Due to the tumor malignancy or immunosuppressive treatment, patients with cancer in general are more susceptible to vaccine-preventable infections. The types, timing, dose of vaccination or even the immunization program for them may differ from those for the normal persons. At present, it is recommended to use inactivated vaccines for patients with cancer rather than attenuated live vaccines, Vaccinations should be avoided during immunosuppressive therapy; patients with cancer should receive double dosage of hepatitis B vaccines and two doses of inactivated influenza vaccines yearly. This paper summarizes the progress in clinical trials of vaccination for cancer patients in foreign countries, and provide reference for the development and implementation of vaccination strategy for cancer patients in China.
China ; Humans ; Neoplasms/prevention & control* ; Research ; Vaccination/trends*

Cloning, Molecular ; methods ; Dental Caries ; immunology ; prevention & control ; Forecasting ; Humans ; Research ; trends ; Research Design ; Vaccination ; Vaccines ; genetics ; immunology

The importance of vaccine on public health is related to the herd protection related to the levels of vaccine coverage, which directly influences the vaccinated individuals as well as the unvaccinated community. Reaching the level of herd protection by increasing vaccine coverage is the basic strategy to eradicate related infectious diseases. Again, herd protection has played an important role in public health practices. With the increasing interests in estimating the vaccine herd protection, we however, have seen only few relevant papers including observational population-based and cluster-randomized clinical trials reported in China. We hope to discuss the study designs for evaluating the vaccine herd protection in order to generate evidence-based related research in this field.
China/epidemiology* ; Communicable Disease Control ; Communicable Diseases/immunology* ; Humans ; Immunity, Herd/immunology* ; Research Design ; Vaccination/trends* ; Vaccines/immunology*

Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities. This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.
Health Status Disparities ; Humans ; Influenza Vaccines/*administration & dosage ; Influenza, Human/epidemiology/*prevention & control ; Patient Acceptance of Health Care ; United States/epidemiology ; Vaccination/*trends/utilization

Adolescent ; Communicable Disease Control ; legislation & jurisprudence ; Female ; Humans ; Immunization Programs ; Male ; Mandatory Programs ; Papillomaviridae ; immunology ; Papillomavirus Vaccines ; therapeutic use ; Patient Compliance ; Risk ; United States ; Vaccination ; legislation & jurisprudence ; trends

INTRODUCTIONAlthough Singapore national guidelines recommend influenza vaccination for individuals with comorbidities, the vaccine uptake remains relatively low. This study examines the rates of influenza vaccine prescriptions in a clinic population, and patient, doctor and clinic factors that could affect the vaccine prescribing rates.

MATERIALS AND METHODSThis retrospective review utilised electronic medical records from HIV-infected patients seen in an infectious disease (ID) specialist clinic. Data from 40 randomly selected patients per physician were analysed for the outcome of influenza vaccine prescriptions from 1 January to 31 December 2007. All 7 consultants and the 6 ID registrars who had spent at least 4 months in the Department during 2007 were included. Data analysed included patient, physician, and clinic characteristics, and clinically relevant outcomes of admission within a year, and the length of hospital stay.

RESULTSOf the 461 HIV-infected patients analysed for this study, only 107 (23%) were prescribed influenza vaccine in 2007. Vaccine prescribing rates by individual physicians ranged from 0% to 77%. The outcome of vaccine prescribing was analysed by patient demographics (age >40 years, gender, race), physician characteristics (doctor grade, gender and training), and clinic volumes (number of patients per clinic session). Multivariate analysis demonstrated that patients with female doctors (OR 1.8, 95% CI, 1.1 to 3.0, P = 0.017), and doctors with overseas medical training (OR 11.6, 95% CI, 6.0 to 22.2, P <0.001) were significantly more likely to have influenza vaccine prescribed. On univariate analysis, patients were more likely to be admitted if they were male (OR 2.1, 95% CI, 1.0 to 5.1, P = 0.041), and over 40 years old (OR 2.1, 95% CI, 1.1 to 4.5, P = 0.024). Patients prescribed influenza vaccine showed a non-significant trend for protection against admission (OR 0.7, P = 0.288), and shorter length of stay (median 5 vs 9 days, P = 0.344).

CONCLUSIONInfluenza vaccine prescribing for HIV-infected outpatients in 2007 was only 23%, even in an ID specialist clinic. There was substantial variability in prescribing rates by individual physicians. Neither patient demographics nor patient volumes per clinic session had an impact on the prescribing rates, but significant predictors included physician gender and medical school training. Patients prescribed influenza vaccine had fewer admissions and shorter hospital lengths of stay, although these trends were non-significant.

Adult ; Drug Prescriptions ; statistics & numerical data ; Female ; HIV Infections ; complications ; Humans ; Influenza A virus ; immunology ; Influenza Vaccines ; pharmacology ; Influenza, Human ; prevention & control ; Male ; Prescription Drugs ; Retrospective Studies ; Singapore ; Vaccination ; trends

This study examined the change of reported incidence rate for viral hepatitis in Hubei province, China, between 2004 to 2010 to provide scientific evidence for viral hepatitis control. Reported viral hepatitis infection cases were queried from Centre for Disease Control of Hubei Province, China. The incidence of viral hepatitis A decreased steadily across the study period. Viral hepatitis B composed 85% of the viral hepatitis cases. When reported incidence rates for chronic hepatitis B increased, the rates of acute and unclassified cases dropped from 2005 to 2010. The reported viral hepatitis B incidence rate for males was around 1.5-2 times higher than for females. The average annual percentage change of reported viral hepatitis B incidence rates was 4%. The same index for viral hepatitis C was 28%. The reported viral hepatitis B incidence rate of people under 20 years old declined over the period. This decrease was mainly attributed to the recent implementation of vaccination plan. Reported incidence rate of viral hepatitis E also rose in those years. Having a better understanding on reported incidence rates of the present surveillance system is important for developing strategies for further prevention of viral hepatitis. In addition, the data showed that a surveillance system that differentiates new and former infected cases will be more effective in providing evidence for disease control.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hepatitis, Viral, Human ; epidemiology ; prevention & control ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Mass Vaccination ; trends ; utilization ; Middle Aged ; Risk Factors ; Sex Distribution ; Viral Hepatitis Vaccines ; therapeutic use ; Young Adult