Mumps is a highly contagious viral infection prevented by immunization with live attenuated vaccines. Mumps vaccines have proven to be safe and effective; however, rare cases of aseptic meningitis (AM) can occur after vaccination. The range of meningitis occurrence varies by different factors (strain, vaccine producer, and so on). Monovaccines or divaccines (mumps-measles vaccine), prepared from the strain Leningrad-3 (L-3), are used in Russia. Meningitis occurrence after vaccination has been established previously as very low. Nevertheless, with the number of children being vaccinated every year, vaccine-associated AM cases still occur. There is no official statistics on AM incidence after mumps vaccines, and information on AM features as an adverse event of mumps vaccination is limited and mostly devoted to vaccines, prepared from strains other than L-3.
The study included patients with AM who were vaccinated against mumps in the previous 30 days before the present disease onset during 2009-2019.
Patients admitted to Infectious Clinical Hospital No. 1, Moscow, Russia, with AM were observed by a pediatrician and were screened for etiological agents of meningitis.
Seven patients were enrolled, and clinical features and the course of infection are presented.
Detection of only 7 cases of AM associated with mumps vaccination during the 10-year period supports very low occurrence of this adverse event after immunization with the L-3 strain-based mumps vaccines. Nevertheless, the annual number of AM cases that occur after mumps vaccination remains unknown and poorly diagnosed in practice because of the low awareness of physicians of this adverse reaction. Detection and objective coverage of such cases can lead to a weakening of 'antivaccination' moods in a society and to restoration of confidence in the healthcare system.
Our objective was to determine the effectiveness of an intervention, the Immunization Reminders Project, in terms of a) improving vaccination coverage rates for measles, mumps and rubella (MMR) among 2-year-olds and b) ameliorating geographical disparities in early childhood immunization coverage.
All 14-month-old and 20-month-old children in Saskatoon Health Region who were overdue for their immunizations.
Saskatoon Health Region (SHR).
The intervention involved calling the parents/caregivers of the children in the target population with a reminder about immunizations. After five telephone calls and if the parent/caregiver could not be reached, a letter was mailed to the last known address. If there was no response to the letter, a reminder home visit was attempted for families residing in the low-income neighbourhoods in Saskatoon. Since January 2009, all reminders for families not residing in the low-income neighbourhoods in Saskatoon are made through mailed letters.
After the introduction of the Immunization Reminders Project, coverage rates among 2-year-olds for MMR increased significantly overall and in most geographical areas examined. Disparities between geographical subgroups appeared to be declining, but not significantly.
A universal approach to early childhood immunization can likely contribute to increases in coverage rates, but there is still room for improvement in SHR. These findings have prompted additional practice and policy changes.
The Danish childhood vaccination programme offers protection against measles, mumps, and rubella (MMR). Nevertheless, many children appear to be unvaccinated according to the national registers. The aim of this study was to estimate the MMR1 vaccination coverage based on a medical record review of children whose vaccination status is negative according to the register-based data.
We conducted a cross-sectional study of 19 randomly selected general practices in the Central Denmark Region including 1,712 children aged 18-42 months. The practices received a registration form listing children with a negative MMR1 vaccination status in the register-based data. The general practices then validated the children's vaccination status by medical record review.
In total, 94% of the children had been vaccinated according to the medical records in general practice compared with 86% according to the register-based data. Of the 246 children who were unvaccinated according to the register-based data, 135 (55%) had been vaccinated according to the medical records. This discrepancy was due mainly to administrative reimbursement errors.
The MMR1 vaccination coverage in Denmark seems to be considerably higher than reflected in national registers. Using medical record review to re-assess the vaccination status revealed that most of the supposedly unvaccinated children had, in fact, been vaccinated.
The Danish Research Foundation for General Practice and the General Practitioners' Foundation for Education and Development.
97 general practices, representing 171 practitioners, were asked about attitudes and certain procedures in relation to vaccination against measles, mumps, and rubella (MMR). Answers were correlated with their actual vaccination rate, calculated from the National Health Service Computer System. All practices expressed a positive attitude towards the usefulness of MMR vaccination, but only 56% of the respondents expressed a whole-hearted positive attitude. The average vaccination rate in practices with unreservedly positive attitudes was 85%, compared with 69% in practices with more guarded attitudes. All practices offered MMR-vaccination with the routine health examinations at the age of 15 months, and all except three practices recommended vaccination. The vaccination was usually done by a doctor. Differences in vaccination rates were not associated with the way of presentation of MMR, the profession of the person who carried out the vaccinations, or the average number of years of postgraduate experience of the doctors in a practice. Unreservedly positive attitudes among general practitioners are necessary, if sufficient vaccine coverage is to be achieved.
Scientific evidence documenting the effectiveness of immunization delivery methods was summarized using the generic approach developed by the Community Health Practice Guidelines Working Group. The delivery methods examined were those for the adult and childhood vaccines of influenza, pneumococcal infection, hepatitis B, measles-mumps-rubella and diphtheria-pertussis-tetanus-polio. Based on a critical appraisal of 54 eligible comparative studies, the effects of different interventions were obtained and pooled effects were calculated for delivery methods oriented to the client, the provider and the system. The results indicate those interventions found to be most effective for each vaccine. This review of the scientific evidence of the effectiveness of immunization delivery methods provides a base for policy development and assists in the planning of resource allocation.
Immunization has unequivocally contributed to large-scale reductions in mortality and morbidity due to infectious diseases. In general, consensus on the scheduling of immunizations has been achieved at the national or international level by immunization advisory committees. However, immunization delivery methods are varied and numerous. Although specific methods have been proposed, compared and evaluated, the available evidence has not been comprehensively summarized for informed public health action. This paper integrates evidence based on scientific documentation, a Canada-wide practice survey and expert opinion to formulate practice recommendations for immunization delivery methods and to identify areas for further research.