In 1990 the Department of National Health and Population Development of South Africa launched a nationwide immunisation coverage campaign targetted mainly at measles. In order to measure the effect of the campaign on vaccination coverage rates for children pre- and post- campaign vaccination coverage surveys were performed using a modified EPI technique, stratified for race and urban/rural residence. The results in Natal/KwaZulu showed no significant changes in vaccination coverage rates as documented by Road-to-Health cards for any race, although the trend was towards a slight increase. The results bring into question the effectiveness of immunisation campaigns as a strategy for raising vaccination coverage levels, and having a sustained impact on the incidence of measles. Alternative strategies, such as the strengthening and expansion of existing primary health care services, and changes to the immunisation schedule for measles, should be considered. / Thesis (MMed.)-University of Natal, Durban, 1992.

BACKGROUND: According to the Centers for Disease Control and Prevention and the National Immunization Program, there is an increase in the re-emergence of past diseases. Even with mandatory vaccination practices in the United States, there are still a number of cases of vaccine-preventable diseases (VPDs) reported yearly. It is speculated that the re-emergence of VPDs is in part due to the increase in international travel as well as the influx of immigrants. One particular group of interest includes the Hispanic migrants coming from Central and South America where some of these diseases are endemic. OBJECTIVE: The purpose of this paper is to determine the extent of VPD cases in the border state of Arizona that may be attributed to Hispanic migrant influx using data from the MMWR: Summary of Notifiable Diseases reports for the United States and the ADHS data from all Arizona counties. RESULTS: Since 1995, rates of hepatitis B and pertussis have been increasing in Arizona and have become higher for non-Hispanics than Hispanics. In 2005, hepatitis B rates were 1.53* for the United States and 7.31* for Arizona; pertussis rates were 8.72* for the United States and 21.60* for Arizona. CONCLUSION: The results of this study's analysis show the need to improve immunization efforts within the non-Hispanic populations in all Arizona counties. (*Per 100,000 population)

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Background: To achieve control of a vaccine preventable communicable disease, it is of importance to establish high enough coverage to reach the threshold for herd immunity.  Preventive public health interventions, such as vaccination programmes, create dilemmas between societal versus individual benefits of the programme. Vaccine providers handle this dilemma when motivating hesitant parents and vaccine providers´ own perceptions of vaccine benefits will possibly influence the parental decision. The motivating strategies need to support parental autonomy, the best interest of the child and societal benefits. By using the bioethical principles autonomy, beneficence and justice, strategies can be analyzed regarding what agents are most benefitted by the strategy. Purpose: To gain insight in how vaccine providers balance between individual, societal, parental and internal values when promoting vaccine towards vaccine hesitant parents. Method:  Explorative qualitative interview study. Results: The respondents´ strategies are more or less influencing and adjusted according to the underlying reason the parents have for hesitation. An underlying strategy is to use means of social interaction to build trustful relationships. Respondents perceived reasons to vaccinate are ranging from individual to societal and are reflected in the strategies and the respondents aim to aid parents to a well informed decision. Some strategies are more persuasive than others and in rare occasions infringe on parental autonomy in a less plausible manner. Conclusions: The findings from this study reflect that the public health dilemma is indeed present in the clinical context when motivating vaccine hesitant parents. Respondents do their utmost to aid the parents to a well informed decision, regardless if the child will be vaccinated or not, or whatever reason parents have for hesitance. Since vaccination  is a voluntary action that is required from many to reach herd immunity, vaccine providers need to consider the ethics surrounding motivating hesitant parents to reach best possible outcome regardless if  this is benefitting the child, society or parental autonomy / Bakgrund: För att kunna kontrollera vaccinerbara smittsamma sjukdomar är det av högsta vikt att etablera hög vaccintäckning och uppnå nivån för flockimmunitet. Preventiva folkhälsointerventioner, såsom vaccinationsprogram, skapar dilemman mellan samhällelig och individnytta. Yrkespersoner som erbjuder vaccin måste hantera detta dilemma när de motiverar föräldrar som är tveksamma till att vaccinera sina barn. Yrkespersonernas uppfattningar om nyttan med vacciner och motivationsstrategierna kan tänkas påverka föräldrarnas beslut. Strategierna behöver stödja såväl föräldrarnas autonomi, barnets rätt och samhällets bästa. Genom användande av de bioetiska principerna autonomi, godhet och rättvisa kan strategierna analyseras utifrån vilka agenter som gagnas mest. Syfte: Att få inblick i hur yrkespersoners balanserar mellan individuella, samhälleliga, föräldrarelaterade och interna värden när de promotar vaccin till föräldrar som är tveksamma till vaccin. Metod: Explorativ kvalitativ intervjustudie. Resultat: Respondenternas strategier anpassas efter föräldrarnas bakomliggande skäl till att inte vaccinera sina barn och är mer eller mindre influerande. En underliggande strategi är att använda social interaktion för att bygga förtroende hos föräldrarna. Respondenterna uppfattade nyttan med vacciner som både individuell och samhällelig och speglades i strategierna. Respondenterna siktade på att föräldrarnas beslut ska vara välgrundat. Några strategier är mer övertalande än andra och i sällsynta fall inkräktande på föräldrarnas autonomi på ett mindre lämpligt sätt. Slutsats: Fynden speglar att folkhälsodilemmat mellan individ och samhälle är närvarande i den kliniska situationen när tveksamma föräldrar ska motiveras till att vaccinera sina barn. Respondenterna gör sitt yttersta för att guida föräldrarna till ett välgrundat beslut, oavsett om barnet blir vaccinerat eller inte, oavsett vilket skäl föräldrarna har till tveksamheten. Eftersom att vaccination är en frivillig handling som krävs av många för att uppnå flockimmunitet så behöver yrkespersoner ta hänsyn till etiken kring när föräldrar motiveras till att vaccinera sina barn. Detta för att uppnå bästa möjliga resultat oavsett om det gagnar barnet, samhället eller föräldrarnas autonomi.

Bakgrund: Skolbarn kan utsättas för onödig smärta vid vaccinering vilket kan leda till ofullständigt vaccinationsskydd samt minskat förtroende för hälso- och sjukvårdspersonal. I Sverige vaccineras barn i skolålder av skolsköterskan. Vaccinationer är den vanligaste orsaken till procedursmärta hos barn. Syfte: Att beskriva skolsköterskans omvårdnadsåtgärder för att minska smärta och oro vid vaccinering. Metod: Studien genomfördes som en allmän litteraturstudie baserad på 14 artiklar som kvalitetsgranskades och analyserades. Resultat: Avledning som omvårdnadsintervention är av betydelse vid vaccinering av skolbarn. Enligt litteraturstudiens resultat innebär avledning information/undervisning, medverkan, träning, miljöanpassning, specifik omvårdnad samt olika former av stöd och läkemedelshantering. Diskussion: Avledning utifrån resultatet är delvis överförbart till liknande situationer som till exempel venprovtagning. Trots att stöd finns för omvårdnadsåtgärd vid vaccinering saknas implementering för det. Slutsats: Skolsköterskan behöver identifiera barns behov och utifrån det välja omvårdnadsintervention. Skolsköterskan ska värna om en god kommunikation samt förtroendefull relation med barn. Vaccinationen kan då genomföras med minskad smärta och oro för barn. / Background: Schoolchildren may be exposed to unnecessary pain during immunization which might lead to incomplete vaccination protection and reduced confidence in healthcare professionals. In Sweden school aged children are vaccinated by the school nurse. Immunization is considered the most common reason for iatrogenic pain in children. Aim: To describe the school nurse’s interventions to reduce pain and anxiety. Methods: The study was conducted as a general literature review based on 14 articles which were quality examined and analysed. Results: Distraction as nursing intervention is of significance in immunization of schoolchildren. According to the result of the literature review distraction includes information/training, involvement, practice, environment adjustment, specific nursing, different form of support and medication. Discussion: Accordingto the result distractionis partly transmittable to similar situations such as venous sampling. Despite supporting evidence that distracting reduces pain and anxiety the interventions are not incorporated. Conclusion:The school nurse should identify the child’s needs and based on this select nursing intervention. The school nurse has to advocate good communication and trustful relation with the child. Immunization can then be conducted with decreased pain and anxiety.

Antibodies play an important role in the natural immune response to invading pathogens. The strong and specific binding to their antigens also make them indispensable tools for research, diagnostics and therapy. This thesis describes the development of methods for characterization of an- tibody specificity and the use of these methods to investigate the polyclonal antibody response after immunization. Paper I describes the development of an epitope-specific serum fractionation technique based on epitope map- ping using overlapping peptides followed by chromatographic separation of polyclonal serum. This technique together with another epitope mapping technique based on bacterial display of protein fragments were then used to generate antibody sandwich pairs (Paper I), investigate epitope variations of repeated immunizations (Paper II) and to determine the ratio of antibodies targeting linear and conformational epitopes of polyclonal antibodies (Paper III). Paper IV describes the optimization of in situ-synthesized high-density peptide arrays for epitope mapping and how different peptide lengths influ- ence epitope detection and resolution. In Paper V we show the development of planar peptide arrays covering the entire human proteome and how these arrays can be used for epitope mapping and off-target binding analysis. In Paper VI we show how polyclonal antibodies targeting linear epitopes can be used for peptide enrichment in a rapid, absolute protein quantification protocol based on mass spectrometry. Altogether these investigations demonstrate the usefulness of peptide arrays for fast and straightforward characterization of antibody specificity. The work also contributes to a deeper understanding of the polyclonal anti- body response obtained after immunization with recombinant protein frag- ments. / <p>QC 20141111</p>

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 5 uppsatser.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, 2006. / Bibliyografya var.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv., 2002. / Härtill 4 uppsatser.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv., 2002. / Härtill 5 uppsatser.