Knowledge and Attitude of Family Physicians Regarding Adult Vaccination

Objective: The aim of this study was to establish the knowledge and attitude of family physcians offering primary health care, towards adult vaccination and their own vaccination coverage. Methods: This descriptive study was performed in May 2009 in Kayseri, Turkey. 282 family physician accepted to fill a questionnaire about adult vaccination. Results: Most of the family physcians (83.0%) thought adult vaccination as a modality of protection and 66.7% wanted a vaccination scheme just like the one in childhood. Their own vaccination rate for Hepatitis B was 67.0% and 58.5% for influenza at any time. Only half of the physcians were vaccinated within the season for influenza. Only 9.2% of the doctors have stated that they ask questions to their patients about their vaccination status. When physcians were questioned about the vaccines they advise to their patients aged 65 and more;70.6% stated influenza and 39.7% stated pneumococcus. Conclusion: In spite of being in the risk group, family physicians have low vaccination coverage rates. Suggestion of the necessary vaccines to the risk groups or to their patients at risk is low as well.

Adult Vaccination and Voluntary Vaccination State of Adults:a Study from Turkey

In this study, establishing the knowledge about adult vaccination and voluntary vaccination state of adults in the prov-ince centre of Kayseri was aimed. This descriptive study was performed in 2009 May-July, in 6 public health centres (PHC) in the province centre of Kayseri, by way of a questionnaire. 998 adults from the population of an area covered by 34 family practitioners, working under six public health care centres, in the province centre of Kayseri, were asked to fill a questionnaire. Chi-square test was used in the statistical analysis and p < 0.05 was accepted as significant. The mean age of the participants was 37.4 ± 14.1 and 56.7% were female. 75.8% of the individuals knew that adults had to be vaccinated and 55.3% that influenza vaccination had to be done every year. 97.9% of the participants were aware of influenza vaccinLation, and the rate of vaccination was 7.8%, 97.8% knew tetanus vaccination, the awareness rate of hepatitis B vaccination was 84.4%, and vaccination rate 25.6%, Human Papilloma Virus (HPV) was known by 44.4%, vaccination rate in women was 1.1%, pneumococcus vaccination was known by 19.8% and vaccination rate was 0.4%. 22.0% of the individuals 65 years old and above had got an influenza vaccination while non-had got a pneumococcus vaccination. It is found that the tetanus, influenza, and hepatitis vaccinations were highly known, whereas, HPV and pneumococcus vaccinations were not, and that the number of individuals stating that they had been vaccinated was quite low.

A Double-Sided View to Adult Vaccination:The Opinions and Attitudes of Patients and Health Workers

Objective: Although there are adult vaccination schemes in our country, there are serious deficiencies in the way that doctors direct the patients to this vaccination, but also patients have to make and demand these vaccinations. The aim of our study is to identify the shortcomings in this area and draw a roadmap for what arrangements should be made in terms of physicians and patients in order to increase adult immunization rates in primary care. Method: We conducted a two-phase, multicentered, descriptive clinical trial between October and December 2017. The first phase of the trial was carried out with patients from 3 Family Health Centers in Antalya, Istanbul and Osmaniye. Patients to be interviewed were selected voluntarily among Family Health Center’s applicants. The second phase of the trial was carried out with health workers, who were participated to trial from 26 different provinces of Turkey. In the process, a questionnaire of 19 questions was applied to primary health care workers by the internet. Results: 490 patients were included in the study. There was a significant difference between gender, age, education level and guideline follow-up and vaccination status of patients [p Conclusion: As a result of the studies including our study about adult vaccination, only 10% - 20% of the targeted groups in adults can be vaccinated. However, just like in childhood during adulthood, vaccinations protect individuals from diseases and provide economic benefits. Firstly, the knowledge level of physicians on adult immunization should be updated with in-service trainings, they should first be convinced to vaccinate because they are in risk group and then they should be recommended vaccination to patient to increase the vaccination rates.

Relationship between T-lymphocyte cytokine levels and sero-response to hepatitis B vaccines

AIM: To investigate the cellular defects by analyzing the (Th1/Th2) cytokine levels in vaccine responders and non-responders. METHODS: Peripheral blood mononuclear cell (PBMC) from responders and non-responders were stimulated with or with out recombinant HBsAg or PHA. Broad spectrum of cytokines viz (Th1) IFN-γ, IL-2, TNF-α, IL-12 and (Th2) IL-10, IL-4 were measured after in vitro stimulation with recombinant HBsAg and were compared with respective antibody titers. RESULTS: A significant decrease (P = 0.001) in Th1 and Th2 cytokines namely, IL-2, INF-γ, TNF-α and IL-10in non-responders was observed. The level of IL-4 was not significant between the three groups. Furthermore, despite a strong Th1 and Th2 cytokine response, the level of IL-12 was elevated in high-responders compared to other groups (P = 0.001) and demonstrated a positive correlation with anti-HBs titers and Th1 cytokine response. CONCLUSION: Our findings suggest that unrespon-siveness to recombinant hepatitis B vaccines (rHB) is multifactorial, including specific failure of antigen presentation or the lack of both T helper Th1 and Th2 response.

Immunogenicity and safety of a new inactivated hepatitis A vaccine in young adults: a comparative study

To evaluate the immunogenicity, safety, and dosage of a new inactivated hepatitis A vaccine administered to young adults Methods One hundred and four normal adult volunteers, seronegative for hepatitis A virus and hepatitis B surface antigen, were randomly assigned to one of three groups The high dose group received a primary dose of 1000 units of the new vaccine, the low dose group received a primary dose of 500 units of the same vaccine, and the Havrix group received a primary dose of 1440 enzyme linked immunosorbent assay units of Havrix, a licensed inactivated hepatitis A vaccine All groups received a booster dose of the same vaccine 6 months after the primary dose Local and systemic adverse reactions, seroconversion rates, and geometric mean titers of hepatitis A virus antibodies were measured in all three groups Results Local and systemic reaction types and rates were similar in all three groups after primary and booster doses, although local reactions were more frequent in the Havrix group following the primary dose No serious adverse reactions occurred One month after the primary dose, the seroconversion rate was 87 5% in the high dose group, 70 0% in the low dose group, and 50.0% in the Havrix group ( P =0.001, versus the high dose group) At month 6 (before administration of the booster dose), seroconversion rates were 96 9% in the high dose group, 65 0% in the low dose group ( P =0 0029), and 68 8% in the Havrix group ( P =0 007) All subjects in all groups seroconverted by one month after receipt of the booster dose Geometric mean titers were similar in all three groups at month 1, but were higher in the high dose group (264 mIU/ml) than those in the Havrix group (135 mIU/ml) at month 6 ( P =0 0013) One month after the booster dose, geometric mean titers in the high dose group (2747 mIU/ml) were higher than those in the low dose group (1657 mIU/ml) ( P =0 0223) or in the Havrix group (1316 mIU/ml) ( P =0 01) Conclusions This new inactivated hepatitis A vaccine is immunogenic and safe; two doses of either 500 or 1000 units can induce hepatitis A virus antibodies well above the protection level

Two-sex logistic model for human papillomavirus and optimal vaccine

We formulate a two-gender susceptible-infectious-susceptible(SIS)model to search for optimal childhood and catch-up vaccines over a 20-year period.The optimal vaccines should minimize the cost of Human Papillomavirus(HPV)disease in random logistically growing population.We find the basic reproduction number Ro for the model and use it to describe the local-asymptotic stability of the disease-free equilibrium(DPE).We estimate the solution of the model to show the role of vaccine in reducing Rq and controlling the disease.We formulate some optimal control problems to find the optimal vaccines needed to control HPV under limited resources.The optimal vaccines needed to keep R_(0)≤1 are the catch-up vaccine rates of 0.004 and 0.005 for females and males,respectively;100%is needed to reduce R_(0)to its minimum value.To reduce the expenses for HPV disease and its vaccines,we need 100%childhood vaccines(both genders)for the first 13-14 years and then gradually reduce the vaccine to reach 0%at year 20.For adults(both genders),we need maximum rates(one)for the first 9 years,then 0.2 for the next 3-4 years before reducing gradually to zero rate at year 20.Although the childhood vaccines provide very early protection strategy against HPV,its time to control HPV is longer than that for adult vaccines.Thus,full adults’only vaccines for enough period is a viable choice to control HPV at minimal cost and short time.