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In 1976, 2 recruits at Fort Dix, New Jersey, had an influenzalike illness. Isolates of virus taken from them included A/New Jersey/76 (Hsw1n1), a strain similar to the virus believed at the time to be the cause of the 1918 pandemic, commonly known as swine flu. Serologic studies at Fort Dix suggested that >200 soldiers had been infected and that person-to-person transmission had occurred. We review the process by which these events led to the public health decision to mass-vaccinate the American public against the virus and the subsequent events that led to the program's cancellation. Observations of policy and implementation success and failures are presented that could help guide decisions regarding avian influenza.
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In April 1955 more than 200 000 children in five Western and mid-Western USA states received a polio vaccine in which the process of inactivating the live virus proved to be defective. Within days there were reports of paralysis and within a month the first mass vaccination programme against polio had to be abandoned. Subsequent investigations revealed that the vaccine, manufactured by the California-based family firm of Cutter Laboratories, had caused 40 000 cases of polio, leaving 200 children with varying degrees of paralysis and killing 10.
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The Cutter Incident: How America's First Polio Vaccine Led to a Growing Vaccine Crisis
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science.sciencemag.org science.sciencemag.org
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2020-05-29
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Graham, B. S. (2020). Rapid COVID-19 vaccine development. Science, 368(6494), 945–946. https://doi.org/10.1126/science.abb8923
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Rapid development of a vaccine to prevent coronavirus disease 2019 (COVID-19) is a global imperative, and defining the stakes and potential hurdles is critical because regulatory and medical decisions are based on benefit:risk calculations. The ability of viruses to achieve pandemic spread is diminished by establishing higher levels of community (herd) immunity, and a key question is whether protection against severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) will happen by widespread deployment of an effective vaccine or by repeated waves of infection over the next few years until ∼60 to 70% of people develop immunity. Because the human population is naïve to SARS-CoV-2, the consequences of repeated epidemics will be unacceptably high mortality, severe economic disruption, and major adjustments to our way of life. Therefore, the benefit of developing an effective vaccine is very high, and even greater if it can be deployed in time to prevent repeated or continuous epidemics.
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10.1126/science.abb8923
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Rapid COVID-19 vaccine development
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2020-08-11
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Callaway, E. (2020). Russia’s fast-track coronavirus vaccine draws outrage over safety. Nature, 584(7821), 334–335. https://doi.org/10.1038/d41586-020-02386-2
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The immunization is the first approved for widespread use but could be dangerous because it hasn’t been tested in large trials, say researchers.
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Russia’s fast-track coronavirus vaccine draws outrage over safety
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www.sciencedirect.com www.sciencedirect.com
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2010-12-16
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Kwon, Y., Cho, H.-Y., Lee, Y.-K., Bae, G.-R., & Lee, S.-G. (2010). Relationship between intention of novel influenza A (H1N1) vaccination and vaccination coverage rate. Vaccine, 29(2), 161–165. https://doi.org/10.1016/j.vaccine.2010.10.063
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We carried out this study to describe the difference between intention to receive vaccine against influenza A (H1N1) before the vaccination campaign and actual vaccine coverage rate after vaccination campaign; and to find out the factors affecting the acceptability. We analyzed data on intention to receive vaccine against influenza A (H1N1) and actual vaccination coverage rate from IR (immunization registry). In a survey of pre-vaccination, the sample size was 1042 and the survey results were weighted with gender and age distribution for sample distribution to be similar to population distribution. Although the intention to receive vaccine against influenza A (H1N1) was high, the actual vaccination coverage was lower than their intention. The factors affecting their intention were the degree of fear for novel influenza A (H1N1), the possibility to be infected with the virus, priority for production of novel influenza vaccine between timing and safety, and belief for effectiveness of novel influenza vaccine. Besides 2009 influenza A (H1N1) vaccination experience developing to resolve the effecting factors on intentions to receive vaccine, which would be the effective way to prepare for anther pandemic in the future.
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10.1016/j.vaccine.2010.10.063
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Relationship between intention of novel influenza A (H1N1) vaccination and vaccination coverage rate
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www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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2010-04-19
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Seale, H., Heywood, A. E., McLaws, M.-L., Ward, K. F., Lowbridge, C. P., Van, D., & MacIntyre, C. R. (2010). Why do I need it? I am not at risk! Public perceptions towards the pandemic (H1N1) 2009 vaccine. BMC Infectious Diseases, 10. https://doi.org/10.1186/1471-2334-10-99
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10.1186/1471-2334-10-99
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BackgroundOn the 30th September 2009, the pandemic (H1N1) 2009 influenza vaccine was made available to adults and children aged 10 years and over, in Australia. Acceptance of a novel vaccine is influenced by perceptions of risk including risk of infection, risk of death or severe illness and risk of serious vaccine side-effects. We surveyed a sample of residents from Sydney, Australia to ascertain their risk perception, attitudes towards the pandemic and willingness to accept the pandemic (H1N1) 2009 influenza vaccine.MethodsWe sampled residents using a cross-sectional intercept design during the WHO Phase 6. Members of the public were approached in shopping and pedestrian malls to undertake the survey during September and October 2009. The survey measured perceived risk, seriousness of disease, recent behavioural changes, likely acceptance of the pandemic (H1N1) 2009 vaccine and issues relating to uptake and perceived safety.ResultsOf the 627 respondents, the majority felt that they had a "very low to low" (332/627, 52.9%) risk of acquiring H1N1. 24.5% (154/627) of respondents believed that the disease would "very seriously or extremely" affect their health. Nearly half (305/627, 48.6%) reported that in response to the "swine flu" outbreak they had undertaken one or more of the investigated behavioural changes. Overall, the self-reported likelihood of accepting vaccination against novel H1N1 was 54.7% (343/627).ConclusionsWhile, most participants did not believe they were at high risk of acquiring pandemic H1N1 2009, over half of the sample indicated that they would accept the vaccine. Participants who were vaccinated against the seasonal influenza were more likely to receive the H1N1 vaccine. Concerns about safety, the possibility of side effects and the vaccine development process need to be addressed.
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Why do I need it? I am not at risk! Public perceptions towards the pandemic (H1N1) 2009 vaccine
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bmcpublichealth.biomedcentral.com bmcpublichealth.biomedcentral.com
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2011-01-06
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10.1186/1471-2458-11-15
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BackgroundVaccination is one of the cornerstones of controlling an influenza pandemic. To optimise vaccination rates in the general population, ways of identifying determinants that influence decisions to have or not to have a vaccination need to be understood. Therefore, this study aimed to predict intention to have a swine influenza vaccination in an adult population in the UK. An extension of the Theory of Planned Behaviour provided the theoretical framework for the study.MethodsThree hundred and sixty two adults from the UK, who were not in vaccination priority groups, completed either an online (n = 306) or pen and paper (n = 56) questionnaire. Data were collected from 30th October 2009, just after swine flu vaccination became available in the UK, and concluded on 31st December 2009. The main outcome of interest was future swine flu vaccination intentions.ResultsThe extended Theory of Planned Behaviour predicted 60% of adults' intention to have a swine flu vaccination with attitude, subjective norm, perceived control, anticipating feelings of regret (the impact of missing a vaccination opportunity), intention to have a seasonal vaccine this year, one perceived barrier: "I cannot be bothered to get a swine flu vaccination" and two perceived benefits: "vaccination decreases my chance of getting swine flu or its complications" and "if I get vaccinated for swine flu, I will decrease the frequency of having to consult my doctor," being significant predictors of intention. Black British were less likely to intend to have a vaccination compared to Asian or White respondents.ConclusionsTheoretical frameworks which identify determinants that influence decisions to have a pandemic influenza vaccination are useful. The implications of this research are discussed with a view to maximising any future pandemic influenza vaccination uptake using theoretically-driven applications.
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Determinants of adults' intention to vaccinate against pandemic swine flu
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www.sciencedirect.com www.sciencedirect.com
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2010-11-29
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Hidiroglu, S., Ay, P., Topuzoglu, A., Kalafat, C., & Karavus, M. (2010). Resistance to vaccination: The attitudes and practices of primary healthcare workers confronting the H1N1 pandemic. Vaccine, 28(51), 8120–8124. https://doi.org/10.1016/j.vaccine.2010.09.104
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During the H1N1 pandemic, most healthcare workers in Turkey were not willing to take up the vaccine. This qualitative study aims to explore the factors that lead to vaccination resistance among a group of primary healthcare workers in Istanbul. Data were collected through focus group discussions. Thematic content analysis was conducted. All participants considered themselves at risk for infection, yet most of them were not vaccinated. Only persons with a “poor” immune system were considered by the respondents at risk for severe disease and death. Health personnel mostly did not realize their potential role in the transmission of influenza to patients. The decision of vaccination was dependent on the information source. The personnel who depended mainly on the media either did not accept vaccination or was undecided. They believed that the vaccine went through an accelerated authorization procedure. Yet the ones who accepted vaccination relied mostly on evidence-based sources and accessed information from the guidelines of the Ministry of Health, Professional Medical Associations and the World Health Organization. Social networks were also influential factors in the decision-making process. It is important to empower healthcare workers through supporting the skills of acquiring and using evidence-based information. This is particularly important for physicians who also serve as opinion leaders.
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10.1016/j.vaccine.2010.09.104
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Resistance to vaccination: The attitudes and practices of primary healthcare workers confronting the H1N1 pandemic
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www.sciencedirect.com www.sciencedirect.com
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2020-03-04
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Yufika, A., Wagner, A. L., Nawawi, Y., Wahyuniati, N., Anwar, S., Yusri, F., Haryanti, N., Wijayanti, N. P., Rizal, R., Fitriani, D., Maulida, N. F., Syahriza, M., Ikram, I., Fandoko, T. P., Syahadah, M., Asrizal, F. W., Aletta, A., Haryanto, S., Jamil, K. F., … Harapan, H. (2020). Parents’ hesitancy towards vaccination in Indonesia: A cross-sectional study in Indonesia. Vaccine, 38(11), 2592–2599. https://doi.org/10.1016/j.vaccine.2020.01.072
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BackgroundHesitancy towards vaccination has been studied as a barrier to vaccination among children, as well as participation in vaccine trials. This study aimed to investigate hesitancy towards vaccination among parents in Indonesia, as a part of the Indonesia Zika Vaccine Study.MethodsA cross-sectional study was conducted in eleven regencies and municipalities in Aceh and West Sumatra province, Indonesia. Parents were recruited from families at outpatient clinics of community health centers or hospitals. The survey included various questions about sociodemographic factors and the Parent Attitudes about Childhood Vaccination (PACV) scale. Linear regression was employed to assess the association between explanatory variables and vaccine hesitancy.ResultsA total of 956 parents were interviewed and 26.4% of participants had heard about Zika. Overall, 152 parents (15.9%) were vaccine hesitant, and this proportion was the highest in the safety and efficacy subdomain (61.6%). In the unadjusted analysis, having a diploma certificate, working in the health sector, and having heard about Zika were significantly associated with non-hesitancy towards children vaccination. Having heard about Zika was the only factor that was significantly associated with hesitancy towards vaccination in multivariate model (aOR: 0.43, 95% CI: 0.26–0.71). Mothers, younger parents (aged 20–29 years old), and those with only a primary school education were more concerned about vaccine safety and efficacy compared to fathers, older groups, and individuals with more education, respectively.ConclusionsHesitancy towards pediatric vaccination is observed in 15% of respondents and most of the hesitancy was expressed in terms of vaccine safety and efficacy. Therefore, continuous dissemination of vaccine information needs to be carried out to earn parents’ trust and increase vaccination coverage in Indonesia.
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10.1016/j.vaccine.2020.01.072
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