Measles immunisation: feasibility of a 90% target uptake.

Lakhani, Azim; Morris, Richard W; Morgan, Myfanwy; Dale, Charlotte; Vaile, Michael

doi:10.1136/adc.62.12.1209

Cited by 16 publications

(4 citation statements)

References 12 publications

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“…3,9]. Lakhani et al (1987) recommended as rapid an increase in the herd immunity of this age as possible [5]. However, it is practically impossible to provide the recommended 90% uptake rate for these children, mainly because public offices would not all obey the recommendations [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

The Measles Outbreak in Chikuhou District, Fukuoka, Japan, 1990: Correlation between Herd Immunity Level and Outbreak Size

Ohga¹,

Okada²,

Miyazaki³

et al. 1992

Pediatrics International

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A measles outbreak occurred in the Chikuhou district of Fukuoka, Japan from May to October 1990, during which 71 patients were cared for at the Itoda Public Hospital. Hospital records revealed a large outbreak in the adjacent town of Kanada. In order to characterize the outbreak, questionnaires were sent to all preschool‐age children in Itoda (73% effective response) and in Kanada (76% effective response) requesting information about their vaccination and/or history of measles. The number of patients was 22 (4%) in Itoda and 63 (14%) in Kanada, most of these being preschoolers, while the vaccination rate was 61% and 44%, respectively. The herd immunity levels in age‐specific groups were compared between the two towns. Before the epidemic, the immunity level of 1 year old children in Kanada, who showed the higher attack rate, was lower (18%) than that in Itoda (39%), while after the epidemic it rose above 60% in both towns. When we studied the correlation between the attack rate and the vaccination rate, or the number of children susceptible to measles (susceptibility rate) in each preschool, the attack rate correlated negatively with the vaccination rate (correlation coefficient [CC] = ‐ 0.818; P < 0.01), and positively with the susceptibility rate (CC 0.860; P < 0.01). The regressed equation on the correlation indicated that the immunity level should be more than 70% to keep the attack rate under 5% in preschoois. After the epidemic, the immunity levels of all preschoolers reached above 70%. Early vaccination should be given to at least 70% of young preschoolers in order to prevent a large outbreak of measles under the present vaccination program in Japan.

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Section: Discussionmentioning

confidence: 99%

The Measles Outbreak in Chikuhou District, Fukuoka, Japan, 1990: Correlation between Herd Immunity Level and Outbreak Size

Ohga¹,

Okada²,

Miyazaki³

et al. 1992

Pediatrics International

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“…In addition, the experience a mother has with the first immunization strongly influences her beliefs about and behaviour toward subsequent immunizations, including those for other children. Bad experiences either in the way the immunization procedure was handled or with side-effects can lead mothers to delay or default (Stevens et al 1986, Funkhouser et al 1987, Lakhani et al 1987. It is important, therefore, to understand how childhood diseases and immuni-zations are perceived and to listen to caregivers' experiences and concerns.…”

Section: Introduction Abstractmentioning

confidence: 99%

‘As every good mother should’. Childhood immunization in New Zealand: a qualitative study

White

Thomson

2007

Health &Amp; Social Care in the Community

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Introduction AbstractImmunization coverage is a cause for concern in both developed and developing countries. In New Zealand immunization uptake rates have been estimated at less than 60% for children under the age of 2 years old. A qualitative exploration of knowledge, experiences and concerns appeared necessary to supplement the quantitative data and offer some explanations for low uptake.Focus groups and individual interviews were held with primary child caregivers in Auckland, a major multi-cultural metropolis of New Zealand. A total of 67 parents took part of whom 97% were mothers. Discussion focused on identifying the knowledge and experiences participants had of childhood diseases and immunizations, and on their concerns. Interview data were analysed following construction of role ordered and conceptually clustered matrices.The results demonstrated limited knowledge and a lack of experience regarding childhood diseases. Some mothers conceptualized immunization using a metaphor of 'protection'. Others perceived immunization as socio-politically driven and were distrustful of immunization campaigns. Many mothers faced a dilemma about immunization and were highly anxious. There was a greater concern about the side effects of immunization than about the side effects of childhood diseases. This may reflect a 'developed world' view with a difference between the concerns of white middle class mothers, and those mothers from the Pacific Islands, where common childhood diseases are more endemic.was not considered to be sufficiently recognized by health service providers. Personalized programmes designed to meet the needs of mothers are required to complement existing population oriented immunization programmes.Predominantly the onus for immunization lay with mothers and this

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“…5 Unfortunately, a number of factors, including inadequate access to medical care, financial barriers, and insufficient education, have contributed to low rates of immunizations in developing countries as well as most developed countries. [6][7][8] Studies have shown 95% to 98% of children in the United States have adequate immunization levels upon school entry, probably due to the strict laws that are enforced in this population.' In comparison, studies of 2-year-olds reveal immunization levels ranging from 49% to 70%.6°lo Documentation of recent measles outbreaks in the United States indicates that 55% of cases occurred among children who had not been routinely vaccinated, although 24% had no obvious contraindication for vaccination.ll The majority of these unvaccinated children were of preschool age.…”

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confidence: 99%

Inadequate Immunizations

Hymel

Sherman

Pope

et al. 1993

Clin Pediatr (Phila)

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Immunizations are cost-effective measures for assuring public health. However, recent outbreaks of measles, mumps, and pertussis underscore the inadequacy of current immunization programs. A model identifying those children who are likely to be inadequately immunized could focus the use of limited health funds. A retrospective examination of the medical charts of 101 children in a large inner-city clinic was undertaken to determine if specific factors were associated with inadequate immunization status. Fifty percent of the children were inadequately immunized by 18 months of age (no measles-mumps-rubella or fewer than three diphtheria-pertussis-tetanus vaccinations). Logistic regression analyses showed that older maternal age, no recurrent or chronic illnesses, and vaginal delivery were independently associated with inadequate immunization status. However, on many charts, information on maternal, social, and environmental variables was incomplete. The increasing use of structured medical charts will enhance data collection and the determination of an appropriate index. A prospective study of the variables identified, along with standardization of medical records and inclusion of social history data, is necessary to further investigate the utility of screening criteria for inadequate immunizations.

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Measles immunisation: feasibility of a 90% target uptake.

Cited by 16 publications

References 12 publications

The Measles Outbreak in Chikuhou District, Fukuoka, Japan, 1990: Correlation between Herd Immunity Level and Outbreak Size

The Measles Outbreak in Chikuhou District, Fukuoka, Japan, 1990: Correlation between Herd Immunity Level and Outbreak Size

‘As every good mother should’. Childhood immunization in New Zealand: a qualitative study

Inadequate Immunizations

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