Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. ...Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.展开更多
Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to pro...Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to provide a reference for future epidemic prevention and control.Methods:The data of reported varicella cases in Banan District from 2014 to 2023 were collected and analyzed using the China Disease Prevention and Control Information System.Descriptive epidemiological methods were employed to assess the changes in the reported incidence of varicella before(2014-2018)and after(2019-2023)the implementation of the two-dose VarV immunization program.Results:The average annual reported incidence rate of varicella in Banan District from 2014 to 2023 was 81.53 per 100,000.From 2014 to 2018,the reported incidence rate showed an upward trend year by year(trend x2=223.96,P<0.05).However,the reported incidence rate decreased from 2019 to 2023(trend x?=189.51,P<0.05).Before and after the adjustment of the immunization program,the reported incidence rate for the 5-9 years old group was 774.62 per 100,000 and 476.98 per 100,000,respectively,with a statistically significant difference(x2=161.26,P<0.05).The onset of varicella showed a bimodal distribution,with peak incidence periods in May-June and October-December.From 2014 to 2023,a total of 155,181 doses of VarV were administered in Banan District.The estimated annual vaccination rate for the first varicella vaccine(VarV1)from 2019 to 2023 was 86.28%,and for the second dose(VarV2)was 59.18%.The primary vaccination targets were the 5-9-year-old group,accounting for 64.21%.Conclusion:After implementing the two-dose VarV immunization program in Banan District,the vaccination rate increased yearly,and the reported incidence of varicella showed a downward trend.The incidence rate of varicella in children aged 5-9 years reduced significantly,but the overall downward trend for the entire population was not as pronounced.Therefore,it is necessary to increase the vaccination rate of VarV2.展开更多
Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, p...Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, partly because of the lack of tumor-infiltrating effector T cells. Cancer vaccines may prime patients for treatments with immune checkpoint inhibitors by inducing effector T-ceU infiltration into the tumors and immune checkpoint signals. The combination of cancer vaccine and an immune checkpoint inhibitor may function synergistically to induce more effective antitumor immune responses, and clinical trials to test the combination are currently ongoing.展开更多
Objectives: To assess the received suspected adverse events occurring upon treatment with drugs and vaccines, at National Centre for Pharmacovigilance, in Togo, from 2009 to 2016. Methods: A crossover study was conduc...Objectives: To assess the received suspected adverse events occurring upon treatment with drugs and vaccines, at National Centre for Pharmacovigilance, in Togo, from 2009 to 2016. Methods: A crossover study was conducted in order to collect data about patients, drugs, suspected adverse events and notifiers. Suspected adverse events were classified using Med DRA 19.1. Notification’s circumstances were classified into Public Health Programs’ campaigns and routine practice. Data were collated into Excel spreadsheet and processed with SPSS software. Key Findings: Regional distribution is irregular. Of the 322 collected report forms, paramedics have notified 60.8% of the cases. Adult patients were the most represented (70.2%). Public Health Programs campaigns provided 72.6% versus 27.4% for routine practice including Neglected Tropical Diseases (41.4%), immunization (27.7%), tuberculosis (25.9%) and 4.5% for HIV. Skin disorders were the most prevalent suspected adverse events (147 sheets;45.7%) followed by general disorders and administration site disorders (29.8%) and gastro-intestinal disorders (12.7%). General anti-infective drugs for systemic use, antiparasites, and insecticides were the most reported class of medications (161 sheets;44.7%). Conclusions: A thorough follow-up of pharmacovigilance launched activities is needed to build a sustainable adverse effect’s surveillance system and routine practice has to be strengthened.展开更多
In order to increase the convenience of application and minimize logistical problems in the recent years, the use of combined vaccines has become a growing trend. The use of combined vaccines offers benefits such as, ...In order to increase the convenience of application and minimize logistical problems in the recent years, the use of combined vaccines has become a growing trend. The use of combined vaccines offers benefits such as, a reduction in the number of patient visits, less complications which are associated with multiple intramuscular drilling and other risks. In 1997 the Department of Epidemiology （DE） of Institute of Public Health initiated and carried out conspicuous quantitative and qualitative modifications of up-to-them statutory notification system thus compiling the new Major Disease-Based Epidemiological Surveillance System. Mandatory reporting system on Measles/Rubella Case-Based Surveillance represents in itself an addendum of the statutory reporting system of infectious diseases. These diseases are enlisted in the Group B of the 14/Sh Form. Diphtheria is enlisted in the Group A containing the infectious diseases of the highest public health importance. They are subject of a mandatory urgent notification from the basic level. The aim of this study is to examine and check up the effectiveness of combined vaccines in our country, through the evaluation of the data from national epidemiologic surveillance verifying the distributions in time and space of these diseases in relation to the history of vaccination policies in Albania.展开更多
目的:分析2005—2023年钦州市甲型肝炎(甲肝)的流行病学特征和甲肝疫苗在2008年纳入扩大国家免疫规划项目(Expanded Program on Immunization,EPI)后的预防效果,为制定甲肝防控策略提供参考。方法:通过中国疾病预防控制信息管理系统收集...目的:分析2005—2023年钦州市甲型肝炎(甲肝)的流行病学特征和甲肝疫苗在2008年纳入扩大国家免疫规划项目(Expanded Program on Immunization,EPI)后的预防效果,为制定甲肝防控策略提供参考。方法:通过中国疾病预防控制信息管理系统收集2005—2023年钦州市甲肝发病情况,对甲肝疫苗纳入EPI前(2005—2007年)和之后(2008—2023年)的甲肝流行特征进行对比性的分析。结果:2005—2023年钦州市共报告甲肝病例1063例,年均发病率为1.75/10万,无死亡病例。甲肝年均发病率由纳入免疫规划前的3.52/10万下降至纳入免疫规划后的1.43/10万(χ^(2)=195.647,P<0.05)。发病无明显季节性。不同县区发病具有差异性。男性发病高于女性(χ^(2)=92.447,P<0.05),男女性别比为2.14∶1。发病年龄后移,15岁以下构成比由41.67%显著下降至11.77%。职业分布以农民为主,占55.03%。适龄儿童甲肝疫苗接种率为88.61%。结论:2005—2023年钦州市甲肝发病呈下降趋势。甲肝疫苗纳入EPI后,目标儿童甲肝发病率显著降低,但成人(尤其是农民)的防控形势仍然严峻,在巩固儿童甲肝疫苗接种的同时,还应加强重点地区、重点人群的甲肝疫苗预防接种及健康教育等综合防控工作。展开更多
目的了解铜陵市儿童家长对非免疫规划疫苗的接种犹豫现状并分析其影响因素,为改善非免疫规划疫苗接种犹豫提供参考。方法采用便利抽样法,选取铜陵地区某院就诊≤12岁儿童的家长开展调查,基于计划行为理论(theory of planned behavior,T...目的了解铜陵市儿童家长对非免疫规划疫苗的接种犹豫现状并分析其影响因素,为改善非免疫规划疫苗接种犹豫提供参考。方法采用便利抽样法,选取铜陵地区某院就诊≤12岁儿童的家长开展调查,基于计划行为理论(theory of planned behavior,TPB)设计问卷收集儿童家长对非免疫规划疫苗的接种犹豫情况,运用多因素logistic回归和结构方程模型(structural equation model,SEM)分析接种犹豫的影响因素。结果共纳入334例儿童家长,非免疫规划疫苗接种犹豫的比率为36.22%(121/334)。多因素logistic回归结果显示,具有医学背景的儿童家长对非免疫规划疫苗仍具有更低的接种犹豫发生率(OR=0.418,P=0.010),儿童近半年生病次数的减少也是非免疫规划疫苗接种犹豫的保护因素(OR=0.198,P<0.001)。TPB模型验证性因子分析检验结果显示,问卷的态度、主观规范、知觉行为控制、感知风险、行为意向等各维度Cronbach’sα系数为0.893~0.955,量表总Cronbach’sα系数为0.941,内部一致性较好。相关性分析表明,平均方差萃取值的平方根均大于潜变量相关系数的最大值,提示具有良好的区分效度。通过SEM分析态度、主观规范、知觉行为控制和感知风险四个因素与儿童家长在非免疫规划疫苗接种方面犹豫之间的关系,SEM总体方差解释率为76.90%,结果显示行为控制(β’=-0.702)、主观规范(β’=-0.651)、态度(β’=-0.511)和感知风险(β’=-0.488)均与儿童家长对非免疫规划疫苗的接种犹豫相关(P<0.05)。结论本研究揭示铜陵市儿童家长对非免疫规划疫苗接种犹豫的影响因素,强调医学背景和儿童健康状况的重要性,并指出通过TPB模型提升家长疫苗信心与认知,结合医务人员及社交媒体的宣传,可以有效提高接种意愿。展开更多
文摘Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.
文摘Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to provide a reference for future epidemic prevention and control.Methods:The data of reported varicella cases in Banan District from 2014 to 2023 were collected and analyzed using the China Disease Prevention and Control Information System.Descriptive epidemiological methods were employed to assess the changes in the reported incidence of varicella before(2014-2018)and after(2019-2023)the implementation of the two-dose VarV immunization program.Results:The average annual reported incidence rate of varicella in Banan District from 2014 to 2023 was 81.53 per 100,000.From 2014 to 2018,the reported incidence rate showed an upward trend year by year(trend x2=223.96,P<0.05).However,the reported incidence rate decreased from 2019 to 2023(trend x?=189.51,P<0.05).Before and after the adjustment of the immunization program,the reported incidence rate for the 5-9 years old group was 774.62 per 100,000 and 476.98 per 100,000,respectively,with a statistically significant difference(x2=161.26,P<0.05).The onset of varicella showed a bimodal distribution,with peak incidence periods in May-June and October-December.From 2014 to 2023,a total of 155,181 doses of VarV were administered in Banan District.The estimated annual vaccination rate for the first varicella vaccine(VarV1)from 2019 to 2023 was 86.28%,and for the second dose(VarV2)was 59.18%.The primary vaccination targets were the 5-9-year-old group,accounting for 64.21%.Conclusion:After implementing the two-dose VarV immunization program in Banan District,the vaccination rate increased yearly,and the reported incidence of varicella showed a downward trend.The incidence rate of varicella in children aged 5-9 years reduced significantly,but the overall downward trend for the entire population was not as pronounced.Therefore,it is necessary to increase the vaccination rate of VarV2.
基金supported by the Viragh Foundation(L.Z.)National Institutes of Health(NIH)(Grant No.K23 CA148964,L.Z.)the NCI SPORE in Gastrointestinal Cancers(Grant No.P50 CA062924,L.Z.)
文摘Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, partly because of the lack of tumor-infiltrating effector T cells. Cancer vaccines may prime patients for treatments with immune checkpoint inhibitors by inducing effector T-ceU infiltration into the tumors and immune checkpoint signals. The combination of cancer vaccine and an immune checkpoint inhibitor may function synergistically to induce more effective antitumor immune responses, and clinical trials to test the combination are currently ongoing.
文摘Objectives: To assess the received suspected adverse events occurring upon treatment with drugs and vaccines, at National Centre for Pharmacovigilance, in Togo, from 2009 to 2016. Methods: A crossover study was conducted in order to collect data about patients, drugs, suspected adverse events and notifiers. Suspected adverse events were classified using Med DRA 19.1. Notification’s circumstances were classified into Public Health Programs’ campaigns and routine practice. Data were collated into Excel spreadsheet and processed with SPSS software. Key Findings: Regional distribution is irregular. Of the 322 collected report forms, paramedics have notified 60.8% of the cases. Adult patients were the most represented (70.2%). Public Health Programs campaigns provided 72.6% versus 27.4% for routine practice including Neglected Tropical Diseases (41.4%), immunization (27.7%), tuberculosis (25.9%) and 4.5% for HIV. Skin disorders were the most prevalent suspected adverse events (147 sheets;45.7%) followed by general disorders and administration site disorders (29.8%) and gastro-intestinal disorders (12.7%). General anti-infective drugs for systemic use, antiparasites, and insecticides were the most reported class of medications (161 sheets;44.7%). Conclusions: A thorough follow-up of pharmacovigilance launched activities is needed to build a sustainable adverse effect’s surveillance system and routine practice has to be strengthened.
文摘In order to increase the convenience of application and minimize logistical problems in the recent years, the use of combined vaccines has become a growing trend. The use of combined vaccines offers benefits such as, a reduction in the number of patient visits, less complications which are associated with multiple intramuscular drilling and other risks. In 1997 the Department of Epidemiology （DE） of Institute of Public Health initiated and carried out conspicuous quantitative and qualitative modifications of up-to-them statutory notification system thus compiling the new Major Disease-Based Epidemiological Surveillance System. Mandatory reporting system on Measles/Rubella Case-Based Surveillance represents in itself an addendum of the statutory reporting system of infectious diseases. These diseases are enlisted in the Group B of the 14/Sh Form. Diphtheria is enlisted in the Group A containing the infectious diseases of the highest public health importance. They are subject of a mandatory urgent notification from the basic level. The aim of this study is to examine and check up the effectiveness of combined vaccines in our country, through the evaluation of the data from national epidemiologic surveillance verifying the distributions in time and space of these diseases in relation to the history of vaccination policies in Albania.
文摘目的:分析2005—2023年钦州市甲型肝炎(甲肝)的流行病学特征和甲肝疫苗在2008年纳入扩大国家免疫规划项目(Expanded Program on Immunization,EPI)后的预防效果,为制定甲肝防控策略提供参考。方法:通过中国疾病预防控制信息管理系统收集2005—2023年钦州市甲肝发病情况,对甲肝疫苗纳入EPI前(2005—2007年)和之后(2008—2023年)的甲肝流行特征进行对比性的分析。结果:2005—2023年钦州市共报告甲肝病例1063例,年均发病率为1.75/10万,无死亡病例。甲肝年均发病率由纳入免疫规划前的3.52/10万下降至纳入免疫规划后的1.43/10万(χ^(2)=195.647,P<0.05)。发病无明显季节性。不同县区发病具有差异性。男性发病高于女性(χ^(2)=92.447,P<0.05),男女性别比为2.14∶1。发病年龄后移,15岁以下构成比由41.67%显著下降至11.77%。职业分布以农民为主,占55.03%。适龄儿童甲肝疫苗接种率为88.61%。结论:2005—2023年钦州市甲肝发病呈下降趋势。甲肝疫苗纳入EPI后,目标儿童甲肝发病率显著降低,但成人(尤其是农民)的防控形势仍然严峻,在巩固儿童甲肝疫苗接种的同时,还应加强重点地区、重点人群的甲肝疫苗预防接种及健康教育等综合防控工作。
