Heta P Nieminen

FVR - Finnish Vaccine Research

Purpose The aim of the NONSEnse project is to investigate the non-specific effects of vaccines and immunisation programmes on the overall health of children by using information from the extensive nationwide registers on health and sociodemographic factors in Denmark, Finland, Norway and Sweden. Participants The cohort covers 9 072 420 children ag...

Background According to earlier studies, live vaccines like measles-mumps-rubella (MMR) vaccine could reduce also other infections than only the infections they are targeted against. This non-specific effect has been seen especially in studies in low-income countries and results from high-income countries have not been unambiguous. In 2011 Finland...

In Finland all children are entitled to regular health check-up visits at child health clinics (CHC). During the visits public health nurses and physicians follow-up the growth and development of the child, evaluate the welfare of the family, give health counselling and vaccinate the children. The aim of this study was to measure the time used by t...

Background Live vaccines potentially have non-specific effects that protect against other infections than those the vaccines are targeted against. The national vaccination program (NVP) in Finland was changed on September 1st, 2006: before BCG vaccine was given to all newborn babies and afterwards to babies in risk groups only. We used this natural...

Objective: To compare the use of antibiotics in children in four Northern European countries. Methods: We conducted a register-based study based on individual-level prescription data from national prescription registers. We identified all redeemed outpatient prescriptions for systemic antibiotics in children aged 0-14 years from July 2006 to Jun...

Purpose: Comparing rates of childhood infectious disease hospitalisations across countries may uncover areas for improvement in the prevention of severe childhood infections. We compared rates of childhood infectious disease hospital contacts across Denmark, Finland, Norway, and Sweden with the overall objective to elucidate potential differences...

Background Improvements in mortality after congenital heart surgery have necessitated a shift in focus to postoperative morbidity as an outcome measure. We examined late morbidity after congenital heart surgery based on prescription medication use. Methods Between 1953 and 2009, 10,635 patients underwent congenital heart surgery at <15 years of ag...

Background: In the nation-wide double-blind cluster-randomised Finnish Invasive Pneumococcal disease trial (FinIP, ClinicalTrials.gov NCT00861380, NCT00839254), we assessed the indirect impact of the 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against five pneumococcal disease syndromes. Methods: Childre...

Background In a previous cohort study of 4-year-old Danish children, revaccination with the live measles-mumps-rubella vaccine (MMR) was associated with a 16% reduction in the rate of hospitalization lasting two days or longer for non-measles-mumps-rubella infections. Aim To examine if the introduction of revaccination with MMR at 4 years of age i...

Background: Patients are surviving decades after congenital heart surgery (CHS), raising the importance of postoperative quality of life as an outcome measure. We determined the long-term social outcomes after CHS performed during childhood. Methods: Between 1953 and 2009, 10 635 patients underwent surgery for congenital heart defects at <15 yea...

Background Postoperative morbidity is an increasingly important outcome measure of patients who have undergone congenital heart surgery ( CHS ). We examined late postoperative morbidity after CHS on the basis of patients’ government‐issued medical special reimbursement rights. Methods and Results Between 1953 and 2009, 10 635 patients underwent CH...

Background Several studies have shown differences in susceptibility to infections and immune response to vaccines by sex. Prematurely born infants are at higher risk for pneumococcal diseases, with lower effectiveness for some vaccines compared to term infants. We have reported the effectiveness of the 10-valent pneumococcal non-typeable Haemophilu...

Background: Pneumococcal conjugate vaccines have potential to prevent significant proportion of childhood pneumonia. Finnish Invasive Pneumococcal disease vaccine trial was designed to assess the vaccine effectiveness (VE) of the 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against several outcomes. We now...

Estimation of the full disease burden caused by Streptococcus pneumoniae is challenging due to the difficulties in assigning the aetiology especially in lower and upper respiratory infections. We estimated the pneumococcal disease burden by using the vaccine-preventable disease incidence (VPDI) of PHiD-CV10 vaccine (GSK) in our clinical trial setti...

Finnish Invasive Pneumococcal disease (FinIP) vaccine trial was designed to evaluate effectiveness of ten-valent pneumococcal conjugate vaccine (PHiD-CV10, GSK). We conducted two satellite studies to evaluate PHiD-CV10 effectiveness against pneumococcal carriage in FinIP-vaccinated children (long-term direct and indirect effectiveness combined) and...

Objectives: We analysed nationwide early and late results after the Mustard, Senning and arterial switch operation. Methods: We included all paediatric patients (<18 years) who underwent a Senning, a Mustard or an arterial switch operation for transposition of the great arteries from 1968 to 2009 in Finland. Data were obtained retrospectively fr...

Background: Comprehensive information regarding causes of late post-operative death following pediatric congenital cardiac surgery is lacking. Objectives: The study sought to analyze late causes of death after congenital cardiac surgery by era and defect severity. Methods: We obtained data from a nationwide pediatric cardiac surgery database a...

The Finnish Invasive Pneumococcal disease (FinIP) vaccine trial was a nationwide cluster-randomised double-blind trial designed to demonstrate the effectiveness of pneumococcal conjugate vaccine in vaccinated children and indirect effects in unvaccinated populations. Together with the parallel carriage/AOM trial, over 47,000 children were enrolled,...

-Surgical treatment of congenital cardiac defects in Finland started over 60 years ago. We analyzed the survival of all the pediatric cardiac surgery patients operated on before 2010. -Data was obtained retrospectively from a pediatric cardiac surgery database. Patient status was received from the Finnish population registry. Survival was determine...

OBJECTIVES Our study is a population-based evaluation of the long-term results after surgical repair for tetralogy of Fallot (TOF). All patients operated on in the country since the first procedure were identified via the Finnish research database of paediatric cardiac surgery and the Finnish population register. The follow-up was 99% completed due...

Background Vaccine effectiveness of pneumococcal conjugate vaccines against culture-confirmed invasive pneumococcal disease has been well documented. In the Finnish Invasive Pneumococcal disease (FinIP) trial, we reported vaccine effectiveness and absolute rate reduction against laboratory-confirmed invasive pneumococcal disease (confirmation by cu...

Antimicrobial drugs are frequently prescribed to children for respiratory tract infections such as otitis, tonsillitis, sinusitis, and pneumonia. We assessed the effect of the ten-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10; GlaxoSmithKline) on antimicrobial purchases. In this nationwide phase 3-4 cluster-rando...

Background: The Finnish Invasive Pneumococcal disease (FinIP) vaccine trial was designed to assess the effectiveness of a pneumococcal vaccine containing ten serotype-specific polysaccharides conjugated to Haemophilus influenzae protein D, tetanus toxoid, and diphtheria toxoid as the carrier proteins (PHiD-CV10) against invasive pneumococcal disea...

To examine the overall morbidity of patients who underwent surgery for congenital cardiac defect during childhood. A congenital cardiac defect treated with surgery is seldom totally cured. The incidence of residua, sequelae, and comorbidity is quite high. The morbidity has not been thoroughly examined. Medication was used as an indicator of morbidi...

Background: Congenital heart defects include a wide range of inborn malformations. Depending on the defect, the life expectancy of a newborn with cardiac anomaly varies from a few days to a normal life span. In most instances surgery, is the only treatment available. The late results of surgery have not been comprehensively investigated. Aims: Mort...

Treatment of a single-ventricle heart defect involves redirecting of systemic venous blood returning to the heart to gradually flow directly into the pulmonary artery without the functional right side of the heart being involved. In developed countries, three out of four persons with this ailment will nowadays reach adulthood. Among these, at least...

This study examined the rate of nosocomial infection (NI) in children who underwent cardiac surgery, and also investigated the impact of postdischarge infection surveillance. Risk factors for surgical site infections (SSIs) also were evaluated. All patients who underwent open-heart cardiac surgery in the Hospital for Children and Adolescents, Helsi...

We examined the causes and modes of late death after pediatric cardiac surgery. The late mortality of patients operated on for congenital heart defect (CHD) is comprehensively unexamined. In this study, the causes of death were examined to obtain further knowledge of the morbidity of the patients. We studied all late deaths of patients operated on...

This population-based study characterizes the history and progress of pediatric cardiac surgery in Finland. For the first time in the literature, all defects and procedures are included in an outcome study, reflecting the true effectiveness of operative treatment. All the patients operated on since the beginning of pediatric cardiac surgery in Finl...

This population-based study was designed to examine the psychosocial outcome of Finnish patients who had been operated on for congenital heart disease during childhood. A questionnaire was mailed to 3789 adult patients who had been operated on for congenital heart defects in Finland. Of these, 2896 (76%) answered the questionnaire. The mean age of...

This population-based study characterizes the history and progress of pediatric cardiac surgery in Finland. For the first time, all defects and procedures are included in an outcome study, reflecting the true effectiveness of operative treatment. All data relating to the operations were collected retrospectively from hospital records. Current patie...