Het Rijksvaccinatieprogramma in Nederland. Ontwikkelingen in 2006

In 2006 several changes were made in the Dutch National Immunisation Programme (NIP): Hepatitis B vaccination at birth was added for children born to mothers positive for hepatitis B surface antigen; a new vaccine for diphtheria, tetanus, pertussis (a-cellular), poliomyelitis and Haemophilus influenzae (DTaP-IPV/Hib) was introduced; vaccination against pneumococcal disease was added at two, three, four and eleven months; risk groups for hepatitis B receive a combined vaccine for DTaP-IPV/Hib and HBV at the same ages; DT-IPV and aP at the age of four years were combined in one vaccine; and new MMR vaccines were introduced. As new information became available in 2006, the desirability to introduce vaccinations in the NIP for the following diseases could be (re)considered: hepatitis B (universal vaccination), rotavirus, varicella and human papillomavirus. For respiratory syncytial virus and meningococcal serogroup B disease no candidate vaccines are available yet. Extension of the programme with available vaccines for hepatitis A, influenza and tuberculosis is not (yet) recommended. The NIP in the Netherlands is effective and safe. However, continued monitoring of the effectiveness and safety of the NIP is important as changes are made regularly. Maintaining high vaccine uptake is vital to prevent (re)emergence of diseases. Furthermore, the programme should be regularly reviewed as new vaccines become available.In 2006 traden verschillende veranderingen op in het Rijksvaccinatieprogramma (RVP) in Nederland: kinderen die geboren worden uit moeders die chronisch geinfecteerd zijn met hepatitis B krijgen vlak na de geboorte een hepatitis B vaccinatie; er is een ander vaccin geintroduceerd voor difterie, kinkhoest (a-cellulair), tetanus, poliomyelitis en Haemophilus influenzae (DaKTP/Hib); vaccinatie tegen pneumokokken is toegevoegd op de leeftijd van 2, drie, vier en elf maanden; risicogroepen voor hepatitis B krijgen op diezelfde leeftijden een combinatievaccin voor DaKTP/Hib en hepatitis B; DTP en aK zijn gecombineerd in een vaccin op vierjarige leeftijd; en er zijn nieuwe BMR vaccins geintroduceerd. Op basis van informatie die in 2006 beschikbaar is gekomen wordt geadviseerd de introductie van vaccinaties voor de volgende ziekten te overwegen: hepatitis B (universele vaccinatie), rotavirus, waterpokken en humaan papillomavirus. Voor respiratoir syncytieel virus en meningokokken B zijn nog geen kandidaatvaccins beschikbaar en uitbreiding van het RVP met beschikbare vaccins voor hepatitis A, influenza en tuberculose wordt nog niet aanbevolen. Het RVP is effectief en veilig, maar voortdurende bewaking hiervan is groot belang, omdat er regelmatig veranderingen optreden. Handhaven van de hoge vaccinatiegraad is essentieel om terugkeer van ziekten te voorkomen. Verder moet regelmatig bekeken worden of het RVP aangepast moet worden aangezien er steeds nieuwe vaccins beschikbaar komen

Formation of humoral and cellular immunity to measles vaccine in adults

Despite adherence to the policy of mass measles vaccination in the majority of countries, this infection still remains far from being fully eradicated. Measles outbreaks are reported worldwide, when the vast majority of cases are recorded in subjects of 18—35 years of age. Studies on assessing measles IgG antibody level in different regions of Russia reveal increased percentage of measles seronegative subjects among young adults. Current study was aimed at investigating formation of humoral and cellular immunity after measles vaccination in seronegative adults aged 18 to 30 years old. There were enrolled 50 measles seronegative healthy volunteers aged 18 to 30 years old. Level of anti-measles IgM and IgG antibodies was measured by ELISA (Vector-Best, Russia). Subclasses of measles specific IgG antibodies were analyzed by ELISA, by replacing IgG conjugate for IgG1, IgG2, IgG3, IgG4 conjugates, whereas measles specific IgA antibodies were estimated by ELISA with IgA conjugate (Polygnost, Russia) at a concentration of 1 μg/ml. Antibody avidity was assessed by ELISA (Euroimmun, Germany). Cell-mediated measles immunity was estimated by CD107a surface expression on CD8hi T cell subset stimulated by measles virus-derived antigens. A specific cellular response to measles antigens before vaccination was detected in 50% of examined subjects, whereas 40% samples showed no signs of cellular immune response, with 10% of remaining cases described as equivocal. It was found that 6 weeks after vaccination all vaccinated subjects developed measles specific IgG antibodies at protective level reaching 1.33 (0.85—1.82) IU/ml [Me (LQ—UQ)]. Anti-measles IgA antibodies were of 0.655 (0.423—1.208) IU/ml [Me (LQ—UQ)]. However, no measles specific IgM antibodies were detected 6 weeks after vaccination. In addition, primary type of immune response (dominant low-avidity anti-measles antibodies IgG3 subclass) to measles vaccination was observed in 24 out of 50 subjects, whereas 26 subjects developed secondary type of immune response (high-avidity anti-measles antibodies dominated by IgG1 subclass). A measles specific cellular immune response was observed in 47 of the 50 examined subjects, and in 3 volunteers it was equivocal. Further analysis revealed a cohort of subjects who were not vaccinated against measles (18 subjects), although 60% of them provided medical record on previous dual measles vaccination occurred in childhood. Another cohort consisted of subjects who had medical record of measles vaccination in childhood (32 subjects), but lost protective measles antibodies produced by plasma cells (23 subjects), and memory T cells (3 subjects), or measles antibodies and memory B cells (6 subjects) over time. Such pattern evidences that measles-specific cellular and humoral arms immune responses were developed and maintained independently of each other

Does social distancing matter for infectious disease propagation? A SEIR model and Gompertz law based cellular automaton

In this paper, we present stochastic synchronous cellular automaton defined on a square lattice. The automaton rules are based on SEIR model with probabilistic parameters gathered from real-world data on human mortality and SARS-CoV-2 disease characteristics. With computer simulations, we show the influence of the neighbourhood radius on the number of infected and deceased agents in the artificial population. The increase of the neighbourhood radius favors the spread of the epidemic. However, for a large range of interactions of exposed (who are both inward for and/or untested against) agents, even isolation of infected agents cannot prevent successful disease propagation. This supports aggressive testing against disease as one of the useful strategies preventing large peaks of infection in SARS-CoV-2-like disease spreading.Comment: 10 pages, 7 figure

The Impact of Social Groups on Variation in Infectious Disease Transmission and Control

Mathematical models of infectious disease are increasingly capable of capturing spatial and demographic factors in transmission. However, there has been limited evaluation of how ethnic and socioeconomic groups within a population might impact transmission, the effectiveness of interventions and inequalities in infectious disease outcomes. A large part of this challenge lies in identifying means by which information about how social groups interact can be measured and included in mechanistic models of transmission. By means of data analysis and mathematical modelling, I have investigated how social groups contribute to heterogeneity in transmission and how these factors may be captured in a model of transmission. In the first part of this thesis I first present my evaluation of the roles of transmission and vaccination differences between social groups in creating inequalities in disease risk. Secondly, I report my analysis of reported cases from the 2009 Influenza H1N1 outbreak to elucidate the spatial and social nature of the early stages of the outbreak. Later I present a novel framework that I have developed for analysis of social contact of school aged children and modelling transmission. This framework utilises national school and pupil data to simulate outbreaks over a network, explicitly accounting for school and household transmission links. Finally, I present the application of this framework in two distinct settings: First, I assess the potential role of the school system in inequalities in influenza risk between ethnic and socioeconomic groups in London. Then I investigate how connections between schools and households in the Netherlands might impact clustering of children unvaccinated against measles. Finally, I evaluate how such clustering impacts the epidemiology of measles in The Netherlands, where vaccine refusal is clearly associated to particular socio-religious communities. I find evidence that inequalities in disease are most sensitive to differences in transmission if the pathogen has a low basic reproduction number. With higher basic reproduction numbers, inequalities are more sensitive to variation in vaccine uptake. Inequalities observed in influenza are not clearly reconciled by the school network structure, however the network may promote inequalities in incidence early in an outbreak, which may be interpreted as inequality in risk. Finally, school networks can explain the observed measles dynamics in the Netherlands well, reproducing the outbreak scale and geographical spread of cases reported in recent outbreaks

Essays on the Economics of Vaccination

I examine vaccination behavior during a measles outbreak. By abandoning the rationalexpectations framework, I develop a model of vaccine behavior which recreates empirically observed vaccine hesitancy, as well as vaccination spikes during an outbreak. I use an agent-based model to simulate disease spread and agent behavior in a measles outbreak, in which rational agents minimize their expected costs by choosing their vaccination state. I allow some agents to instead use a heuristic, and others to have misinformation regarding vaccine risks, and finds that both reduce welfare. Including a social network has an ambiguous effect, as using more relevant local data allows agents to better estimate their risk from disease, but the same social network amplifies the impact of misinformation. I then examine a series of regulator interventions, and find that using a social media campaign to change agent’s perceptions of their peers’ views is the most cost-effective intervention. This presents regulators with a new framework with which to understand vaccine hesitancy, and an expanded menu of options to employ in the event of an outbreak

Vaccination issues on the threshold of the third millenium

Tato dizertační práce na základě deskriptivní průřezové studie vyhodnocuje různé názory a jejich vliv na důvěru v očkování ve skupině studentů medicíny a pedagogiky, protože oba tyto obory hrají důležitou roli ve vzdělávání dětí i dospělých, v případě pedagogiky formují dovednosti kritického myšlení. Studentům medicíny a studentům pedagogických oborů byly distribuovány anonymní dotazníky, které měly za cíl zmapovat jejich názory a postoje k výše uvedené problematice. Data prošla statistickým porovnáním dvou souborů pomocí logistické regrese. Z celkového počtu 722 respondentů bylo 386 studentů medicíny a 336 studentů pedagogiky. Statisticky významná většina respondentů uvedla, že nejsou zastánci alternativní medicíny. Mezi studenty Pedagogické fakulty však byl výrazně vyšší počet stoupenců alternativní medicíny. Míra pozitivního vnímání očkování (MPVO) u studentů obou fakult nezávisí na behaviorálních faktorech, ale je jasně podmíněna přístupem k alternativní medicíně. Strach z infekcí dramaticky zvýšil MPVO (až 6,7x) nad těmi, kteří se infekce nebáli nebo si nebyli zcela jisti, zda se jí mají bát. Strach z vedlejších účinků vakcíny jasně snížil MPVO alespoň na 84 %.This thesis based on descriptive comparative study is to evaluate different opinions and its influence to vaccination confidence in two branches of students, medical and pedagogical, as both of them plays important roles in children and adults education and, in case of pedagogy, forming the skills of critical thinking. Multi-item, opinion-based, paper-and-pencil typed anonymous questionnaires were distributed within medical students and students of pedagogical fields of study. Data has been sorted and divided into two clusters which underwent a statistical comparison using a logistic regression. From total of 722 respondents, 386 were medical students and 336 were pedagogical students. Most respondents said they were not in favor of alternative medicine; however, a significantly higher number of alternative medicine followers were among the respondents of the Faculty of Education. Positive vaccination perception rate (PVPR) is not dependent on behavioral factors of students at both faculties but it is clearly conditioned by attitude to alternative medicine. Fear of infections dramatically increased the PVPR (up to 6.7x) over those who were not afraid of the infection or were not quite sure whether to fear it. Fear of vaccines side effects clearly reduced the PVPR by at least 84%.Ústav epidemiologie a biostatistikyDepartment of Epidemiology and biostatisticsThird Faculty of Medicine3. lékařská fakult

Sociocultural concepts of pandemic influenza and determinants of community vaccine acceptance in Pune, India

Vaccines are considered one of public health’s greatest achievements. Yet, public concerns and hesitancy towards acceptance of vaccines has been noted around the world for various vaccines. Limited vaccine uptake against influenza A (H1N1) was a problem during the 2009-2010 pandemic. Ensuring the ability to rapidly produce large quantities of an efficacious vaccine has been a focus of pandemic preparedness at the global and national levels. Notwithstanding the importance of these preparedness measures, its availability and clinical efficacy alone may not be sufficient for the vaccine to be effective at a community level. Culture has a powerful influence on the understanding of sickness and illness-related behaviour. The framework of cultural epidemiology used in this thesis integrates the local validity of anthropology and the explanatory power of epidemiology to clarify the cultural basis of vaccine hesitancy and acceptance. Despite cross-cultural differences and an acknowledged need for country-specific studies, relatively little research has focussed on pandemic influenza vaccine hesitancy in lower income settings. A mixed-methods research study was conducted in urban and rural Pune, a hotspot of the influenza pandemic in India. The aim was to study local sociocultural features of illness and determinants of pandemic influenza vaccine acceptance from a community perspective. This work is a contribution to global advances in the study of vaccine hesitancy and it underscores the value of sociocultural study and community preferences in planning effective vaccine action

Английский язык для биологии и медицины: бакалавров и магистров

Терминология в условиях ускорения научно-технического прогресса приобретает особое значение. Она является источником получения информации, инструментом освоения специальности. Любая область науки и техники находит своё выражение в терминах. Практически нет ни одной области знания, которая изучается, не владея терминологией. Медицинская терминология является одним из специфических пластов лексики, которая в силу особенностей структурно-семантического, словообразовательного и стилистического характера отличается от общеупотребительных слов и занимает особое место в лексической системе языка. Медицинская терминология – это пласт лексического фонда со своими специфическими особенностями, ибо в каждом профессиональном подъязыке существует номенклатурная лексика, соотносимая с определенными реалиями и объектами. Особенность словарного состава терминологии заключается в том, что её номены представлены в ней шире, многообразнее, чем в других лексических подсистемах. Выбор английского языка в качестве второго языка сопоставительного исследования обусловлен его все возрастающей коммуникативной ролью в мировом сообществе, популярностью, сегодняшней жизненной необходимостью. Учебник предназначен для бакалавров и магистров в сфере биологии и медицины. Он состоит из 4 глав и параграфов. В каждой главе дается целый ряд основных лексических номенов, помогающие понять сложные тексты из неадаптированных источников этой сферы. Также прилагается несколько десятков упражнений для лучшего понимания и усвоения данного материала. Красочные иллюстрации наглядно демонстрируют основные положения и понятия в сфере биологии и медицины

State of the World 2003

If we are going to reverse biodiversity loss, dampen the effects of global warming, and eliminate the scourge of persistent poverty, we need to reinvent ourselves -- as individuals, as societies, as corporations, and as governments. In this 20th anniversary edition of a Worldwatch classic, the Institute's highly respected interdisciplinary research team argues that past successes -- such as the elimination of smallpox and the encouraging drop in birth rates in many countries -- prove that humanity is capable of redirecting itself in positive ways. Most encouraging, the world is sitting on the cusp of similar successes that could usher in a sustainable human civilization. The use of clean, renewable energy technologies, like wind turbines and photovoltaics for example, is growing at over 25 percent per year, and they are increasingly competitive with fossil fuels. Organic farming is the fastest-growing sector of the world agricultural economy, with the potential to rejuvenate rural communities from the Philippines to Sweden. And a quickening of religious interest in humanity's place in the natural environment could awaken a powerful new constituency to the cause of sustainability. The challenges are still immense, of course, as the book also documents, but the building blocks for a historic reinvention of human civilization are now within reach

History of pharmacy

ПОСОБИЯИСТОРИЯ МЕДИЦИНЫФАРМАЦИЯ /ИСТОРИЯИСТОРИЯ ФАРМАЦИИЛЕКАРСТВОВЕДЕНИЕИНТЕРНЫHISTORY OF PHARMACYИНОСТРАННЫЕ СТУДЕНТЫСодержит актуальную информацию об основных этапах становления и развития фармации от рабовладельческого периода и до конца XX века, показана роль выдающихся ученых в развитии фармацевтической науки. Приведена хронология важнейших событий и открытий в фармации. Для студентов фармацевтического факультета и факультета подготовки иностранных граждан с английским языком обучения, интернов, специалистов фармацевтических организаций, интересующихся историей фармации