Adult immunizations effectively reduce diseases. Despite this, it is difficult to convince patients to be vaccinated. We developed and implemented two different strategies, each deployed separately to improve our flu vaccination rates in two flu seasons. Data assayed from two seasons (2015-16 and 2016-17) show changes by approach used. Results suggest the strategy involving the most effort was no more effective than the lower effort strategy. These data are discussed in terms of appropriate metrics and future research.

Research on health prevention behaviors of Mexican immigrant mothers regarding immunizations has been limited. As of 2014, Hispanics or Latinos comprised 9.6% of the population of the state of Oklahoma and were the largest minority group within Oklahoma. This minority population has continued to grow at a rapid rate in Oklahoma. The purpose of this study was to explore the perceptions of immunizations held by Mexican immigrants who are mothers residing in Oklahoma. The aim of this study was to identify their perceived risk of contracting a vaccine-preventable disease if not immunized and knowledge of immunizations as a health prevention behavior. The health belief model and the sociocultural theory provided the theoretical underpinnings for this qualitative study. Semistructured interviews were conducted with a purposeful sample of 12 immigrants living in a rural area of Oklahoma. Data were triangulated and analyzed to identify themes and patterns. Findings indicated participants perceived susceptibility of contracting a vaccine-preventable disease if not immunized, with the severity of the disease having the potential to cause death. Identified barriers in immunization uptake were language barrier, lack of immunization information in Spanish, and fear of deportation. Recommendations include public health outreach providing culturally, linguistic appropriate immunization information to immigrants within communities. Findings provide health psychologists and other health care professionals the ability to formulate interventions targeting immunizations in female Mexican immigrants. These interventions could promote positive social change by decreasing immigrants' and their children's risk of morbidity and mortality related to lack of immunization uptake.

Background: Following the publication of Andrew Wakefield’s article claiming a link between Autism and the MMR vaccine in 1998, the U.K. and U.S. experienced a decline in vaccination rates. Combating the anti-vaccine messages highlighted by the media are the medical providers, who are consistently reported as an influential source of information for parental vaccine decision making. Despite efforts of the medical and public health community, some developed countries have seen a resurgence of vaccine preventable diseases. Purpose: This study seeks to examine parental vaccination concern in a private pediatric practice in metropolitan Atlanta. Methods: A questionnaire was created by the PI to assess parental vaccination concerns, including items to assess parental feelings toward the providers and nurses regarding preventative care. Data was analyzed in SPSS version 19.0. The study was approved by the IRB at Georgia State University. Results: A total of 283 participant responses were included in the sample. Overall vaccine adherence was 96.1% (272). However, a large minority of participants who were considered to have vaccine concerns were identified: 40.3% (114) of participants responded yes to at least one vaccine hesitation item. Conclusion: Vaccine adherence in a private pediatric practice remains high. However some parents continue to have vaccination concerns and may be at risk for deviating from the vaccine schedule. Using qualitative methods to obtain parental beliefs may provide a deeper understanding of parental decisions to aid in the development of public health education programs. The feasibility of collecting data at a private pediatric practice is discussed.

Durante la pandemia por la COVID-19, enfermería realizó denotados esfuerzos por mantener operativos los servicios de inmunizaciones y alcanzar coberturas que signifiquen una protección específica para las poblaciones. Objetivo: Describir, analizar y comprender las experiencias de enfermeras que laboraron en la estrategia de inmunizaciones durante la pandemia de la micro red Chiclayo, 2021. Método: estudio cualitativo, descriptivo, los sujetos de estudio fueron profesionales de enfermería que laboraban en el servicio de inmunizaciones de la micro red, el tamaño de la muestra fue de 12 enfermeras, obtenida por criterios de saturación y redundancia, el muestreo fue no probabilístico por conveniencia. Para la recolección de datos se usó la entrevista semiestructurada, on-line validada por juicio de expertos y estudio piloto y los datos obtenidos fueron procesados por análisis de contenido. Durante la investigación se tuvo en cuenta los principios de rigor científico y ético. Resultados: dos categorías: A) Dificultades ante uso y escasez de equipos de protección personal durante vacunación en pandemia y B) Verificación de protocolo para asistencia y aplicación de inmunizaciones ante la COVID-19. Conclusión: Las enfermeras de la micro red de Chiclayo mostraron dificultades por el uso y también por la escasez de los EPP, durante la vacunación en pandemia, pero supieron aplicar el protocolo para la asistencia y aplicación de las vacunas y generaron citas para guardar un orden en asistencia a los consultorios durante la misma, haciendo uso de llamadas telefónicas y verificación de carnet de vacunación. / During the COVID-19 pandemic, nursing made notable efforts to keep immunization services operational and achieve coverage that means specific protection for the populations. Objective: Describe, analyze and understand the experiences of nurses who worked on the immunization strategy during the Chiclayo micro network pandemic, 2021. Method: qualitative, descriptive study, the study subjects were nursing professionals who worked in the health service. immunizations of the micro network, the sample size was 12 nurses, obtained by saturation and redundancy criteria, the sampling was non-probabilistic for convenience. For data collection, the semi-structured, online interview validated by expert judgment and pilot study was used and the data obtained were processed by content analysis. During the research, the principles of scientific and ethical rigor were taken into account. Results: two categories: A) Difficulties with the use and shortage of personal protective equipment during vaccination in a pandemic and B) Verification of protocol for assistance and application of immunizations against COVID-19. Conclusion: The nurses of the Chiclayo micro network showed difficulties due to the use and also the shortage of PPE, during the vaccination in a pandemic, but they knew how to apply the protocol for the assistance and application of the vaccines and generated appointments to maintain order. in assistance to the clinics during the same, making use of telephone calls and verification of the vaccination card.

Background and Purpose: Just over 15% of children under 18 years of age in the UnitedStates, or approximately 11.2 million children, are estimated to have special healthcare needs.Although children with special healthcare needs (CSHCN) make up a small percentage of thepediatric population, they account for over one third of pediatric medical care. Parental attitudesregarding immunization play a significant role in vaccination rates among children. The purposeof this research is to explore parental attitudes regarding immunization of CSHCN.Methods: This qualitative study focused on parental perceptions and beliefs aboutimmunizations for CSHCN. Sixteen participants, who were parents of CSHCN from onepediatric specialty care clinic participated in focus groups. Institutional review board approvalwas received prior to data collection.Results: While the purpose of this study was to determine the attitudes of parents ofCSHCN regarding immunizations, analysis revealed parents simply wanted to share their lifeexperiences rearing these children, with issues of immunization being secondary. Participantsdescribed the experience of caring for their CSHCN related to isolationism and the weight ofresponsibility as leader of their childs care. Additionally, the majority of parents thatparticipated viewed childhood vaccinations in a positive light. Parents acknowledged that it wasimportant for their own children to receive vaccines. Participants also recognized that it wasimportant for the community to be vaccinated in order to protect their child. However, the desirefor individualized care, at times, caused parents to disregard the immunization schedulerecommended by Center for Disease Control and Prevention.Conclusions: Health care providers can be effective and influential members of the healthcare team by engaging in community based education about vaccines, building trustingrelationships with parents and helping parents understand the need to follow the recommendedschedule for immunizations.

No description available.

With the rise of vaccine preventable illness in the US, the importance of timely vaccinations in children remains a priority. Mandatory school vaccination requirements are effective because they are generally accepted by the public, they allow schools and immunization programs to share resources, and they serve as a safety net to ensure all school children are immunized appropriately regardless of race, socioeconomic status (SES), or access to medical care2. However, it has repeatedly been shown that low-income, urban minority children have higher rates of underimmunization11-13, 15,16. The city of Philadelphia has a disproportionately large number of undervaccinated students compared to the rest of the state36. Philadelphia also has the highest poverty rate in the 10 largest cities of the US, and the majority of those living in poverty are minorities37. Given that the majority of Philadelphia students attend Philadelphia public schools, and of those students, greater than 75% are minorities, the disparity follows established trends39. Understanding the beliefs, attitudes, and behaviors of guardians of students in the School District of Philadelphia regarding mandatory immunization requirements and their barriers to fulfilling mandatory requirements can help facilitate future compliance. Ultimately, this information can reduce the number of undervaccinated students in the city and bridge this gap dividing students along racial and SES lines. / Urban Bioethics

Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-09-20T13:42:20Z No. of bitstreams: 0 / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-10-16T11:34:15Z (GMT) No. of bitstreams: 0 / Made available in DSpace on 2018-10-16T11:34:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-02-28 / Devido à ampla distribuição da malária entre os continentes e ao elevado número de casos clínicos e óbitos registrados anualmente, o desenvolvimento de uma vacina antimalárica segura e eficaz contra a doença ainda é de extrema importância. Dentre os vários modelos propostos até o momento, aquelas compostas por parasitos vivos ou por extrato proteico têm sido as mais promissoras no desenvolvimento de imunidade antimalárica. Entretanto, ainda não claro se imunizações com cepas com baixo potencial de virulência seriam capazes de prevenir ou amenizar os sintomas associados à malária grave. Assim, o presente estudo teve como objetivo investigar se camundongos imunizados com extrato proteico de Plasmodium berghei NK65, cepa de baixa virulência e não indutora de malária cerebral nesse modelo, são protegidos contra o desenvolvimento de malária cerebral induzida pela cepa ANKA de Plasmodium berghei (PbA). Para isto, foram realizados dois ciclos de imunização utilizando extrato proteico de Plasmodium berghei associado ao adjuvante CPG-ODN, com intervalo de 21 dias, em camundongos fêmeas C57BL/6, com idade entre 6 e 8 semanas. Após 30 dias da última imunização foi realizado o desafio experimental utilizando a cepa ANKA de P. berghei e iniciado o acompanhamento diário dos animais para avaliação do seu quadro clínico e da carga parasitária. Diante da presença de sinais neurológicos (escore clínico < 5), os animais foram pesados e eutanasiados para realização da coleta de sangue, baço e cérebro, enquanto animais sem esses sinais continuaram por ser acompanhados diariamente e, então, sacrificados a partir do 13º dia. A partir das amostras coletadas, foram determinados os níveis de anticorpos sorológicos, a frequência da população celular esplênica (células T CD4+ e CD8+, e linfócitos B), níveis de citocinas teciduais e análise histopatológica do tecido nervoso. Observouse que 46% dos animais imunizados com extrato de PbN e 69% dos animais imunizados com extrato de PbA foram protegidos do desenvolvimento de malária cerebral e tiveram sua taxa de sobrevivência prolongada, entretanto, estes animais desenvolveram hiperparasitemia sanguínea, com níveis de até 38% de parasitos circulantes. Estes animais não apresentaram sinais clínicos neurológicos, o que foi confirmado macroscopicamente pela ausência de hemorragia e reduzida inflamação no cérebro em relação aos animais que evoluíram para malária cerebral. Histopatologicamente, os animais com hiperparasitemia apresentaram poucos leucócitos aderidos ao endotélio vascular e ausência de vasos obstruídos. Em relação aos níveis de citocinas (IL-10, TNF-α, IFN-) e número de linfócitos esplênicos (T CD4+ e CD8+, e linfócitos B), estes estiveram significativamente reduzidos nos animais que desenvolveram hiperparasitemia em relação aos que desenvolveram malária cerebral. Interessantemente, os animais imunizados foram capazes de reconhecer tanto antígenos homólogos quanto heterólogos ao utilizado durante o processo de imunização, porém, esses anticorpos pareceram não influenciar o padrão clínico apresentado pelos animais. Portanto, nosso estudo demonstra que imunizações com parasitos de baixa virulência podem induzir imunidade capaz de proteger contra cepas altamente virulentas, mas os fatores que medeiam essa proteção ainda precisam ser melhor investigados. / The broad distribution of malaria around of the globe and the large number of clinical cases/deaths attributed to this disease turns the discovery of a safe and effective malaria vaccine an essential tool to halt the spread of the disease. Vaccines focused on the use of live parasites and crude parasites antigens have shown good results on the induction of antimalarial immunity, although it is still not clear if immunizations with low virulent strains are capable to prevent the development of symptoms of cerebral malaria. This research aim to investigate if immunizations with crude antigen of Plasmodium berghei NK65 (PbN), a low virulence strain noninductive of cerebral malaria in C57BL/6 mice, are able to protect the animals against the development of cerebral malaria after challenge with Plasmodium berghei ANKA (PbA). Mice were immunized twice with crude antigen associated to CPG-ODN adjuvant. Thirty days after the second immunization animals were challenged with 105 red blood cells infected with P. berghei ANKA. Animals were daily monitored to evaluate the clinical score and parasitaemia levels. If the presence of neurological signs (score < 5) were detected, animals were euthanized and blood samples, spleen and brain were collected; animals without neurological commitment were followed daily until the 14 day post-infection. Antibodies and cytokines levels, splenic cellular population (T CD4+, T CD8+ and B lymphocytes) and histopathological analysis were performed. The results showed that 46% of the animals immunized with crude antigen of PbN and 69% of the animals immunized with crude antigen of PbA were protected from the development of cerebral malaria and had their survival rate prolonged, however, these animals developed hyperparasitaemia, with levels up to 38% of circulating parasites. These animals did not present neurological signs which were confirmed macroscopically by the absence of hemorrhage and reduce brain inflammation in relation to the animals that evolved to cerebral malaria. Histopathologically, the animals with hyperparasitaemia presented few adhered leukocytes in the vascular endothelium and absence of obstructed vessels. In relation to cytokine levels and number of splenic lymphocytes, these were significantly reduced in animals that developed hyperparasitism in comparison with those who developed cerebral malaria. Interestingly, the immunized animals were able to recognize both homologous and heterologous antigens used during the immunization process, however, these antibodies did not appear to influence at the clinical condition presented by the animals. Therefore, our study demonstrates that immunizations with low virulence parasites may induce immunity capable of protecting against highly virulent strains, but the factors that mediate this protection still need to be better investigated.

No description available.

Anecdotal evidence indicated vaccine coverage disparities among foster-care (FCA) and natural-home adolescents (NHA). Arkansas laws require 5 vaccines for school entry (FVSE) to prevent 9 common childhood diseases. The study problem was that Pulaski County, Arkansas adolescent birth cohort (PCABC) immunization rates were low compared to U.S. adolescents for these FVSE. This study examined the extent to which (1) PCABC immunization rates were significantly different from those estimated for U.S. adolescents in 2006–2008, (2) NHA and FCA immunization rates were different in 2003– 2008; (3) sociodemographic variables mediate associations between home of residence (HOR), NHA or FCA, and up to date (UTD) status for FVSE; and (4) vaccination game theory (VGT) estimated deaths differ between individual-equilibrium and group-optimum behaviors. The methodologies applied were direct standardization, χ2, multiple logistic regressions, and VGT to analyze PCABC retrospective secondary data from the Arkansas immunization registry. The results revealed that U.S. adjusted UTD coverage rates for Hepatitis B, measles-mumps-rubella, and varicella were greater than those for PCABC. Race-adjusted FCA immunization rates were 120% higher than for NHA. Race mediated the association between HOR and UTD FVSE status, and African Americans had 80% greater odds of being UTD with FVSE compared to Caucasians. Group-optimum behavior was associated with fewer estimated deaths than individual equilibrium; thus, it is protective against disease outbreaks. Positive social change may occur among the PCABC when healthcare providers include these results in communications with parents at FCA and NHA community health clinics. Parental vaccine acceptance for their children may increase vaccinations and improve PCABC health and wellness.