Immunisation Horizon Scanning Bulletin Volume 2 Issue 4

Eligibility and willingness of first-year students entering university to participate in a HPV vaccination catch-up program

Source: Eur J Obstet Gynecol Reprod Biol, 2010 Feb; 148(2): 186-90.

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Date of publication: February 2010

Publication Type: Journal Article

In a nutshell: OBJECTIVES: In France, human papillomavirus (HPV) vaccine is routinely recommended for 14-year-old girls; a catch-up vaccination should be offered to girls and women 15-23 years of age before the first time they have sex or within the first year after sexual activity begins. The aim of the present study was to examine the eligibility and willingness of first-year college students of Toulouse University (France) to participate in a HPV vaccination catch-up program, and to estimate their knowledge of HPV vaccination and cervical cancer screening. STUDY DESIGN: The study was conducted from January to April 2008 simultaneously at the three university medical centres (Science, Literature-Psychology, Law-Social Sciences). Female students entering the University were asked to complete an anonymous questionnaire at the time of their preventive medical visit. The questionnaire included questions on demographics, knowledge about HPV vaccination, sexual behaviour, and willingness to participate in the French vaccination program. RESULTS: In total, 606 women from the 3 colleges were included. The response rate of the questionnaire was 93.1%. The median age of participants was 19 and 8.3% of them had already been vaccinated. Of the respondents, 67.2% were sexually experienced and 25.3% of sexually experienced students had their first intercourse less than 1 year prior. Knowledge of HPV infections, associated diseases, and prevention was limited, a finding that indicates the need to pursue educational campaigns. Among respondents, 42.7% were eligible for catch-up vaccination, and 64.1% of them were willing to be vaccinated. We did not observe significant differences among the three colleges. CONCLUSIONS: First-year college preventive consultation is an opportunity to vaccinate near 43% of women according to French recommendations. Improved education about HPV-related diseases and their prevention is needed.

Length of publication: 5 page article

Raising awareness of the risk of sexually transmitted infection among overseas travellers

Source: Nursing Times, 2010 March 2-8; 106(8): 20-2.

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Date of publication: March 2010

Publication Type: Journal Article

In a nutshell: A range of factors can increase the risk of sexually transmitted infections in overseas travellers. Since many people receive travel advice and vaccinations before they travel, nurses have an opportunity to offer education and advice to increase travellers’
awareness of how they can minimise their risk. Interventions should be tailored to the individual and simple, direct questions should be used to assess risk.

Length of publication: 3 page article

Vaccinating premature infants in a special care baby unit in the UK: Results of a prospective, non-inferiority based, pragmatic case series study

Source: Human Vaccines, 2010 June 9; 6 (6)

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Date of publication: June 2010

Publication Type: Journal Article

In a nutshell: Premature infants are at greater risk of infections in part because of impaired functioning of external barriers, innate and adaptive systems. For similar immunological reasons, diminished responses to particular vaccines have also been reported. This study, utilising a prospective, pragmatic case series approach was designed to show non-inferiority of antibody response in premature infants to diphtheria, tetanus, Haemophilus influenzae type b conjugate (Hib), meningococcal C conjugate (MenC) and pneumococcal conjugate (PnC) vaccines between immunization in a routine clinical situation rather than a vaccine trial. A secondary objective was to determine the effect of gestational age on antibody response to these vaccines. The case series comprised 131 infants born at </=32 weeks gestation and managed on the Special Care Baby Unit (SC BU) of a District General Hospital in Stockport, UK. For diphtheria and tetanus, 98.3% and 100% of premature infants respectively developed a minimum protective antibody response; 86.6% were protected against Men C. However, only 67.8% preterm infants achieved anti-polyribosylribitolphosphate (PRP) antibodies >0.15 mug against Hib, with only 34.7% having a level >/=1.0 mug, and responses to the different pneumococcal serogroups ranged from 67.5% against serotype 6B to 92.5% against serogroup 19F. In comparison to term infants, preterm infants were less likely to achieve protective levels against MenC and Hib: there were no significant differences in the proportions of infants protected against diphtheria and tetanus. Protection was inferior to expected based on published premature infant clinical trial data for Hib and particular pneumococcal serotypes; data for Men C were also lower than expected.

Length of publication: Unknown

Factors underlying parental decisions about combination childhood vaccinations including MMR: A systematic review

Source: Vaccine, 2010 April 30 [Epub ahead of print]

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Date of publication: April 2010

Publication Type: Journal Article

In a nutshell: Suboptimal childhood vaccination uptake results in disease outbreaks, and in developed countries is largely attributable to parental choice. To inform evidence-based interventions, we conducted a systematic review of factors underlying parental vaccination decisions. Thirty-one studies were reviewed. Outcomes and methods are disparate, which limits synthesis; however parents are consistently shown to act in line with their attitudes to combination childhood vaccinations. Vaccine-declining parents believe that vaccines are unsafe and ineffective and that the diseases they are given to prevent are mild and uncommon; they mistrust their health professionals, Government and officially-endorsed vaccine research but trust media and non-official information sources and resent perceived pressure to risk their own child’s safety for public health benefit. Interventions should focus on detailed decision mechanisms including disease-related anticipated regret and perception of anecdotal information as statistically representative. Self-reported vaccine uptake, retrospective attitude assessment and unrepresentative samples limit the reliability of reviewed data – methodological improvements are required in this area.

Length of publication: Unknown

Swine flu will be back in the winter

Source: Telegraph

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Date of publication: April 2010

Publication Type: News-Item

In a nutshell: The pandemic is not over and the H1N1 virus is likely to return in the winter when flu would normally be expected, scientists have said. Despite the feeling that most people have already had the bug, even if they didn’t show symptoms, tests have shown that in some areas of the country 85 per cent have not yet contracted H1N1. Uptake of the vaccine has varied from around 10 per cent to 30 per cent of those offered it so many of the most vulnerable are not protected, they said.

Length of publication: 1 page news-item

Survey of girls’ recall of a film providing information on human papillomavirus and cervical cancer 6 months after an offer of vaccination

Source: Vaccine, 2010 May 5 [Epub ahead of print]

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Date of publication: May 2010

Publication Type: Journal Article

In a nutshell: Pre-adolescent girls who have been successfully immunised against human papillomavirus (HPV) may have relatively little knowledge about cervical cancer. A questionnaire was sent to 1084 girls approximately 6 months after they had been offered vaccination to assess whether an educational film had influenced their vaccine decision and what information they recalled. Girls who viewed the film were more likely to have wanted the vaccine than non-viewers (p = 0.015), but only 42% of them could recall details of the film 6 months later. Fear of cervical cancer may motivate young adolescents for vaccination but false assumptions might undermine later preventive actions by both the vaccinated and unvaccinated groups.

Length of publication: Unknown

Systematic review of interventions to increase influenza vaccination rates of those 60 years and older

Source: Vaccine, 2010 Feb 17; 28(7):1684-701

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Date of publication: February 2010

Publication Type: Systematic Review

In a nutshell: A systematic literature review identified 44 RCTs testing interventions to increase influenza vaccination rates among seniors ≥60. Case–control and cohort studies were excluded after review because of problems identifying secular trends and unknown confounders. Because of heterogeneity and unique interventions tested by a single or a few RCTs few studies could be pooled in meta-analysis. Using the CDC classification of interventions: (1) Increasing community demand: there is evidence of low quality that reminders increase influenza vaccination rates; (2) Increasing access: there is evidence of moderate quality thathomevisits to those≥60 promoting influenza vaccination increase rates, and (3) Provider- and system-based interventions: there is evidence of moderate quality that facilitators working to improve preventive interventions in practices increase rates.

Length of publication: 18 page systematic review

Further information: Increasing influenza vaccination rates: Where is the behaviour change theory? (Letter to the Editor). Source: Vaccine, 2010 May 7;28(21):3632. Follow this link for abstract.

NHS launches new meningitis vaccination

Source: Nursing Times

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Date of publication: April 2010

Publication Type: News-Item

In a nutshell: A new meningitis vaccination for children has been launched which experts predict could save thousands of lives. The NHS will make the jab available as part of its childhood immunisation scheme as the UK becomes one of the first countries internationally to introduce it. The vaccine offers patients greater protection against 13 strains of the disease. The previous vaccine only protected against seven. It will provide increased protection against the most lethal type of bacterial meningitis, pneumococcal meningitis.

 Length of publication: 1 page news-item

Referrals for MMR immunisation in hospital

Source: Archives of Diseases in Childhood, 2010 Apr 6 [Epub ahead of print]

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Date of publication: April 2010

Publication Type: Journal Article

In a nutshell: Concern exists about measles, mumps and rubella (MMR) vaccine in egg-allergic children, although this has been shown to be safe. Guidelines from the Royal College of Paediatrics and Child Health (RCPCH) and British Society of Allergy and Clinical Immunology (BSACI) suggesting which children should be referred to hospital for MMR, were published in 2000. We audited referrals to hospital for MMR against these guidelines. One hundred and ten children were referred for MMR to Birmingham Heartlands Hospital (2002–2004) and Alder Hey Children’s Hospital (2006–2009). Eighty-two (75%) children did not meet the published criteria. Only 13 children (12%) had severe egg allergy. The first dose of MMR vaccine was delayed by >30 days in 81% of children. All children were given MMR, none had a significant reaction. Children with egg allergy do not need to be given MMR in hospital, but MMR is often delayed by unnecessary hospital referral. New BSACI guidelines encouraging MMR vaccination of egg-allergic children in primary care need to be disseminated.

Length of publication: 4 page article