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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Contrary to the regular immunization schedule for children, the majority of immunization are done in adulthood in case of special risks only, such as old age, chronic illness or exposure. The protection against a variety of communicable diseases has to be monitored and if necessary to be boosted regularly. Based on the routine vaccination scheme 1991 of the Federal Department of Public Health, the following vaccinations which are commercially available in Switzerland are discussed in this review: diphtheria, Haemophilus influenzae, hepatitis B, influenza, measles + mumps + rubella, meningococci, pertussis, pneumococci, poliomyelitis, tetanus, rabies, tuberculosis, varicella and tick encephalitis. Furthermore, the current recommendations are given for the prophylactic and therapeutic use of immunoglobuline preparations.
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PMID:[Active and passive immunization: 1991 status]. 185 65

Communicable diseases represent a considerable burden in terms of suffering and costs. The decision to develop a new vaccine varies with perspectives. The public health perspective is influenced largely by cost-benefit ratios; the community perspective by a strong desire to alleviate suffering and disability from disease and from vaccine side-effects; and that of vaccine producers by demand, technological feasibility of development, and anticipated return on investment. Each of these perspectives is important. However, they often are mutually exclusive. From a humanitarian and epidemiological perspective, the most urgent needs related to communicable diseases are those of the poorest countries; in the industrialised world, with the exception of the vaccine for the acquired immunodeficiency syndrome (AIDS), public health priorities, evaluated in terms of the cost-benefit ratio, often differ from those of the market, which usually selects its priorities according to return on investment. The six vaccines used in the Expanded Programme of Immunisation (EPI) are offered cheaply through a highly efficient bidding system. It would have to be extended, under the same form or differently, to other vaccines, such as those for rabies, hepatitis B, or japanese encephalitis. For vaccines that are being developed, such as conjugated polysaccharide or acellular pertussis vaccines, it is difficult to foresee how these expensive vaccines can be distributed. The situation is even worse for vaccines to be developed specifically for the third world. To make these vaccines available to everyone there must be technology that enables producers to sharply reduce production costs, and a subsidy for research and development and production.
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PMID:Lag between discovery and production of new vaccines for the developing world. 197 2

The resurgence of measles has highlighted concerns about U.S. programs for immunization in infants and children. In order to put the problems into perspective, this review will address such issues as the safety of pertussis vaccines; oral vs inactivated poliovirus vaccine; vaccines for measles-mumps-rubella, Hemophilus influenzae type B, and hepatitis B; and varicella vaccine.
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PMID:Immunization practices in children. 211 22

The authors describe 2 new vaccines now available in France: one is the GenHevac, an hepatitis B vaccine, the first virus recombinant vaccine; the other one is the Typhim Vi, a polysaccharide typhoid vaccine. Three other vaccines are currently used in foreign countries and will be soon available: the Hemophilus influenzae vaccine, the acellular pertussis vaccine and the varicella vaccine. Rotavirus and Cytomegalovirus vaccines are studied for their clinical efficacy.
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PMID:[Present status of vaccines in 1989]. 256 Jan 59

In most developing countries hepatitis B virus is endemic and prevention has to be carried out early in life and on a mass scale. In these regions, simultaneous administration of multiple antigens is normal practice. We have therefore, investigated the interaction of hepatitis B vaccine with DTP-Polio vaccine. Studies include the immune response post one and two injections to diphtheria and tetanus toxoid, pertussis and hepatitis B surface antigen. The vaccines were given simultaneously or not at a 6 months interval. The immune response to HBsAg vaccine and DTP-Polio vaccine injected simultaneously was equal to the immune response observed after administration of vaccines alone. Moreover, no adverse reactions were noted. This trial also demonstrated that immunization with two doses of DTP-Polio vaccine, containing 30 Lf of diphtheria and tetanus toxoids, at a 6 months interval is sufficient to obtain a very good immune response.
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PMID:Simultaneous administration of diphtheria/tetanus/pertussis/polio vaccine and hepatitis B vaccine in a simplified immunization programme. 288 21

We studied the interactions of hepatitis B vaccine with other vaccines used in the World Health Organization expanded programs of immunization. Three groups of Senegalese children were vaccinated with hepatitis B vaccine (HB) alone, diphtheria-tetanus-pertussis (DTP)-polio vaccine alone, or a combination of hepatitis B vaccine and DTP-polio vaccines simultaneously. The immune responses to HBsAg, tetanus toxoid, diphtheria toxoid, and pertussis were measured after one and two vaccinations at 6-month intervals. The immune responses to the combination of HB vaccine and DTP-polio vaccines were similar to the immune responses observed after administration of each vaccine alone. In addition, no adverse reactions were noted. These experimental trials also demonstrated that with a DTP-polio vaccine containing 30Lf of tetanus and diphtheria toxoids, two doses given at 6-month intervals are sufficient to provide a satisfactory immune response. In the case of pertussis and HB vaccines; however, a third dose is necessary.
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PMID:Simultaneous administration of diphtheria-tetanus-pertussis-polio and hepatitis B vaccines in a simplified immunization program: immune response to diphtheria toxoid, tetanus toxoid, pertussis, and hepatitis B surface antigen. 293 84

A study was conducted in the rural areas of Senegal to assess the immunogenic effect of 2 doses of hepatitis B vaccine with a 6-month interval followed by a booster dose after another month and to compare them with those obtained using 2 doses of a vaccine with a 2-month interval or 3 doses at 1-month intervals. The study population of infants received 3 injections of hepatitis B vaccine at 6-month intervals (T0, T6, and T12, respectively), with the 3rd dose as a booster. Other vaccines also were administered to subsets of children: BCG and diphtheria/tetanus/pertussis-polio (DTP-polio) at T0 and DTP-polio at T6 and T12. 664 infants received the 1st dose of hepatitis B vaccine, 409 the 2nd dose, and 177 the 3rd dose. Blood samples were taken at the time of each injection and in the case of 89 infants also 2 months after the last (booster) dose. Only 26.7% of the infants completed the entire series of injections. Only results from infants who were seronegative at T0 are presented, i.e., 281 infants at T6, 116 at T12, and 65 at T14. At T0 the mean age of the seronegative infants was 10.2 months and that of the seropositive infants with anti-HB antibodies was 7.4 months. The mean age of infants who were only anti-HBc-positive was 4.8 months and that of infants who were already HBsAg-positive at T0 was 14.3 months. The results were compared with those reported for 2 other groups of Senegalese infants: 72 seronegative infants who were immunized using a protocol of 2 doses of hepatitis B vaccine with a 2-month interval; and 111 seronegative infants immunized using 3 doses at 1-month intervals. Both groups also received a booster 12 months after the 1st dose. The anti-HBs response was determined 6 months after the T0 dose of hepatitis B vaccine for the 281 infants who were seronegative. 185 of these children (65.8%) exhibited anti-HB antibodies, but the geometric mean titre (GMT) was only 6.1 mlU/ml. The anti-HBs response of the 116 infants who received the 2nd dose of vaccine was determined when the 3rd (booster) injection was given (T12): 104 were positive for anti-HBs (89.7%), and the anti-HBs GMT was 83.7 mlU/ml. Assay of blood samples from 65 infants 2 months after the booster dose indicated that 62 (95.4%) had anti-HBs antibodies, the anti-HBs GMT reaching 348 mlU/ml. The study results establish that infants administered two 5-mcg doses of hepatitis B vaccine with a 6-month interval exhibit a seroconversion rate and antibody levels comparable to those produced using a protocol comprising 2 doses with a 2-month interval or 3 doses at 1-month intervals.
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PMID:Clinical trial of hepatitis B vaccine in a simplified immunization programme. 295 Oct 32

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

Focusing on the worldwide state of immunization, attention is directed to the progress being made in control of the 6 diseases -- measles, pertussis, diphtheria, tetanus, poliomyelitis, and tuberculosis -- using the vaccines and equipment now available. Major problems in world-wide vaccine coverage to be resolved are: management to ensure that adequate amounts of potent vaccine are delivered on time to susceptible infants; and funds to pay for this system of delivery over the next few decades. In 1974, at the time Expanded Program on Immunization (EPI) was conceived, 5% of infants in the developing world received a 3rd dose of DPT or polio vaccine. At this time, more than 1/3 of infants in the developing countries receive a 3rd dose of DPT or polio vaccine, although only about 20% receive measles vaccine. Progress has been made, but it is not sufficient if the global target is to be realized. Except for measles, the target diseases have been brought under control in most of the European region, and eradication targets have been set for the end of the century. Additionally, there is wide use of vaccines against other diseases of importance to public health including rubella, mumps, hepatitis B, influenza, pneumonococcal and meningococcal infections. Africa has the highest mortality and morbidity rates for the target diseases, yet there has been some progress in EPI. In 1983, 19 countries achieved fully immunized rates of 45-87% of their target population. A priority for the African region is the upgrading of the management skills of the health workers involved in EPI. A major constraint in the region is the need for a good 'cold chain" to ensure that vaccines are stored and transported within the safe temperature range. 26 countries in the American region are considered to have achieved control of paralytic poliomyelitis. Innovative ideas have been used in this region, including the use of national immunization days and revolving funds for bulk purchase of vaccines. In the Southeast Asia region there has been a slow but steady increase in coverage for all antigens except BCG and measles. The major constraints in the Western Pacific region as the other regions are lack of management skills and financial resources. Some progress has been made in the Eastern Mediterranean region despite great variation in socioeconomic status between countries. Alternative strategies for the acceleration of EPI activities are outlined.
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PMID:A global view of immunisation. 382 Jan 51


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