In low-income countries, infectious diseases still account for a large proportion of deaths, highlighting health inequities largely caused by economic differences. Vaccination can cut health-care costs and reduce these inequities. Disease control, elimination or eradication can save billions of US dollars for communities and countries. Vaccines have lowered the incidence of hepatocellular carcinoma and will control cervical cancer. Travellers can be protected against "exotic" diseases by appropriate vaccination. Vaccines are considered indispensable against bioterrorism. They can combat resistance to antibiotics in some pathogens. Noncommunicable diseases, such as ischaemic heart disease, could also be reduced by influenza vaccination. Immunization programmes have improved the primary care infrastructure in developing countries, lowered mortality in childhood and empowered women to better plan their families, with consequent health, social and economic benefits. Vaccination helps economic growth everywhere, because of lower morbidity and mortality. The annual return on investment in vaccination has been calculated to be between 12% and 18%. Vaccination leads to increased life expectancy. Long healthy lives are now recognized as a prerequisite for wealth, and wealth promotes health. Vaccines are thus efficient tools to reduce disparities in wealth and inequities in health.
Mixing DTaP and Hib vaccines for primary immunization caused a decrease in anti-Hib antibody response, although after primary immunization as after booster doses, all subjects showed antibody concentrations considered to be protective for invasive Hib disease. Mixing of the vaccines did not result in increased reactogenicity.
and H2) were recognized from MV cases during 1992-2007. Viruses of genotype H1 and D3 are implicated as indigenous strains in Taiwan. In Taiwan, one-dose measles immunization program began in 1978, and two-dose policy started in 1984. Two catch-up campaigns were implemented in 1992-1994 and 2002-2004 separately. The vaccine coverage rate with 1st dose MV (for 12-15 months) and 2nd dose MMR (for 6 years old) was over 90% and 95% since 1996. The multiple genotypes and sporadic cases discovered after 2003 (except 2 cases in 2005) were all imported. The measles mass vaccination program has successfully interrupted the transmission of indigenous MV in Taiwan.
Background
Immunogenicity and safety of varicella vaccine (Varilrix™ [Oka‐RIT]; GlaxoSmithKline Vaccines) in adults who had undergone autologous hematopoietic stem cell transplantation (HSCT) were assessed (September 2003 to September 2007; NCT00792623).
Methods
Two Oka‐RIT doses were given at 4.5 and 6.5 months post transplantation. Humoral immune responses were assessed using an immunofluorescence assay (anti‐varicella zoster virus [VZV] antibody; cutoff 1:4) after each vaccine dose. Solicited local (8 day) and general (43 day), unsolicited (until day 43) adverse events (AEs) after each vaccine dose and serious adverse events (SAEs) (until 17.5 months post dose 2) were recorded.
Results
Of 45 patients, 19 were included in the according to protocol cohort for immunogenicity; 15 patients had pre‐ and post‐vaccination serum samples positive for anti‐VZV antibodies. Vaccine responses (anti‐VZV antibody titer ≥1:4 in seronegative patients, and ≥4‐fold increase in anti‐VZV antibody titer in seropositive patients) were elicited by only 2 patients 2 months post dose 1, and by a single patient 1.5 months post dose 2. Although no major safety signals were detected, any and Grade 3 solicited AEs that were causally related to vaccination were reported by 44.8% and 10.3% patients, respectively. During the 43‐day follow‐up period, 3 patients developed varicella‐like rash (1 vaccine‐type VZV). Beyond 43 days, herpes zoster was reported in 2 patients and wild‐type varicella infection in 2 patients (1 was breakthrough infection). Four non‐fatal SAEs were reported by patients and considered causally unrelated to vaccination.
Conclusion
Oka‐RIT was poorly immunogenic but safe when given to adults up to 6 months post autologous HSCT, and alternative strategies are required to prevent VZV‐associated complications in these populations.
Untuk menilai reaktogenitas dan imunogenitas vaksin varisela hidup yang dilemahkan (galur-Oka) pada anak sehat. Studi deskriptif dilakukan pada 300 anak yang berumur 1-12 tahun dan dibagi menjadi 3 subgrup menurut umur (1 -<3 tahun, 3 -<7 tahun, 7-12 tahun). Sebelum penelitian anak-anak tersebut dimintakan kesediaan dari orang tuanya secara tertulis, dilakukan anamnesis mengenai riwayat varisela sebelumnya, dan pemeriksaan titer anti-varisela. Dalam kurun waktu waktu 2 minggu apabila hasil negatif, maka diberikan suntikan vaksin varisela (Varilrix) 0,5 ml pada lengan deltoid kiri, setelah dilakukan pemeriksan fisis sebelumnya. Sesuai penyuntikan pada orangtua pasien diberikan kartu harian untuk mencatat suhu tubuh, gejala lokal atau umum yang terjadi setelah penyuntikan. Bila dianggap perlu, orang tua dapat membawa anak untuk diperiksa. Pada hari ke-42 dilakukan pemeriksaan fisis pada setiap anak dilanjutkan dengan pengambilan darah pasca vaksinasi. Kartu harian dikumpulkan kembali untuk dianalisis. Penelitian dilakukan di Bagian Ilmu Kesehatan Anak FKUI-RSCM Jakarta, dari tanggal 3 Mei 1998 sampai dengan 22 Oktober 1998. Seluruh sediaan arah pravaksinasi diperiksa di Laboratorium Bioanalytical Research Corporation (Barc) Jakarta dengan metode ELISA. Separuh diantara spesimen disimpan menunggu separuh spesimen darah pravaksinasi yang akan dikirim ke Rixenstat, Belgia untuk diperiksa ulang titer pra vaksinasi sekaligus memeriksa titer pasca vaksinasi, dengan metode Indirek Immunoflouresent test (IIF). Dari 300 anak yang masuk dalam penelitian ada 5 anak yang tidak menyelesaikan penelitian. Reaksi umum (9,80%) lebih banyak dijumpai daripada reaksi lokal (1%). Demam tinggi didapatkan pada 3 anak (1,7%), tiga diantaranya disangka (probable/suspected) ada hubungannya dengan tindakan vaksinasi. Subyek yang memperlihatkan gejala ruam tidak menunjukan gejala demam tinggi. Semua gejala tadi menghilang tidak lebih dari 5 hari. Enam minggu setelah penyuntikan hanya satu subyek yang tidak menunjukkan adanya serokonversi (0,7%). Golongan umur muda menunjukkan nilai gmt yang lebih tinggi. Vaksin varisela hidup yang dilemahkan (galur Oka) pada penelitian ini aman, ditoleransi dengan baik dan mempunyai tingkat perlindungan yang tinggi pada anak 1 -12 tahun Kata kunci: reaktogenitas, imonugenitas, vaksin varisela. Sari Pediatri, Vol. 3, No. 4, Maret 2002: 202 -205 aksin varisela hidup yang dilemahkan (strain = galur) Oka/SB Bio (Varilrix) pertama kali diperkenalkan penggunaannya untuk kelompok risiko tinggi. Sejak komersial di Eropa, sedangkan di Amerika Serikat mendapat lisensi untuk pertama kali pada tahun 1995. Rekomendasi penggunaan
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