Vaccination and immunisation
NUMBER OF RECORDS LOCATED =    16
 

Decision analysis model for rotavirus immunization program in managed care
Ou BS and Raebel MA
Pharmacotherapy Apr 1999;19(4):498-499
Paper presented at the International Congress on Clinical Pharmacy of the
American College of Clinical Pharmacy and the European Society of Clinical
Pharmacy, Orlando, Florida, 11-14 Apr 1999.  Abstract No. 135.  A decision
analysis model was developed to analyse costs from the perspective of the HMO
over a 1-year period.  The decision tree used estimates of disease burden,
birth cohort, vaccine safety and efficacy, costs, and prices obtained from
published and site-specific sources.  Vaccine was proposed to be administered
to infants aged 2, 4, and 6 months as part of routine childhood immunisations.
The target population included children ages 6 to 24 months who become ill from
rotavirus infection.  Main outcome measures included total costs, cost per case
prevented, and cost per health system encounter prevented.  It was found that a
routine, universal rotavirus vaccination programme would prevent an estimated
400 case of diarrhoea (of severity sufficient to result in a physician visit),
save approximately 28 emergency department visits, and avoid 16
hospitalisations annually.  At US$38 per dose, the net cost of the vaccination
programme is over US$550,000 annually and within the range of sensitivity
analyses performed, the costs would not be offset by the cost of the disease
prevented.  The authors conclude that a rotavirus immunisation programme would
not be cost effective, especially when compared with other vaccination
programmes (e.g. Haemophilus, pneumococcus or influenza).



Paralytic poliomyelitis associated with live oral poliomyelitis vaccine in
child with HIV infection in Zimbabwe: case report
Chitsike I and van Furth R
British Medical Journal 27 Mar 1999;318:841-843
Case report of a 4.5 year old boy with HIV infection in whom paralytic
poliomyelitis was caused by poliovirus type 2 infection after a second dose of
oral poliomyelitis vaccine given during national immunisation days in Zimbabwe.
(13 refs.)



Debate revived on hepatitis B vaccine value
Marwick C and Mitka M
Journal of the American Medical Association 7 Jul 1999;282:15-17 (Medical News
& Perspectives)
News article discussing the potential risks associated with the routine
hepatitis B immunisation of newborn infants in the USA.



Promoting breastfeeding through health education at the time of immunizations:
a randomized trial from Guinea Bissau
Jakobsen MS et al.
Acta Paediatrica Jul 1999;88(7):741-747




Can influenza be controlled?
O'Connell N
Hospital Pharmacist May 1999;6(5):133
Report on the 9th congress of the European Society of Clinical Microbiology and
Infectious Diseases, Berlin, 21-24 Mar 1999.



Safety and immunogenicity of an acellular pertussis vaccine in premature
infants
Rolf L et al.
Pediatrics May 1999;103(5):e60
Fifty preterm infants and 50 term infants as a control group received a
two-compartment acellular pertussis vaccine.  Adverse reactions were
documented.  The vaccine was found to be safe for preterm infants. The immune
response is significantly lower in preterm infants compared with term infants,
but efficacy is high.  The complete original article is only available online
at http://www.pediatrics.org/cgi/content/full/103/5/e60



Measles immunization in HIV-infected children
American Academy of Pediatrics
Pediatrics May 1999;103(5):1057-1060
The Committe on Infectious Diseases and Committee on Pediatric AIDS give
recommendations following a fatal case of pneumonia attributable to vaccine
type-measles virus in a young adult with AIDS.  Because a protective immune
response often does not develop in severely immunocompromised HIV-infected
patients after immunisation and some risk of severe complications exists,
HIV-infected children, adolescents and young adults who are severely
immunocompromised should not receive measles vaccine.  All other HIV-infected
children, adolescents and young adults who are not severely immunocompromised
should receive measles-mumps-rubella vaccine.



Combination vaccines for childhood immunization: recommendations of the
Advisory Committee on Immunization Practices (ACIP), the American Academy of
Pediatrics (AAP), and the American Academy of Family Physicians (AAFP)
American Academy of Pediatrics
Pediatrics May 1999;103(5):1064-1077
Combination vaccines represent one solution to the problem of increased numbers
of injections during single clinic visits.  This statement provides general
guidance on the use of combination vaccines and related issues and questions,
including interchangeability of vaccine products, and improving immunisation
records.



Naturally attenuated HIV - lessons for AIDS vaccines and treatment
Collins KL and Nabel GJ
New England Journal of Medicine 3 Jun 1999;340:1756-1757 (editorial)
Editorial, referring to a study in this issue (p.1715-1722). (15 refs.)




Cytokine-based approaches to the treatment of multidrug-resistant tuberculosis
Condos R and Schluger NW
BioDrugs Mar 1999;11:165-173
The most disturbing aspect of the current epidemic of tuberculosis (TB) is the
appearance of large numbers of strains of Mycobacterium tuberculosis that are
resistant to one or more of the first-line agents used to treat the disease.
Recent research into the immunopathogenesis of tuberculosis has provided
insight into the constituents of the host immune system needed to control the
infection in vivo.  These elements include CD4+ and CD8+ T cells as well as
cytokines such as interferon gamma (IFN-gamma), interleukin-12 (IL-12) and
tumour necrosis factor (TNF).  IL-2, IFN-gamma and M. vaccae vaccination have
all shown promising effects in small preliminary studies.  Evidence suggests
that TNF antagonists and IL-12 may also prove useful.



Pertussis in adults
Cherry JD
Annals of Internal Medicine 1 Jan 1998;128(1):64-66 (editorial)



Efficacy of hepatitis A vaccine in prevention of secondary hepatitis A
infection: a randomised trial
Sagliocca L et al.
Lancet 3 Apr 1999;353:1136-1139
Randomised controlled trial of hepatitis A vaccine in household contacts of
people with sporadic hepatitis A virus infection in Naples, Italy, where
hepatitis A virus infection is endemic.  The authors conclude that hepatitis A
vaccine is effective in prevention of secondary infection (18 individuals
needed to be vaccinated to prevent one secondary infection), and that it should
be recommended for household contacts of primary cases of hepatitis A virus
infection. (19 refs.)



Hepatocellular carcinoma
Schafer DF and Sorrell MF
Lancet 10 Apr 1999;353:1253-1257
Review of this terminal complication of chronic inflammatory and fibrotic liver
disease. (66 refs.)




Effectiveness of live, attenuated intranasal influenza virus vaccine in
healthy, working adults
Nichol KL et al. (Live Attenuated Influenza Virus Vaccine in Healthy Adults
Trial Group)
Journal of the American Medical Association 14 Jul 1999;282:137-144
4561 healthy, working adults (age 18-64yr) were randomised 2:1 to receive
intranasally administered live attenuated influenza virus vaccine or placebo in
autumn 1997.  The incidence of febrile illness through the 1997-98 influenza
season was similar across the two groups, however, vaccination signif reduced
the number of severe febrile illness (by 18.8%) and febrile upper respiratory
tract illnesses (by 23.6%) compared to placebo.  Vaccination also reduced work
absenteeism, health care visits, and antibiotic and OTC medication use.  Also
see editorial p182-184.



Intranasal influenza vaccine.  Adding to the armamentarium for influenza
control
Poland G and Couch R
Journal of the American Medical Association 14 Jul 1999;282:182-184 (editorial)
Editorial comment on an accompanying paper (p.137-144) that reported on the
effectiveness and safety of live, attenuated intranasal in healthy, working
adults.  The editorial suggests the intranasal vaccine is probably as effective
as inactivated influenza vaccine, but may offer several advantages, including
self-administration. (32 refs.)



Growing role for biotech vaccines
Greener M
Inpharma 12 Jun 1999;1191:9-10
Data are reviewed under the headings - vaccines from plants, epicoat for breast
cancer?, genital warts vaccine close, targeting HIV infection, TA-GW clears
warts, and but wait, there's more.