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ObjectiveTo analyze the occurrence of suspected adverse events following immunization （AEFI） after changing the priority vaccination sites of the adsorbed acellular diphtherior-pertussis-tetanus vaccine （hereinafter referred to as DPT vaccine）， so as to provide scientific basis for mass vaccination. MethodsMonitoring data of AEFI for the DPT vaccine in Wujiang District from September 2020 to August 2022 were collected from China's disease prevention and control information system， and the vaccination information of DPT vaccine in all children's vaccination clinics in Wujiang District during the same period was selected. The incidence of AEFI for the DPT vaccine was analyzed and compared. ResultsThe reported incidence of AEFI was significantly lower in the buttocks than that in other sites （P<0.05）. The reported incidence of AEFI was significantly higher in booster immunization than that in basic immunization （P<0.05）. After inoculation at different sites， the main clinical symptoms of AEFI were local redness and swelling. There were significant differences in the incidence of local redness and swelling， local induration， pruritus and other symptoms （lethargy， abnormal crying， etc.） （P<0.05）. There were significant differences in the severity of local redness and swelling in different sites （P<0.05）. The degree of redness and swelling in the anterolateral thigh was lower than that in other sites （P<0.05）. The local strong reaction of swelling （>5.0 cm） in the deltoid muscle of the upper arm was significantly higher than that in the buttocks （P<0.05）. ConclusionThe DPT vaccine is safe in different parts of the body and is worth popularizing.
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Se relata el nacimiento, auge y decadencia, de la producción de vacunas en el antiguo Instituto Bacteriológico de Chile, desde su fundación en 1929 hasta su fin en 1980, por boca de quien fuera por diecisiete años primero encargado de la fabricación de vacunas bacterianas y luego director de la institución. Las vicisitudes de la vacuna BCG, la introducción del toxoide tetánico, el fin de la vacuna antivariólica y el triunfo de vacuna antirrábica de Fuenzalida y Palacios, se narran a menudo con comentarios de quienes participaron en estos hechos.
The birth, rise and decline, of vaccine production at the Bacteriological Institute of Chile is recounted by mouth of who was for seventeen years first in charge of manufacturing and then director of the institution. The vicissitudes of the BCG vaccine, the introduction of tetanus toxoid, the end of smallpox vaccine, and the triumph of the rabies vaccine are often related with comments from those who participated in the events.
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Objective: To delineate the clinical profile, complications, intensive care needs, andpredictors of mortality in children with critical pertussis. Methods: Retrospective analysis ofcase records of children in the pediatric intensive care unit of a tertiary-care hospital, with adiagnosis of critical pertussis over 3 years. Diagnostic criteria included CDC case definitionand confirmation by polymerase chain reaction (PCR), when available. Survivors and non-survivors were compared to identify predictors of mortality. Results: 36 records wereanalysed, most cases were infants (31, 86.1%). 10 (27.7%) were (below 6 weeks of age). Inthe rest, 16 (61.5%) were partially immunized or unimmunized against pertussis. Rapidbreathing (88.9%), paroxysmal cough (86.1%) and apnea (41.7%) were common presentingcomplaints. Hypoxemia (97.2%), hyperleukocytosis (61.1%) and encephalopathy (52.8%)were common complications. Intensive care needs were mechanical ventilation in 11(30.6%), vasoactive support in 7 (19.4%) and exchange transfusion in 3 (8.3%). Femalegender, apnea, hyperleukocytosis, encephalopathy, need for vasoactive support, andmechanical ventilation predicted mortality. Conclusion: Pertussis demands attention due toits varied presentation, increased complications and higher mortality.
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Aims: This study was made to evaluate the immune response to pertussis among children under five years old by measuring the level of circulating Immunoglobulin G (IgG) antibodies against pertussis toxin (IgG-PT) after immunization with the primary series of DPT (DPT1-3)and then determining the coverage rates of universal childhood vaccines.Study Design:Cross-sectional laboratory study.Place and Duration of Study:Department of Medical Microbiology and Clinical Immunology, Faculty of Medicine and Health Sciences, Sana’a University, between June and October 2010.Methodology:A total of 345 children were randomly selected and investigated for universal childhood vaccination coverage rates; of these, 273 children who had received 3 full doses of DPT were studied for their pertussis immunological status. Blood samples were collected from the latter group and then tested for levels of IgG-PT by ELISA method. For assessment IgG-PT levels more than 24 units/ml were considered protected against pertussis. Data were analyzed according to Original Research Article gender and age groups. Results:The coverage rate of pertussis vaccine was 79.1%; only 71.4% of vaccinated children responded to the vaccinewith mean level of 33 U/ml. A statistically significant difference was observed with respect to sero-protective IgG-PT between males and females (63.8% and 84.8% respectively, with χ2=15, p=0.0001). Also, a statistically significant difference was observed with respect to sero-protective IgG-PT in different age groups, with older children (>48 months) having a higher rate of antibodies than younger (13-24 months) (90% and 59.1% respectively, with χ2=3.87, p=.04). Conclusion:We conclude that a considerable proportion of vaccinated children with a normal immune status were not serologically immune to pertussis. They remain to be reconsidered for either revaccination or booster doses due to lack of or inadequate response. Also, the rates of vaccine coverage for the main universal childhood vaccines are low.
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Though vaccines have been in use for over seventy years, we have been unable to eradicate or control pertussis. This disease is a worldwide problem, and recently has been occurring in outbreaks even in places with good immunization coverage. The debate about the use of acellular or whole cell vaccine has taken attention away from the other significant issues. The high rate of serious disease and death in young infants, and the repeated outbreaks of pertussis even in highly-vaccinated populations is a matter for grave concern. Finding strategies to protect the most vulnerable is a priority. Newer vaccines are under development, and will be welcome, but may be too expensive for mass use in resource-poor nations. It is important to adopt cost-effective strategies to deal with this disease.
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This paper investigates the factors associated with childhood immunization in Uganda. We used nationallyrepresentative data from Uganda Demographic and Health Survey (UDHS) of 2006. Both bivariate and multivariate approaches were employed in the analysis. The bivariate approach involved generating average percentages of children who were immunized, with analysis of pertinent background characteristics. The multivariate approach involved employing maximum likelihood probit technique and generating marginal effects to ascertain the probability of being immunized, given the same background characteristics. It revealed that slightly over 50% of children in Uganda were fully immunized. Additionally, 89%, 24%, 52%, and 64% received BCG, DPT, polio and measles vaccines respectively. Factors which have a significant association with childhood immunization are: maternal education (especially at post-secondary level), exposure to media, maternal healthcare utilization, maternal age, occupation type, immunization plan, and regional and local peculiarities. Children whose mothers had post-secondary education were twice as likely to be fully immunized compared to their counterparts whose mothers had only primary education (p<0.01). Thus, gender parity in education enhancement efforts is crucial. There is also a need to increase media penetration, maternal healthcare utilization, and to ensure parity across localities and regions.