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A study was conducted to evaluate the immunization status of migrant farm worker children in South Carolina. Results of this study indicate that the children receive their immunizations at times which are significantly later than the recommended schedule. The first, second, third, and fourth oral poliomyelitis vaccine (OPV) doses are being given approximately 10, 15, 23, and 32 months late, respectively. Diphtheria, pertussis, tetanus vaccine (DPT) is likewise late with the first, second, third, and fourth doses occurring 9, 14, 20, and 26 months late. The fifth booster dose in both series was timed properly. The mumps, measles, rubella vaccine (MMR) is approximately 28 months late, on average. An evaluation of antibody status of 41 migrant farm worker children (5-10 years old) revealed that, even with aberrant patterns of administration, all children had adequate antibody titers. These data indicate that, although adequate levels of protection are reached with the pattern of immunization that migrant farm worker children have, there are large groups of children that are unprotected early in life when they are most susceptible to these diseases.
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PMID:The delayed immunization of children of migrant farm workers in South Carolina. 211 93

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 Central Government of Calcutta, India aimed to immunize 85% (85,262) of the city's 12 month old infants against polio, diphtheria, measles, tuberculosis, pertussis and tetanus. The Universal Immunization Program (UIP) achieved this target 3 months earlier than intended. In fact, at the end of December 1990, it achieved 110.6% for DPT3, 142.16% for OPV3, 151.96% for BCG, and 97% for measles. UIP was able to surpass its targets by emphasizing team work. Government, the private sector, UNICEF, and the voluntary sector made up the Apex Coordination Committee on Immunization headed up by the mayor. The committee drafted an action plan which included routine immunization sessions on a fixed day and intensive immunization drives. Further the involved organizations pooled together cold chain equipment. In addition, the District Family Welfare Bureau was the distribution center for vaccines, syringes, immunization cards, report formats, vaccine carriers, and ice packs. Health workers administered immunizations from about 300 centers generally on Wednesday, National Immunization Day. Intensive immunization drives focused on measles immunizations. UIP leaders encouraged all center to routinely record coverage and submit monthly progress reports to the District Family Welfare Bureau. The Calcutta Municipal Corporation coordinated promotion activities and social mobilization efforts. Promotion included radio and TV announcements, newspaper advertisements, cinema slides, billboards, and posters. The original UIP plan to use professional communicators to mobilize communities was ineffective, so nongovernmental organizations entered the slums to encourage people to encourage their neighbors to immunize their children. Further Islamic, Protestant, and Catholic leaders encouraged the faithful to immunize their children. A UNICEF officer noted that this success must be sustained, however.
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PMID:Universal immunization in urban areas: Calcutta's success story. 213 77

Seroprevalence was used to evaluate the vaccination programme in the Elim health ward of Gazankulu. Antibodies to measles and polio were measured in 1-6-year-old children together with vaccination status. In 224 children studied using a cluster sampling technique, vaccine coverage was found to be 86% for measles and over 90% for polio and diphtheria, pertussis and tetanus. It was difficult to determine vaccine failure rates accurately; 21% of children were seronegative after having received measles vaccine, 32% who had apparently not been vaccinated had antibodies, while a total of 27% had no measles antibodies. Thirty-nine per cent of children failed to demonstrate antibodies to all 3 types of poliovirus after having received 3 doses of oral polio vaccine, 94% had immunity against type 2, and 76% and 74% were immune to types 1 and 3, respectively. Reasons for diminished effectiveness of vaccination programmes are cited; in this study it was probably due to decreased vaccine efficacy related to inadequacies in the cold-chain. Recommendations are that seroprevalence studies are useful, but only after vaccine coverage and the cold-chain have been optimised.
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PMID:Vaccination status and seroprevalence of measles and polio antibodies in 1-6-year-old children in the Elim health ward of Gazankulu. 217 79

An audit of Leeds health professionals' knowledge of valid contraindications to measles/mumps/rubella (MMR) vaccine was undertaken by postal questionnaire, three months after its introduction. The health professional groups were health visitors, clinical medical officers, general practice trainers and general practice vocational trainees. The results indicate that some health professionals would give MMR vaccine to children when it was contraindicated (e.g. to a child receiving chemotherapy or radiotherapy). However, a much greater problem was the number of health professionals stating that they would not vaccinate children with MMR vaccine in clinical situations where there were no valid contraindications to its use. Some health professionals were also applying contraindications to the use of pertussis vaccine to the use of MMR vaccine. The information contained in the Joint Committee on Vaccination and Immunisation handbook Immunisation against infectious disease on contraindications to MMR vaccine use is also reviewed. It is important that false contraindications are not used by health professionals to wrongly deny children the protection provided by MMR vaccine.
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PMID:Measles/mumps/rubella vaccine (MMR): an audit of Leeds health professionals' knowledge of contraindications and intention to vaccinate assessed by postal questionnaire. 222 97

Recent epidemics of poliomyelitis and measles in the Edendale/Vulindlela district of KwaZulu spurred an investigation into the causes of vaccination failure. Vaccination coverage achieved by routine clinic services and by two mass campaigns was assessed. The validity of routine clinic vaccination records was also determined. Using a modified 30 x 7 random cluster sampling technique, 224 children aged 1-5 years were studied. Of these, 62% had a 'Road to Health' card. Best estimates show that 87% had had BCG, 62% three doses of diphtheria, pertussis and tetanus and polio, and 55% measles vaccine. The mass campaigns raised coverage for measles by 26%, and that for polio by 27%. Coverage estimates made from routine clinic data were consistently 13-25% higher than from this survey. This discrepancy is unfortunate, since it could lead to complacency if certain targets are apparently achieved using only clinic records, and points to the need for regular population-based surveys in all but the best organised health services. Inadequate vaccination coverage alone can explain the epidemics of polio and measles. The reasons for this, in the presence of an adequate clinic infrastructure, need to be assessed urgently to prevent further outbreaks.
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PMID:Vaccination--coverage of under-fives, validity of records, and the impact of mass campaigns in the Edendale/Vulindlela district of KwaZulu. 225 30

Twenty five children who had undergone their full course of childhood immunization schedule were compared with 25 children who did not have any vaccinations for a period of five years. Parameters for comparison were measles, pertussis, poliomyelitis, tetanus and tuberculosis. Out of the 25 vaccinated children, only one child had mild measles at 2 1/2 years while 4 had suspected whooping cough at different points of the study period but not clinically diagnosed as pertussis. Among the unvaccinated group, 2 died of measles before the age of 3 years while 11 others went down with measles during an outbreak in 1986. An unvaccinated child also died of tetanus within the study period. In this paper we advocate the total integration of every community in the ongoing Expanded Programme for Immunization in Nigeria.
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PMID:Vaccinated versus unvaccinated children: how they fare in first five years of life. 226 Feb 20

In a clinical trial of stabilized yellow fever vaccine from Institute Pasteur in 77 children aged seven to eight months, fever was the most significant immediate and delayed side effect. Fever occurred in 12 (15.6%) children with in 48 hours of vaccination while it occurred in 10 (12.9%) children within ten days of vaccination. Other recorded side effects were pain at innoculation site in four (5.2%) children and vomiting in one (1.3%) child. Temperature recorded in 20 of the 22 febrile episodes ranged from 37.8 degrees C to 38.6 degrees C. One of the two patients who had temperatures of 39 degrees C and above had malaria parasites in her blood film. All episodes of fever except one responded to antipyretic. There was no episode of febrile convulsion and no feature suggestive of encephalitis. Of the 20 children who had neutralization test carried out against yellow fever virus six weeks after vaccination, the test was positive in post vaccination sera of 12 (60%) children whose pre-vaccination sera were negative. Two others showed evidence of partial protection. Although the seroconversion rate of 60% is less than reported in adults and older children, the result of this study shows that yellow fever vaccine is safe and fairly effective in infants. It is our suggestion that if a larger trial confirms our findings, the vaccine may be incorporated into the expanded programme on immunization (EPI) to be given at the age of seven months after completion of diptheria, tetanus, pertussis and poliomyelitis vaccinations and before measles vaccination is due.
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PMID:Safety and efficacy of yellow fever vaccine in children less thanone-year-old. 227 33

A retrospective study was carried out to determine the effect of common childhood infectious diseases on the hemoglobin level of a cohort of Alaskan Eskimo children born between 1960 and 1962. Hemoglobin and health records were available on 308 children between 6-11 and 12-17 months of age. Additional records were available on 187 of these children at 18-23 months of age. Episodes of chickenpox, measles, pertussis, and lower respiratory infections were reviewed. Between 38 and 50% of infants between 6 and 23 months of age had hemoglobin levels below 11.0 g/dl. The mean hemoglobin level of infants 6-11 and 12-17 months of age decreased with increasing number of total infectious episodes occurring within the 3 months before hemoglobin measurement. This trend was not apparent for infants in the 18-23 months age interval nor were low hemoglobins predictive of illness during the 3 months after the hemoglobin determination. At the 6-11 and 12-17 month age interval the number of lower respiratory infectious were most significantly associated with a decreased hemoglobin value. These observations are consistent with more recent reports that document iron deficiency anemia among children with antecedent infections and again emphasize the role of infection in the development and maintenance of anemia in children about 1 year of age.
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PMID:Associations of early childhood infections and reduced hemoglobin levels in a historic cohort of Alaska Native infants. 227 96

The coverage rates of six vaccines (BCG, polio, DPT, measles, mumps and varicella) and the prevalence of these diseases in Japan were investigated. It was found that 82.2% of children had been inoculated with BCG before their first birthday, and 85.4% were given two doses of polio vaccine before their second birthday. The high acceptance rates of these vaccines seem to be attributable to mass inoculations at health centers. On the other hand, the median age when the first dose of DPT vaccine was given was as late as 22 months. Mass administration of this vaccine during infancy should be performed since about one-quarter of the patients with diphtheria, pertussis or tetanus were less than one year old. The cumulative percentage for measles inoculation failed to reach 60% by the second birthday. Considering that the incidence of measles has not yet been satisfactory lowered and that infants under 23 months of age account for about one-half of this incidence, more children less than 18 months old should be immunized. The ineffective rate of varicella vaccine was found to be 18.2%, although reestimation of its effectiveness may be necessary.
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PMID:Vaccination of children in Japan. 227 61


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