Uptake of meningococcal vaccine in Arizona schoolchildren after implementation of school-entry immunization requirements.
ABSTRACT Meningitis and bacteremia due to Neisseria meningitidis are rare but potentially deadly diseases that can be prevented with immunization. Beginning in 2008, Arizona school immunization requirements were amended to include immunization of children aged 11 years or older with meningococcal vaccine before entering the sixth grade. We describe patterns in meningococcal vaccine uptake surrounding these school-entry requirement changes in Arizona.
We used immunization records from the Arizona State Immunization Information System (ASIIS) to compare immunization rates in 11- and 12-year-olds. We used principal component analysis and hierarchical cluster analysis to identify and analyze demographic variables reported by the 2010 U.S. Census.
Adolescent meningococcal immunization rates in Arizona increased after implementation of statewide school-entry immunization requirements. The increase in meningococcal vaccination rates among 11- and 12-year-olds from 2007 to 2008 was statistically significant (p<0.0001). All demographic groups had significantly higher odds of on-schedule vaccination after the school-entry requirement change (odds ratio range = 5.57 to 12.81, p<0.0001). County demographic factors that were associated with lower odds of on-schedule vaccination included higher poverty, more children younger than 18 years of age, fewer high school graduates, and a higher proportion of Native Americans.
This analysis suggests that implementation of school immunization requirements resulted in increased meningococcal vaccination rates in Arizona, with degree of response varying by demographic profile. ASIIS was useful for assessing changes in immunization rates over time. Further study is required to identify methods to control for population overestimates in registry data.
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ABSTRACT: Recent data have shown that the immune protection evoked by vaccines given in the first years of life progressively weakens, and that this is associated with a higher than expected incidence of vaccine-preventable diseases in adolescents and young adults. Furthermore, the greater circulation of pathogens among adolescents and young adults leads to a high risk of infection in unvaccinated or not fully vaccinated younger children. These findings, together with the availability of vaccines specifically developed to prevent infections that typically occur during adolescence, have induced a number of experts to suggest radical changes in the immunisation schedules usually recommended by health authorities. The most important of these relate pertussis, meningococcal and human papillomavirus vaccines but, although they are based on unexceptionable scientific premises, the suggestions have been only slowly and partially received in most countries, even in those in which vaccination programmes are usually adequately implemented and monitored. Adolescence is a particular period of life characterised by changes in intellectual, moral, physical, emotional and psychological development. All of these can have a considerable impact on compliance with immunisation schedules because the approach to any preventive method no longer entirely depends on parents' and pediatricians' judgements as in the first years of life but is the consequence of a more complex process involving the adolescents' thoughts and opinions, their relationships with their parents, friends and physicians, and the information they receive from the mass media. Every effort should be made to overcome the barriers to adolescent immunisation, including those arising from the adolescents themselves.Vaccine 09/2013; 31(46). DOI:10.1016/j.vaccine.2013.08.092 · 3.49 Impact Factor
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ABSTRACT: Starting in 2008 several European countries experienced a financial crisis. Historically, diseases whose prevention and treatment depend highly on the continuity of healthcare re-emerge during political and financial crises. Evidence suggests that the current financial crisis has had an impact on the health and welfare of Europeans and that population health status and morbidity as well as mortality patterns may change in the coming years. At the same time decisions about expenditure for health services may impact the ability of public health providers to respond. It is expected that the current crisis will further exacerbate socioeconomic and health inequalities and novel vulnerable groups will emerge in addition to existing ones. We review the available evidence and discuss how the current crisis may have an impact on vaccine-preventable diseases and influence vaccination coverage rates in Europe.
Rebecca A Hills