Browsing by Subject "Immunization"

Now showing 1 - 10 of 13
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    Cartoon advertisement of airplane bombing a vehicle emphasizing the importance of diptheria immunization.
    (Indiana State Board of Health, 1934-01)
    [Text within image] Toxin Antitoxin prevents Dip
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    Cartoon of "Uncle Doc" looking at pigs behind a fence.
    (Indiana State Board of Health, 1934-01)
    [Text within image] Lem Sikes has had his hogs immunized against cholera. His children are still un-protected against diphtheria and smallpox, but of course his pigs are thorobreds."
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    Determinants of Long Immunization Clinic Wait Times in a Sub-Saharan African Country
    (Sage, 2021-06-29) Ekhaguere, Osayame Austine; Oluwafemi, Rosena Olubanke; Oyo-Ita, Angela; Mamlin, Burke; Bondich, Paul; Mendonca, Eneida A.; Rollins, Angela L.; Pediatrics, School of Medicine
    The wait time clients spend during immunization clinic visits in low- and middle-income countries is a not well-understood reported barrier to vaccine completion. We used a prospective, observational design to document the total time from client arrival-to-discharge and all sequential provider-client activities in 1 urban, semi-urban, and rural immunization clinic in Nigeria. We also conducted caregiver and provider focus group discussions to identify perceived determinants of long clinic wait times. Our findings show that the time from arrival-to-discharge varied significantly by the clinic and ranged between 57 and 235 minutes, as did arrival-to-all providers-client activities. Focus group data attributed workflow delays to clinic staff waiting for a critical mass of clients to arrive for their immunization appointment before starting the essential health education talk or opening specific vaccine vials. Additionally, respondents indicated that complex documentation processes caused system delays. Research on clinic workflow transformation and simplification of immunization documentation is needed.
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    Development of Combination Vaccine Conferring Optimal Protection against Six Pore-Forming Toxins of Staphylococcus aureus
    (American Society for Microbiology, 2021) Zhang, QingFeng; Jiang, TingTing; Mao, Xinrui; Kim, Jae Deog; Ahn, Dong Ho; Jung, Yunjin; Bae, Taeok; Lee, Bok Luel; Microbiology and Immunology, School of Medicine
    In the Gram-positive pathogen Staphylococcus aureus, pore-forming toxins (PFTs), such as leukocidins and hemolysins, play prominent roles in staphylococcal pathogenesis by killing host immune cells and red blood cells (RBCs). However, it remains unknown which combination of toxin antigens would induce the broadest protective immune response against those toxins. In this study, by targeting six major staphylococcal PFTs (i.e., gamma-hemolysin AB [HlgAB], gamma-hemolysin CB [HlgCB], leukocidin AB [LukAB], leukocidin ED [LukED], Panton-Valentine leukocidin [LukSF-PV], and alpha-hemolysin [Hla]), we generated 10 recombinant toxins or toxin subunits, 3 toxoids, and their rabbit antibodies. Using the cytolytic assay for RBCs and polymorphonuclear cells (PMNs), we determined the best combination of toxin antibodies conferring the broadest protection against those staphylococcal PFTs. Although anti-HlgA IgG (HlgA-IgG) showed low cross-reactivity to other toxin components, it was essential to protect rabbit and human RBCs and human PMNs. For the protection of rabbit RBCs, HlaH35L toxoid-IgG was also required, whereas for human PMNs, LukS-IgG and LukAE323AB-IgG were essential too. When the toxin/toxoid antigens HlgA, LukS-PV, HlaH35L, and LukAE323AB were used to immunize rabbits, they increased rabbit survival; however, they did not block staphylococcal abscess formation in kidneys. Based on these results, we proposed that the combination of HlgA, LukS, HlaH35L, and LukAE323AB is the optimal vaccine component to protect human RBCs and PMNs from staphylococcal PFTs. We also concluded that a successful S. aureus vaccine requires not only those toxin antigens but also other antigens that can induce immune responses blocking staphylococcal colonization.
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    Effect of Haemophilus influenzae Type b and 13-Valent Pneumococcal Conjugate Vaccines on Childhood Pneumonia Hospitalizations and Deaths in Botswana
    (Oxford University Press, 2021-07-15) Congdon, Morgan; Hong, Hwanhee; Young, Rebecca R.; Cunningham, Coleen K.; Enane, Leslie A.; Arscott-Mills, Tonya; Banda, Francis M.; Chise, Mamiki; Motlhatlhedi, Keneilwe; Feemster, Kristen; Patel, Sweta M.; Boiditswe, Sefelani; Leburu, Tiroyaone; Shah, Samir S.; Steenhoff, Andrew P.; Kelly, Matthew S.; Pediatrics, School of Medicine
    Background: Globally, pneumonia is the leading cause of death among children. Few data exist regarding the effect of Haemophilus influenzae type b (Hib) vaccine and 13-valent pneumococcal conjugate vaccine (PCV-13) on the burden of childhood pneumonia in African settings. Methods: We collected data on children aged 1 to 59 months at 3 hospitals in Botswana. Hib vaccine and PCV-13 were introduced in Botswana in November 2010 and July 2012, respectively. We compared pneumonia hospitalizations and deaths prevaccine (January 2009 to October 2010) with postvaccine (January 2013 to December 2017) using seasonally adjusted, interrupted time-series analyses. Results: We identified 6943 pneumonia hospitalizations and 201 pneumonia deaths. In the prevaccine period, pneumonia hospitalizations and deaths increased by 24% (rate, 1.24; 95% CI, .94-1.64) and 59% (rate, 1.59; 95% CI, .87-2.90) per year, respectively. Vaccine introduction was associated with a 48% (95% CI, 29-62%) decrease in the number of pneumonia hospitalizations and a 50% (95% CI, 1-75%) decrease in the number of pneumonia deaths between the end of the prevaccine period (October 2010) and the beginning of the postvaccine period (January 2013). During the postvaccine period, pneumonia hospitalizations and deaths declined by 6% (rate, .94; 95% CI, .89-.99) and 22% (rate, .78; 95% CI, .67-.92) per year, respectively. Conclusions: Pneumonia hospitalizations and deaths among children declined sharply following introduction of Hib vaccine and PCV-13 in Botswana. This effect was sustained for more than 5 years after vaccine introduction, supporting the long-term effectiveness of these vaccines in preventing childhood pneumonia in Botswana.
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    Ensuring Uptake of Vaccines against SARS-CoV-2
    (Massachusetts Medical Society, 2020-06-26) Mello, Michelle M.; Silverman, Ross D.; Omer, Saad B.; Health Policy and Management, School of Public Health
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    Health care providers’ perceptions of use and influence of clinical decision support reminders: qualitative study following a randomized trial to improve HPV vaccination rates
    (BMC, 2017-08-10) Dixon, Brian E.; Kasting, Monica L.; Wilson, Shannon; Kulkarni, Amit; Zimet, Gregory D.; Downs, Stephen M.; Epidemiology, School of Public Health
    Background Human Papillomavirus (HPV) leads to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. Furthermore, providers recommend the HPV vaccine less than half the time for eligible patients. Prior informatics research has demonstrated the effectiveness of computer-based clinical decision support (CDS) in changing provider behavior, especially in the area of preventative services. Methods Following a randomized clinical trial to test the effect of a CDS intervention on HPV vaccination rates, we conducted semi-structured interviews with health care providers to understand whether they noticed the CDS reminders and why providers did or did not respond to the prompts. Eighteen providers, a mix of medical doctors and nurse practitioners, were interviewed from five publicly-funded, urban health clinics. Interview data were qualitatively analyzed by two independent researchers using inductive content analysis. Results While most providers recalled seeing the CDS reminders, few of them perceived the intervention as effective in changing their behavior. Providers stated many reasons for why they did not perceive a change in their behavior, yet the results of the trial showed HPV vaccination rates increased as a result of the intervention. Conclusions CDS reminders may be effective at changing provider behavior even if providers perceive them to be of little use. Trial registration ClinicalTrials.gov Identifier: NCT02551887 , Registered on September 15, 2015 Electronic supplementary material The online version of this article (doi:10.1186/s12911-017-0521-6) contains supplementary material, which is available to authorized users.
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    How Can Public Health Leaders Improve School Compliance with the Indiana Department of Health Mandatory Vaccine Requirements for School-Aged Populations?
    (2023) Carlson, Megan Marie; Stone, Cynthia; Silverman, Ross; McCormick, David
    Primary and Secondary Schools in the United States have consistently served as a safety net to prevent outbreaks of vaccine-preventable diseases, with state policy enactment requiring vaccines for school entry. While states have long implemented vaccination mandates for schools as a public health measure, the enforcement of those mandates by states and schools has been inconsistent. Over the past few years, there has been a significant decline in the vaccination rates among Indiana children, which was recently accelerated by the COVID-19 pandemic. Public health officials and legislatures continue to adopt policies and laws to combat growing vaccine noncompliance and non-medical exemption requests. However, an essential component of this process is being overlooked, the implications for schools, particularly for schools without a medical professional on staff. The purpose of this study is to gather qualitative insights from school personnel regarding perceptions, challenges, and barriers impacting the enforcement of state-mandated school entry vaccines. The overall aim of this study is to draw on the experiences of these key participants and ‘experts’ to inform public health interventions or policy changes that will support improved vaccination reporting and compliance among school systems. The Consolidated Framework for Implementation Research (CFIR) framework was used to examine the implementation of the school vaccine mandate by school personnel who played a role in the vaccine requirement process. Semi-structured interviews were conducted with a range of personnel (n=25) supporting medical, non-medical, and administrative roles within a public or charter school or district. Interview Guides for the semi-structured interviews were developed focusing on known current processes of school vaccine mandates applied to constructs within the Inner Setting domain. Responses were categorized into themes based on eleven constructs from the CFIR Inner Setting domain. Findings show school personnel experience a variety of conditions, challenges, and barriers impacting their abilities to comply with state vaccine requirements. Findings also yielded several considerations for facilitators to improve vaccination uptake. A plan for change to improve vaccination rates through a policy analysis and subsequent policy change is presented.
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    Mandatory Vaccinations: Precedent and Current Laws
    (Congressional Research Service, 2011-03-10) Swendiman, Kathleen S
    Historically, the preservation of the public health has been the primary responsibility of state and local governments, and the authority to enact laws relevant to the protection of the public health derives from the state’s general police powers. With regard to communicable disease outbreaks, these powers may include the enactment of mandatory vaccination laws. This report provides an overview of the legal precedent for mandatory vaccination laws, and of state laws that require certain individuals or populations, including school-aged children and health care workers, to be vaccinated against various communicable diseases. Also discussed are state laws providing for mandatory vaccinations during a public health emergency or outbreak of a communicable disease. --- Federal jurisdiction over public health matters derives from the Commerce Clause of the United States Constitution, which states that Congress shall have the power “[t]o regulate Commerce with foreign Nations, and among the several States ... ” Congress has enacted requirements regarding vaccination of immigrants seeking entry into the United States, and military regulations require American troops to be immunized against a number of diseases. The Secretary of Health and Human Services has authority under the Public Health Service Act to issue regulations necessary to prevent the introduction, transmission, or spread of communicable diseases from foreign countries into the states or from state to state. Current federal regulations do not include any mandatory vaccination programs; rather, when compulsory measures are needed, measures such as quarantine and isolation are generally utilized to halt the spread of communicable diseases.