POSSIBLE CAUSES IN HUMAN ACTIVE IMMUNISATION FAILURE

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POSSIBLE CAUSES IN HUMAN ACTIVE IMMUNISATION
FAILURE

• Authors
• Dr. DANA GABRIELA NEGRU, dr. Preotescu George
• MD, senior epidemiologist, Arad County Public
  Health Department
• MD,manager, Chisineu Cris Sfantul Gheorghe
  Hospital

2
INTRODUCTION

• Active immunisation saved many lives from XIX-th
  century but the infectious diseases emerge or
  re-emerge spectacularly. Our decenal study shows
  the result obtains in Arad County between
  1985-2004 from the active immunisation point of
  view and also observes reasons in failure
  causes. Tuberculosis, measles, tetanous and
  hepatitis A and B viruses are the most important
  infections, in individual or public health.
  Despite a higher rate in vaccination coverage,
  these infections remaines an important problem in
  public health. We saw that BCG vaccination is not
  enough in tuberculosis control also measles
  elimination is a far away goal. Tetanous is
  present equaly in pediatric and in adult cases,
  with a high rates of fatality .Only vaccination
  against hepatitis A and B viruses could be
  considered succesfully.
• National Programme of Imunisation depends of
  chain cold facility, accesibility to medical
  services, educational items, large vaccination
  coverage and, at last, but not at least, of
  vaccines products, which must have higher
  immunogenicity and less adverse reaction.

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MATERIAL AND METHODS

• We analised all infections diseses due to
  Clostridium tetanii (mandatory and exhaustive
  reported),Bacillus Koch, Morbillivirus and
  hepatitis A and B viruses registreted in Arad
  County between 1985-2004.
• All data were processed in Excel and SPSS 7.5
  for Windows, for obtaining Risk Ratio in
  vaccinated versus nonvaccinated persons/by age.
  Also we use vaccination coverage procent in
  all these years for correlating eficiency of
  vaccination in relation with new cases .

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Evolution of infection diseases in Arad County
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Tetanous incidence in Arad County
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RESULTS AND DISCUSSION
Exposed to tetanous pacient healthy total od ratio
vaccination within 10 year 15 533 548 2,7
non-vaccination 9 63 72 12,5
cases deceased recovered total deceased ratio
pediatric cases 4 6 10 40
adults cases 9 5 14 64,28
total 13 11 24  
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Measles evolution in Arad County/cases
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MEASLES

• Measles also manifest epidemic out breaks at
  every 7-10 years and SLAM receptors for free
  Morbillivius are not blocked by anti
  morbiliviruses vaccine.

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Incidence in oo for hepatitis A viruses in Arad
County, comparable for non vaccination period
1987-1995/vaccination period 1996-2004
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HEPATITIS A and B

• Only vaccination against hepatitis A and B
  viruses are effective.
• In Arad County acute hepatitis due to hepatitis A
  virus are endemo-epidemics and endemic at low
  level for hepatitis B virus.
• Our study reveals evident improvment in
  surveillance of hepatitis A and B viruses since
  these vaccination are available.
• Risk ratio is lower in targeted vaccination than
  sporadic vaccination/by age.

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Risk Ratio in sporadic vaccination anti hepatitis
A viruse versus targeted vaccination, in Arad
County
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Incidence in oo for hepatitis B viruse in Arad
County, comparable for non vaccination period
1987-1995/vaccination period 1996-2004
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Risk Ratio in vaccination anti hepatitis B
viruse correlated with age, in Arad County
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CONCLUSIONS

• Vaccination is an important weapon in
  immunisation but many failures can apears
• if vaccine are not well preserved in cold
  chaines and active ingredients, which are
  termosensible, and are compromised
• if vaccination coverage are under 60 for
  eligible population
• vaccines doesnt protect against wild
  circulating strains or if these strains are
  escape mutants developed under vaccination
  pressing
• if non-responding population rates are more than
  5.