Factors influencing completion of multi-dose vaccine schedules in adolescents: a systematic review.

BACKGROUND: Completion of multiple dose vaccine schedules is crucial to ensure a protective immune response, and maximise vaccine cost-effectiveness. While barriers and facilitators to vaccine uptake have recently been reviewed, there is no comprehensive review of factors influencing subsequent adherence or completion, which is key to achieving vaccine effectiveness. This study identifies and summarises the literature on factors affecting completion of multi-dose vaccine schedules by adolescents. METHODS: Ten online databases and four websites were searched (February 2014). Studies with analysis of factors predicting completion of multi-dose vaccines were included. Study participants within 9-19 years of age were included in the review. The defined outcome was completion of the vaccine series within 1 year among those who received the first dose. RESULTS: Overall, 6159 abstracts were screened, and 502 full texts were reviewed. Sixty one studies were eligible for this review. All except two were set in high-income countries. Included studies evaluated human papillomavirus vaccine, hepatitis A, hepatitis B, and varicella vaccines. Reported vaccine completion rates, among those who initiated vaccination, ranged from 27% to over 90%. Minority racial or ethnic groups and inadequate health insurance coverage were risk factors for low completion, irrespective of initiation rates. Parental healthcare seeking behaviour was positively associated with completion. Vaccine delivery in schools was associated with higher completion than delivery in the community or health facilities. Gender, prior healthcare use and socio-economic status rarely remained significant risks or protective factors in multivariate analysis. CONCLUSIONS: Almost all studies investigating factors affecting completion have been carried out in developed countries and investigate a limited range of variables. Increased understanding of barriers to completion in adolescents will be invaluable to future new vaccine introductions and the further development of an adolescent health platform. PROSPERO reg# CRD42014006765.

Experimental study of new laser-based alignment system at the KEK B-factory injector linear accelerator.

A new laser-based alignment system for the precise alignment of accelerator components along an ideal straight line at the KEK B-factory injector linear accelerator (linac) is under development. This system is strongly required in the next generation of B-factories for the stable acceleration of high-brightness electron and positron beams with high bunch charges and also for maintaining the stability of injection beams with high quality. A new laser optics for the generation of a so-called Airy beam has been developed for the laser-based alignment system. The laser propagation characteristics both in vacuum and at atmospheric pressure have been systematically investigated in an 82-m-long straight section of the injector linac. The laser-based alignment measurements based on the new laser optics have been carried out with a measurement resolution of ±0.1 mm level by using an existing laser detection electronics. The horizontal and vertical displacements from a reference laser line measured using this system are in good agreement with those measured using a standard telescope-based optical alignment technique. In this report, we describe the experimental study in detail along with the basic designs and the recent developments in the new laser-based alignment system.

New beam-charge interlock system for radiation safety at the KEKB injector linac.

A new beam-charge interlock system is under development for radiation safety and machine protection at the KEKB injector linac. A hardware-based interlock system is required instead of the present software-based interlock system in order to boost its reliability. This system restricts the integrated amount of beam charges delivered to four different storage rings. The beam charges are measured using wall-current monitors and detection electronics at six locations along the linac. The detection electronics independently transmits a beam-abort request through a twisted hardwire cable directly to the safety control system of the linac, when the integrated amount of beam charges exceeds a certain threshold level prescribed for each location. We describe the characteristics and performance of the new beam-charge interlock system along with the details of the experimental tests.