Risk factors for pertussis among children hospitalized for pertussis during 2016-2017, in Guizhou Province of China: a case-control study

Aim:Pertussis is a respiratory tract infection,the vaccine for which was introduced in the Expanded Programme on Immunization(EPI)in Guizhou Province of China(hereafter referred as Guizhou)in the 1980s.This vaccine rapidly decreased incidence rates of pertussis in the province,however,despite the wide high coverage of the diphtheria,tetanus and acellular pertussis(DTaP)combined vaccine,there has been a resurgence of pertussis since 2014.Even with this recent increase in disease transmission,risk factors for pertussis infection have not been evaluated in Guizhou.We aimed to provide information on pertussis risk factors and insight on designing targeted pertussis control policies and measures through this study.Methods:A 1:2 matched retrospective case-control study was conducted between 2016 and 2017,involving infants and children younger than 6 years old and parents of the participants.The enrolled cases included clinical and laboratory confirmed pertussis cases according to the WHO-recommended pertussis definition.Controls were selected from children in the same neighborhood who were not diagnosed with pertussis prior to our investigation and did not exhibit any clinical manifestations of pertussis.Results:The household size[Matched odds ratio(OR_(m)=1.4,95%confidence interval(Cl):1.1-1.7]and household members with antecedent cough(OR_(m)=3.6,95%CI:1.8-7.2)were significantly associated with their child’s pertussis onset.The parents’occupations were significantly associated with their child’s pertussis onset(ORm=9.4,95%CI:1.6-54.8,for mother side;ORm=4.5,95%CI:1.2-16.5,for father side),when they worked in the business and/or service industry.Having family members with a history of cough was an independent risk factor for pertussis[Adjusted odds ratio(AOR)=43.6,95%CI:2.7-694.0].Besides,the parents’demographic characteristics and DTaP doses were not found to be independent factors.Conclusion:Household exposure is an important risk factor for pertussis infection in infants and young children and should therefore be considered as a major factor during formulation of pertussis control policies and measures.

Wearable energy harvesters generating electricity from low-frequency human limb movement

A wearable energy harvester technology is developed for generating electricity from the movement of human joints.A micro-electroplated ferromagnetic nickel cantilever is integrated with a piezoelectric element and bonded on a flexible substrate.Based on the magnetic interaction between the magnetized cantilever and a magnet on the substrate,a novel vertical-vibration frequency-up-conversion(FUC)structure is formed to generate stable amounts of electric energy per cycle from the horizontal substrate stretching/rebounding.The two ends of the flexible substrate are attached on both sides of a limb joint to transform joint rotation into substrate stretching.During limb movement,the flexible substrate is horizontally stretched and rebounded,causing the cantilever to vertically release from and return to the magnet,thereby exciting the piezoelectric cantilever into resonant generation.Since the horizontal lowfrequency limb movement is perpendicular to the vertical high-frequency resonance,the stretch has little influence on the resonance of the cantilever.Thus the generated energy is always stable within a wide frequency range of limb movements.The performance of the novel harvester is experimentally verified using a stretching/rebounding movement cycle,where the cycle corresponds to the frequency range of 0.5–5.0 Hz.Within one stretching/rebounding movement cycle,the generated electric energy is stable in the approximate range of 0.56–0.69μJ for the whole frequency range.Two flexible harvesters are worn on the human elbow and knee for a body kinetic energy harvesting test.Considerable power can always be generated under typical low-frequency limb movements,such as squatting,walking,jogging,and fast running,where the peak-to-peak generated voltages are always approximately 4.0 V.Additionally,energy harvesting under two-directional area stretching is also realized by adjusting the FUC structure layout.The flexible-substrate harvester is promising for various wearable applications.

Vaccination Guidelines During and After the COVID-19 Epidemic in China

In late December 2019,clinicians in Hubei Province noticed and reported to health authorities a cluster of cases of pneumonia of unknown etiology(PUE)that turned out to be the start of the coronavirus disease 2019(COVID-19)pandemic(1).By January 29,2020,all provincial-level administrative divisions(PLADs)across the country had launched their highest public health emergency responses(Level 1 responses)(2-3).

Vaccine-Associated Paralytic Poliomyelitis--8 PLADs,China,October 2012–March 2014

Introduction:Poliomyelitis is a highly contagious,seasonal viral disease caused by any of three poliovirus(PV)serotypes(types 1,2,or 3).Oral poliovirus vaccine(OPV)on rare occasions causes vaccineassociated paralytic poliomyelitis(VAPP)in recipients of OPV and close contacts of recently vaccinated individuals.This study describes the epidemiology of VAPP when an all OPV schedule was used in the Expanded Program on Immunization(EPI).Methods:VAPP cases were identified using standardized diagnostic criteria from data reported by 8 provincial-level administrative divisions(PLADs)to the National Acute Flaccid Paralysis(AFP)Surveillance System in an 18-month period between October 2012 and March 2014.Results:During this period,28 VAPP cases were reported.Using the number of births as a denominator,the estimated incidence of VAPP was 2.47 cases per million births.Using the number of OPV doses administered through routine immunization,the VAPP incidence was 0.55 cases per million doses.Among vaccine-recipient VAPP cases,22(85%)were associated with the first dose of OPV;3 were associated with the second OPV dose.The relative risk of VAPP following the first dose compared with the second dose was 7.07.Conclusions and Implications for Public Health Practice:The per-dose and per-child incidences of VAPP were consistent with incidence estimates by the World Health Organization(WHO).The vast majority(85%)of VAPP in China was associated with the first dose of OPV in an all-OPV schedule.Because inactivated polio vaccine(IPV)is known to prevent VAPP from subsequent doses of OPV in immunocompetent children,this association provided strong evidence for using an IPV-first,sequential IPVOPV polio vaccination schedule in China during the globally-synchronized cessation of type 2 OPV and introduction of IPV in 2016.

Impact of Influenza and Pneumococcal Polysaccharide Vaccination on Economic Burden from Acute Exacerbations of Chronic Obstructive Pulmonary Disease-Hebei Province,China,November 2018 to November 2020

Summary What is already known on this topic?Chronic obstructive pulmonary disease(COPD)exacerbations increase household economic burden,but there is limited evidence from prospective cohort studies in China about the impact of vaccination on economic burden.What is added by this report?This study demonstrated the economic burden of COPD exacerbations,pneumonia,and hospitalization in COPD patients in China is substantial.Influenza vaccine and 23-valent pneumococcal polysaccharide vaccine(PPSV23),separately or together,were significantly associated with decreased economic burden.What are the implications for public health practice?Our study supports evidence on recommendations that COPD patients in China are offered both influenza vaccine and PPSV23.

Effectiveness of Catch-Up Vaccinations after COVID-19 Containment--China,2020

Introduction:In the early stages of the coronavirus disease 2019(COVID-19)epidemic in China,the highest level of public health emergency response(Level 1 Response)was launched in all province-level administrative divisions(PLADs)across the country.Provision of vaccination services was selectively suspended due to the physical distancing and gathering restrictions required of Level 1 Response.The purpose of this paper is to evaluate the impact of COVID-19 on vaccination services and the effectiveness of selective vaccination service suspension and catch-up vaccinations in China.Methods:Vaccine doses administered,routine vaccination coverage levels,catch-up vaccine doses administered,and coverage levels after the catch-up campaign were determined from individual vaccination records in sampled clinics,standard routine immunization administrative coverage reports,and catch-up vaccination activity reports submitted by PLADs between October 2019 and October 2020.Results:National Immunization Program(NIP)and non-NIP vaccine doses administered in sampled clinics decreased by 80% and 90%,respectively,compared with doses administered before the COVID-19 pandemic.Coverage with the birth dose of hepatitis B vaccine(HepB1)and the Bacillus Calmette-Guérin vaccine(BCG)—two vaccinations recommended to continue throughout the epidemic due to their timecritical nature—were maintained at over 85%,while coverage of other NIP vaccines decreased to below 60%by February 2020.Catch-up vaccination coverage of the 29 PLADs,excluding Xinjiang and Xizang(Tibet),began in April 2020 and exceeded 90%;Hubei catch-up coverage was 95% by October 2020.Conclusions and Implications for Public Health Practice:The COVID-19 pandemic had a great impact on China’s vaccination services.During the epidemic and time of local transmission of the coronavirus,HepB1,BCG,rabies vaccine for postexposure prophylaxis,and tetanus antitoxin(TAT)for wound prophylaxis were maintained at high levels.Of the 69 million vaccine doses postponed during the time of local transmission of the coronavirus,94% were administered in the catch-up campaign.China’s pandemic immunization practices may provide evidence for other countries’immunization programs.

Immunogenicity of 23-Valent Pneumococcal Polysaccharide Vaccine in Patients with Chronic Obstructive Pulmonary Disease—Hebei Province,China,September−December,2019

Summary What is already known on this topic?The global burden of chronic obstructive pulmonary disease(COPD)is serious.Pneumococcal infection is associated with acute exacerbations of COPD(AECOPD).The 23-valent pneumococcal polysaccharide vaccine(PPSV23)is recommended for COPD patients to decrease AECOPD due to pneumococcus,but evidence on the immunogenicity of PPSV23 in COPD patients is limited.What is added by this report?

Active Vaccine Safety Surveillance: Global Trends and Challenges in China

Importance.The great success in vaccine-preventable diseases has been accompanied by vaccine safety concerns.This has caused vaccine hesitancy to be the top 10 in threats to global health.The comprehensive understanding of adverse events following immunization should be entirely based on clinical trials and postapproval surveillance.It has increasingly been recognized worldwide that the active surveillance of vaccine safety should be an essential part of immunization programs due to its complementary advantages to passive surveillance and clinical trials.Highlights.In the present study,the framework of vaccine safety surveillance was summarized to illustrate the importance of active surveillance and address vaccine hesitancy or safety concerns.Then,the global progress of active surveillance systems was reviewed,mainly focusing on population-based or hospital-based active surveillance.With these successful paradigms,the practical and reliable ways to create robust and similar systems in China were discussed and presented from the perspective of available databases,methodology challenges,policy supports,and ethical considerations.Conclusion.In the inevitable trend of the global vaccine safety ecosystem,the establishment of an active surveillance system for vaccine safety in China is urgent and feasible.This process can be accelerated with the consensus and cooperation of regulatory departments,research institutions,and data owners.

Progress of Active Surveillance for Vaccine Safety in China

Vaccination is one of the most cost-effective interventions for saving lives and promoting public health.The coronavirus disease 2019(COVID-19)pandemic is providing a stark reminder of the importance and power of vaccines(1).However,vaccines can cause harm,and their rare safety concerns have increased in relative visibility as successful control and prevention of vaccine preventable diseases has diminished awareness of these diseases.