Browsing by Subject "immunization"

Now showing 1 - 8 of 8
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    Achieving an Optimal Childhood Vaccine Policy
    (American Medical Association, 2017-09-01) Opel, Douglas J.; Schwartz, Jason L.; Omer, Saad B.; Silverman, Ross D.; Duchin, Jeff; Kodish, Eric; Diekema, Douglas S.; Marcuse, Edgar K.; Orenstein, Walt; Health Policy and Management, School of Public Health
    Policies to remove parents' ability to opt-out from school immunization requirements on the basis of religious or personal beliefs (ie, nonmedical exemptions) may be a useful strategy to increase immunization rates and prevent outbreaks of vaccine-preventable disease. However, there is uncertainty about the effectiveness of this strategy and the range of possible outcomes. We advocate for a more deliberative process through which a broad range of outcomes is scrutinized and the balance of values underlying the policy decision to eliminate nonmedical exemptions is clearly articulated. We identify 3 outcomes that require particular consideration before policies to eliminate nonmedical exemptions are implemented widely and outline a process for making the values underlying such policies more explicit.
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    Adolescent Consent for HPV Vaccine: Ethical, Legal, and Practical Considerations
    (Elsevier, 2021) Zimet, Gregory D.; Silverman, Ross D.; Bednarczyk, Robert A.; English, Abigail; Pediatrics, School of Medicine
    Healthy People 2020 set a goal of 80% series completion for HPV vaccine. 1 The 2019 National Immunization Survey-Teen shows that 54.2% of adolescents aged 13-17 years were up-to-date with the vaccine series. 2 Although this coverage level represents an incremental increase over 2018, it remains well-below the Healthy People goal. Furthermore, HPV vaccine ordering and administration have dropped dramatically during the COVID-19 pandemic.
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    Coronavirus Disease 2019 and Vaccination of Children and Adolescents: Prospects and Challenges
    (Elsevier, 2021-04) Zimet, Gregory D.; Silverman, Ross D.; Fortenberry, J. Dennis; Pediatrics, School of Medicine
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    Human Papillomavirus Vaccine Initiation among 9-13-Year-Olds in the United States
    (Elsevier, 2015) Donahue, Kelly L.; Hendrix, Kristin S.; Sturm, Lynne A.; Zimet, Gregory D.; Department of Pediatrics, IU School of Medicine
    OBJECTIVE: The quadrivalent and 9-valent human papillomavirus (HPV) vaccines are licensed for administration among 9-26-year-old males and females, with routine vaccination recommended for 11-12-year-olds. Despite the availability of the vaccine at younger ages, few studies have explored vaccine uptake prior to age 13, and national HPV vaccination surveillance data is limited to 13-17-year-olds. Our objective was to examine rates and predictors of HPV vaccine initiation among 9-13-year-olds in the United States. METHODS: A national sample of mothers of 9-13-year-olds in the United States (N=2,446) completed a 2014 Web-based survey assessing socio-demographic characteristics, child's HPV vaccination history, provider communication regarding the vaccine, and other attitudes and behaviors pertaining to vaccination and healthcare utilization. The main outcome measure was child's initiation of the HPV vaccine (i.e., receipt of one or more doses). RESULTS: Approximately 35% of the full sample and 27.5% of the 9-10-year-olds had initiated HPV vaccination. Females were more likely than males to have initiated HPV vaccination by the age of 13 but not by younger ages. Strength of health provider recommendation regarding HPV vaccination was a particularly salient predictor of vaccine initiation. CONCLUSIONS: Approximately a third of children may be initiating the HPV vaccine series before or during the targeted age range for routine administration of the vaccine. Because coverage remains below national targets, further research aimed at increasing vaccination during early adolescence is needed. Improving providers' communication with parents about the HPV vaccine may be one potential mechanism for increasing vaccine coverage.
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    Level and Duration of IgG and Neutralizing Antibodies to SARS-CoV-2 in Children with Symptomatic or Asymptomatic SARS-CoV-2 Infection
    (AAI, 2022-06-01) Khaitan, Alka; Datta, Dibyadyuti; Bond, Caitlin; Goings, Michael; Co, Katrina; Odhiambo, Eliud O.; Miller, Lucy; Zhang, Lin; Beasley, Stephanie; Poorbaugh, Josh; John, Chandy C.; Pediatrics, School of Medicine
    There are conflicting data about level and duration of Abs to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children after symptomatic or asymptomatic infection. In this human population, we enrolled adults and children in a prospective 6-mo study in the following categories: 1) symptomatic, SARS-CoV-2 PCR+ (SP+; children, n = 8; adults, n = 16), 2) symptomatic, PCR−, or untested (children, n = 27), 3) asymptomatic exposed (children, n = 13), and 4) asymptomatic, no known exposure (children, n = 19). Neutralizing Abs (nAbs) and IgG Abs to SARS-CoV-2 Ags and spike protein variants were measured by multiplex serological assay. All SP+ children developed nAb, whereas 81% of SP+ adults developed nAb. Decline in the presence of nAb over 6 mo was not significant in symptomatic children (100 to 87.5%; p = 0.32) in contrast to adults (81.3 to 50.0%; p = 0.03). Among children with nAb (n = 22), nAb titers and change in titers over 6 mo were similar in symptomatic and asymptomatic children. In children and adults, nAb levels postinfection were 10-fold lower than those reported after SARS-CoV-2 mRNA vaccination. Levels of IgG Abs in children to SARS-CoV-2 Ags and spike protein variants were similar to those in adults. IgG levels to primary Ags decreased over time in children and adults, but levels to three spike variants decreased only in children. Children with asymptomatic or symptomatic SARS-CoV-2 infection develop nAbs that remain present longer than in adults but wane in titer over time and broad IgG Abs that also wane in level over time. However, nAb levels were lower postinfection than those reported after immunization.
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    Provider Communication and Mothers’ Willingness to Vaccinate Against HPV and Influenza: A Randomized Health Messaging Trial
    (Elsevier, 2017) Donahue, Kelly; Hendrix, Kristin; Sturm, Lynne; Zimet, Gregory; Department of Pediatrics, School of Medicine
    Objective Understand the effect of a health messaging intervention focused on provider communication about vaccination on mothers’ willingness to vaccinate children against HPV and seasonal influenza. Methods 2,476 mothers of 9-13-year-olds in the U.S. completed a Web-based survey in August 2014. Mothers were randomized to one of two groups targeting HPV or influenza vaccine. Mothers whose child had not received the target vaccine (i.e., zero doses of HPV vaccine/no prior-year administration of influenza vaccine) were randomized to the intervention. The study used a 3x2 between-subjects design; illustrated vignettes depicted one of three levels of provider recommendation strength (brief mention of vaccination, strong recommendation of vaccination, or personal disclosure of vaccination of own children), and presence or absence of information comparing safety of vaccination to the safety of a common daily activity. Outcome was mothers’ willingness to have their child receive the target vaccine (0-100.) Perceived benefits of vaccination were assessed prior to viewing the intervention and included as a covariate in analyses, along with child gender. Results For HPV vaccine, there was a main effect of safety information, F(1,684)=7.99, p=.005, and perceived benefits of vaccination, F(1,684)=221.64, p<.001) on mothers’ willingness to vaccinate. For influenza, perceived benefits of vaccination significantly related to willingness, F(1,462)=105.78, p<.001). Child gender was not associated with willingness. Conclusions Provider communication about vaccination may need to be tailored to the vaccine in question. A next step to increasing coverage for both HPV and influenza vaccines may be an intervention aimed at increasing mothers’ perceived benefits of vaccination.
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    Understanding vaccines: what they are, how they work
    (2003-07) National Institute of Allergy and Infectious Diseases (U.S.)
    Background information on vaccines and vaccination. Includes an extensive glossary.