(From the ISHN Member information service) Two articles in Issue #1, 2015 of Vaccine examine the work of National Advisory Committees on Immunization/Vaccinations in several developed countries in Europe, North America and the Pacific. One of the articles is an editorial that recommends several criteria for improving the effectiveness of such committees. The second article reports on an international study of the functioning of these committees according to criteria such as transparency, scientific validity and committee operations. Both analysis are sensible and scientific, perhaps too much so. In our reading of the criteria for effectiveness, we looked for assessments that suggested these committees were working in the real world, that they were recommending strategies to increase the reach of immunization programs, that they were addressing issues related to vaccine hesitancy, that they devised strategies for communication with parents, that they addressed equity and cultural issues and that they considered how schools can be a partner in almost all vaccination/immunization policies and programs. Perhaps this type of information is available on the various health ministry/committee web sites (the primary source of information for the articles) but these two articles did not report such. It might be time for these national advisory committee members to get out of the laboratory and into the real world of vaccine delivery. Read more>>
0 Comments
(From the ISHN Member information service) An article in Issue #49, 2014 of Vaccines reports on a WHO led study on the growing trend among parents around the world. "Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite the availability of vaccination services. Different factors influence vaccine hesitancy and these are context-specific, varying across time and place and with different vaccines. Factors such as complacency, convenience and confidence are involved. Acceptance of vaccines may be decreasing and several explanations for this trend have been proposed." The WHO Strategic Advisory Group of Experts (SAGE) has developed an explanatory model that was tested and found useful in explaining the results of this interview-based study in Immunization Managers in several countries. "Even if there had been reports of vaccine hesitancy in their country, 11 of the 13 IMs considered that vaccine hesitancy was not common and that it did not have a significant impact on vaccine uptake in the routine immunization programmes. IMs from two countries indicated that mass immunization campaigns, rather than routine immunization programmes, were affected by vaccine hesitancy. Factors concerning convenience and ease of access were perceived to be important by nine of the IM's Convenience was a factor for sub-populations which did not use the health services provided and for hard-to-reach populations. However, two IMs stated that vaccine hesitancy was an important issue in their country." When IMs were asked about the percentage of non-vaccinated and under-vaccinated individuals in their country due to lack of confidence in vaccination, only six provided estimates ranging from less than 1% to 20%. Four IMs reported issues of complacency in their countries." Religious beliefs were often a causal factor in vaccine hesitancy (cited by nine IMs).Risk perceptions were identified by seven IMs as causal factors. This included concerns regarding vaccine safety, lack of perceived benefits of vaccination and lack of understanding of the burden of vaccine-preventable diseases. The new, basic understanding of vaccine hesitancy from this first study, which shows an apparent lack of urgency among Immunization Managers, runs counter to the many news stories of returning diseases such as measles in high income countries as well as renewed concerns about infectious diseases in low resource countries. Schools are a convenient site for vaccinations as well as a strong connection for educating parents. School policies about vaccination requirements are also key. More attention and action are warranted. Read more>>
(From the ISHN Member information service) An article in Issue #5, 2015 of Vaccine provides an update on the number of countries currently using schools to deliver vaccinations to their populations. The article covers only the delivery of the vaccines and does not discuss the other roles that schools can play in informing parents, educating students, and responding to outbreaks but it underlines the need for a global discussion of the school's role in immunization, development and in national policies/committees." Every year since 1998, UNICEF and WHO collect data through the “WHO-UNICEF Joint Reporting Form (JRF)”, which is completed by Ministries of Health in all Member States [5]. Since 2009, the data includes data on whether a school-based approach is used in a country, what vaccines are being given at what grade and to what age groups, the sex of the children targeted, as well as some additional questions. Countries are asked whether “routine immunization is given to school-aged children using the school as a venue” and should include only “doses that are given as part of the national immunization schedule”, i.e. excluding campaigns". "Of the 195 countries and territories that had been requested to complete the JRF report in 2013 (reporting 2012 data), 189 submitted a JRF form, of which 174 included information on whether a school-based approach was used in their country as of 2012. Of these, 95 answered positively, while 79 said no school-based approach was being used for immunization services". "64% of high income or higher middle income countries reported the existence of a school-based immunization program, against 28% of lower and lower middle income countries". "Most countries provided more than one antigen using a school-based approach, often using combination vaccines. Only 13 countries just gave one antigen, while at the other extreme 3 countries gave 10 different antigens." Read more>>
(From the ISHN Member information service) An article in Issue #2, 2015 of the Journal of Interpersonal Violence reports that severe physical abuse affects student educational achievement. Mild physicalabuse and sexual abuse were not correlated with student dropout and eventual years of schooling several years later. "We used data from the Ontario Child Health Study (N = 1,893), a province-wide longitudinal survey. Potential confounding variables (family socio-demographic and parental capacity) and child-level characteristics were assessed in 1983, and child abuse was determined in 2000-2001 based on retrospective self-report. Results showed that PA and SA were associated with several factors indicative of social disadvantage in childhood. Multilevel regression analyses for years of education revealed a significant estimate for severe PA based on the unadjusted model (−0.60 years, 95% CI = [−0.45, −0.76]); estimates for non-severe PA (0.05 years, CI = [−0.15, 0.26]) and SA (−0.25 years, CI = [−0.09, −0.42]) were not significant. In the adjusted full model, the only association to reach significance was between severe PA and reduced years of education (−0.31 years, CI = [−0.18, −0.44]). Multilevel regression analyses for failure to graduate from high school showed significant unadjusted estimates for severe PA (OR = 1.77, 95% CI = [1.21, 2.58]) and non-severe PA (OR = 1.61, CI = [1.01, 2.57]); SA was not associated with this outcome (OR = 1.40, CI = [0.94, 2.07]). In the adjusted full models, there were no significant associations between child abuse variables and failure to graduate. The magnitude of effect of PA on both outcomes was reduced largely by child individual characteristics. Of particular note, severe PA was associated with reduced years of education after accounting for a comprehensive set of potential confounding variables and child characteristics". Read more>>
|
Welcome to our
|