Since medieval times, university academics have vigorously defended their "right of self-governance and the pursuit of scholarship and teaching without censure or constraint" 1. ...academic ...institutions, as employers and equippers, have an obligation to provide appropriate oversight to ensure the scientific veracity of their teaching and research.
Abstract The Strategic Group of Advisory Experts (SAGE) on immunization is an independent advisory committee with a mandate to advise the World Health Organization (WHO) on the development of vaccine ...and immunization related policies. SAGE working groups are established on a time-limited basis to review and provide evidence-based recommendations, together with their implications, for open deliberation and decision-making by SAGE. In making its recommendations, SAGE takes into consideration: the epidemiologic and clinical characteristics of the disease; vaccine and immunization characteristics; economic analysis; health system considerations; the existence of and interaction with other intervention and control strategies; costing and social impacts; and legal and ethical concerns. Since 1998, WHO has produced evidence-based vaccine position papers for use primarily by national public health officials and immunization programme managers. Since April 2006 all new or updated position papers have been based on SAGE recommendations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach has been adopted by WHO and, since 2008, GRADE tables that rate the quality of evidence have been produced in support of key recommendations. SAGE previously expressed concern that GRADE was not ideally suited to many immunization-specific issues such as the vaccine population level effect and the inclusion of surveillance system data, particularly for vaccine safety. Extensive productive interactions with various advisory groups including the US Advisory Committee on Immunization Practices, the European Centres for Disease Control, the German Standing Committee on Vaccination (STIKO), WHO's Global Advisory Committee on Vaccine Safety and the GRADE working group resulted in key enhancements to accommodate vaccine-relevant evidence. This facilitated integration and acceptability of the GRADE approach in the development of immunization related SAGE and WHO recommendations. Ongoing utilisation should result in further fine-tuning of the approach to ensure that recommendations are based on the full range of appropriate evidence.
Australia avoided the worst effects of the COVID-19 pandemic, but still experienced many negative impacts. Reflecting on lessons from Australia's public health response, an Australian expert panel ...composed of relevant discipline experts identified the following key lessons: 1) movement restrictions were effective, but their implementation requires careful consideration of adverse impacts, 2) disease modelling was valuable, but its limitations should be acknowledged, 3) the absence of timely national data requires re-assessment of national surveillance structures, 4) the utility of advanced pathogen genomics and novel vaccine technology was clearly demonstrated, 5) decision-making that is evidence informed and consultative is essential to maintain trust, 6) major system weaknesses in the residential aged-care sector require fixing, 7) adequate infection prevention and control frameworks are critically important, 8) the interests and needs of young people should not be compromised, 9) epidemics should be recognised as a ‘standing threat’, 10) regional and global solidarity is important. It should be acknowledged that we were unable to capture all relevant nuances and context specific differences. However, the intent of this review of Australia's public health response is to critically reflect on key lessons learnt and to encourage constructive national discussion in countries across the Western Pacific Region.
Time for an immunisation paradigm shift Durrheim, D. N; Goodson, J. L
Transactions of the Royal Society of Tropical Medicine and Hygiene,
02/2017, Letnik:
111, Številka:
2
Journal Article
Locally specific epidemiological understanding is pivotal to the success of malaria elimination in South Africa. Here, we focus on how the host, vector, parasite and environment and their ...interactions have influenced malaria incidence in South Africa between 1995 and 2012. Broad environmental considerations are necessary, including the physical (temperature and humidity), social (migration patterns), economic (quality of housing stock) and political (regional collaboration).
The accurate determination of population immunity is constrained by the inadequate quality of routinely available administrative data in many settings i.e., recording of vaccine doses administered ...either during the routine immunisation programme or by supplementary immunisation activities (SIAs) as the numerator, while the denominator is estimated from census data after considering births, deaths, and migration. ...failures may be caused by compromised vaccine potency due to cold chain breaches, vaccinator error, interference by maternal antibodies when infants are only vaccinated during the first year of life and, for many failures, unknown reasons (e.g., optimal vaccination in the second year of life is associated with failure rates of around 5%). There are a number of examples, e.g., Australia, Japan and Republic of Korea, where national measles serosurveys have identified immunity gaps in specific age cohorts, assisted in refining the routine immunisation schedule or designing targeted SIAs, and then been used to evaluate and confirm the success of the specific strategies adopted to reduce the immunity gaps 4–6. Improving routine data quality and conducting excellent case investigation and epidemiological analysis when outbreaks occur are pivotal to avoiding misinformed serosurvey assessment.Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Following the introduction of mandatory influenza vaccination for staff working in high risk clinical areas in 2018, we conducted active surveillance for adverse events following immunisation ...utilising an automated online survey to vaccine recipients at three and 42 days post immunisation. Most participants 2285 (92%) agreed to participate; 515 (32%) staff reported any symptom and eight (1.6%) sought medical attention. The odds of having a reaction decreased with age by approximately 2% per year. The system was acceptable to staff, and the data demonstrated rates of reported symptoms within expected rates for influenza vaccines from clinical trials. Rates of medical attendance were similar to previous surveillance. Participant centred real-time safety surveillance proved useful in this staff influenza vaccination context, providing reassurance with expected rates and profile of common adverse events following staff influenza vaccination.
Summary Background Australian Bat Lyssavirus is endemic in Australian bats. More Australians are travelling to rabies (Lyssavirus 1) endemic countries. The nature and frequency of lyssavirus ...exposures and characteristics of New South Wales (NSW) residents exposed have not previously been described. Method Access to free rabies post-exposure treatment (PET) can only be arranged through Public Health Units in NSW. Details of people receiving PET after potential exposures to rabies or ABLV from 1 January 2007 to 31 December 2011 were extracted from an NSW Ministry of Health web-based database and analysed to better understand lyssavirus exposure epidemiology. Results Of 1195 people receiving PET, 415 exposures were in Australia and 780 abroad; 78.3% occurring in Southeast Asia, mainly Indonesia (47.6%) where most were on the island of Bali (95.2%). PET use increased substantially for domestic and international exposures. In Australia, most bat exposures were to members of the public (76.0%), rather than to people who work with bats professionally or as volunteers, with 54.1% due to bat rescue attempts. Injuries abroad were mainly from monkeys (49.4%) and from dogs (35.8%). Only 4.0% of international travellers were vaccinated prior to their exposure. Conclusions Increasing rates of PET in travelling and non-travelling Australians emphasise the need for more effective communication about appropriate animal avoidance and the measures required if exposed. Opportunities for increasing pre-exposure treatment amongst individuals likely to be exposed should be promoted.
The preventable tragedy of diphtheria in the 21st century Blumberg, L.H.; Prieto, M.A.; Diaz, J.V. ...
International journal of infectious diseases,
June 2018, 2018-06-00, 20180601, 2018-06-01, Letnik:
71, Številka:
C
Journal Article
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