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Paul A Gastañaduy, Jeremy Budd, Nicholas Fisher, Susan B Redd, Jackie Fletcher, Julie Miller, Dwight J McFadden, Jennifer Rota, Paul A Rota, Carole Hickman, Brian Fowler, Lilith Tatham, Gregory S Wallace, Sietske de Fijter, Amy Parker Fiebelkorn, Mary DiOrio
Background Although measles was eliminated in the United States in 2000, importations of the virus continue to cause outbreaks. We describe the epidemiologic features of an outbreak of measles that originated from two unvaccinated Amish men in whom measles was incubating at the time of their return to the United States from the Philippines and explore the effect of public health responses on limiting the spread of measles. Methods We performed descriptive analyses of data on demographic characteristics, clinical and laboratory evaluations, and vaccination coverage...
October 6, 2016: New England Journal of Medicine
Jai K Das, Rehana A Salam, Ahmed Arshad, Zohra S Lassi, Zulfiqar A Bhutta
Vaccination strategies are among the most successful and cost-effective public health strategies for preventing disease and death. Until recently, most of the existing immunization programs targeted infants and children younger than 5 years which have successfully resulted in reducing global infant and child mortality. Adolescent immunization has been relatively neglected, leaving a quarter of world's population underimmunized and hence vulnerable to a number of preventable diseases. In recent years, a large number of programs have been launched to increase the uptake of different vaccines in adolescents; however, the recommended vaccination coverage among the adolescent population overall remains very low, especially in low- and middle-income countries...
October 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Suchitra Rao, Joshua T B Williams, Michelle R Torok, Maureen A Cunningham, Mary P Glodè, Karen M Wilson
OBJECTIVES: To identify the extent and characteristics of missed opportunities for influenza vaccination among children hospitalized with influenza at a tertiary children's hospital. METHODS: We conducted a retrospective cohort study of hospitalized patients with polymerase chain reaction-confirmed influenza admitted to Children's Hospital Colorado from 2010 to 2014. We reviewed medical records for vaccination status and previous visits. The primary outcome was the proportion of underimmunized patients hospitalized with influenza with at least 1 missed opportunity visit (visit before influenza diagnosis in which an eligible patient did not receive the influenza vaccine)...
September 2016: Hospital Pediatrics
Elizabeth Wolf, Ali Rowhani-Rahbar, Azadeh Tasslimi, Jasmine Matheson, Chas DeBolt
BACKGROUND: Underimmunization of certain immigrant populations can place them at high risk of experiencing vaccine-preventable disease outbreaks. METHODS: We conducted a retrospective cohort study between January 1, 2008, and May 1, 2013, among children included in the Washington State Immunization Information System. We assessed receipt of 1 or more doses of measles-containing, hepatitis A, pneumococcal, and diphtheria-tetanus-acellular pertussis-containing vaccines between 12 and 23 months of age...
July 2016: Pediatrics
Edward T Walker, Christopher M Rea
OBJECTIVES: To understand contextual associations between medical care providers-pediatricians, family medical practitioners, and alternative medicine practitioners-and personal belief exemptions (PBEs) from mandated school entry vaccinations. METHODS: Data on kindergarten PBEs from the California Department of Public Health were analyzed for 2010, 2011, and 2012, with each school sorted into Primary Care Service Areas (PCSAs). Provider data from federal sources and state records of alternative medicine providers, alongside controls for school factors, were used to estimate panel models...
July 2016: American Journal of Public Health
Charity Warigon, Pascal Mkanda, Ado Muhammed, Andrew Etsano, Charles Korir, Samuel Bawa, Emmanuel Gali, Peter Nsubuga, Tesfaya B Erbeto, George Gerlong, Richard Banda, Yared G Yehualashet, Rui G Vaz
INTRODUCTION: Poliomyelitis remains a global threat despite availability of oral polio vaccine (OPV), proven to reduce the burden of the paralyzing disease. In Nigeria, children continue to miss the opportunity to be fully vaccinated, owing to factors such as unmet health needs and low uptake in security-compromised and underserved communities. We describe the implementation and evaluation of several activities to create demand for polio vaccination in persistently poor-performing local government areas (LGAs)...
May 1, 2016: Journal of Infectious Diseases
Louise-Anne McNutt, Cristina Desemone, Erica DeNicola, Hassan El Chebib, Jessica A Nadeau, Robert A Bednarczyk, Jana Shaw
BACKGROUND: Non-medical vaccine exemption rates in California private schools far exceed those of public schools, but little is known about specific factors which may be associated with high exemption rates in private schools. METHODS: The percent of personal-belief exemptions (PBEs) among California public and private kindergartens were computed for 2000-2001 to 2014-2015 academic years. For the 2014-2015 academic year, a random sample of private schools was selected to investigate associations between kindergarten characteristics (tuition amount, religious affiliation) and vaccine profile (non-medical vaccine exemptions, vaccine coverage)...
March 29, 2016: Vaccine
Sarah E Williams, Ashley Morgan, Douglas Opel, Kathryn Edwards, Stuart Weinberg, Russell Rothman
The Parent Attitudes about Childhood Vaccines (PACV) survey for identifying vaccine-hesitant parents was recently validated in Washington State but did not include all recommended childhood vaccines. The current study compares vaccination rates for all recommended childhood vaccines and PACV scores at one pediatric practice in Tennessee. Children were enrolled at the 2-week well visit, and vaccination rates were assessed at 19 months of age. Outcomes at 19 months of age included mean percentage of days underimmunized and up-to-date status (yes/no) compared with PACV scores...
June 2016: Clinical Pediatrics
Svapna S Sabnis, James H Conway
Vaccines are one of the greatest public health achievements, preventing both mortality and morbidity. However, overall immunization rates are still below the 90% target for Healthy People 2020. There remain significant disparities in immunization rates between children of different racial/ethnic groups, as well as among economically disadvantaged populations. There are systemic issues and challenges in providing access to immunization opportunities. In addition, vaccine hesitancy contributes to underimmunization...
October 2015: Pediatric Clinics of North America
Kevin J McHugh, Rohiverth Guarecuco, Robert Langer, Ana Jaklenec
Currently, vaccination is the most efficient and cost-effective medical treatment for infectious diseases; however, each year 10 million infants remain underimmunized due to current vaccination schedules that require multiple doses to be administered across months or years. These dosing regimens are especially challenging in the developing world where limited healthcare access poses a major logistical barrier to immunization. Over the past four decades, researchers have attempted to overcome this issue by developing single-administration vaccines based on controlled-release antigen delivery systems...
December 10, 2015: Journal of Controlled Release: Official Journal of the Controlled Release Society
Kimberly M Thompson, Kasper H Kisjes
Measles outbreaks in the United States continue to occur in subpopulations with sufficient numbers of undervaccinated individuals, with a 2014 outbreak in Amish communities in Ohio pushing the annual cases to the highest national number reported in the last 20 years. We adapted an individual-based model developed to explore potential poliovirus transmission in the North American Amish to characterize a 1988 measles outbreak in the Pennsylvania Amish and the 2014 outbreak in the Ohio Amish. We explored the impact of the 2014 outbreak response compared to no or partial response...
July 2016: Risk Analysis: An Official Publication of the Society for Risk Analysis
Tracy A Lieu, G Thomas Ray, Nicola P Klein, Cindy Chung, Martin Kulldorff
BACKGROUND AND OBJECTIVE: Parental refusal and delay of childhood vaccines has increased in recent years and is believed to cluster in some communities. Such clusters could pose public health risks and barriers to achieving immunization quality benchmarks. Our aims were to (1) describe geographic clusters of underimmunization and vaccine refusal, (2) compare clusters of underimmunization with different vaccines, and (3) evaluate whether vaccine refusal clusters may pose barriers to achieving high immunization rates...
February 2015: Pediatrics
Linda Y Fu, Kathleen Zook, Janet Gingold, Catherine W Gillespie, Christine Briccetti, Denice Cora-Bramble, Jill G Joseph, Rachel Y Moon
OBJECTIVE: To examine missed opportunities to administer an eligible vaccination (MOs) and their contribution to underimmunization in contemporary pediatric practices. STUDY DESIGN: This study was a retrospective analysis from 42 diverse pediatric practices located throughout the US. Medical records of 50 randomly selected children 3-18 months of age per practice were reviewed in Spring 2013. Immunization status for age and MOs were assessed as of each encounter and as of March 1, 2013...
February 2015: Journal of Pediatrics
Donald Robert Haley
BACKGROUND: Despite high immunization rates, hundreds of thousands of poor and underserved children continue to lack their necessary immunizations and are at risk of acquiring a vaccine-preventable disease. Local Health Departments (LHDs) and public health clinicians figure prominently in efforts to address this problem. METHODS: This exploratory research compared ten (10) North Carolina LHDs with respect to immunization delivery factors. The study sample was identified based on urban designation as well as county demographic and socio-economic indicators that identified predicted "pockets" of underimmunization...
May 2014: International Journal of Health Policy and Management
Roger S Akins, Paula Krakowiak, Kathleen Angkustsiri, Irva Hertz-Picciotto, Robin L Hansen
OBJECTIVE: To compare the utilization of conventional treatments and utilization of complementary and alternative medicine in preschoolers with autism spectrum disorders (ASD) and other developmental disabilities (DD). METHODS: Participants were 578 children who were part of an ongoing population-based, case-control study of 2- to 5-year olds with ASD, DD, and the general population. Parents completed an interview on past and current services. RESULTS: Four hundred fifty-three children with ASD and 125 DD children were included...
January 2014: Journal of Developmental and Behavioral Pediatrics: JDBP
Jessica A Kattan, Kathy S Kudish, Betsy L Cadwell, Kristen Soto, James L Hadler
OBJECTIVES: We examined socioeconomic status (SES) disparities and the influence of state Immunization Action Plan-funded vaccination coordinators located in low-SES areas of Connecticut on childhood vaccination up-to-date (UTD) status at age 24 months. METHODS: We examined predictors of underimmunization among the 2006 birth cohort (n = 34,568) in the state's Immunization Information System, including individual demographic and SES data, census tract SES data, and residence in an area with a vaccination coordinator...
January 2014: American Journal of Public Health
Matthew G Johnson, Kristy K Bradley, Susan Mendus, Laurence Burnsed, Rachel Clinton, Tejpratap Tiwari
Homeschooled children represent an increasing proportion of school-aged children in the United States. Immunization rates among homeschooled children are largely unknown because they are usually not subject to state-based school-entry vaccination requirements. Geographic foci of underimmunized children can increase the risk for outbreaks of vaccine-preventable diseases. In 2012, 2 cases of tetanus were reported in Oklahoma; both cases involved homeschooled children without documentation of diphtheria-tetanus-acellular pertussis vaccination...
December 2013: Pediatrics
Douglas J Opel, James A Taylor, Chuan Zhou, Sheryl Catz, Mon Myaing, Rita Mangione-Smith
IMPORTANCE: Acceptance of childhood vaccinations is waning, amplifying interest in developing and testing interventions that address parental barriers to immunization acceptance. OBJECTIVE: To determine the predictive validity and test-retest reliability of the Parent Attitudes About Childhood Vaccines survey (PACV), a recently developed measure of vaccine hesitancy. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort of English-speaking parents of children aged 2 months and born from July 10 through December 10, 2010, who belonged to an integrated health care delivery system based in Seattle and who returned a completed baseline PACV...
November 2013: JAMA Pediatrics
Rachel N Caskey, Everly Macario, Daniel C Johnson, Tamara Hamlish, Kenneth A Alexander
BACKGROUND: Many adolescents underutilize preventive services and are underimmunized. METHODS: To promote medical homes and increase immunization rates, we conceptualized and implemented a 3-year, 8-school pilot school-located vaccination collaborative program. We sought community, parent, and school nurse input the year prior to implementation. We selected schools with predominantly Medicaid-enrolled or Medicaid-eligible students to receive Vaccines For Children stock vaccines...
September 2013: Journal of the Pediatric Infectious Diseases Society
Amy V Groom, Tammy A Santibanez, Ralph T Bryan
BACKGROUND AND OBJECTIVES: A previous study on vaccination coverage in the American Indian/Alaska Native (AI/AN) population found that disparities in coverage between AI/AN and white children existed from 2001 to 2004 but were absent in 2005. The objective of this study was to describe vaccination coverage levels for AI/AN children aged 19-35 months in the United States between 2006 and 2010, examining whether gains found for AI/AN children in 2005 have been sustained. METHODS: Data from the 2006 through 2010 National Immunization Surveys were analyzed...
December 2012: Pediatrics
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