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Walter W Williams - One of the best experts on this subject based on the ideXlab platform.
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Influenza Vaccination Coverage Among Pregnant Women in the U.S., 2012–2015
American journal of preventive medicine, 2019Co-Authors: Helen Ding, Alissa O’halloran, Katherine E. Kahn, Carla L. Black, Walter W WilliamsAbstract:Introduction Pregnant women are at increased risk for severe illness from influenza and influenza-related complications. Vaccinating pregnant women is the primary strategy to protect them and their infants from influenza. This study aims to assess influenza Vaccination Coverage during three influenza seasons (2012–2015) from a national probability-based sampling survey and evaluate potential factors that influence Vaccination uptake among pregnant women. Methods Data from the 2012 through 2015 National Health Interview Surveys were analyzed in 2017. Pregnant women aged 18−49 years were included in the analysis. The Kaplan−Meier survival analysis procedure was used for Vaccination Coverage in each season. Bivariate and multivariable logistic regression analyses were performed to examine factors associated with Vaccination. Adjusted Vaccination Coverage and adjusted prevalence ratios are reported with corresponding 95% CIs. Results In the 2012−2013, 2013−2014, and 2014−2015 influenza seasons, 40.4%, 45.4%, and 43.1% of pregnant women were vaccinated, respectively. Multivariable analysis indicated that factors independently associated with a lower likelihood of Vaccination included having only a high school education, having three or less provider visits, and having no usual place of care (p Conclusions Vaccination Coverage among pregnant women from this nationally representative sample was suboptimal during recent influenza seasons. Vaccination Coverage was lower among certain sociodemographic, access-to-care subgroups. Multifactorial Vaccination barriers may exist. Interventions, such as assessing Vaccination history at every visit and implementing reminder–recall systems, standing orders, and addressing Vaccination hesitancy, are needed to increase Vaccination uptake among pregnant women.
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influenza Vaccination Coverage among pregnant women united states 2016 17 influenza season
Morbidity and Mortality Weekly Report, 2017Co-Authors: Helen Ding, Walter W Williams, Katherine E. Kahn, Carla L. Black, Sarah Ball, Rebecca V Fink, Amy Parker Fiebelkorn, Denise V Dangelo, Rebecca Devlin, Stacie M GrebyAbstract:Pregnant women and their infants are at increased risk for severe influenza-associated illness (1), and since 2004, the Advisory Committee on Immunization Practices (ACIP) has recommended influenza Vaccination for all women who are or might be pregnant during the influenza season, regardless of the trimester of the pregnancy (2). To assess influenza Vaccination Coverage among pregnant women during the 2016-17 influenza season, CDC analyzed data from an Internet panel survey conducted during March 28-April 7, 2017. Among 1,893 survey respondents pregnant at any time during October 2016-January 2017, 53.6% reported having received influenza Vaccination before (16.2%) or during (37.4%) pregnancy, similar to Coverage during the preceding four influenza seasons. Also similar to the preceding influenza season, 67.3% of women reported receiving a provider offer for influenza Vaccination, 11.9% reported receiving a recommendation but no offer, and 20.7% reported receiving no recommendation; among these women, reported influenza Vaccination Coverage was 70.5%, 43.7%, and 14.8%, respectively. Among women who received a provider offer for Vaccination, Vaccination Coverage differed by race/ethnicity, education, insurance type, and other sociodemographic factors. Use of evidence-based practices such as provider reminders and standing orders could reduce missed opportunities for Vaccination and increase Vaccination Coverage among pregnant women.
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surveillance of Vaccination Coverage among adult populations united states 2015
Morbidity and mortality weekly report. Surveillance summaries (Washington D.C. : 2002), 2017Co-Authors: Walter W Williams, Pengjun Lu, Tamara Pilishvili, Lisa A Grohskopf, Tami H Skoff, Noele P Nelson, Rafael Harpaz, Lauri E Markowitz, Alissa Ohalloran, Alfonso RodriguezlainzAbstract:PROBLEM/CONDITION: Overall, the prevalence of illness attributable to vaccine-preventable diseases is greater among adults than among children. Adults are recommended to receive Vaccinations based on their age, underlying medical conditions, lifestyle, prior Vaccinations, and other considerations. Updated Vaccination recommendations from CDC are published annually in the U.S. Adult Immunization Schedule. Despite longstanding recommendations for use of many vaccines, Vaccination Coverage among U.S. adults is low. PERIOD COVERED: August 2014-June 2015 (for influenza Vaccination) and January-December 2015 (for pneumococcal, tetanus and diphtheria [Td] and tetanus and diphtheria with acellular pertussis [Tdap], hepatitis A, hepatitis B, herpes zoster, and human papillomavirus [HPV] Vaccination). DESCRIPTION OF SYSTEM: The National Health Interview Survey (NHIS) is a continuous, cross-sectional national household survey of the noninstitutionalized U.S. civilian population. In-person interviews are conducted throughout the year in a probability sample of households, and NHIS data are compiled and released annually. The survey objective is to monitor the health of the U.S. population and provide estimates of health indicators, health care use and access, and health-related behaviors. RESULTS: Compared with data from the 2014 NHIS, increases in Vaccination Coverage occurred for influenza vaccine among adults aged ≥19 years (a 1.6 percentage point increase compared with the 2013-14 season to 44.8%), pneumococcal vaccine among adults aged 19-64 years at increased risk for pneumococcal disease (a 2.8 percentage point increase to 23.0%), Tdap vaccine among adults aged ≥19 years and adults aged 19-64 years (a 3.1 percentage point and 3.3 percentage point increase to 23.1% and to 24.7%, respectively), herpes zoster vaccine among adults aged ≥60 years and adults aged ≥65 years (a 2.7 percentage point and 3.2 percentage point increase to 30.6% and to 34.2%, respectively), and hepatitis B vaccine among health care personnel (HCP) aged ≥19 years (a 4.1 percentage point increase to 64.7%). Herpes zoster Vaccination Coverage in 2015 met the Healthy People 2020 target of 30%. Aside from these modest improvements, Vaccination Coverage among adults in 2015 was similar to estimates from 2014. Racial/ethnic differences in Coverage persisted for all seven vaccines, with higher Coverage generally for whites compared with most other groups. Adults without health insurance reported receipt of influenza vaccine (all age groups), pneumococcal vaccine (adults aged 19-64 years at increased risk), Td vaccine (adults aged ≥19 years, 19-64 years, and 50-64 years), Tdap vaccine (adults aged ≥19 years and 19-64 years), hepatitis A vaccine (adults aged ≥19 years overall and among travelers), hepatitis B vaccine (adults aged ≥19 years, 19-49 years, and among travelers), herpes zoster vaccine (adults aged ≥60 years), and HPV vaccine (males and females aged 19-26 years) less often than those with health insurance. Adults who reported having a usual place for health care generally reported receipt of recommended Vaccinations more often than those who did not have such a place, regardless of whether they had health insurance. Vaccination Coverage was higher among adults reporting one or more physician contacts in the past year compared with those who had not visited a physician in the past year, regardless of whether they had health insurance. Even among adults who had health insurance and ≥10 physician contacts within the past year, depending on the vaccine, 18.2%-85.6% reported not having received Vaccinations that were recommended either for all persons or for those with specific indications. Overall, Vaccination Coverage among U.S.-born adults was higher than that among foreign-born adults, with few exceptions (influenza Vaccination [adults aged 19-49 years and 50-64 years], hepatitis A Vaccination [adults aged ≥19 years], and hepatitis B Vaccination [adults aged ≥19 years with diabetes or chronic liver conditions]). INTERPRETATION: Coverage for all vaccines for adults remained low but modest gains occurred in Vaccination Coverage for influenza (adults aged ≥19 years), pneumococcal (adults aged 19-64 years with increased risk), Tdap (adults aged ≥19 years and adults aged 19-64 years), herpes zoster (adults aged ≥60 years and ≥65 years), and hepatitis B (HCP aged ≥19 years); Coverage for other vaccines and groups with Vaccination indications did not improve. The 30% Healthy People 2020 target for herpes zoster Vaccination was met. Racial/ethnic disparities persisted for routinely recommended adult vaccines. Missed opportunities to vaccinate remained. Although having health insurance Coverage and a usual place for health care were associated with higher Vaccination Coverage, these factors alone were not associated with optimal adult Vaccination Coverage. HPV Vaccination Coverage for males and females has increased since CDC recommended Vaccination to prevent cancers caused by HPV, but many adolescents and young adults remained unvaccinated. PUBLIC HEALTH ACTIONS: Assessing factors associated with low Coverage rates and disparities in Vaccination is important for implementing strategies to improve Vaccination Coverage. Evidence-based practices that have been demonstrated to improve Vaccination Coverage should be used. These practices include assessment of patients' Vaccination indications by health care providers and routine recommendation and offer of needed vaccines to adults, implementation of reminder-recall systems, use of standing-order programs for Vaccination, and assessment of practice-level Vaccination rates with feedback to staff members. For Vaccination Coverage to be improved among those who reported lower Coverage rates of recommended adult vaccines, efforts also are needed to identify adults who do not have a regular provider or insurance and who report fewer health care visits.
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surveillance of Vaccination Coverage among adult populations united states 2014
Morbidity and mortality weekly report. Surveillance summaries (Washington D.C. : 2002), 2016Co-Authors: Walter W Williams, Pengjun Lu, Tamara Pilishvili, Lisa A Grohskopf, Tami H Skoff, Noele P Nelson, Rafael Harpaz, Lauri E Markowitz, Alissa Ohalloran, Alfonso RodriguezlainzAbstract:PROBLEM/CONDITION: Overall, the prevalence of illness attributable to vaccine-preventable diseases is greater among adults than among children. Adults are recommended to receive Vaccinations based on their age, underlying medical conditions, lifestyle, prior Vaccinations, and other considerations. Updated Vaccination recommendations from CDC are published annually in the U.S. Adult Immunization Schedule. Despite longstanding recommendations for use of many vaccines, Vaccination Coverage among U.S. adults is low. REPORTING PERIOD: August 2013-June 2014 (for influenza Vaccination) and January-December 2014 (for pneumococcal, tetanus and diphtheria [Td] and tetanus and diphtheria with acellular pertussis [Tdap], hepatitis A, hepatitis B, herpes zoster, and human papillomavirus [HPV] Vaccination). DESCRIPTION OF SYSTEM: The National Health Interview Survey (NHIS) is a continuous, cross-sectional national household survey of the noninstitutionalized U.S. civilian population. In-person interviews are conducted throughout the year in a probability sample of households, and NHIS data are compiled and released annually. The survey objective is to monitor the health of the U.S. population and provide estimates of health indicators, health care use and access, and health-related behaviors. RESULTS: Compared with data from the 2013 NHIS, increases in Vaccination Coverage occurred for Tdap vaccine among adults aged ≥19 years (a 2.9 percentage point increase to 20.1%) and herpes zoster vaccine among adults aged ≥60 years (a 3.6 percentage point increase to 27.9%). Aside from these modest improvements, Vaccination Coverage among adults in 2014 was similar to estimates from 2013 (for influenza Coverage, similar to the 2012-13 season). Influenza Vaccination Coverage among adults aged ≥19 years was 43.2%. Pneumococcal Vaccination Coverage among high-risk persons aged 19-64 years was 20.3% and among adults aged ≥65 years was 61.3%. Td Vaccination Coverage among adults aged ≥19 years was 62.2%. Hepatitis A Vaccination Coverage among adults aged ≥19 years was 9.0%. Hepatitis B Vaccination Coverage among adults aged ≥19 years was 24.5%. HPV Vaccination Coverage among adults aged 19-26 years was 40.2% for females and 8.2% for males. Racial/ethnic differences in Coverage persisted for all seven vaccines, with higher Coverage generally for whites compared with most other groups. Adults without health insurance were significantly less likely than those with health insurance to report receipt of influenza vaccine (aged ≥19 years), pneumococcal vaccine (aged 19-64 years with high-risk conditions and aged ≥65 years), Td vaccine (aged ≥19 years), Tdap vaccine (aged ≥19 years and 19-64 years), hepatitis A vaccine (aged ≥19 years overall and among travelers), hepatitis B vaccine (aged ≥19 years, 19-49 years, and 19-59 years with diabetes), herpes zoster vaccine (aged ≥60 years and 60-64 years), and HPV vaccine (females aged 19-26 years and males aged 19-26 years). Adults who reported having a usual place for health care generally were more likely to receive recommended Vaccinations than those who did not have a usual place for health care, regardless of whether they had health insurance. Vaccination Coverage was significantly higher among those reporting one or more physician contacts in the past year compared with those who had not visited a physician in the past year, regardless of whether they had health insurance. Even among adults who had health insurance and ≥10 physician contacts within the past year, 23.8%-88.8% reported not having received Vaccinations that were recommended either for all persons or for those with some specific indication. Overall, Vaccination Coverage among U.S.-born respondents was significantly higher than that of foreign-born respondents with few exceptions (influenza Vaccination [adults aged 19-49 years], hepatitis A Vaccination [adults aged ≥19 years], hepatitis B Vaccination [adults with diabetes aged ≥60 years], and HPV Vaccination [males aged 19-26 years]). INTERPRETATION: Overall, increases in adult Vaccination Coverage are needed. Although modest gains occurred in Tdap Vaccination Coverage among adults aged ≥19 years and herpes zoster Vaccination Coverage among adults aged ≥60 years, Coverage for other vaccines and risk groups did not improve, and racial/ethnic disparities persisted for routinely recommended adult vaccines. Coverage for all vaccines for adults remained low, and missed opportunities to vaccinate adults continued. Although having health insurance Coverage and a usual place for health care are associated with higher Vaccination Coverage, these factors alone do not assure optimal adult Vaccination Coverage. PUBLIC HEALTH ACTIONS: Assessing associations with Vaccination is important for understanding factors that contribute to low Coverage rates and to disparities in Vaccination, and for implementing strategies to improve Vaccination Coverage. Practices that have been demonstrated to improve Vaccination Coverage should be used. These practices include assessment of patients' Vaccination indications by health care providers and routine recommendation and offer of needed vaccines to adults, implementation of reminder-recall systems, use of standing-order programs for Vaccination, and assessment of practice-level Vaccination rates with feedback to staff members. For Vaccination to be improved among those least likely to be up-to-date on recommended adult vaccines, efforts also are needed to identify adults who do not have a regular provider or insurance and who report fewer health care visits.
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influenza Vaccination Coverage among health care personnel united states 2014 15 influenza season
Morbidity and Mortality Weekly Report, 2015Co-Authors: Carla L. Black, Walter W Williams, Sarah Ball, Xin Yue, Sara Donahue, David Izrael, Marie A De Perio, Scott A Laney, Megan C Lindley, Samuel B GraitcerAbstract:The Advisory Committee on Immunization Practices recommends annual influenza Vaccination for all health care personnel (HCP) to reduce influenza-related morbidity and mortality among both HCP and their patients and to decrease absenteeism among HCP. To estimate influenza Vaccination Coverage among U.S. HCP for the 2014–15 influenza season, CDC conducted an opt-in Internet panel survey of 1,914 HCP during March 31–April 15, 2015. Overall, 77.3% of HCP survey participants reported receiving an influenza Vaccination during the 2014–15 season, similar to the 75.2% Coverage among HCP reported for the 2013–14 season. Vaccination Coverage was highest among HCP working in hospitals (90.4%) and lowest among HCP working in long-term care (LTC) settings (63.9%). By occupation, Coverage was highest among pharmacists (95.3%) and lowest among assistants and aides (64.4%). Influenza Vaccination Coverage was highest among HCP who were required by their employer to be vaccinated (96.0%). Among HCP without an employer requirement for Vaccination, Coverage was higher for HCP working in settings where Vaccination was offered on-site at no cost for 1 day (73.6%) or multiple days (83.9%) and lowest among HCP working in settings where vaccine was neither required, promoted, nor offered on-site (44.0%). Comprehensive Vaccination strategies that include making vaccine available at no cost at the workplace along with active promotion of Vaccination might help increase Vaccination Coverage among HCP and reduce the risk for influenza to HCP and their patients.
Wilhelmina L M Ruijs - One of the best experts on this subject based on the ideXlab platform.
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Vaccination Coverage for measles, mumps and rubella in anthroposophical schools in Gelderland, The Netherlands
European journal of public health, 2014Co-Authors: Judith H.e. Klomp, Alies Van Lier, Wilhelmina L M RuijsAbstract:Background : Social clustering of unvaccinated children in anthroposophical schools occurs, as inferred from various measles outbreaks that can be traced to these schools. However, accurate Vaccination Coverage data of anthroposophical schools are not widely available. Methods: In 2012, we performed a survey to estimate the Vaccination Coverage in three different grades of 11 anthroposophical schools in Gelderland, The Netherlands. We also gauged the opinion on childhood Vaccination of the parents and compared these with the results of a national survey. In 2014, we were also able to obtain the registered total Vaccination Coverage per school from the national Vaccination register to compare this with our survey data. Results: The self-reported MMR Vaccination Coverage (2012) in the three grades of the schools in our study was 83% (range 45–100% per school). The registered total Vaccination Coverage (2014) was 78% (range 59–88% per school). The 95% confidence intervals of the two different Vaccination Coverages overlap for all schools. The parents in this study were less convinced about the beneficial effect of Vaccinations and more worried about the possible side effects of Vaccination compared with parents in general. Conclusion: Despite high overall Vaccination Coverage, the WHO goal to eliminate measles and rubella will not easily be achieved when social clustering of unvaccinated children in anthroposophical schools remains.
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Estimation of vaccine efficacy and critical Vaccination Coverage in partially observed outbreaks.
PLoS computational biology, 2013Co-Authors: Michiel Van Boven, Wilhelmina L M Ruijs, Jacco Wallinga, Philip D. O'neill, Susan HahnéAbstract:Classical approaches to estimate vaccine efficacy are based on the assumption that a person's risk of infection does not depend on the infection status of others. This assumption is untenable for infectious disease data where such dependencies abound. We present a novel approach to estimating vaccine efficacy in a Bayesian framework using disease transmission models. The methodology is applied to outbreaks of mumps in primary schools in the Netherlands. The total study population consisted of 2,493 children in ten primary schools, of which 510 (20%) were known to have been infected, and 832 (33%) had unknown infection status. The apparent Vaccination Coverage ranged from 12% to 93%, and the apparent infection attack rate varied from 1% to 76%. Our analyses show that Vaccination reduces the probability of infection per contact substantially but not perfectly ( = 0.933; 95CrI: 0.908–0.954). Mumps virus appears to be moderately transmissible in the school setting, with each case yielding an estimated 2.5 secondary cases in an unvaccinated population ( = 2.49; 95%CrI: 2.36–2.63), resulting in moderate estimates of the critical Vaccination Coverage (64.2%; 95%CrI: 61.7–66.7%). The indirect benefits of Vaccination are highest in populations with Vaccination Coverage just below the critical Vaccination Coverage. In these populations, it is estimated that almost two infections can be prevented per Vaccination. We discuss the implications for the optimal control of mumps in heterogeneously vaccinated populations.
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Religious subgroups influencing Vaccination Coverage in the Dutch Bible belt: an ecological study
2012Co-Authors: Wilhelmina L M Ruijs, Jeannine L A Hautvast, Sjoerd De Vos, Hans Knippenberg, K. Van Der Velden, Marlies E. J. L. HulscherAbstract:Background - The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox Protestant groups are living. Lacking information on the Vaccination Coverage in this minority, and its various subgroups, control of vaccine preventable diseases is focused on the geographical area of the Bible belt. However, the adequacy of this strategy is questionable. This study assesses the influence of presence of various orthodox Protestant subgroups (orthodox Protestant denominations, OPDs) on municipal Vaccination Coverage in the Bible belt. Methods - We performed an ecological study at municipality level. Data on number of inhabitants, urbanization level, socio-economical status, immigration and Vaccination Coverage were obtained from national databases. As religion is not registered in the Netherlands, membership numbers of the OPDs had to be obtained from church year books and via church offices. For all municipalities in the Netherlands, the effect of presence or absence of OPDs on Vaccination Coverage was assessed by comparing mean Vaccination Coverage. For municipalities where OPDs were present, the effect of each of them (measured as membership ratio, the number of members proportional to total number of inhabitants) on Vaccination Coverage was assessed by bivariate correlation and multiple regression analysis in a model containing the determinants immigration, socio-economical status and urbanization as well. Results - Mean Vaccination Coverage (93.5% ± 4.7) in municipalities with OPDs (n=135) was significantly lower (p
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Measuring Vaccination Coverage in a hard to reach minority.
European journal of public health, 2011Co-Authors: Wilhelmina L M Ruijs, Jeannine L A Hautvast, Wilke J C Van Ansem, Reinier Akkermans, Kees Van ’t Spijker, Marlies E. J. L. Hulscher, Koos Van Der VeldenAbstract:Background: Although childhood Vaccination programmes have been very successful, there are some hard to reach minority groups that object to Vaccination. The Netherlands has experienced several epidemics of vaccine-preventable diseases, confined to the orthodox Protestant minority. However, Vaccination Coverage in this minority is still unknown and this hampers prevention and control of epidemics. Methods: We estimated Vaccination Coverage among the orthodox Protestant minority and its various subgroups (denominations), using two sub-studies with different design and study population. For both sub-studies separately, we determined overall Vaccination Coverage and Vaccination Coverage per denomination. The results were compared and discussed. Results: An online survey was filled out by 1778 orthodox Protestant youngsters, invited via orthodox Protestant media using a snowball method. Next to that, results of a national sample study on Vaccination were used, of which only orthodox Protestant respondents were included in our analyses ( N = 2129). Overall Vaccination Coverage among orthodox Protestants in The Netherlands was estimated to be at minimum 60%. Moreover, in both sub-studies three clusters of denominations could be identified, with high (>85%), intermediate (50–75%) and low (
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Religious subgroups influencing Vaccination Coverage in the Dutch Bible belt: an ecological study
BMC public health, 2011Co-Authors: Wilhelmina L M Ruijs, Koos Van Der Velden, Jeannine L A Hautvast, Sjoerd De Vos, Hans Knippenberg, Marlies E. J. L. HulscherAbstract:Background: The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox protestant groups are living. Lacking information on the Vaccination Coverage in this minority, and its various subgroups, control of vaccine preventable diseases is focused on the geographical area of the Bible belt. However, the adequacy of this strategy is questionable. This study assesses the influence of presence of various orthodox protestant subgroups (orthodox protestant denominations, OPDs) on municipal Vaccination Coverage in the Bible belt. Methods: We performed an ecological study at municipality level. Data on number of inhabitants, urbanization level, socio-economical status, immigration and Vaccination Coverage were obtained from national databases. As religion is not registered in the Netherlands, membership numbers of the OPDs had to be obtained from church year books and via church offices. For all municipalities in the Netherlands, the effect of presence or absence of OPDs on Vaccination Coverage was assessed by comparing mean Vaccination Coverage. For municipalities where OPDs were present, the effect of each of them (measured as membership ratio, the number of members proportional to total number of inhabitants) on Vaccination Coverage was assessed by bivariate correlation and multiple regression analysis in a model containing the determinants immigration, socio-economical status and urbanization as well. Results: Mean Vaccination Coverage (93.5% ± 4.7) in municipalities with OPDs (n = 135) was significantly lower (p < 0.001) than in 297 municipalities without OPDs (96.9% ± 2.1). Multiple regression analyses showed that in municipalities with OPDs 84% of the variance in Vaccination Coverage was explained by the presence of these OPDs. Immigration had a significant, but small explanatory effect as well. Membership ratios of all OPDs were negatively related to Vaccination Coverage; this relationship was strongest for two very conservative OPDs. Conclusion: As variance in municipal Vaccination Coverage in the Bible belt is largely explained by membership ratios of the various OPDs, control of vaccine preventable diseases should be focused on these specific risk groups. In current policy part of the orthodox protestant risk group is missed.
Stacie M Greby - One of the best experts on this subject based on the ideXlab platform.
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influenza Vaccination Coverage among pregnant women united states 2016 17 influenza season
Morbidity and Mortality Weekly Report, 2017Co-Authors: Helen Ding, Walter W Williams, Katherine E. Kahn, Carla L. Black, Sarah Ball, Rebecca V Fink, Amy Parker Fiebelkorn, Denise V Dangelo, Rebecca Devlin, Stacie M GrebyAbstract:Pregnant women and their infants are at increased risk for severe influenza-associated illness (1), and since 2004, the Advisory Committee on Immunization Practices (ACIP) has recommended influenza Vaccination for all women who are or might be pregnant during the influenza season, regardless of the trimester of the pregnancy (2). To assess influenza Vaccination Coverage among pregnant women during the 2016-17 influenza season, CDC analyzed data from an Internet panel survey conducted during March 28-April 7, 2017. Among 1,893 survey respondents pregnant at any time during October 2016-January 2017, 53.6% reported having received influenza Vaccination before (16.2%) or during (37.4%) pregnancy, similar to Coverage during the preceding four influenza seasons. Also similar to the preceding influenza season, 67.3% of women reported receiving a provider offer for influenza Vaccination, 11.9% reported receiving a recommendation but no offer, and 20.7% reported receiving no recommendation; among these women, reported influenza Vaccination Coverage was 70.5%, 43.7%, and 14.8%, respectively. Among women who received a provider offer for Vaccination, Vaccination Coverage differed by race/ethnicity, education, insurance type, and other sociodemographic factors. Use of evidence-based practices such as provider reminders and standing orders could reduce missed opportunities for Vaccination and increase Vaccination Coverage among pregnant women.
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Vaccine exemptions and the kindergarten Vaccination Coverage gap.
Vaccine, 2017Co-Authors: Philip J. Smith, Ranee Seither, Cynthia L Knighton, Jana Shaw, Adriana S. Lopez, Holly A. Hill, Mike Underwood, Zhen Zhao, Megha Shah Ravanam, Stacie M GrebyAbstract:Abstract Background Vaccination requirements for kindergarten entry vary by state, but all states require 2 doses of measles containing vaccine (MCV) at kindergarten entry. Objective To assess (i) national MCV Vaccination Coverage for children who had attended kindergarten; (ii) the extent to which underVaccination after kindergarten entry is attributable to parents’ requests for an exemption; (iii) the extent to which undervaccinated children had missed opportunities to be administered missing vaccine doses among children whose parent did not request an exemption; and (iv) the Vaccination Coverage gap between the “highest achievable” MCV Coverage and actual MCV Coverage among children who had attended kindergarten. Methods A national survey of 1465 parents of 5–7 year-old children was conducted during October 2013 through March 2014. Vaccination Coverage estimates are based provider-reported Vaccination histories. Children have a “missed opportunity” for MCV if they were not up-to-date and if there were dates on which other vaccines were administered but not MCV. The “highest achievable” MCV Vaccination Coverage rate is 100% minus the sum of the percentages of (i) undervaccinated children with parents who requested an exemption; and (ii) undervaccinated children with parents who did not request an exemption and whose Vaccination statuses were assessed during a kindergarten grace period or period when they were provisionally enrolled in kindergarten. Results Among all children undervaccinated for MCV, 2.7% were attributable to having a parent who requested an exemption. Among children who were undervaccinated for MCV and whose parent did not request an exemption, 41.6% had a missed opportunity for MCV. The highest achievable MCV Coverage was 98.6%, actual MCV Coverage was 90.9%, and the kindergarten Vaccination gap was 7.7%. Conclusion Vaccination Coverage may be increased by schools fully implementing state kindergarten Vaccination laws, and by providers assessing children’s Vaccination status at every clinic visit, and administering missed vaccine doses.
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Vaccination Coverage Among Children in Kindergarten - United States, 2014-15 School Year.
MMWR. Morbidity and mortality weekly report, 2015Co-Authors: Ranee Seither, Cynthia L Knighton, Jenelle Mellerson, Stacie M Greby, Kayla Calhoun, Seth Meador, Ashley Tippins, Vance DietzAbstract:State and local jurisdictions require children to be vaccinated before starting school to maintain high Vaccination Coverage and protect schoolchildren from vaccine-preventable diseases. State Vaccination requirements, which include school Vaccination and exemption laws and health department regulations, permit medical exemptions for students with a medical contraindication to receiving a vaccine or vaccine component and may allow nonmedical exemptions for religious reasons or philosophic beliefs. To monitor state and national Vaccination Coverage and exemption levels among children attending kindergarten, CDC analyzes school Vaccination data collected by federally funded state, local, and territorial immunization programs. This report describes Vaccination Coverage estimates in 49 states and the District of Columbia (DC) and Vaccination exemption estimates in 46 states and DC that reported the number of children with at least one exemption among kindergartners during the 2014-15 school year. Median Vaccination Coverage* was 94.0% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 94.2% for the local requirements for diphtheria, tetanus, and acellular pertussis vaccine (DTaP); and 93.6% for 2 doses of varicella vaccine among the 39 states and DC with a 2-dose requirement. The median percentage of any exemptions† was 1.7%. Although statewide Vaccination Coverage among kindergartners was high during the 2014-15 school year, geographic pockets of low Vaccination Coverage and high exemption levels can place children at risk for vaccine-preventable diseases. Appropriate school Vaccination Coverage assessments can help immunization programs identify clusters of low Coverage and develop partnerships with schools and communities to ensure that children are protected from vaccine-preventable diseases.
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Vaccination Coverage among children in kindergarten united states 2013 14 school year
Morbidity and Mortality Weekly Report, 2014Co-Authors: Ranee Seither, Svetlana Masalovich, Cynthia L Knighton, Jenelle Mellerson, James A Singleton, Stacie M GrebyAbstract:State and local Vaccination requirements for school entry are implemented to maintain high Vaccination Coverage and protect schoolchildren from vaccine-preventable diseases. Each year, to assess state and national Vaccination Coverage and exemption levels among kindergartners, CDC analyzes school Vaccination data collected by federally funded state, local, and territorial immunization programs. This report describes Vaccination Coverage in 49 states and the District of Columbia (DC) and Vaccination exemption rates in 46 states and DC for children enrolled in kindergarten during the 2013-14 school year. Median Vaccination Coverage was 94.7% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 95.0% for varying local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine; and 93.3% for 2 doses of varicella vaccine among those states with a 2-dose requirement. The median total exemption rate was 1.8%. High exemption levels and suboptimal Vaccination Coverage leave children vulnerable to vaccine-preventable diseases. Although Vaccination Coverage among kindergartners for the majority of reporting states was at or near the 95% national Healthy People 2020 targets for 4 doses of DTaP, 2 doses of MMR, and 2 doses of varicella vaccine, low Vaccination Coverage and high exemption levels can cluster within communities. Immunization programs might have access to school Vaccination Coverage and exemption rates at a local level for counties, school districts, or schools that can identify areas where children are more vulnerable to vaccine-preventable diseases. Health promotion efforts in these local areas can be used to help parents understand the risks for vaccine-preventable diseases and the protection that Vaccinations provide to their children.
Marlies E. J. L. Hulscher - One of the best experts on this subject based on the ideXlab platform.
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Religious subgroups influencing Vaccination Coverage in the Dutch Bible belt: an ecological study
2012Co-Authors: Wilhelmina L M Ruijs, Jeannine L A Hautvast, Sjoerd De Vos, Hans Knippenberg, K. Van Der Velden, Marlies E. J. L. HulscherAbstract:Background - The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox Protestant groups are living. Lacking information on the Vaccination Coverage in this minority, and its various subgroups, control of vaccine preventable diseases is focused on the geographical area of the Bible belt. However, the adequacy of this strategy is questionable. This study assesses the influence of presence of various orthodox Protestant subgroups (orthodox Protestant denominations, OPDs) on municipal Vaccination Coverage in the Bible belt. Methods - We performed an ecological study at municipality level. Data on number of inhabitants, urbanization level, socio-economical status, immigration and Vaccination Coverage were obtained from national databases. As religion is not registered in the Netherlands, membership numbers of the OPDs had to be obtained from church year books and via church offices. For all municipalities in the Netherlands, the effect of presence or absence of OPDs on Vaccination Coverage was assessed by comparing mean Vaccination Coverage. For municipalities where OPDs were present, the effect of each of them (measured as membership ratio, the number of members proportional to total number of inhabitants) on Vaccination Coverage was assessed by bivariate correlation and multiple regression analysis in a model containing the determinants immigration, socio-economical status and urbanization as well. Results - Mean Vaccination Coverage (93.5% ± 4.7) in municipalities with OPDs (n=135) was significantly lower (p
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Measuring Vaccination Coverage in a hard to reach minority.
European journal of public health, 2011Co-Authors: Wilhelmina L M Ruijs, Jeannine L A Hautvast, Wilke J C Van Ansem, Reinier Akkermans, Kees Van ’t Spijker, Marlies E. J. L. Hulscher, Koos Van Der VeldenAbstract:Background: Although childhood Vaccination programmes have been very successful, there are some hard to reach minority groups that object to Vaccination. The Netherlands has experienced several epidemics of vaccine-preventable diseases, confined to the orthodox Protestant minority. However, Vaccination Coverage in this minority is still unknown and this hampers prevention and control of epidemics. Methods: We estimated Vaccination Coverage among the orthodox Protestant minority and its various subgroups (denominations), using two sub-studies with different design and study population. For both sub-studies separately, we determined overall Vaccination Coverage and Vaccination Coverage per denomination. The results were compared and discussed. Results: An online survey was filled out by 1778 orthodox Protestant youngsters, invited via orthodox Protestant media using a snowball method. Next to that, results of a national sample study on Vaccination were used, of which only orthodox Protestant respondents were included in our analyses ( N = 2129). Overall Vaccination Coverage among orthodox Protestants in The Netherlands was estimated to be at minimum 60%. Moreover, in both sub-studies three clusters of denominations could be identified, with high (>85%), intermediate (50–75%) and low (
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Religious subgroups influencing Vaccination Coverage in the Dutch Bible belt: an ecological study
BMC public health, 2011Co-Authors: Wilhelmina L M Ruijs, Koos Van Der Velden, Jeannine L A Hautvast, Sjoerd De Vos, Hans Knippenberg, Marlies E. J. L. HulscherAbstract:Background: The Netherlands has experienced epidemics of vaccine preventable diseases largely confined to the Bible belt, an area where -among others- orthodox protestant groups are living. Lacking information on the Vaccination Coverage in this minority, and its various subgroups, control of vaccine preventable diseases is focused on the geographical area of the Bible belt. However, the adequacy of this strategy is questionable. This study assesses the influence of presence of various orthodox protestant subgroups (orthodox protestant denominations, OPDs) on municipal Vaccination Coverage in the Bible belt. Methods: We performed an ecological study at municipality level. Data on number of inhabitants, urbanization level, socio-economical status, immigration and Vaccination Coverage were obtained from national databases. As religion is not registered in the Netherlands, membership numbers of the OPDs had to be obtained from church year books and via church offices. For all municipalities in the Netherlands, the effect of presence or absence of OPDs on Vaccination Coverage was assessed by comparing mean Vaccination Coverage. For municipalities where OPDs were present, the effect of each of them (measured as membership ratio, the number of members proportional to total number of inhabitants) on Vaccination Coverage was assessed by bivariate correlation and multiple regression analysis in a model containing the determinants immigration, socio-economical status and urbanization as well. Results: Mean Vaccination Coverage (93.5% ± 4.7) in municipalities with OPDs (n = 135) was significantly lower (p < 0.001) than in 297 municipalities without OPDs (96.9% ± 2.1). Multiple regression analyses showed that in municipalities with OPDs 84% of the variance in Vaccination Coverage was explained by the presence of these OPDs. Immigration had a significant, but small explanatory effect as well. Membership ratios of all OPDs were negatively related to Vaccination Coverage; this relationship was strongest for two very conservative OPDs. Conclusion: As variance in municipal Vaccination Coverage in the Bible belt is largely explained by membership ratios of the various OPDs, control of vaccine preventable diseases should be focused on these specific risk groups. In current policy part of the orthodox protestant risk group is missed.
Gabriele Poggensee - One of the best experts on this subject based on the ideXlab platform.
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Varicella Vaccination Coverage of children under two years of age in Germany
BMC public health, 2010Co-Authors: Annicka M Reuss, Marcel Feig, Lutz Kappelmayer, Anette Siedler, Tim Eckmanns, Gabriele PoggenseeAbstract:Since July 2004, routine varicella Vaccination is recommended by the German Standing Vaccination Committee in Germany. Health Insurance Funds started to cover Vaccination costs at different time points between 2004 and 2006 in the Federal States. Nationwide representative data on Vaccination Coverage against varicella of children under two years of age are not available. We aimed to determine varicella Vaccination Coverage in statutory health insured children under two years of age in twelve German Federal States using data from associations of statutory health insurance physicians (ASHIPs), in order to investigate the acceptance of the recommended routine varicella Vaccination programme. We analysed data on varicella Vaccination from 13 of 17 ASHIPs of the years 2004 to 2007. The study population consisted of all statutory health insured children under two years of age born in 2004 (cohort 2004) or 2005 (cohort 2005) in one of the studied regions. Vaccination Coverage was determined by the number of children vaccinated under 2 years of age within the study population. Varicella Vaccination Coverage of children under two years of age with either one dose of the monovalent varicella vaccine or two doses of the measles, mumps, rubella, and varicella vaccine increased from 34% (cohort 2004) to 51% (cohort 2005) in the studied regions (p < 0.001). More than half of the vaccinated children of cohort 2004 and two third of cohort 2005 were immunised at the recommended age 11 to 14 months. The level of Vaccination Coverage of cohort 2004 was significantly associated with the delay in introduction of cost Coverage since the recommendation of varicella Vaccination (p < 0.001). Our study shows increasing varicella Vaccination Coverage of young children, indicating a growing acceptance of the routine varicella Vaccination programme by the parents and physicians. We recommend further monitoring of Vaccination Coverage using data from ASHIPs to investigate acceptance of the routine Vaccination programmes over time.
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Varicella Vaccination Coverage of children under two years of age in Germany
BMC Public Health, 2010Co-Authors: Annicka M Reuss, Marcel Feig, Lutz Kappelmayer, Anette Siedler, Tim Eckmanns, Gabriele PoggenseeAbstract:Background Since July 2004, routine varicella Vaccination is recommended by the German Standing Vaccination Committee in Germany. Health Insurance Funds started to cover Vaccination costs at different time points between 2004 and 2006 in the Federal States. Nationwide representative data on Vaccination Coverage against varicella of children under two years of age are not available. We aimed to determine varicella Vaccination Coverage in statutory health insured children under two years of age in twelve German Federal States using data from associations of statutory health insurance physicians (ASHIPs), in order to investigate the acceptance of the recommended routine varicella Vaccination programme. Methods We analysed data on varicella Vaccination from 13 of 17 ASHIPs of the years 2004 to 2007. The study population consisted of all statutory health insured children under two years of age born in 2004 (cohort 2004) or 2005 (cohort 2005) in one of the studied regions. Vaccination Coverage was determined by the number of children vaccinated under 2 years of age within the study population. Results Varicella Vaccination Coverage of children under two years of age with either one dose of the monovalent varicella vaccine or two doses of the measles, mumps, rubella, and varicella vaccine increased from 34% (cohort 2004) to 51% (cohort 2005) in the studied regions (p < 0.001). More than half of the vaccinated children of cohort 2004 and two third of cohort 2005 were immunised at the recommended age 11 to 14 months. The level of Vaccination Coverage of cohort 2004 was significantly associated with the delay in introduction of cost Coverage since the recommendation of varicella Vaccination (p < 0.001). Conclusions Our study shows increasing varicella Vaccination Coverage of young children, indicating a growing acceptance of the routine varicella Vaccination programme by the parents and physicians. We recommend further monitoring of Vaccination Coverage using data from ASHIPs to investigate acceptance of the routine Vaccination programmes over time.