the medical examination were inspected, the given data recorded in a standardised way and subsequently rendered anonymous. According to the available results the mass immunisation rates for diptheria, tetanus and polio met the infection epidemiology requirements by over 90%. The HiB, MMR and whooping cough vaccinations were in on the average 80% for mass immunisation, which no longer meets the epidemiological requirements. BCG inoculation was only given to every tenth child in the relevant age group. A positive aspect was the comparatively high immunisation rate of almost 50% on hepatitis B immunisation. Only one child in twenty in the relevant age group had the full immunisation protection recommended by STIKO. Due to the great acceptance and willingness to co-operate on the part of the parents/legal guardians the review of the immunisation status through the Childrens and Young People's Public Health Authority (KJGD) made it possible to establish the current mass immunisation rate for children of one birth year. In this way, it will be possible by means of relevant immunisation recommendations and immunisation strategies to close the immunisation gaps and raise the mass immunisation rates.
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PMID:[Immunization monitoring of students starting school: a regional contribution from the Bavaria district]. 1092 May 68


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