Advantage of a two-dose versus one-dose varicella vaccine in healthy non-immune teenagers and young adults.

This study was undertaken to compare the immunogenicity and reactogenicity of two vaccines based on the attenuated Oka-strain of Varicella zoster virus (VZV), in adolescents and young adults. One hundred and eighty-six subjects, aged 13 to 29 years, were randomized to one of two groups to receive a one- or a two-dose VZV vaccine. Pre- and post-vaccination blood samples were assayed for VZV-specific IgG. Solicited local and general symptoms, as well as unsolicited symptoms, were recorded post-vaccination. Seroconversion rates were 94.9% in the one-dose, and 100% in the two-dose, regimen. The two-dose vaccine elicited significantly higher geometric mean antibody titer, 392.5 vs 86.8 pfu. Transient local injection site pain was the most frequently-reported symptom per dose in both groups (one dose: 48.9%; two-dose: 32.8%). The two-dose vaccine regimen afforded the advantage of higher antibody titers and potential increased protection from disease, without significantly increased reactogenicity.

Comparison of the reactogenicity and immunogenicity of two different dose levels of hepatitis A vaccine in healthy children and adolescents.

An open study was performed to compare the reactogenicity and immunogenicity of an inactivated hepatitis A vaccine administered in two different doses and schedules to 460 healthy volunteers aged 3-18 years. Participants were randomized to two groups to receive either two doses of 720 ELISA Units (EL.U) inactivated hepatitis A per 0.5 ml dose according to a 0, 6-month schedule, or three doses of 360 EL.U according to a 0, 1, 6-month schedule. Transient local injection soreness was the most commonly reported symptom in almost half of both groups with no serious adverse events. One month after the primary course (one dose of 720 EL.U and two doses of 360 EL.U), 99% of 720 EL.U vaccinees had seroconverted, compared with 100% seroconversion in the 360 EL.U group. All vaccinees were seropositive after the booster dose of both vaccines with geometric mean anti-HAV titers of 2,359 and 2,967 mIU/ml in the 720 EL.U and 360 EL.U groups, respectively. The vaccine containing 720 EL.U of antigen per dose offers the advantage of convenience and acceptance of immunization afforded by a two-dose course of vaccination accompanied by a comparable antibody response with that achieved after three doses of vaccine containing 360 EL.U of antigen per dose.

Risk factors for neonatal Klebsiella septicemia in Srinagarind Hospital.

Three years' data were analysed to assess the risk factors for neonatal Klebsiella septicemia in Srinagarind Hospital. The incidence of Klebsiella septicemia was 4.1 per 1,000 livebirths or 5.2 per 100 discharged infants. Eighty-two per cent of infected cases were low birth weight infants and 67.7% were born prematurely. From multivariate analysis, the risk factors were endotracheal intubation (OR 31.57, 95% CI 289-343.82) and central venous catheterization (OR 16.99, 95% CI1.15-250.37). The overall mortality rate was 67.7%. Periodic review and continuous reinforcement of infection control policies in the neonatal unit are of paramount importance to decrease the incidence of nosocomial infection and successful control of outbreaks as well.