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Antimicrobial Chemoprophylaxis

Chemoprophylaxis is prevention of disease by administration of an anti-infective drug product. An antimicrobial product is given to an individual who is at risk of developing an infection following exposure to bacteria, viruses, fungi, mycobacteria, or parasites. The term “prophylaxis” as used in this chapter does not apply to those situations in which infection is already established; however, for some children who already are infected but…

Active Immunization

Immunization and Vaccines: Overview Immunization is the process of artificially inducing immunity or providing protection from disease. Active immunization is the process of stimulating the body to produce antibody and other immune responses (e.g., cell-mediated immunity) through administration of a vaccine or toxoid. Passive immunization is provision of temporary immunity via administration of preformed antibodies derived from humans or animals (see Chapter 5 ). Vaccines are…

Passive Immunization

Immunoglobulin therapy plays an increasingly important role in the treatment of a variety of medical conditions, not only to prevent or ameliorate infection but also because of antiinflammatory and immunomodulating effects. Passive immunization provides exogenous, preformed antibodies that can prevent or treat certain infectious diseases. In the early 20th century, hyperimmune animal sera were produced to treat specific infections. After human plasma fractionation was developed (during…

Infectious Diseases in Refugee and Internationally Adopted Children

In this chapter, the infectious disease issues of 2 groups of immigrants are discussed: refugees and internationally adopted children. Refugees are noncitizen immigrants who are unable or unwilling to return to their country of origin because of persecution or a fear of persecution. Internationally adopted children are immigrants who are classified as orphans; most however are not truly orphaned but have been abandoned by or separated…

Infections Associated With Group Childcare

On average, 12.5 million (61%) of the 20.4 million children in the United States who are younger than 5 years of age were enrolled in a regular childcare arrangement during the spring of 2011. Children in group childcare experience increased frequency of certain infectious diseases and amplify outbreaks of illness ( Table 3.1 ). Aggregation of young children potentiates transmission of organisms that can produce disease…

Pediatric Healthcare: Infection Epidemiology, Prevention and Control, and Antimicrobial Stewardship

Pediatric healthcare epidemiology is the study and analysis of the distribution (who, when, where) of patterns and determinants of health and disease conditions in healthcare settings where children receive healthcare or gather in locations where disease conditions could be present. Prevention of healthcare-associated infections (HAIs) is the major goal and is an important component of quality and patient safety programs. Healthcare epidemiologists must be ready to…

Principles of Epidemiology and Public Health

Epidemiology is the study of the distribution and determinants of disease or other health-related states or events in specified populations and the application of this study to the control of health problems. A key component of this definition is that epidemiology focuses on populations, an emphasis that distinguishes epidemiology from clinical case studies, which focus on individual subjects. Health events can be characterized by their distribution…

Websites and Applications for Mobile Devices With Information About Immunization

CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) WEBSITES National Center for Immunization and Respiratory Diseases (NCIRD) www.cdc.gov/vaccines NCIRD is an interdisciplinary immunization program that brings together vaccine-preventable disease science and research with immunization program activities. Its website provides information about vaccine-preventable diseases, the benefits and risks of immunization, vaccine licensures, Advisory Committee on Immunization Practices (ACIP) recommendations, Vaccine Information Statements (VISs), and vaccine supply issues, as…

Vaccines to Prevent Mpox

INTRODUCTION Mpox (formerly monkeypox) is a disease caused by infection with the Monkeypox virus (MPXV), a zoonotic orthopoxvirus (OPXV) in the same genus as Variola virus (which causes smallpox). There are two distinct genetic clades, Clade I (formerly Congo Basin Clade) and Clade II (formerly West African Clade); historically, Clade I was believed to cause more severe disease and be more transmissible. The virus was first…

Ethics

The global effort to develop and deliver vaccines against COVID-19 has brought unprecedented attention and scrutiny to all aspects of vaccines and vaccination efforts, including the many ethical issues they raise. During public health emergencies and ongoing disease prevention efforts alike, vaccines present a spectrum of novel ethical considerations compared with those associated with other medical interventions. Central to these differences are the role of vaccines…

Legal Issues

This chapter reviews liability for vaccine injuries historically; the rationale, development, and implementation of the National Vaccine Injury Compensation Program (VICP); the VICP’s current status; and the CDC COVID-19 Vaccination Program; international vaccine compensation programs; and the power to compel vaccination in the United States. The first part of the chapter discusses the development of the law in the United States until 1986, the year of…

Vaccine Hesitancy and Behavioral Factors Associated With Vaccine Uptake

While vaccine development, manufacturing, and delivery remain important components of a robust immunization system, vaccines only provide individual and societal benefits if eligible individuals can access and accept them. Therefore, it is important to understand and focus on the behavioral factors associated with vaccine uptake, in addition to addressing practical barriers. According to WHO Strategic Advisory Group of Experts working group on vaccine hesitancy, “Vaccine hesitancy…

Vaccine Safety

During the past 100 years, pharmaceutical companies have made vaccines against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, varicella, hepatitis A, hepatitis B, Haemophilus influenzae type B (Hib), pneumococcus, meningococcus, rotavirus, and human papillomavirus, among others ( Table 83.1 ) and ( Table 83.2 ). As a consequence, the number of children in the United States killed by pertussis decreased from 8000 each year in the…

Regulation of Vaccines in Low- and Middle-Income Countries

The World Health Organization (WHO) supports member states in strengthening their regulatory systems by setting norms and standards, promoting smart regulation, identifying strengths and gaps, providing specialized technical assistance, and capacity-building opportunities and advising on quality assurance of medicines for national and international markets. Regulatory alignment and collaboration are some of the key components that will help facilitate equitable access to safe and effective vaccines that…

Regulation of Vaccines in Europe

## Vaccines are complex biological medicinal products developed using increasingly varied and/or novel sophisticated technologies. They can contain live or attenuated infectious agents, recombinant pathogen proteins, and other types of components, such as adjuvants. Because of the major individual and population benefits, immunization with certain vaccines is mandatory in many European countries, and any safety hazard could affect a large number of persons. In this context,…

Regulation and Testing of Vaccines in the US

## Vaccines are one of the most significant achievements of science and public health. As a result of successful vaccination programs and campaigns, many vaccine-preventable diseases are now uncommon in the United States. Vaccines for the prevention of infectious diseases are regulated by the U.S. Food and Drug Administration (FDA), and the legal framework for regulation is derived from Section 351 of the Public Health Service…

Economic Analyses of Vaccine Policies

At the time of writing this chapter, COVID-19 is the pandemic of the century, globally affecting macro and micro-economies. Recognition of the economic disruption from outbreaks on the regional level (Ebola viral disease) and global level (COVID-19) has led to justifying novel financial mechanisms to address the macroeconomic impact of uncontrolled communicable diseases. New national and international mechanisms of global collaborations have been established to mitigate…

Community Protection

Vaccines are given to people to protect them against disease. They are also given to reduce transmission of infection, thereby preventing disease even in nonvaccinated persons, and thus protecting communities. The extension of perspective from individuals to their communities is the business of public health. The use of an increasing number of different vaccines, in all populations of the world, represents a major, evolving, and highly…

Immunization in Low- and Middle-Income Countries

Since the late 1970s, childhood immunization has been one of the most effective and cost-effective public health preventive measures for all countries. Amongst low- and middle-income countries (LMICs) (a categorization based on income used by World Bank instead of “developing countries”), immunization prevented an estimated 37 million deaths from 2000 through 2019. The history of immunization in low-income countries can be traced back to the birth…

Immunization and Vaccine-Preventable Diseases in the Asia-Pacific Region

In the 20th century, the development, licensing, and implementation of vaccines as part of large, systematic immunization programs, aimed to address health inequities that existed globally. Yet access to vaccines that prevent life-threatening infectious diseases remains unequal among infants, children, and adults worldwide. This is a problem globally that governments and partner agencies are working hard to address. In recent years, the World Health Organization (WHO)…