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Query: UMLS:C0348321 (Haemophilus)
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Potential factors that confer risk or protection for invasive Haemophilus influenzae type b disease were evaluated in Los Angeles County children 18-60 months of age by case-control methods. In this age group, 79 H. influenzae type b cases were identified by overlapping surveillance methods, and 221 random controls were selected by random digit dialing. Cases and controls were similar in sex, prior health, proportion attending day care, parental educational level, history of breast feeding, and proportion vaccinated with measles/mumps/rubella vaccine. The effect of H. influenzae type b vaccination was controlled in all analyses, and results of vaccine efficacy have been reported elsewhere. Cases were more likely to have a significant underlying medical condition, reside in home with more than six residents, have a lower yearly household income, have two or more smokers in the home, and to be black. Using conditional logistic regression models, the following were significant independent risk factors after adjusting for age, month of diagnosis, H. influenzae type b vaccine status, and the other factors: 1) more than two smokers in the house (odds ratio (OR) = 6.00; 95% confidence interval (CI) 1.49-24.06); 2) household size of more than six persons (OR for more than six vs. less than three persons = 3.71; 95% CI 1.10-12.60); and 3) black maternal race (OR for black vs. Hispanic = 3.47; 95% CI 1.41-8.53). We conclude that exposure to smoking in the home, living in households with more than six members, and the black race are each independently associated with an increased risk for H. influenzae type b disease in Los Angeles County children and, when combined, constitute a major reason for H. influenzae type b disease occurrence.
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PMID:Risk factors for invasive Haemophilus influenzae type b in Los Angeles County children 18-60 months of age. 141 44

During the 1970s and the early 1980s, immunization practices in the United States were unchanged. Immunization against pertussis, tetanus, diphtheria, measles, mumps, rubella, and polio were routinely administered to children. Infections with these organisms declined dramatically. Nonetheless, research was vigorous, culminating in the 1980s in new vaccines and changes in immunization strategies and practices. This presentation will focus on these changes: universal hepatitis B immunization; two-dose schedule for the measles, mumps, rubella (MMR) vaccine, Hemophilus influenza type B vaccine for infants, acellular pertussis vaccine as booster immunizations, the inactivated polio vaccine, and the yet-to-be-licensed live varicella vaccine.
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PMID:Immunization update. 149 Jun 20

Family physicians can play a key role in reversing the resurgence of vaccine-preventable illnesses by making sure that patients are fully immunized. Childhood immunization schedules have recently changed. A second dose of measles, mumps and rubella (MMR) vaccine should be given at age four to six years. It has been recommended that hepatitis B vaccine be administered routinely to all infants in the United States. Both hepatitis B vaccine and hepatitis B immunoglobulin should be given to offspring of hepatitis B carriers. Haemophilus b conjugate vaccine (HbCV) should be administered to all infants, beginning at two months of age. Vaccines can be safely administered to patients with mild illnesses, allergic rhinitis, low-grade fever or penicillin allergy, as well as to those taking antibiotics. If indicated, several vaccines, such as diphtheria, tetanus and pertussis, oral poliovirus, HbCV and MMR, can be given simultaneously.
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PMID:Childhood immunizations: a practical approach for clinicians. 155 51

Low immunization rates among US preschool children suggest a need for improved immunization practices. Immunization and encounter records were reviewed to ascertain immunization rates and missed opportunities for vaccine administration among 515 preschool children who were active patients at a hospital-based primary care center serving lower socioeconomic status families in Rochester, NY. The point prevalence at a mean age of 4.4 years for lack of one or more recommended immunizations was 27%; 7% were missing measles-mumps-rubella, 18% were missing Haemophilus influenzae type b, 8% were missing two or more diphtheria-tetanus-pertussis, and 4% were missing two or more oral poliovirus immunizations. A visit was counted as a missed opportunity if an immunization was due but not given. Over the period from birth through age 36 months, 422 (82%) of children missed at least one immunization opportunity. For these 422 children, there was a mean of 7.2 missed opportunities per child. Although 64% of missed opportunities occurred at an acute illness visit, 36% occurred at well-child, administrative, follow-up, or chronic illness visits. Review of 200 medical records randomly selected from all opportunities at acute illness visits found no contraindication in 63% (50% nonfebrile infectious disease, 13% minor noninfectious problems). Findings for random samples of 100 missed diphtheria-tetanus-pertussis opportunities for children aged 2 to 6 months and 100 missed measles-mumps-rubella opportunities for children 15 to 24 months were similar to findings for the sample of all acute illness visits. Emergency department visits, where immunization records were not readily available, accounted for 18% of missed opportunities.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immunization opportunities missed among urban poor children. 812 12

On June 13, 1991, President George Bush announced in a White House ceremony a local planning effort to break down barriers and provide better access to immunization in six representative localities "to solve the problem of late immunization." (children need to be immunized appropriately by their second birthday, not just in time for school.). The community "Immunization Action Plans" (IAP) are one of several Federal, State, and local responses to an outbreak of measles that produced 27,600 cases and 89 deaths in 1990. The community effort and subsequent early childhood immunization plans around the country are also part of a much broader effort initiated by Secretary Sullivan as a Healthy People Year 2000 goal to increase immunization levels to at least 90 percent for the nation's children by their second birthday. These efforts also respond to 13 recommendations for improving immunization availability made by the National Vaccine Advisory Committee in January 1991. The recommendations focused on improvements in the management of immunization delivery and in methods for measuring immunization status, increasing appropriate consumer demand, and other prevention needs. Although measles prompted the action, the immunization initiative is aimed also at eight other communicable childhood diseases--diphtheria, tetanus, pertussis or whooping cough, poliomyelitis, mumps, rubella, and Haemophilus influenza type b that causes bacterial meningitis, and hepatitis B. Details are described of the immunization action plans developed by Dallas, TX; Maricopa County (Phoenix), AZ; South Dakota; Detroit, MI; San Diego, CA; and Philadelphia, PA, to ensure that children are fully immunized not just by the time they enter school but by age 2 years. The six were chosen by the Centers for Disease Control as representative of many without adequate childhood immunization coverage.
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PMID:Six areas lead national early immunization drive. 159 33

New vaccine developments will reflect achievements of the World Health Organization's (WHO) Expanded Programme on Immunization (EPI), as well as resistance from the public toward increasing numbers of vaccines. WHO's EPI program has concentrated on tuberculosis, diphtheria, tetanus, whooping cough, polio, and measles. 35 countries are attempting to control hepatitis B with universal vaccination. Now some countries are also recommending vaccination against Haemophilus influenza, mumps, and rubella. The complexity of multiple injections has prompted new research on acellular vaccines for pertussis, hepatitis A and B, varicella, and malaria. Combined vaccines and new adjuvants are also targets of intense research. Vaccines are a priority, because they are among the most cost-effective of medical interventions.
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PMID:New developments in vaccinology. 163 65

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

Immunization practice in 32 countries in Europe, North America, Japan, and Australia is reviewed. in most countries, immunization practices are set by the federal government which sometimes works with the private sector. Almost all countries routinely immunize against diphtheria, tetanus, whooping cough, polio, and measles. About half try to prevent rubella, several try to prevent mumps, usually in combination with measles and rubella (MMR). More than half use bacillus Calmette-Guerin (BGG) vaccine to prevent tuberculosis, and a few give Hemophilus Influenza type B polysaccharide. Poliomyelitis vaccine comes in 2 forms: 1) oral live attenuated (OPV) or injectable inactivated (IPV). OPV is more used, but there is a new "enhanced potency IPV." All countries except Japan give DPT in 3 doses during the 1st year of life. OPV is usually given at the same time that DPT is. Measles vaccine or MMR is usually given between 12 and 18 months of age. Primary vaccine failure occurs in 2-5% of people who get measles vaccine, but this may be enough to "sustain transmission." In most countries, the government provides for immunizing children. An exception in the US. In the UK, low coverage has taken place because of concern for adverse reactions (whooping cough) or lack of appreciation of the disease's impact (measles). Coverage against both measles and pertussis has improved in the UK lately. In each developed country, vaccines have had "spectacular" effects. However, there are too many contraindications and there is "undue fear of adverse events." Also, there are surveillance deficiencies, a lack of coordination, and countries vary in their commitment to "reduction/elimination targets." Varicella vaccine, respiratory syncytial virus vaccine, and rotavirus vaccine are being considered for universal use. Attempts are being made to improve the safety of some vaccine.
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PMID:Immunisation practice in developed countries. 196 69

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

Vaccines have given health care providers control over a substantial portion of the morbidity and mortality in the developing world. Global efforts have immunized two-thirds of the world's children with DTP and polio vaccines; 72% have received BCG and 59% measles vaccine; but only 29% of pregnant women have received two doses of tetanus toxoid. In addition, vaccines against yellow fever, Japanese encephalitis, hepatitis B, rubella, and mumps and meningococcal polysaccharide vaccine are being used in specific regions of the world. New vaccine candidates will enhance the vaccine armamentarium over the next decade to include the causes of pneumonia, diarrhea, and meningitis: Haemophilus influenzae type b, pneumococcal and meningococcal protein conjugate vaccines, typhoid and rotavirus vaccine. Genetically engineered vaccine vehicles, genetic reassortants, and genetic deletions are being investigated as new vaccine candidates.
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PMID:Vaccine-preventable disease and immunization in the developing world. 219 Jan 45


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