Parental Refusal of Varicella Vaccination and the Associated Risk of Varicella Infection in Children
Institute for Health Research, Kaiser Permanente Colorado, PO Box 378066, Denver, CO 80237-8066. JAMA Pediatrics
(Impact Factor: 5.73).
01/2010; 164(1):66-70. DOI: 10.1001/archpediatrics.2009.244
To quantify both the individual-level and attributable risk of varicella infection requiring medical care in children whose parents refuse varicella immunizations.
Matched case-control study with conditional logistic regression analysis.
Kaiser Permanente of Colorado (KPCO) health plan between 1998 and 2008.
Each pediatric physician-diagnosed case of varicella (n = 133) was matched to 4 randomly selected controls (n = 493). Cases were matched by age, sex, and length of enrollment in KPCO. Main Exposures Varicella vaccine refusal.
There were 7 varicella vaccine refusers (5%) among the cases and 3 (0.6%) among the controls. Children of parents who refused varicella immunizations were at a greatly increased risk of varicella infection requiring medical care (odds ratio, 8.6; 95% confidence interval, 2.2-33.3) compared with children of parents who accepted vaccinations (P = .004). In the entire KPCO pediatric population, 5% of varicella cases were attributed to parental vaccine refusal.
Children of parents who refuse varicella immunizations are at high risk of varicella infection relative to vaccinated children. These results will be helpful to health care providers and parents when making decisions about immunizing children.
Available from: link.springer.com
- "In addition to " righting the wrong " of pox parties, the medical community can begin integrating them into a comprehensive public health strategy. First, many parents who refuse vaccination do not make active efforts to infect their children with the virus (Glanz et al. 2010), thereby putting them at risk for more deadly infections in adulthood. Supporting pox parties as a medically viable alternative to vaccination may thus be a good way to increase varicella immunity in the child population. "
Available from: Michel Cabassud
[Show abstract] [Hide abstract]
ABSTRACT: Operation of a batch reactor covers a wide domain from optimization of operating conditions to on-line control and monitoring. This paper focuses on the overall methodology developed in our laboratory for more than 10 years, in the field of fine chemical industry. This methodology lies on tendency modeling for stoichiometry and kinetic determination, optimization of operating conditions, and control of batch reactor by linear or non-linear Model Predictive Control.
[Show abstract] [Hide abstract]
ABSTRACT: Since 2004, general varicella vaccination has been recommended for all children 11-14 months of age in Germany. The objective of this study was to examine vaccination coverage in children and factors associated with parental acceptance during the first years after recommendation. In a regional surveillance area, cross-sectional parent surveys were conducted in 2006, 2007 and 2008 in random samples (n=600) of children aged 18-36 months; data were obtained for 372, 364 and 352 children, respectively. Parents were questioned on their child's varicella disease history, and on varicella vaccination status as recorded in the child's vaccination booklet. Overall coverage increased from 38% in 2006 to 51% in 2007 and stagnated at 53% in 2008; in susceptible children (without previous varicella disease until vaccination or time of survey) coverage was 42%, 61% and 59%, respectively. Recommendation by the paediatrician as reported by the parents increased from 48% (2006) to 57% (2007) and 60% (2008), and was the main independent factor associated with parental acceptance. In 32-35% of unvaccinated children parents had not yet decided whether to vaccinate against varicella. Additional programmes targeting paediatricians' and parents' acceptance of varicella vaccination are needed to achieve the WHO-defined goal of at least 85% coverage.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.