UMLS:C0043167 - FACTA Search

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The international community has launched the Children's Vaccine Initiative, which has created the most ambitious grouping of public and private sector interests ever to tackle a global health issue. Developed by WHO, UNICEF, UNDP, the World Bank, and the Rockefeller Foundation, the initiative is the result of decisions taken at the World Summit for Children, held in New York in September 1990. During that meeting, world leaders requested greater resources for the development of new or better vaccines. The Children's Vaccine Initiative, says WHO Director-General Dr. Hiroshi Nakajima, will not only yield specific benefits in improving vaccines, it will also establish a process of collaboration between the public and private sectors, which will have far-reaching benefits in other areas. The new initiative comes on the heels of another international effort, the successful Expanded Program on Immunization, which in 1990 achieved its goal of immunizing 80% of the world's children against 6 major childhood diseases: poliomyelitis, measles, tuberculosis, diphtheria, pertussis, and tetanus. The new initiative will strive to develop vaccines against a wider spectrum of viral, bacterial, and parasitic diseases which cause mortality in children. These diseases include rotavirus infection, hepatitis A and E, dengue, Japanese encephalitis, acute respiratory diseases, meningococcal meningitis, diarrheal diseases, pneumococcal pneumonia, and malaria. The new initiative will also seek to improve existing vaccines, making them easier to administer and less painful and costly.
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PMID:New children's vaccine initiative launched. 160 Apr 43

116 immunizations were given to 61 children with febrile convulsion or epilepsy who had not had a seizure for 1 year since the last attack. In 92 of the 116 immunizations the electroencephalogram (EEG) was examined before and after immunization. No adverse effects on the EEG were observed in 19 immunizations with Japanese encephalitis, measles, mumps or rubella vaccines. Epileptic spikes reappeared after 10 immunizations and epileptic spikes increased after 10 immunizations among 73 given for diphtheria, acellular pertussis and tetanus (DPT), diphtheria and tetanus (DT), or Bacillus Calmette-Guerin (BCG). A convulsion was observed once in one child 7 days after immunization with BCG. A follow-up EEG examination is necessary after children with convulsive disorders are immunized.
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PMID:Adverse effects on EEG and clinical condition after immunizing children with convulsive disorders. 228 15

In developing countries, where economic development is lacking and literacy rates are low, priority must be given to primary health care and to the establishmend of sustainable health care delivery systems. The World Health Organization's Expanded Program of Immunization was designed with the goal of immunizing all children against measles, pertussis, tetanus, poliomyelitis, tuberculosis, and diphtheria by 1990. A second function of the immunization program is to establish a health care delivery system. Today 50% of infants receive 3 doses of diptheria/pertussis/tetanus and polio vaccines, and 70% receive at least 1 dose. Measles kills 2 million children every year. The standard strain of attenuated vaccine is given at 9 months, and 1 dose protects 95% of children for life. Tetanus kills 800,000 infants every year. The vaccine must be refrigerated, and 2 doses are essential. Tuberculosis kills 2 million children under 5 every year. The attenuated BCG vaccine should be given at birth, and a single dose confers some protection. Diphtheria is most common among poor, urban children in termperate climates, and 3 doses of toxoid at monthly intervals are recommended. Poliomyelitis paralyzes 250,000 children a year. 4 doses of live attenuated Sabin vaccine are recommended. The vaccine is very sensitive to heat. Other vaccines in use or being developed include yellow fever, meningococcus, Japanese B encephalitis, rubella, hepatitis B, cholera, rotavirus, pneumonococcus, and Haemophilus influezae. 2 problems that confront the delivery of health services, including immunization, are lack of funds and lack of access to susceptible populations. Approaches to the lack of funds problem include fee for service, taxation, beter management of existing resources, reallocation of health resources, and increased funding from donor nations. Approaches to the problem of access include vaccination whenever children come into contact with a health facility for any reason, channeling by members of the community, involvement of traditional healers and birth attendants, outreach services, mass campaigns, pulse technics, and financial incentives.
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PMID:Vaccination strategies in developing countries. 305 59

The Expanded Program on Immunization was initiated by the World Health Organization in 1974. In 1984, the World Bank, the UN Development Program, the UN Children's Fund, the World Health Organization, and the Rockefeller Foundation formed the Task Force for Child Survival, which, along with private and voluntary groups mobilizes support for the Immunization Program. With collaboration from the US Centers for Disease Control, the World Health Organization has produced training materials for use in various countries and worked with the UN Childrens Fund, which has contributed new cold chain methods for the immunization program. The immunization program provided a building block for a health infrastructure in many countries. It collaborated with the Diarrheal Diseases Control Program to develop integrated training programs, with the Division of Family Health to develop a training module on child spacing, and with the Nutrition Program in introducing vitamin A and iodine supplementation. In 1974, fewer than 5% of children in developing countries were immunized; today 50% are reached with a 3rd dose of polio or diphtheria-pertussis-tetanus vaccines. Immunization started slowly and then increased rapidly since the mid-1980s because the program's 1st objectives were to develop sound national plans and to train a core of competent managers in each country. Measles immunization coverage is low (37%) because the vaccination program is recent and the present vaccine cannot be given before the age of 9 months. Coverage of pregnant women for tetanus is even lower (19%). The number of immunizations could be increased if clinics would provide immunizations during acute care visits. Community mobilization and outside financial assistance are needed; full immunization of 1 child costs $10. The Expanded Program on Immunization hopes to achieve the eradication of polio by 2000 and the eradication of neonatal tetanus and 90% reduction in measles by 1995. Vaccines are being developed for yellow fever, hepatitis B, Japanese encephalitis B, rotavirus, typhoid, shigella, cholera, and leprosy, as well as a measles vaccine that can be given at 6 months. Primary care emphases will be on maternal and child nutrition, diarrheal disease control, birth spacing, and vitamin A and iodine supplementation. The Expanded Program on Immunization will focus on applied research, leaving basic research to be carried out by the Vaccine Development Program, the Basic Vaccinology Program, the Special Program of Research Development and Research Training in Human Reproduction, and the Diseases Control Program.
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PMID:Immunizing the children of the world: progress and prospects. 326 62

A total of 1044 children selected in age groups of 4, 8 and 12 years old from 12 countries (cities) with stratified random sampling method were monitored on the present situation of immune levels according to the programme on immunization in 1991. The results showed that the positive rates and the geometric mean titers of antibodies to measles were 87.16% +/- 3.14%, 5.83 +/- 0.41 (56.90%, < 1:8), respectively; to pertussis were 78.13% +/- 9.19% 218.10 +/- 23.39 (41.62%, > or = 1:320); to DAT were 74.4% +/- 11.04%, 0.098 +/- 0.025; to TAT were 75.86% +/- 11.09%, 0.136 +/- 0.03; to poliomyelitis (ELISA) were type I 89.99%, 220.51, type II 83.38%, 201.27, type III 86.09%, 275.08, 3 types 79.48%, 255.91 (27.23%, > or = 1:400); to Japanese B encephalitis (HI) were 67.47% +/- 3.34%, 39.44 +/- 1.48. The conversion of OT was 24.73%. It showed significant difference among these counties and among 3 age groups (P < 0.01). In 4-year age group, the vaccinated rate and the result of immune surveillance were the same. The antibody level and the incidence of measles showed negative correlation.
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PMID:[The surveillance on the present situation of immune levels of 1044 children vaccinated with seven kinds of vaccines in Dali Prefecture]. 783 90

UNICEF decided to achieve the 1977 World Health Organization objective Health For All By The Year 2000 through primary health care, utilizing growth monitoring, oral rehydration therapy, breast-feeding, immunization, family planning, and education of women. Since the 1960s BCG (bacillus Calmette-Guerin) vaccination, DPT (diphtheria, pertussis, tetanus) and OPV (oral polio vaccine) have been available in Sri Lanka. The expanded program of immunization has almost eliminated diphtheria, pertussis, neonatal tetanus, and poliomyelitis. Tuberculous meningitis, bone and joint tuberculosis, measles, and miliary tuberculosis have become very rare. Among other vaccine-preventable diseases, mumps is the commonest cause of aseptic meningitis and viral encephalitis in children. Maternal rubella in the first trimester causes abortion or gross teratogenic effects including congenital heart disease. Safe vaccines may be used to prevent mumps and rubella. In recent years there has been a resurgence of measles in North America among school children, and presently a 2nd dose of vaccine is recommended for children. Japanese B encephalitis has a mortality rate of over 30% and half the survivors have residual brain damage. The Ministry of Health has immunized susceptible children in some of the prevalent areas. This vaccine also gives partial protection against dengue hemorrhagic fever. In Hong Kong, Singapore, and Taiwan hepatitis B vaccine is part of the national immunization schedule because of the common occurrence of primary hepatoma of the liver. At present this vaccine is recommended for health workers in Sri Lanka. Meningococcal meningitis occurs in some Middle East countries such as Saudi Arabia, thus Haj pilgrims are advised to be vaccinated against it before the pilgrimage. In Sri Lanka beta-thalassemia major is prevalent, and as most of these patients are subjected to splenectomy, pneumococcal vaccine should be given to them. Currently research work is being carried out for development of vaccines against rotavirus, streptococcal, and hepatitis A infection.
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PMID:Improving child survival through immunisation. 814 30

In 1998 there were 85,096 notifications to the National Notifiable Diseases Surveillance System; slightly lower than in 1997 (89,579). The number of measles cases remained low, and well below the number reported in the outbreak years of 1993 and 1994. Rubella notifications further decreased and remained low in 1998. The Measles Control Campaign from August to November 1998, did not impact significantly on the number of measles or rubella cases reported for 1998. Notifications of Haemophilus influenzae type b reached a record low since surveillance began in 1991, and appeared to have stabilised at a low rate since the introduction of the conjugated vaccine in 1992. The previously reported outbreak of pertussis in 1997 tapered off in early 1998. Food-borne disease, or detection of disease, appeared to be on the rise with an increase in notification rates of campylobacteriosis and salmonellosis. Notifications of hepatitis A decreased, correcting the previous high number of notifications in 1997. Sexually transmissible diseases (STDs) increased. Notifications for chlamydial infection were the highest for all sexually transmitted diseases and third highest for all notifiable diseases. Notifications of gonococcal infection also continued to rise and have doubled since 1991, whilst notifications for syphilis increased slightly after falling steadily over recent years. Arbovirus infections of concern in 1998 were dengue outbreaks in Far North Queensland and the first case of Japanese Encephalitis for mainland Australia, highlighting the importance of surveillance of arboviruses and vectors for their detection and management.
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PMID:Australia's notifiable diseases status, 1998. Annual report of the National Notifiable Diseases Surveillance System. 1064 2

We studied immunization for 128 handicapped patients, from 3 to 15 years of age, in a Seishi Gakuen Hospital, with 8 vaccines: diphtheria-purified acellular pertussis-tetanus combined (DPT), BCG, polio, measles, rubella, mumps, varicella, and Japanese B encephalitis. The rate of vaccination in these patients was lower than in healthy children at 3 years of age in Kanazawa City. There was no significant difference between patients with and without epilepsy. The rate was higher in the hospitalized patients than in the outpatients. More than 90% of the hospitalized patients was immunized against influenza under informed consent in 1997 and 1998. Despite pandemics of influenza in Kanazawa City, where the hospital was located, the period of fever by influenza was significantly shorter in our patients in both 1997 and 1998 than in 1996. Although a half of our patients had epilepsy, they were safely vaccinated with few side effects.
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PMID:[Survey of vaccination for physically-handicapped and epileptic children]. 1119 90

The Centers for Disease Control and Prevention has identified immunization as the most important public health advance of the 20th century. The purpose of this article is to review the changes that have taken place in active immunization in the United States over the past decade. Since 1990, new vaccines have become available to prevent five infectious diseases: varicella, rotavirus, hepatitis A, Lyme disease, and Japanese encephalitis virus infection. Improved vaccines have been developed to prevent Haemophilus influenzae type b, pneumococcus, pertussis, rabies, and typhoid infections. Immunization strategies for the prevention of hepatitis B, measles, meningococcal infections, and poliomyelitis have changed as a result of the changing epidemiology of these diseases. Combination vaccines are being developed to facilitate the delivery of multiple antigens, and improved vaccines are under development for cholera, influenza, and meningococcal disease. Major advances in molecular biology have enabled scientists to devise new approaches to the development of vaccines against diseases ranging from respiratory viral to enteric bacterial infections that continue to plague the world's population.
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PMID:Active immunization in the United States: developments over the past decade. 1158 89

In 1984 an insurance plan for child immunization was introduced in the counties of Wuji, Linzhang, an Zunhua, and in the city of Xingtai in the province of Hebei, China. The remuneration of village physicians and payment for vaccination services was linked to their effectiveness. In Wuji county children under 2 up to the age of 7 could be enrolled. If a child contracted measles, $8.50 was paid as compensation, $29 for tetanus, $43 for diphtheria, and $57 for poliomyelitis. If death was caused by one of these diseases, $85 was paid. 84% of children of this age range participated in the plan. 36% of the money from policy purchases of $36,000 was allocated to compensation and administration and 64% to municipal health centers for replacement of supplies and to village doctors performing vaccinations whose annual income ranged between $86 and $286 plus $37 for vaccinations. In the 1st year 31 cases were compensated for a total of $600. In the other countries similar schemes were operational: rural doctors pitched in with 5-20-25% of compensation, and the health care system paid the rest. In 1987, two-thirds of cities in the province adopted this plan enlisting 2,559,780 children (31% of those under 7) and accumulating a total fund of $2,500,000. A 1987 sample of 36, 992 children indicated a 94% coverage for BCG (bacillus Calmette-Guerin), 85% for poliomyelitis, 80% for DPT (diphtheria-pertussis-tetanus), 80% for measles, 90% for Japanese B encephalitis and epidemic meningitis. In 1986, there were 273,000 fewer cases of measles, polio, diphtheria, pertussis, epidemic meningitis, and Japanese encephalitis with 4200 fewer deaths, and 3000 fewer incapacities (or possibly 1,000,000, 15,000 and 5000 fewer, respectively, because of nonreporting). Measles morbidity declined from 16/100,000 in 1986 to 3.7/100,000 in the first 11 months of 1987.
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PMID:[Monetary incentives for a more effective immunization program]. 1217 53

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