Whole-cell pertussis vaccine (DTwP) has no influence on allergic diseases and atopic sensitization in children.

INTRODUCTION: Vaccine opponents indicate that the infant's immune system is inadequately developed to handle multiple vaccines which may overwhelm the immune system, leading to allergic diseases. AIM: To verify the association between the vaccine antigen overload derived from DTwP and the development of atopic sensitization and allergic diseases. MATERIAL AND METHODS: Data from an earlier established birth cohort in Krakow, followed up to the 6th year of life were used. Allergic diseases such as eczema, hay fever and asthma were diagnosed by a physician and reported every half a year from the 1st to 6th year of life by the child's parent. Skin prick tests (SPT) were performed in children at 5 years of age. The data on infants' vaccination were extracted from the physician's records. The status of vaccine antigen exposure was based on different types of vaccines against pertussis (DTwP or DTaP) in a primary course. Results were determined by multiple logistic regression, adjusted to potential confounders. RESULTS: The analyzed population consisted of 234 children: 53.4% - boys and 46.6% - girls. Infants up to the age of 8 months were vaccinated with the primary course against pertussis, with DTwP - 60.7%, DTaP - 32.9% and further 6.4% with a mixed course (DTwP + DTaP). There were no significant relationships between any of vaccination groups and allergic disease and allergen sensitivity in the multiple logistic regression model with adjustment to potential confounders. CONCLUSIONS: The exposure to a large number of vaccine antigens derived from DTwP has no influence on the development of allergic diseases and atopic sensitization in children.

Lung function growth trajectories in non-asthmatic children aged 4-9 in relation to prenatal exposure to airborne particulate matter and polycyclic aromatic hydrocarbons - Krakow birth cohort study.

BACKGROUND: Patterns of lung function development during childhood can be helpful in understanding the pathogenesis of respiratory diseases. A variety of environmental and lifestyle factors, present from the prenatal period to adulthood, may affect or modulate lung function growth. The aim of this study was to investigate, the associations between individual growth trajectories of children's lung function during childhood and prenatal exposure to airborne fine particulate matter (PM2.5) and polycyclic aromatic hydrocarbons (PAH), which were hypothesized to adversely affect spirometry parameters. MATERIAL AND METHODS: The study group comprised 294 non-asthmatic, full term children from the Krakow birth cohort, who underwent annual spirometry testing at the ages of 4-9 years. Individual personal air monitoring of PM2.5 and PAH were performed over 48 h in the second trimester of pregnancy. Possible confounders or modifiers such as child's gender, height, atopic status and exposure to environmental tobacco smoke (ETS) were considered. Polynomial multilevel mixed models were used to assess the growth rates of children's lung functions. RESULTS: Lung function trajectories differed significantly for boys and girls for FVC, FEV1 and FEF25-75. Girls had lower rates of increase than boys: - 20.5 (95%CI: - 32.4; - 8.6) ml/year (FVC); - 19.9 (95%CI: -30.7;-9.0) ml/year (FEV1); and - 32.5 (95%CI: - 56.9; - 8.2) ml/year (FEF25-75). Spirometry functions increased with age; however the growth rate decelerated over time. Significant lung function impairment (lower FVC and FEV1 levels) was observed from 4 to 9 years among subjects prenatally exposed to higher levels of PM2.5 as well as PAH, but not in the case of FEF25-75. No significant differences were observed in the rates of increase over time in relation to prenatal PM2.5 and PAH exposure. CONCLUSION: Our results indicate that in non-asthmatic children high prenatal exposure to airborne PM2.5 and PAH is associated with lower trajectories of FVC and FEV1, but not the rate of increase over time, suggesting that the initial effect is not diminishing in time.

What mother know about vaccine preventable diseases?

INTRODUCTION AND OBJECTIVE: The improving epidemiological situation of the most of communicable diseases causes, that the real and potential risks attributable to them have been forgotten. The aim of study was to determine the mothers knowledge about vaccine preventable diseases MATERIALS AND METHODS: A survey was conducted among 177 randomly selected mothers. The interviews with mothers hospitalized after childbearing in two hospitals in Krakow and Myslenice were conducted at the end of 2014 and in 2015 RESULTS: The assessment of risk to develop an infectious diseases in unvaccinated children significantly varied among mothers. Individual respondents claimed that the risk does not exist regarding each of considered disease. The highest percentage of that kind of answers was related to poliomyelitis ­ 3.9% of mothers assessed that unvaccinated children have no risk to become ill. The similar percentage of respondents assessed a risk as remote probable regarding poliomyelitis, pertussis and hepatitis A - 16.8%, 15.2% and 16.3%, respectively. The highest risk was attributed to varicella ­ 50.6% mothers gave that answers. Mothers could not state a risk of disease developing mostly with regard to poliomyelitis, diphtheria, hepatitis A and pertussis ­ 42.7%, 38.2%, 33.7% and 33.2%, respectively. Relatively high percentage of respondents stated a mild course of that kind of diseases like varicella, mumps, rubella, infectious diarrhea and measles - from 17.4% with respect to measles to 34.3% regarding varicella. To life-threating category mothers primarily included sepsis (74.2%), meningitis and tick-borne encephalitis (each obtained 68.5% answers) CONCLUSIONS: Mothers knowledge about vaccine preventable diseases varied depending on the type of disease. The lack of awareness of the risk related to communicable diseases regarded not only those diseases which have not been occurred in Poland for many years but also those ones that still represent significant epidemiological problem. The society too often has an opinion that some diseases like varicella, mumps or rubella are the mild diseases what can conduce to easy withdrawal from those vaccinations

Opinions about vaccination among mothers who delivered newborns in two hospitals in Krakow and Myslenice

INTRODUCTION AND OBJECTIVE: Campaigns against vaccinations in Poland have been increasingly more frequently observed in recent years, that was the reason of bigger number of parents refusing a consent for their children immunization. The aim of study was to determine the sources of information which significantly influence mothers' opinions about vaccinations. MATERIALS AND METHODS: A survey was conducted among 154 randomly selected mothers hospitalized after childbearing in two hospitals in Krakow and Myslenice at the end of 2014 and in 2015. The research tool was the author's structured questionnaire interview. RESULTS: The majority of mothers regarded vaccinations as an efficient method of children protection against infectious diseases. Nevertheless, a few percent of women admitted that it is not efficient method or had no opinion about it. The mothers' confidence was higher for vaccines known for many years compared to new formulations ­ 23.7% did not trust them and 22.4% had no statement on it. The most of respondents claimed that the safety of polyvalent vaccines is lower than single formulas, and were convinced that children receive too many vaccines. About 54.6% of mothers had no opinion and 13.6% admitted that children with chronic diseases should not be vaccinated. Depending on the question content from 3.2% to 54.6% respondents had no opinion about included vaccination issues. The pediatricians and family doctors were the main and the most reliable source of information about vaccinations. The reliability of doctors was assessed higher by citizens of big city compared to women living in rural area (statistically significant). Above 50% of mothers used mass media as a source of information about vaccination but less than 8% regarded them as reliable. CONCLUSIONS: Despite the wide access to different source of information, the newborns' mothers too often had the knowledge and opinions about vaccination inconsistent with data derived from medical facts. Furthermore, significant group of mothers had no opinions about important issues with respect to vaccinations. At the beginning of infants life when parents decide of their child immunization, the reliable knowledge about that issue should be delivered by GPs because the other sources of information are assessed as much less reliable.

The effectiveness of rotavirus vaccine in preventing acute gastroenteritis during rotavirus seasons among Polish children.

INTRODUCTION: Rotavirus is the main etiological cause of intestinal infections in children. Voluntary rotavirus vaccines were included in the Polish vaccination schedule in 2007. The aim of this study was to assess the effectiveness of a completed rotavirus vaccination course in preventing acute gastroenteritis in Polish infants during their first five years of life. MATERIAL AND METHODS: This was a retrospective cohort study conducted in Lesser Poland (Malopolska Province). The sample population included a group of 303 children who received the completed rotavirus vaccination course and 303 children not vaccinated against rotavirus. The date of the child's acute gastroenteritis diagnosis and his or her vaccination history were extracted from the physicians' records. Each kind of diagnosed acute gastroenteritis during winter-spring rotavirus seasons was treated as the endpoint. The relative risk of having gastrointestinal infection was assessed using the hazard ratio from the Cox proportional hazards regression model. RESULTS: In the examined group, 96 (15.8%) children had winter-spring gastrointestinal infections. In the non-vaccinated children, the cumulative incidence of these infections in the first 5 years of life was 20.8%, whereas in the children vaccinated with Rotarix it was only 10.9%. Those who were vaccinated with Rotarix had a 44% reduction in the risk of a winter-spring acute gastroenteritis infection compared to those not vaccinated with Rotarix (p = 0.005). Birth weight less than 2500 g increased the risk of the infection twofold and also reached statistical significance (p = 0.044). CONCLUSIONS: The results showed that Rotarix is effective in preventing acute gastroenteritis in Polish children during rotavirus seasons.

Depressed height gain of children associated with intrauterine exposure to polycyclic aromatic hydrocarbons (PAH) and heavy metals: the cohort prospective study.

Fetal exposure to environmental toxicants may program the development of children and have long-lasting health impacts. The study tested the hypothesis that depressed height gain in childhood is associated with prenatal exposure to airborne polycyclic aromatic hydrocarbons (PAH) and heavy metals (lead and mercury). The study sample comprised 379 children born to non-smoking mothers among whom a total of 2011 height measurements were carried out over the 9-year follow-up period. Prenatal airborne PAH exposure was assessed by personal air monitoring of the mother in the second trimester of pregnancy and heavy metals were measured in cord blood. At the age of 3 residential air monitoring was done to evaluate the level of airborne PAH, and at the age 5 the levels of heavy metals were measured in capillary blood. The effect estimates of prenatal PAH exposure on height growth over the follow-up were adjusted in the General Estimated Equation (GEE) models for a wide set of relevant covariates. Prenatal exposure to airborne PAH showed a significant negative association with height growth, which was significantly decreased by 1.1cm at PAH level above 34.7 ng/m(3) (coeff.=-1.07, p=0.040). While prenatal lead exposure was not significantly associated with height restriction, the effect of mercury was inversely related to cord blood mercury concentration above 1.2 µg/L (coeff.=-1.21, p=0.020), The observed negative impact of prenatal PAH exposure on height gain in childhood was mainly mediated by shorter birth length related to maternal PAH exposure during pregnancy. The height gain deficit associated with prenatal mercury exposure was not seen at birth, but the height growth was significantly slower at later age.

Early exposure to thimerosal-containing vaccines and children's cognitive development. A 9-year prospective birth cohort study in Poland.

UNLABELLED: The controversial topic of the early exposure to mercury is regarding ethylmercury, which is present in the thimerosal-containing vaccines (TCVs). The objective of this study was to determine the relationship between the early exposure to TCVs and cognitive development in children during the first 9 years of life. The cohort included 318 children vaccinated in an early period (neonatal and up to 6 months) against hepatitis B and diphtheria-tetanus-pertussis (DTP) using formulation with or without thimerosal. The children's development was assessed using the Fagan test (6th month of life), the Bayley Scales of Infant Development (BSID)-II (12th-36th month), the Raven test (5th, 8th year), and the Wechsler Intelligence Scale for Children (WISC-R) (6th, 7th, 9th year). Results were determined by multivariable linear and logistic regression, adjusted to potential confounders. Children exposed and not exposed to TCVs in the neonatal period had similar outcomes of cognitive-developmental tests; only the results of BSID-II at the 36th month and WISC-R at the 9th year were significantly higher for those exposed to TCVs. Developmental test results in children exposed to TCVs up to the 6th month of life also did not depend on thimerosal dose. CONCLUSION: TCV administration in early infancy did not affect children's cognitive development.

Sensitivity of passive diarrhea surveillance in infants up to the second year of life in Malopolskie voivodeship.

INTRODUCTION: In EU countries and also in Poland, the surveillance of infectious acute gastro-enteritis is a mandatory system based on cases notification (suspected and confirm) conducted by physicians in hospitals and ambulatory care. STUDY OBJECTIVE: The assessment of surveillance sensitivity on acute diarrhea in children up to 2nd year of life in Malopolskie voivodeship from 2009 to 2012. MATERIAL AND METHODS: The data about 720 infants surveyed respectively from birth up to 2nd year of life were used in this study. The information on acute diarrhea cases (outpatient and hospitalized) occurred in infants during follow-up was included in analysis. The data derived from medical records. Each case of acute diarrhea in infants detected by medical records was surveyed in local surveillance system on infectious diseases whether it was notified by physician. RESULTS: The surveillance sensitivity on acute diarrhea in infants up to 2nd year of life increased in Malopolskie voivodeship from 14.3% in 2009 to 24.3% in 2012. The sensitivity of surveillance on hospitalized cases was twofold higher compared to all kind of cases assessed inclusively. CONCLUSION: The surveillance sensitivity on acute diarrhea in infants up to 2nd year of life improved significantly in recent years but is still too low, especially with respect to outpatient cases.

Validity and clinical utility of children development assessement using milestones reported by mothers.

INTRODUCTION: The monitoring of infants development during preventive care visits to identify children whose development is concerning for delay is an essential part of pediatric practice. STUDY OBJECTIVE: The aim of the study was to examine the validity and clinical utility of developmental milestones reported by mothers in assessment of children development compared with the outcomes of BSID-II (Bayley Scales of Infant Development--second edition). MATERIAL AND METHODS: The cohort recruited prenatally, included 384 children. The Mental and Motor Scales of BSID-II were administered to each child at the end of the 12th, 24th and 36th month of life. When children were 3 years old, mothers were questioned about their child's age at attainment of 8 significant developmental milestones. RESULTS: Sensitivity for the developmental milestones compared with score on the motor and mental scales of the BSID-II varied from 25.0% to 75.0%, specificity from 54.1% to 80.2%. The all of analysed milestones were characterized by low positive predictive value and rather high the negative one. CONCLUSION: Parent report developmental milestones are a better tool for excluding those children who attain milestones rapidly, as a group with low risk of developmental delays, than in identifying children whose development is suspected of being delayed.

[Ebola virus disease]. / Ebola virus disease.

Ebola is one of the most virulent zoonotic RNA viruses causing in humans haemorrhagic fever with fatality ratio reaching 90%. During the outbreak of 2014 the number of deaths exceeded 8.000. The "imported" cases reported in Western Europe and USA highlighted the extreme risk of Ebola virus spreading outside the African countries. Thus, haemorrhagic fever outbreak is an international epidemiological problem, also due to the lack of approved prevention and therapeutic strategies. The editorial review article briefly summarizes current knowledge on Ebola virus disease epidemiology, etiology, pathogenesis, clinical presentation, diagnosis as well as possible prevention and treatment.

Ebola virus disease control in Poland - are we ready for fight?

Despite very low risk assessment, Polish authorities should be prepared for imported EVD cases and be ready to protect public against the spread of Ebolavirus (EBOV). There is the consistent system of infectious diseases surveillance and control in entire country, regulated by law. In Poland the Public Sanitary Inspection has jurisdiction over infectious diseases surveillance. A reporting system functions at three levels. The entire spectrum of viral hemorrhagic fevers is included in the list of 59th notifiable diseases and causative organisms. EVD is regarded as sever, often fatal communicable disease that should be notify promptly. According to Polish legislation EVD cases would be obligatorily isolated in hospital ward. Each potential contact of EVD case should be individually assessed for risk of exposure and categorized for staying under mandatory quarantine or under active monitoring. The governor of each Polish province has established the Epidemic Active Plan and indicated the place for quarantine if needed. The Ministry of Health established the procedures of management of EVD suspected cases and persons in risk to be infected with EBOV in outpatient care. There are prepared separate procedures for dispatcher of emergency medical service, GP's, hospital emergency departments and airports. There are 10 hospitals with division of infectious diseases, with high level isolation units, ready for EVD patient's admission. There is one reference laboratory in Poland in National Institute of Public Health, which performed tests for EBOV detection. The hospitals and outpatient care services and sanitary inspection were evaluated on possession the appropriate PPE for medical staff, in case of direct contact with EVD patient would be needed. Regardless, very law risk for Poland to be affected by EVD outbreak our country is sufficiently prepared for fighting with EBOV infection.

Is measles elimination possible in WHO European region up to 2015?

STUDY OBJECTIVE: The assessment ofepidemiological situation of measles in WHO European Region during last decade in terms of progress in disease elimination. MATERIAL AND METHODS: [corrected] The surveillance data regarding measles control and vaccination coverage in entire region were compared to the targets that should be achieved at the last stage of measles elimination program. RESULTS: There were not sufficient vaccination coverage to protect population against measles outbreaks in many areas of WHO European Region during last decade. The incidence of measles was significantly higher than is required on that stage of measles elimination i.e. 1/1,000,000 excluding imported cases. Furthermore, there were notified 42 fatal cases related to measles during considered period. CONCLUSIONS: The insufficient vaccination coverage in many countries of the region causes the sustainable virus transmission in population. That situation lies behind the high probability of measles outbreaks in nearly future, that could delay the disease elimination in the set limit of time.

Stability of the mental and motor Bayley Scales of Infant Development (2nd ed.) in infants over first three years of life.

UNLABELLED: Despite the Bayley Scales of Infant Development second edition (BSID-II) are wide used both clinically and in research settings, only a few published studies have been examined their stability over time. AIM OF STUDY: The aim of this study was to examine the stability of mental and motor BSID-II scores over the first three years of life. MATERIAL AND METHODS: All children included in this study were a sample followed up in a study on the susceptibility of the fetus and child to environmental factors. The cohort recruited prenatally in Krakow Poland, included 408 children. The mental and motor scales of BSID-II were administered to infants at the end of 12th, 24th and 36th month of life. Stability of the test scores from first to second and third assessment was evaluated using the Pearson's correlation coefficient calculated for the entire group of infants, and for the each gender separately. RESULTS: The older infants obtained the better outcomes in BSID-II. The correlation between the first and second assessments for the Psychomotor Developmental Index (PDI) was r = 0.30, for the Mental Developmental Index (MDI) was r = 0.33, and between the second and third assessments the correlation for the PDI was r = 0.40, for the MDI was r = 0.59. That results suggest a low or moderate degree of relationship between the tests outcomes. Only 8,8% to 34,8% of variance in the infants later BSID-II scores could be explained by their earlier scores. The correlation between the tests scores was higher between outcomes obtained by girls than boys. CONCLUSION: The BSID-II should not be treated as a useful measure for predictive purposes of infants development.

Usefulness of maternal assessment of children development based on reported age of achieved milestones.

STUDY OBJECTIVE: The aim of the study was to examine the usefulness of maternal recall of selected developmental milestones by testing their correlations with the Bayley Scales of Infant Development (BSID-II). MATERIAL AND METHODS: Prospective cohort study. The cohort recruited prenatally, included 387 children. The BSID-II tests were carried out in each child at the end of the 12th, 24th and 36th month of life. When children were 3 years old, mothers were questioned about their child's age at attainment of 8 significant developmental milestones. RESULTS: The infants who attained developmental milestones earlier in their first years of life were more likely to achieved a better scores on the motor scale of the BSID-II. Correlation coefficients ranged from -0.117 for bladder control to -0.424 for standing without assistance and -0.586 for walking unassisted. Correlation arose when the difference between the time of achieving a particular milestone and time of managing the BSID-II was smaller. CONCLUSION: Our study demonstrated that maternal reports of developmental milestones of children under 3 years old are sufficiently reliable to be used in clinical judgment.

Measles, mumps and rubella (MMR) vaccination has no effect on cognitive development in children - the results of the Polish prospective cohort study.

OBJECTIVES: The aim of the study was to examine the hypothesis that MMR exposure has a negative influence on cognitive development in children. Furthermore, MMR was compared to single measles vaccine to determine the potential difference of these vaccines safety regarding children's cognitive development. METHODS: The prospective birth cohort study with sample consisted of 369 infants born in Krakow. Vaccination history against measles (date and the type of the vaccine) was extracted from physicians' records. Child development was assessed using the Bayley Scales of Infant Development (BSID-II) up to 3rd year of life, Raven test in 5th and 8th year and Wechsler (WISC-R) in 6th and 7th year. Data on possible confounders came from mothers' interview, medical records and analyses of lead and mercury level at birth and at the end of 5th year of life. Linear and logistic regression models adjusted for potential confounders were used to assess the association. RESULTS: No significant differences in cognitive and intelligence tests results were observed between children vaccinated with MMR and those not vaccinated up to the end of the 2nd year of life. Children vaccinated with MMR had significantly higher Mental BSID-II Index (MDI) in the 36th month than those vaccinated with single measles vaccine (103.8±10.3 vs. 97.2±11.2, p=0.004). Neither results of Raven test nor WISC-R were significantly different between groups of children vaccinated with MMR and with single measles vaccine. After standardization to child's gender, maternal education, family economical status, maternal IQ, birth order and passive smoking all developmental tests were statistically insignificant. CONCLUSION: The results suggest that there is no relationship between MMR exposure and children's cognitive development. Furthermore, the safety of triple MMR is the same as the single measles vaccine with respect to cognitive development.

The frequency and risk factors of allergy and asthma in children with autism--case-control study.

INTRODUCTION: The evolution of autistic disorders in children depends on many factors, like concomitance of the other diseases, which can escalate the autistic symptoms. One of those groups are allergic diseases, which have one of the highest prevalence rates in children. OBJECTIVES: The aim of this analysis was to determine the frequency of asthma and allergy in children with autism in comparison to controls and the risk factors of allergic diseases and asthma in both groups. MATERIAL AND METHODS: Study population included 96 cases diagnosed with childhood or atypical autism and 192 controls matched individually by year of birth, gender and physician's practice. The analysis was performed in each group separately giving possibility to compare the results between study groups. RESULTS: The frequency of asthma and allergic diseases in both groups has not revealed any statistically significant differences. Children with autism have been affected by asthma in 5,2% and by allergy in 25,0%, controls in 4,7% and 21,9% respectively. All cases of asthma was diagnosed in boys, commonly allergy was also more frequent in boys than girls in both studied groups. However those differences was statistically insignificant. The father's allergy and asthma was revealed as a risk factor of allergy in children with autism. In controls additionally allergy or asthma diagnosed in mother or grandparent increased risk of allergy in children. CONCLUSIONS: Children with autism were affected by asthma and allergy with similar frequency like children without autistic disorders. Allergy in father was the risk factor of allergic diseases in children with autism.

[The influence of rotavirus vaccinations on the risk of gastrointestinal infections in children. Methods and preliminary results]. / Wplyw szczepien przeciwko rotawirusom na wystepowanie infekcji jelitowych u dzieci--metodyka oraz wyniki badania pilotazowego.

UNLABELLED: The gastrointestinal infection in infants are the significant health and epidemiological issue. The voluntary rotavirus vaccines was included to Polish vaccination schedule in 2007. AIM OF THE STUDY: Aim of the study was the assessment of rotaviruses vaccines effectiveness in prevention of rotavirus gastrointestinal infections requiring hospitalization and the influence or these vaccinations on the risk of gastrointestinal outpatient infections. The additional aim of the study was determine the incidence of adverse events following immunization caused by rotavirus vaccinations and comparison of both vaccines--Rotarix and RotaTeq with respect to the mentioned objectives. MATERIALS AND METHODS: The retrospective cohort study was designed to achieve the aims of study. The study cohort included infants from Malopolska Voivodeship vaccinated with rotavirus vaccine in 2007-2008 and eligible matched unvaccinated children. The preliminary study was conducted in 2011. RESULTS: The cohort study included 74 vaccinated and 74 unvaccinated infants. The preliminary analysis revealed that infants vaccinated against rotavirus had 40% lower risk to be affected by gastrointestinal infections in comparison to unvaccinated children. Nevertheless the results were not statistically significant owing to the scarce number of infants in pilot study group (95% CI: 0,27-1,30). CONCLUSION: The preliminary results indicates, that the rotavirus vaccines have the positive influence on the decrease risk of gastrointestinal infections in children up to 2 years of years but the evidence is not sufficient yet, to be conclusive. The ongoing survey is given the possibility to gain the bigger cohort under study and to attain the presumed objectives.

Neonatal exposure to Thimerosal from vaccines and child development in the first 3 years of life.

BACKGROUND: Despite the common use of Thimerosal as a preservative in childhood vaccines since the 1930s, there are not many studies on ethylmercury toxicokinetics and toxicodynamics in infants. The knowledge of ethylmercury's potential adverse effects is derived mostly from parallel methylmercury research or from animal and theoretical models. AIM OF THE STUDY: This study was designed to examine the relationship between neonatal exposure to Thimerosal-containing vaccine (TCV) and child development. MATERIAL AND METHODS: The study sample consisted of 196 infants born between January 2001 and March 2003 to mothers attending ambulatory prenatal clinics in the first and second trimesters of pregnancy in Krakow. Vaccination history (date and the type of the vaccine) was extracted from physicians' records. Child development was assessed using the Bayley Scales of Infant Development (BSID-II) measured in one-year intervals over 3years. General Linear Model (GLM) and Generalized Estimating Equation (GEE) models adjusted for potential confounders were used to assess the association. RESULTS: An adverse effect of neonatal TCV exposure was observed for the psychomotor development index (PDI) only in the 12th and 24th months of life (ß=-6.44, p<0.001 and ß=-5.89, p<0.001). No significant effect of neonatal TCV exposure was found in the 36th month. The overall deficit in the PDI attributable to neonatal TCV exposure measured over the course of the three-year follow-up (GEE) was significantly higher in TCV group (ß=-4.42, p=0.001). MDI scores did not show the adverse association with neonatal TCV exposure.

[The evolution of Polish immunization schedule during the last 10 years]. / Ewolucja Polskiego programu szczepien ochronnych na przestrzeni ostatnich 10 lat.

The Polish Immunization Program has improved for the last ten years. The most of available new vaccines were in short order included in voluntary vaccination schedule during this time. Nevertheless, the improvement of mandatory vaccination schedule was not sufficient, therefore the Polish Immunization Program diverged significantly from the most of European programs.