A critical component of the 2009 H1N1 vaccination campaign was the collection of immunization data at the point of care. To meet reporting requirements and to ensure timely availability of coverage information, many jurisdictions across Canada employed new or modified approaches to vaccine data collection. The objective of this study was to observe and characterize the range of influenza immunization data collection approaches used across Canada.
As part of a multi-stage observational study, the research team visited immunization clinics at which tasks related to data collection and management were observed. Tasks included registration, medical history collection and review, vaccine record-keeping, proof of vaccination preparation, and data entry. Field notes were analyzed in order to understand the data collection mechanisms that comprised each information system as a whole.
Data collection mechanisms were grouped into two categories: electronic systems (9/38), in which all data were captured on computer; and hybrid systems (29/38), comprised of computerized and paper-based data collection tasks. Observed systems included stand-alone databases, immunization registries, and electronic health records. Organizations incorporated magnetic card reader technology, telephone registration, and pre-populated fields into data collection approaches. Electronic systems captured a greater number of data elements.
Canadian jurisdictions employed a range of data collection approaches during the H1N1 vaccination campaign. System characteristics can have important implications for on-site efficiency and organization as well as program planning and evaluation. The systems observed have been described in detail to allow vaccine providers and planners to learn from what has been done elsewhere.
The aim of our analysis was to investigate the association between acculturation and the vaccination coverage among pre-school children.
We performed a study of vaccination status for measles-mumps-rubella and hepatitis B among pre-school children, during mandatory school entry examinations, in a district of Bavaria, Germany, in 2004 and 2005 (N = 2,043). Prior to the examinations, parents were asked to fill out a self-administered questionnaire assessing socio-demographic information, including variables related to migration background (response rate 73%, N = 1,481). We used Categorical Principal Component Analysis (CATPCA) to create an acculturation index and assessed the association between the acculturation and vaccination status for both vaccines.
We found no difference in vaccination status with the measles-mumps-rubella vaccine in relation to acculturation. The coverage with at least three doses of hepatitis B vaccine was similar among migrants and in the indigenous population, but the risk of incomplete (1 or 2 doses) versus full vaccination was higher (OR = 2.74, 95% CI 1.34-5.61) and the risk of lacking vaccination lower (OR = 0.30, 95% CI 0.12-0.77) among less acculturated migrants compared to the indigenous population.
For multi-dose vaccines lower acculturation was associated with incomplete vaccination, but the partial protection in this group was higher compared to indigenous population.
Determining vaccine dose-level protection is essential to minimize program costs and increase mass vaccination program feasibility. Currently, a 3-dose vaccination schedule is recommended for both the quadrivalent and bivalent human papillomavirus (HPV) vaccines. Although the primary goal of HPV vaccination programs is to prevent cervical cancer, condyloma related to HPV types 6 and 11 is also prevented with the quadrivalent vaccine and represents the earliest measurable preventable disease outcome for the HPV vaccine.
To examine the association between quadrivalent HPV vaccination and first occurrence of condyloma in relation to vaccine dose in a population-based setting.
An open cohort of all females aged 10 to 24 years living in Sweden (n?=?1,045,165) was followed up between 2006 and 2010 for HPV vaccination and first occurrence of condyloma using the Swedish nationwide population-based health data registers.
Incidence rate ratios (IRRs) and incidence rate differences (IRDs) of condyloma were estimated using Poisson regression with vaccine dose as a time-dependent exposure, adjusting for attained age and parental education, and stratified on age at first vaccination. To account for prevalent infections, models included a buffer period of delayed case counting.
A total of 20,383 incident cases of condyloma were identified during follow-up, including 322 cases after receipt of at least 1 dose of the vaccine. For individuals aged 10 to 16 years at first vaccination, receipt of 3 doses was associated with an IRR of 0.18 (95% CI, 0.15-0.22) for condyloma, whereas receipt of 2 doses was associated with an IRR of 0.29 (95% CI, 0.21-0.40). One dose was associated with an IRR of 0.31 (95% CI, 0.20-0.49), which corresponds to an IRD of 384 cases (95% CI, 305-464) per 100,000 person-years, compared with no vaccination. The corresponding IRDs for 2 doses were 400 cases (95% CI, 346-454) and for 3 doses, 459 cases (95% CI, 437-482). The number of prevented cases between 3 and 2 doses was 59 (95% CI, 2-117) per 100,000 person-years.
Although maximum reduction in condyloma risk was seen after receipt of 3 doses of quadrivalent HPV vaccine, receipt of 2 vaccine doses was also associated with a considerable reduction in condyloma risk. The implications of these findings for the relationship between number of vaccine doses and cervical cancer risk require further investigation.
Comment In: JAMA. 2014 Jun 18;311(23):243924938569
Comment In: JAMA. 2014 Jun 18;311(23):2439-4024938570
To describe the association between Bacille Calmette-Gu?rin (BCG) vaccination and IDDM development in two different case-control series (A and B) in Montreal.
Case-control series A comprised 93 IDDM cases and 2,903 control subjects who participated in a community-based tuberculin reactivity survey and who belonged to the same birth cohorts and areas of residence as the IDDM cases, Case-control series B comprised 249 IDDM cases and 431 age- and sex-matched friends and neighborhood control subjects.
In series A, the BCG vaccination prevalence among cases and control subjects was 21.5% (95% CI 13.2-29.8%) and 22.3% (95% CI 20.8-23.8%), respectively. The odds ratio (OR) for IDDM associated with BCG vaccination was 1.09 (95% CI 0.62-1.91), after adjusting for the birth cohorts and areas of residence. The vaccination prevalence in series B was 17.7% (95% CI 13.0-22.4%) among cases and 15.1% (95% CI 11.7-18.5%) among control subjects. The OR for IDDM due to BCG vaccination was 1.26 (95% CI 0.79-2.02), taking into account the matched sets. Only one case (3.3%) from series B who had been vaccinated at birth was diagnosed by age 5, compared with 52 cases (24.5%) who had not been vaccinated (P
Rabies is endemic throughout arctic areas including the region of Nunavik, situated north of the 55th parallel of Québec, Canada, and raises public health concerns. The aim of this paper is to provide a descriptive overview of the temporal and regional distributions of three important components of arctic rabies in Nunavik from 1999 to 2012, following a "One Health" approach: animal rabies tests and confirmed cases, dog vaccination, and human consultations for potential rabies exposures. Forty-four cases of rabies, involving mainly arctic and red foxes, were confirmed in animals during this period. The mean number of dogs vaccinated per 1,000 inhabitants was highly variable and lower in the Hudson region than the Ungava region. 112 consultations for potential rabies exposure were analyzed, of which 24 were exposure to a laboratory confirmed rabid animal. Children less than 10 years of age were the age group most commonly exposed. The median time between potential exposure and administration of the first post-exposure prophylaxis dose was four days. This study confirms that the risk of human exposure to rabid animals in Nunavik is present and underlines the need to follow a "One Health" approach to prevent rabies in humans in similar contexts worldwide.
The association between health status and influenza vaccination was examined among 129,809 Canadians 12 years of age or more in 2003. Of them, 46.7% had influenza vaccination at least once in their life and 27.6% had one in the past 12 months. Seniors and women were more likely to have one. Major chronic disease and self-perceived health were strong predictors. Overall hospitalization was also positively associated with an increased proportion of influenza vaccination. To increase the coverage of influenza vaccination in the general population and in the elderly subpopulation, those who consider themselves to be healthy need more attention.
Information on pneumococcal serotype distribution before vaccination is a prerequisite for evaluation of vaccine effect. The aim was to investigate the prevalence of pneumococcal serotypes isolated from middle ear (ME), lower respiratory tract (LRT) and from invasive disease (IPD) in Iceland prior to implementation of ten-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV-10) into the infant vaccination program (April 2011).
All isolates cultured 2007-2011 from ME, LRT and IPD identified as pneumococci were serotyped and tested for susceptibility at the Clinical Microbiology Department, Landspitali University Hospital that serves approximately 85% of the Icelandic population. Pneumococcal isolates were 1711 and 1616 (94.4%) were available for serotyping and included. Isolates belonging to PHiD-CV10 serotypes (VTs) were 1052 (65.1%). Isolates from ME were 879 (54.4%), with 639 (72.7%) from 0-1 year old patients and 651 of VTs (74%). Isolates from LRT were 564 (34.9%), with 292 (51.8%) from =65 years old patients, and 300 (53.2%) of VTs. IPD isolates were 173 (10.7%), although more evenly distributed according to age than isolates from the other sites most were from adults and the youngest age group,101 (58.4%) isolates were of VTs. The most common serotype was 19F, 583 (36.1%). Its prevalence was highest in ME, 400 (45.5%), 172 (30.5%) in LRT and 11 isolates (6.4%), in IPD. Penicillin non-susceptible isolates were 651 (40.3%), mainly belonging to VTs, 611 (93.9%), including 535 (82.2%) of 19F.
Multiresistant isolates of serotype 19F were highly prevalent, especially from ME of young children but also from LRT of adults. Serotype 14 was the most common serotype in IPD. The rate of VTs was high and almost all PNSP were of VTs. There was great difference in vaccine coverage between sampling sites, also reflecting difference in vaccine coverage by age groups.
Cites: Microb Drug Resist. 2009 Dec;15(4):269-7719857133
Over the last decade, in response to the heightened awareness of HBV and HIV infections, world health authorities have produced specific infection control recommendations for dental practices. Surveys have been done in various countries to investigate the level of compliance to these recommendations. This paper reports on the changes in compliance over a six year period among British Columbia dentists, as indicated from four volunteer surveys conducted between 1987 and 1993. During that period, the percentage of dentists who reported taking a medical history for each new patient increased from 70 per cent to 99 per cent. The routine use of gloves increased from 61 per cent to 95 per cent, and of face masks from 49 per cent to 83 per cent. In 1993, most dentists (91 per cent) used a new pair of gloves with each patient, up from 62 per cent three years earlier. Dentists also reported on their sterilization and hygiene methods. Autoclavable handpieces were used by 66 per cent of respondents in 1990, and by 74 per cent in 1993. High-speed autoclavable handpieces were used by 83 per cent of dentists in 1993, but only 62 per cent sterilized these handpieces. Similarly, 65 per cent reported using low-speed autoclavable handpieces, but only 47 per cent sterilized them. It is apparent that disinfection of handpieces and intraoral instruments is still an important part of regular operatory hygiene. Biologic monitors were used by 61.6 per cent of respondents to test the efficiency of their office sterilizer in 1993.(ABSTRACT TRUNCATED AT 250 WORDS)