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Addressing the emergence of pediatric vaccination concerns: recommendations from a Canadian policy analysis.

https://arctichealth.org/en/permalink/ahliterature169730
Source
Can J Public Health. 2006 Mar-Apr;97(2):139-41
Publication Type
Article
Author
Kumanan Wilson
Meredith Barakat
Edward Mills
Paul Ritvo
Heather Boon
Sunita Vohra
Alejandro R Jadad
Allison McGeer
Author Affiliation
Department of Medicine, University of Toronto, Toronto, ON. Kumanan.Wilson@uhn.on.ca
Source
Can J Public Health. 2006 Mar-Apr;97(2):139-41
Language
English
Publication Type
Article
Keywords
Adverse Drug Reaction Reporting Systems
Attitude to Health
Canada
Child
Compensation and Redress
Health Policy
Humans
Immunization Programs
Liability, Legal - economics
Organizational Objectives
Pediatrics
Public Health Administration
Risk assessment
Trust
Vaccines - administration & dosage - adverse effects
Abstract
Ever since the advent of pediatric vaccination, individuals have expressed concerns about both its risks and benefits. These concerns have once again resurfaced among some segments of the population and could potentially undermine national vaccination programs. The views of the public, however, must be considered and respected in the formulation of vaccination policy. We have conducted an analysis of the pediatric vaccination "debate" in the Canadian context. We believe that there is common ground between those who support pediatric vaccination and those who are concerned about these programs. Based on our findings, we believe that the goal of public health authorities should be to maintain trust in vaccines by continuing to meet certain reciprocal responsibilities. To do so, we recommend the following: 1) increased investment in adverse event reporting systems; 2) request for proposals for consideration of a no-fault compensation program; 3) developing pre-emptive strategies to deal with potential vaccine risks; 4) further examination of mechanisms to improve communication between physicians and parents concerned about vaccination. All of these approaches would require additional investment in pediatric vaccination. However, such an investment is easy to justify given the benefits offered by pediatric vaccination and the ramifications of failing to maintain confidence in vaccination programs or missing a vaccine-related adverse event.
Notes
Comment In: Can J Public Health. 2006 Mar-Apr;97(2):86-916619991
PubMed ID
16620003 View in PubMed
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Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

https://arctichealth.org/en/permalink/ahliterature105745
Source
PLoS One. 2013;8(12):e81070
Publication Type
Article
Date
2013
Author
Steven Hawken
Jeffrey C Kwong
Shelley L Deeks
Natasha S Crowcroft
Robin Ducharme
Douglas G Manuel
Kumanan Wilson
Author Affiliation
ICES uOttawa, Ottawa, Ontario, Canada ; Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada ; Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Source
PLoS One. 2013;8(12):e81070
Date
2013
Language
English
Publication Type
Article
Keywords
Birth Order
Child
Child, Preschool
Diphtheria-Tetanus-Pertussis Vaccine - adverse effects
Emergency Service, Hospital - statistics & numerical data
Female
Haemophilus Vaccines - adverse effects
Hospitalization - statistics & numerical data
Humans
Incidence
Infant
Male
Ontario - epidemiology
Poliovirus Vaccine, Inactivated - adverse effects
Vaccination
Vaccines, Conjugate - adverse effects
Abstract
We investigated the association between a child's birth order and emergency room (ER) visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations.
We included all children born in Ontario between April 1(st), 2006 and March 31(st), 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI) of events among 1(st)-born and later-born children using relative incidence ratios (RIR).
For the 2-month vaccination, the RIR for 1(st)-borns versus later-born children was 1.37 (95% CI: 1.19-1.57), which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st)-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99), representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st) vs. later-borns was 1.27 (95% CI: 1.09-1.48), or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21), or 249 excess events/100,000 vaccinated.
Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st)-born children had significantly higher relative incidence of events compared to later-born children.
Notes
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Cites: Pediatrics. 2000 Nov;106(5):E6211061799
Cites: Am J Epidemiol. 2001 Nov 15;154(10):909-1511700245
Cites: Am J Epidemiol. 2002 Nov 1;156(9):882; author reply 883-412397008
PubMed ID
24324662 View in PubMed
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Association between socioeconomic status and adverse events following immunization at 2, 4, 6 and 12 months.

https://arctichealth.org/en/permalink/ahliterature117174
Source
Hum Vaccin Immunother. 2013 May;9(5):1153-7
Publication Type
Article
Date
May-2013
Author
Kumanan Wilson
Robin Ducharme
Steven Hawken
Author Affiliation
Department of Medicine; Ottawa Hospital Research Institute; University of Ottawa; Ottawa, ON Canada; ICES@Uottawa; Ottawa Hospital Research Institute; University of Ottawa; Ottawa, ON Canada.
Source
Hum Vaccin Immunother. 2013 May;9(5):1153-7
Date
May-2013
Language
English
Publication Type
Article
Keywords
Drug-Related Side Effects and Adverse Reactions - epidemiology
Emergency Medical Services - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Humans
Incidence
Infant
Male
Ontario - epidemiology
Social Class
Vaccination - adverse effects - methods
Vaccines - administration & dosage - adverse effects
Abstract
Using a population-based self-controlled case series design, we examined data on children born between the years 2002 and 2009 in the province of Ontario, Canada. We specifically examined how socioeconomic status (SES) influences rates of adverse events following immunization (AEFI), defined as emergency room visits and / or hospital admissions. For vaccination at 2, 4 and 6 mo combined, the relative incidence of AEFI (95% CI) in the first 72 h after vaccination was 0.69 (0.67 to 0.71). For all three vaccinations combined, we observed no relationship between the relative incidence of an event and quintile of socioeconomic status (p = 0.1433). For the 12-mo vaccination alone, the relative incidence of events (95% CI) on days 4 to 12 following immunization was 1.35 (1.31 to 1.38). We observed a significant relationship between socioeconomic status and vaccination at 12 mo, with lower SES being associated with a higher relative incidence of events (p = 0.0075). When the lowest 2 quintiles of income combined were compared with the highest 3 quintiles, the relative incidence ratio (95% CI) was 0.94 (0.89 to 0.99, p = 0.02). These results translate to 150 additional adverse events in the lower SES quintiles as compared with the higher SES quintiles for every 100,000 children vaccinated, or 1 additional event for every 666 individuals vaccinated. Future studies should explore potential explanations for this observation.
Notes
Cites: Stat Med. 2006 May 30;25(10):1768-9716220518
Cites: CMAJ. 2006 Jan 17;174(2):177-8316415462
Cites: Nat Rev Immunol. 2008 Sep;8(9):737-4418728636
Cites: Ann Fam Med. 2009 Sep-Oct;7(5):396-40519752467
Cites: J Nutr. 2009 Nov;139(11):2154S-218S19793845
Cites: Vaccine. 2011 May 12;29(21):3746-5221443964
Cites: Vaccine. 2011 Oct 26;29(46):8267-7421907256
Cites: PLoS One. 2011;6(12):e2789722174753
Cites: Hum Vaccin Immunother. 2012 May;8(5):592-522634444
Cites: Vaccine. 2012 Sep 21;30(43):6115-2022709951
Cites: Am J Epidemiol. 2012 Dec 1;176(11):1035-4223118103
Cites: Pediatrics. 2000 Nov;106(5):E6211061799
Cites: Br Med J. 1975 Aug 30;3(5982):5221080682
Cites: Br Med J (Clin Res Ed). 1987 Jan 31;294(6567):294-63101849
Cites: Am J Public Health. 1992 Jun;82(6):816-201585961
Cites: Wkly Epidemiol Rec. 1992 Nov 27;67(48):357-611449986
Cites: Am J Epidemiol. 1993 Nov 1;138(9):746-558237989
Cites: Lancet. 1995 Mar 4;345(8949):567-97619183
Cites: J Nutr. 1999 Aug;129(8):1569-7310419992
Cites: Ann Emerg Med. 1999 Aug;34(2):155-910424915
Cites: Epidemiology. 2005 Jul;16(4):526-3115951671
Cites: J Comp Pathol. 2007 Jul;137 Suppl 1:S46-5017559869
PubMed ID
23328278 View in PubMed
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Attitudes towards vaccination among chiropractic and naturopathic students.

https://arctichealth.org/en/permalink/ahliterature155876
Source
Vaccine. 2008 Nov 18;26(49):6237-43
Publication Type
Article
Date
Nov-18-2008
Author
Jason W Busse
Kumanan Wilson
James B Campbell
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada L8N 3Z5.
Source
Vaccine. 2008 Nov 18;26(49):6237-43
Date
Nov-18-2008
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Chiropractic - education - history - statistics & numerical data
Complementary Therapies - education
Cross-Sectional Studies
Curriculum
Data Collection
Focus Groups
History, 19th Century
History, 20th Century
Humans
Naturopathy - statistics & numerical data
Students, Health Occupations
Vaccination - psychology
Abstract
We have investigated the attitudes towards vaccination of undergraduate chiropractic and naturopathic students in the two major complementary and alternative medicine colleges in Canada. While the majority of the students were not averse to vaccination, we found in both colleges that anti-vaccination attitudes were more prevalent in the later years of the programs. Reasons for this are discussed, and we provide suggestions for strategies to address the situation.
PubMed ID
18674581 View in PubMed
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A Canadian Agency for Public Health: could it work?

https://arctichealth.org/en/permalink/ahliterature181913
Source
CMAJ. 2004 Jan 20;170(2):222-3
Publication Type
Article
Date
Jan-20-2004
Author
Kumanan Wilson
Author Affiliation
Department of Medicine, University of Toronto, Toronto, Ont. kumanan.wilson@uhn.on.ca
Source
CMAJ. 2004 Jan 20;170(2):222-3
Date
Jan-20-2004
Language
English
Publication Type
Article
Keywords
Canada
Communicable Disease Control - organization & administration
Government Agencies - organization & administration
Humans
Program Development
Public Health Administration
Risk assessment
Severe Acute Respiratory Syndrome - prevention & control
Notes
Cites: CMAJ. 2003 May 27;168(11):1381, 138312771050
Cites: CMAJ. 2000 Apr 18;162(8):1171-410789636
PubMed ID
14734436 View in PubMed
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A Canadian framework for applying the precautionary principle to public health issues.

https://arctichealth.org/en/permalink/ahliterature138061
Source
Can J Public Health. 2010 Sep-Oct;101(5):396-8
Publication Type
Article
Author
Erica Weir
Richard Schabas
Kumanan Wilson
Chris Mackie
Author Affiliation
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON. Erica.weir@york.ca
Source
Can J Public Health. 2010 Sep-Oct;101(5):396-8
Language
English
Publication Type
Article
Keywords
Canada
Environmental Policy
Health Policy
Humans
Policy Making
Public Health
Risk Management
Abstract
The precautionary principle has influenced environmental and public health policy. It essentially states that complete evidence of a potential risk is not required before action is taken to mitigate the effects of the potential risk. The application of precaution to public health issues is not straightforward and could paradoxically cause harm to the public's health when applied inappropriately. To avoid this, we propose a framework for applying the precautionary principle to potential public health risks. The framework consists of ten guiding questions to help establish whether a proposed application of the precautionary principle on a public health matter is based on adequacy of the evidence of causation, severity of harm and acceptability of the precautionary measures.
PubMed ID
21214055 View in PubMed
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Canadian national surveys on pandemic influenza preparations: pre-pandemic and peri-pandemic findings.

https://arctichealth.org/en/permalink/ahliterature115214
Source
BMC Public Health. 2013;13:271
Publication Type
Article
Date
2013
Author
Paul Ritvo
Daniel F Perez
Kumanan Wilson
Jennifer L Gibson
Crissa L Guglietti
C Shawn Tracy
Cecile M Bensimon
Ross E G Upshur
Author Affiliation
School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto M3J 1P3, Canada. pritvo@yorku.ca
Source
BMC Public Health. 2013;13:271
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Canada - epidemiology
Female
Health Planning - ethics
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human - epidemiology - prevention & control
Male
Middle Aged
Pandemics - prevention & control
Public Opinion
Qualitative Research
Time Factors
Young Adult
Abstract
Prior to the 2009 H1N1 Influenza pandemic, public health authorities in Canada and elsewhere prepared for the future outbreak, partly guided by an ethical framework developed within the Canadian Program of Research on Ethics in a Pandemic (CanPREP). We developed a telephone-based survey based on that framework, which was delivered across Canada in late 2008. In June, 2009, the WHO declared pandemic Phase 6 status and from the subsequent October (2009) until May 2010, the CanPREP team fielded a second (revised) survey, collecting another 1,000 opinions from Canadians during a period of pre-pandemic anticipation and peri-pandemic experience.
Surveys were administered by telephone with random sampling achieved via random digit dialing. Eligible participants were adults, 18 years or older, with per province stratification approximating provincial percentages of national population. Descriptive results were tabulated and logistic regression analyses used to assess whether demographic factors were significantly associated with outcomes, and to identify divergences (between the pre-pandemic and intra-pandemic surveys).
N = 1,029 interviews were completed from 1,986 households, yielding a gross response rate of 52% (AAPOR Standard Definition 3). Over 90% of subjects indicated the most important goal of pandemic influenza preparations was saving lives, with 41% indicating that saving lives solely in Canada was the highest priority and 50% indicating saving lives globally was the highest priority. About 90% of respondents supported the obligation of health care workers to report to work and face influenza pandemic risks excepting those with serious health conditions which that increased risks. Strong majorities favoured stocking adequate protective antiviral dosages for all Canadians (92%) and, if effective, influenza vaccinations (95%). Over 70% agreed Canada should provide international assistance to poorer countries for pandemic preparation, even if resources for Canadians were reduced.
Results suggest Canadians trust public health officials to make difficult decisions, providing emphasis is maintained on reciprocity and respect for individual rights. Canadians also support international obligations to help poorer countries and associated efforts to save lives outside the country, even if intra-national efforts are reduced.
Notes
Cites: N Engl J Med. 2009 Jun 18;360(25):2605-1519423869
Cites: J Clin Virol. 2009 Jul;45(3):169-7319540800
Cites: PLoS One. 2009;4(12):e803219997505
Cites: Risk Anal. 2011 Apr;31(4):645-5621077927
Cites: BMC Public Health. 2010;10:12520219140
Cites: BMC Public Health. 2011;11:221199571
Cites: Arch Med Res. 2009 Nov;40(8):669-7220304254
PubMed ID
23530550 View in PubMed
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Canadian survey on pandemic flu preparations.

https://arctichealth.org/en/permalink/ahliterature144953
Source
BMC Public Health. 2010;10:125
Publication Type
Article
Date
2010
Author
Paul Ritvo
Kumanan Wilson
J L Gibson
C. Guglietti
C S Tracy
J X Nie
A R Jadad
R E G Upshur
Author Affiliation
School of Kinesiology and Health Science, York University, Toronto, Canada. pritvo@yorku.ca
Source
BMC Public Health. 2010;10:125
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Female
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Influenza, Human - epidemiology - prevention & control
Male
Middle Aged
Pandemics - prevention & control
Patient Acceptance of Health Care - psychology
Preventive Health Services - standards
Quarantine
Questionnaires
Resource Allocation
Abstract
The management of pandemic influenza creates public health challenges.An ethical framework, 'Stand on Guard for Thee: ethical considerations in pandemic influenza preparedness' that served as a template for the World Health Organization's global consultation on pandemic planning, was transformed into a survey administered to a random sample of 500 Canadians to obtain opinions on key ethical issues in pandemic preparedness planning.
All framework authors and additional investigators created items that were pilot-tested with volunteers of both sexes and all socioeconomic strata. Surveys were telephone administered with random sampling achieved via random digit dialing (RDD). Eligible participants were adults, 18 years or older, with per province stratification equaling provincial percent of national population. Descriptive results were tabulated and logistic regression analyses were used to assess whether demographic factors were significantly associated with outcomes.
5464 calls identified 559 eligible participants of whom 88.5% completed surveys. Over 90% of subjects agreed the most important goal of pandemic influenza preparations was saving lives, with 41% endorsing saving lives solely in Canada and 50% endorsing saving lives globally as the highest priority. Older age (OR = 8.51, p
Notes
Cites: Bioethics. 2005 Aug;19(4):348-6116222844
Cites: BMC Med Ethics. 2006;7:E516626488
Cites: Soc Sci Med. 2007 Dec;65(12):2566-7517765374
Cites: Lancet. 2009 Jan 31;373(9661):423-3119186274
Cites: Am J Bioeth. 2008 Aug;8(8):31-318802857
Cites: Nurs Inq. 2008 Dec;15(4):261-219076701
Cites: Am J Bioeth. 2008 Aug;8(8):4-1918802849
PubMed ID
20219140 View in PubMed
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The case for a vaccine injury compensation program for Canada.

https://arctichealth.org/en/permalink/ahliterature124972
Source
Can J Public Health. 2012 Mar-Apr;103(2):122-4
Publication Type
Article
Author
Kumanan Wilson
Jennifer Keelan
Author Affiliation
Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON. kwilson@ohri.ca
Source
Can J Public Health. 2012 Mar-Apr;103(2):122-4
Language
English
Publication Type
Article
Keywords
Canada
Compensation and Redress - legislation & jurisprudence
Costs and Cost Analysis
Health Policy - legislation & jurisprudence
Humans
Liability, Legal
National Health Programs - legislation & jurisprudence
Vaccination - adverse effects - economics
Vaccines - adverse effects - economics
Abstract
Despite its being deliberated since at least the 1980s, a national vaccine injury compensation program still does not exist in Canada. The omission of such a program stands as a gap in Canadian immunization policy in comparison to many other equivalently developed countries. This article outlines the arguments for a compensation program and the design elements that would be best suited to a program in the Canadian context.
PubMed ID
22530534 View in PubMed
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Characteristics of pediatric and adolescent patients attending a naturopathic college clinic in Canada.

https://arctichealth.org/en/permalink/ahliterature175966
Source
Pediatrics. 2005 Mar;115(3):e338-43
Publication Type
Article
Date
Mar-2005
Author
Kumanan Wilson
Jason W Busse
Amy Gilchrist
Sunita Vohra
Heather Boon
Edward Mills
Author Affiliation
Department of Medicine, University of Toronto, Toronto, Ontario, Canada. kumanan.wilson@uhn.on.ca
Source
Pediatrics. 2005 Mar;115(3):e338-43
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Abdominal Pain - therapy
Adolescent
Attention Deficit Disorder with Hyperactivity - therapy
Canada
Child
Child, Preschool
Complementary Therapies - utilization
Exanthema - therapy
Female
Humans
Infant
Infant, Newborn
Male
Naturopathy - utilization
Vaccination - utilization
Abstract
The use of complementary and alternative medicine (CAM) has grown substantially in North America and has drawn the attention of conventional-medicine practitioners. Conventional-medicine practitioners have expressed concern about the potential for unregulated CAM therapies to cause harm, the sometimes-uncertain cost-benefit ratios associated with these therapies, and the possibility that some CAM providers might advise against established conventional therapies, such as vaccination. These concerns are heightened with respect to the pediatric use of CAM products. To address this issue, we conducted a systematic audit of pediatric and adolescent case files at a large, college-based, Canadian naturopathic teaching clinic. We specifically sought to describe the demographic characteristics, reasons for presentation, use of CAM products, and vaccinations status of children presenting for naturopathic assessment. We also determined factors associated with the use of CAM products and vaccination status.
We identified all charts for children (
PubMed ID
15741360 View in PubMed
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49 records – page 1 of 5.