OBJECTIVES: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. METHODS: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. RESULTS: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. CONCLUSIONS: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.
Child ; Child, Preschool ; Female ; *Health Policy ; Humans ; Immunization/*statistics & numerical data ; Immunization Programs/standards/*statistics & numerical data ; Korea

OBJECTIVETo analyze the immunization status of category II vaccine in Chinese Mainland in 2012.

METHODSThe completeness of report unit by township and county, including 31 provinces (cities, municipalities) and Xinjiang Production and Construction Corps, the number of doses and the number of counties covered for category II vaccine at different areas, average types of category II vaccine by county were analyzed by descriptive epidemiological methods, according to monthly report of vaccination data for category II vaccines by township in 2012 which all of provinces and population were almost covered, through the National Immunization Program(NIP) monitoring information system of China.

RESULTSA total of 29 kinds of category II vaccine with 90 843 530 doses were reported in 2012, and the total average dose was 674.2 per 10 000 people. The report completeness by county and township were 83.32% (29 557/35 472) and 80.01% (396 652/495 756) respectively. The reported doses of rabies vaccine for human use, Haemophilus influenza type b vaccine and influenza vaccine was the top third vaccine, among those for all kinds of category II vaccine, which were 17 027 259, 13 996 206, 11 324 518 respectively, and 126.4, 103.9, 84.1 doses per 10 000 people. In 2773 county units, varicella attenuated live vaccine, influenza vaccine, rabies vaccine for human use were the top three kinds of category II vaccine in terms of the number of county where vaccines have been used in 2012, which were 2442(88.06%), 2415(87.09%), 2366(85.32%) respectively. Guangdong province with 12 266 531 doses was the highest report doses for category II vaccine whereas Qinghai province with 57 767 doses was the lowest number in 2012. Regarding to the average report doses by province, the highest or lowest number was 2425.0 doses per 10 000 people in Shanghai province, and 101.7 doses per 10 000 people in Qinghai province separately.

CONCLUSIONMany kinds of category II vaccine with a large amount have been used in China, and there are significant different among areas. Surveillance and management for category II vaccines should be future improved.

China ; epidemiology ; Humans ; Immunization Programs ; statistics & numerical data ; Population Surveillance ; Vaccination ; statistics & numerical data

PURPOSE: This study was aimed to determine the status and related factors of age-appropriate immunization among urban-rural children aged 24-35 months in a 2005 population-based survey in Nonsan, Korea. MATERIALS AND METHODS: We conducted household survey and provider check using questionnaire and checklist to obtain data on immunization status for children, aged 24-35 months. Age-appropriate immunization was defined as status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), 3 Polio, the first measles-mumps-rubella (1 MMR) doses, and the 4 : 3 : 1 series. RESULTS: Age-appropriate immunization rates were 51.7% for 4 DPT, 88.0% for 3 Polio, 87.9% for 1 MMR, and 50.3% for the 4 : 3 : 1 series. First-born children, lower perceived barrier scores, and higher perception of immunization data were significantly related to age-appropriate immunization. CONCLUSION: The findings indicated that age-appropriate immunization rate could be improved by implementing reminder/recall service and providing the knowledge about immunization. Identification and consideration related factors would improve immunization rate and age-appropriate immunization.
Child, Preschool ; Data Collection ; Humans ; Immunization/*statistics & numerical data ; *Immunization Schedule ; Republic of Korea ; Rural Population/statistics & numerical data ; Urban Population/statistics & numerical data

OBJECTIVETo evaluate the authenticity of the parents' memory on their children's immunization status.

METHODSTwo counties and 1 district in each of the 18 prefectures were selected, and parents of the children 1 - 2 years old, residents in counties or floating in district, were studied on the authenticity of their memory regarding their children's immunization status.

RESULTSThe rates of inoculation with all the four expanded programme on immunization (EPI) vaccines were 89.7% in the whole province, and 77.9% among floating children. The authenticity of the reply from parents on their children, inoculation status with vaccines was above 96%. However, less than 50% of the parents could remember what specific vaccines that their children had received. The authenticity of parents' memory was higher in the parents with high school or college education than those who were illiterates or only having had elementary school education. Mothers had better memory than the fathers. Of the children whose parents could not remember the vaccination status, 97% of them had been inoculated.

CONCLUSIONThe definite answer of parents to children's immunization status had high creditability, especially when the mothers having had more schooling. Those children whose parents failed to remember whether vaccination had been received should not be ranked as unimmuned.

Cross-Sectional Studies ; Humans ; Immunization ; statistics & numerical data ; Immunization Schedule ; Infant ; Memory ; Parent-Child Relations ; Parenting ; psychology ; Social Class

Rapid survey methodologies are widely used for assessing immunization coverage in developing countries, approximating true stratified random sampling. Non-random ('convenience') sampling is not considered appropriate for estimating immunization coverage rates but has the advantages of low cost and expediency. We assessed the validity of a convenience sample of children presenting to a travelling clinic by comparing the coverage rate in the convenience sample to the true coverage established by surveying each child in three villages in rural Papua New Guinea. The rate of DTF immunization coverage as estimated by the convenience sample was within 10% of the true coverage when the proportion of children in the sample was two-thirds or when only children over the age of one year were counted, but differed by 11% when the sample included only 53% of the children and when all eligible children were included. The convenience sample may be sufficiently accurate for reporting purposes and is useful for identifying areas of low coverage.
Data Collection/*methods ; Developing Countries ; Immunization ; Immunization Programs ; Papua New Guinea ; Population Surveillance ; Rural Population ; Sampling Studies ; Statistics, Nonparametric

OBJECTIVETo review the re-examination sampling method and procedure of national immunization survey for the national immunization program vaccines coverage at the township level by the national level in 2013, China.

METHODSAccording to the result of immunization coverage at the township level through self-assessment by county, all townships were stratified by whether a township with ≥ 90% immunization coverage for the second dose of measles-containing vaccines (MCV2), and a township was urban or rural. After then, 2 townships for each province were randomly sampled from those strata through the surveyselect procedure of the statistics analysis system 9.2 (SAS 9.2).

RESULTS64 townships were randomly sampled from 32 provincial units for the re-examination, i.e. an urban township and a rural township each province, of which there were 38 townships with ≥ 90% MCV2 coverage and 26 townships with < 90% MCV2 coverage. There were 24 urban townships, 2 rural townships with < 90% MCV2 coverage and 8 urban townships, 30 rural townships with ≥ 90% MCV2 coverage, respectively.

CONCLUSIONSBased on the information of the self-assessment result of immunization coverage survey by counties, Stratified randomized sampling were employed for the re-examination through the Surveyselect procedure of statistics analysis system (SAS) to implement the sampling procedure. This can enhance the sampling efficiency, ensure the randomness of the sample, and make the survey much more representative and comparable.

China ; Humans ; Immunization ; Immunization Programs ; statistics & numerical data ; Measles Vaccine ; Rural Population ; Sampling Studies ; Surveys and Questionnaires ; Urban Population ; Vaccination ; statistics & numerical data ; Vaccines

The purpose of this study was to investigate the educational needs of a mother when nurturing children from neonates to the schoolage. A total of 657 subjects responded to the survey about the level of educational needs when nurturing children. The subjects of the study constituted of 401 mothers who visited the health center for immunization and 256 mothers who visited the pediatric outpatient department or whose children were hospitalized in pediatrics. This instrument had 64 items about nurturing children from neonates to the schoolage and one item had a score range of one to four. In data analysis, SPSSWIN 9.0 program was utilized for descriptive statistics. The results were as follows. 1) Mothers who had the neonates represented the highest educational needs about parental-neonates attachments with 3.47 of mean score compared to neonatal convulsion(3.44), management of common colds(3.44), nutrition(3.44), fever control (3.42). 2) Mothers who had infancy represented the highest educational needs about management of common colds with 3.34 of mean score compared to psychosocial developments (3.23), management of foreign bodies (3.22), feeding the food(3.19), playing with the infant(3.16). 3) Mothers who had toddlers represented the highest educational needs about psychosocial developments with 3.35 of mean score compared to discipline for children(3.34), management of teeth (3.29), management of common colds (3.21), management of accidents(3.20). 4) Mothers who had the a child in preschool represented the highest educational needs about psychosocial developments with 3.53 of mean score compared to management of accidents(3.23), discipline for children (3.00). 5) Mothers who had the child in secondary school represented the highest educational needs about psychosocial developments with 3.42 of mean score compared to management of teeth(3.13), management of accidents (3.05).
Child* ; Common Cold ; Fever ; Foreign Bodies ; Humans ; Immunization ; Infant, Newborn ; Mothers* ; Outpatients ; Pediatrics ; Statistics as Topic ; Tooth

Objective: Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination, to promote the recommendation profile on Hepatitis E vaccination program, in China. Methods: Three phases of time span were divided as 2004-2007, 2008-2011 and 2012-2015, with age groups divided as <20, 20-29, 30-39 and ≥40. Incidence rates in both different phases and age groups were compared. Numbers of Hepatitis A and E vaccines released and used, were described. Results: Between 2004 and 2015, a declining trend in the reported incidence of hepatitis A (t=-12.15, P<0.001), but an increasing trend in hepatitis E (t=6.63, P<0.001) were noticed. The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015. The peaks of hepatitis E appeared persistent annually, in March. The incidence of hepatitis A declined in three regions, with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (χ(2)=32 630, P<0.01). The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000), but more in the eastern region (2.66/100 000) (χ(2)=6 009, P<0.01). Incidence of hepatitis A declined in all age groups and declined by 84.36% among the 0-19 group. However, the incidence of hepatitis E showed an increasing trend among the ≥20 group. Incidence rates appeared higher in the older age groups. The coverage of hepatitis A vaccine increased from 62.05% to 93.54%, but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69, χ(2)<0.05). Conclusion: The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004 to 2015, calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
Adolescent ; Adult ; Aged ; China/epidemiology* ; Health Care Surveys ; Hepatitis A/epidemiology* ; Hepatitis A Vaccines/administration & dosage* ; Hepatitis E/epidemiology* ; Humans ; Immunization/statistics & numerical data* ; Immunization Programs ; Incidence ; Middle Aged ; Population Surveillance ; Vaccination/statistics & numerical data* ; Young Adult

OBJECTIVEThe expanded programme on immunization (EPI) is an important part of the social commonwealth projects providing health care service by the government, which benefits communities. Government has the responsibility for EPI's financing which should be covered by the national budget. It is essential that the cost of EPI service be scientifically estimated to provide propriety information for policy makers.

METHODSThis study, using the cost accounting theory of health economics, to calculate EPI service cost at different levels. 3 provinces, 3 prefectures, 9 counties, 18 towns and 12 villages were selected from three provinces Guizhou, Heilongjiang and Zhejiang from the western, central and eastern regions of the country.

RESULTSThe average costs for one EPI-targeted child in Guizhou, Heilongjiang and Zhejiang, were 15.68 Yuan, 29.00 Yuan and 31.09 Yuan, and the costs for one dose were 10.99 Yuan, 18.64 Yuan and 16.51 Yuan, respectively. The costs for complete immunization program for one child were 131.88 Yuan, 242.32 Yuan and 280.67 Yuan, respectively. The main factors affecting the cost would include the average personnel cost (salary and benefit cost) by different economic levels of areas, the number of EPI items developed, and the number of total doses for one child.

CONCLUSION(1) Obvious differences were found between different areas. (2) The proportion of the cost was not reasonably set because of the shortage of input. (3) Guideline for different areas to compensate the working item cost according to the number of the items should be formulated.

China ; epidemiology ; Cost-Benefit Analysis ; Health Expenditures ; statistics & numerical data ; Humans ; Immunization Programs ; economics ; organization & administration ; Population Surveillance ; methods ; Program Evaluation ; Socioeconomic Factors ; Vaccination ; statistics & numerical data

INTRODUCTIONWe undertook a study to evaluate the effectiveness of the National Childhood Immunisation Programme (NCIP) over the past 26 years by reviewing the epidemiological trends of the diseases protected, the immunisation coverage and the changing herd immunity of the population during the period of 1982 to 2007.

MATERIALS AND METHODSThe epidemiological data of all cases of diphtheria, pertussis, poliomyelitis, measles, mumps, rubella and acute hepatitis B notified to the Communicable Diseases Division, Ministry of Health (MOH) from 1982 to 2007 were collated and analysed. Data on tuberculosis (TB) cases were obtained from the TB Control Unit, Tan Tock Seng Hospital. Cases of neonatal tetanus and congenital rubella syndrome (CRS) among infants born in Singapore were identified from the Central Claims Processing System. The number of therapeutic abortions performed for rubella infections was retrieved from the national abortion registry. Coverage of the childhood immunisation programme was based on the immunisation data maintained by the National Immunisation Registry, Health Promotion Board. To assess the herd immunity of the population against the various vaccine-preventable diseases protected, the findings of several serological surveys conducted from 1982 to 2005 were reviewed.

RESULTSThe incidence of vaccine-preventable diseases covered under the NCIP had declined over the last 26 years with diphtheria, neonatal tetanus, poliomyelitis and congenital rubella virtually eliminated. The last case of childhood TB meningitis and the last case of acute hepatitis B in children below 15 years were reported in 2002 and 1996, respectively.

CONCLUSIONThe NCIP has been successfully implemented as evidenced by the disappearance of most childhood diseases, excellent immunisation coverage rate in infants, preschool and school children, and high level of herd immunity of the childhood population protected.

Adolescent ; Adult ; Child ; Child, Preschool ; Communicable Disease Control ; statistics & numerical data ; trends ; Communicable Diseases ; epidemiology ; Disease Notification ; statistics & numerical data ; Humans ; Immunity, Herd ; Immunization Programs ; statistics & numerical data ; Incidence ; Infant ; Population Surveillance ; Prevalence ; Singapore ; epidemiology