Last data update: Jun 24, 2024. (Total: 47078 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Huang WT [original query] |
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System and facility readiness assessment for conducting active surveillance of adverse events following immunization in Addis Ababa, Ethiopia
Zeleke ED , Yimer G , Lisanework L , Chen RT , Huang WT , Wang SH , Bennett SD , Makonnen E . Int Health 2023 BACKGROUND: To help distinguish vaccine-related adverse events following immunization (AEFI) from coincidental occurrences, active vaccine pharmacovigilance (VP) prospective surveillance programs are needed. From February to May 2021, we assessed the system and facility readiness for implementing active AEFI VP surveillance in Addis Ababa, Ethiopia. METHODS: Selected hospitals were assessed using a readiness assessment tool with scoring measures. The site assessment was conducted via in-person interviews within the specific departments in each hospital. We evaluated the system readiness with a desk review of AEFI guidelines, Expanded Program for Immunization Guidelines and Ethiopian Food and Drug Administration and Ethiopian Public Health Institute websites. RESULTS: Of the hospitals in Addis Ababa, 23.1% met the criteria for our site assessment. During the system readiness assessment, we found that essential components were in place. However, rules, regulations and proclamations pertaining to AEFI surveillance were absent. Based on the tool, the three hospitals (A, B and C) scored 60.6% (94/155), 48.3% (75/155) and 40% (62/155), respectively. CONCLUSIONS: Only one of three hospitals assessed in our evaluation scored >50% for readiness to implement active AEFI surveillance. We also identified the following areas for improvement to ensure successful implementation: training, making guidelines and reporting forms available and ensuring a system that accommodates paper-based and electronic-based recording systems. |
Narcolepsy and adjuvanted pandemic influenza A (H1N1) 2009 vaccines - Multi-country assessment
Weibel D , Sturkenboom M , Black S , de Ridder M , Dodd C , Bonhoeffer J , Vanrolleghem A , van der Maas N , Lammers GJ , Overeem S , Gentile A , Giglio N , Castellano V , Kwong JC , Murray BJ , Cauch-Dudek K , Juhasz D , Campitelli M , Datta AN , Kallweit U , Huang WT , Huang YS , Hsu CY , Chen HC , Giner-Soriano M , Morros R , Gaig C , Tio E , Perez-Vilar S , Diez-Domingo J , Puertas FJ , Svenson LW , Mahmud SM , Carleton B , Naus M , Arnheim-Dahlstrom L , Pedersen L , DeStefano F , Shimabukuro TT . Vaccine 2018 36 (41) 6202-6211 BACKGROUND: In 2010, a safety signal was detected for narcolepsy following vaccination with Pandemrix, an AS03-adjuvanted monovalent pandemic H1N1 influenza (pH1N1) vaccine. To further assess a possible association and inform policy on future use of adjuvants, we conducted a multi-country study of narcolepsy and adjuvanted pH1N1 vaccines. METHODS: We used electronic health databases to conduct a dynamic retrospective cohort study to assess narcolepsy incidence rates (IR) before and during pH1N1 virus circulation, and after pH1N1 vaccination campaigns in Canada, Denmark, Spain, Sweden, Taiwan, the Netherlands, and the United Kingdom. Using a case-control study design, we evaluated the risk of narcolepsy following AS03- and MF59-adjuvanted pH1N1 vaccines in Argentina, Canada, Spain, Switzerland, Taiwan, and the Netherlands. In the Netherlands, we also conducted a case-coverage study in children born between 2004 and 2009. RESULTS: No changes in narcolepsy IRs were observed in any periods in single study sites except Sweden and Taiwan; in Taiwan incidence increased after wild-type pH1N1 virus circulation and in Sweden (a previously identified signaling country), incidence increased after the start of pH1N1 vaccination. No association was observed for Arepanrix-AS03 or Focetria-MF59 adjuvanted pH1N1 vaccines and narcolepsy in children or adults in the case-control study nor for children born between 2004 and 2009 in the Netherlands case-coverage study for Pandemrix-AS03. CONCLUSIONS: Other than elevated narcolepsy IRs in the period after vaccination campaigns in Sweden, we did not find an association between AS03- or MF59-adjuvanted pH1N1 vaccines and narcolepsy in children or adults in the sites studied, although power to evaluate the AS03-adjuvanted Pandemrix brand vaccine was limited in our study. |
Vaccination and unexplained sudden death risk in Taiwanese infants
Huang WT , Chen RT , Hsu YC , Glasser JW , Rhodes PH . Pharmacoepidemiol Drug Saf 2016 26 (1) 17-25 PURPOSE: In March 1992, eight infants who had died within 36 hours of receiving whole-cell pertussis vaccine (diphtheria, tetanus, and whole-cell pertussis [DTwP]) prompted the Taiwan health authorities to suspend its use. We conducted an investigation of vaccination and sudden unexplained infant death (SUID) and repeated it more recently after Taiwan switched to acellular pertussis vaccine (diphtheria, tetanus, and acellular pertussis [DTaP]) in 2010. METHODS: All SUIDs aged 31-364 days during 1990-1992 and 1996-2013 were selected from the death registration databases. The case-control investigation matched each case to two controls on clinic, sex, and birth date, whereas the follow-up self-controlled case series study compared risk of death during the 30-day post-vaccination risk periods with those in the control periods within the same case. RESULTS: Sudden unexplained infant death was associated with never receiving DTwP (odds ratio 2.28, 95% confidence interval 1.25-4.15) in the case-control investigation. The odds ratios within 0-1, 2-7, 8-14, and 15-30 days of DTwP administration were 1.18, 0.26, 0.50, and 0.77. In the 1996-2013 self-controlled case series studies, this temporal shift between DTwP and SUID was consistently observed for female (incidence rate ratio 1.70, 0.75, 1.01, and 0.84) but not male or DTaP recipients. A pooled analysis showed significant risk within 2 days of receiving DTwP in female infants (incidence rate ratio 1.66, 95% confidence interval 1.05-2.60). CONCLUSIONS: Being unvaccinated and recent receipt of DTwP in female infants was significantly associated with SUID; the latter was consistent with a temporal shift pattern without overall increase in risk. The currently used pertussis vaccine, DTaP, did not increase risk of SUID. |
Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data
Quinn JA , Munoz FM , Gonik B , Frau L , Cutland C , Mallett-Moore T , Kissou A , Wittke F , Das M , Nunes T , Pye S , Watson W , Ramos AA , Cordero JF , Huang WT , Kocchar S , Buttery J . Vaccine 2016 34 (49) 6047-6056 Preterm birth is commonly defined as any birth before 37 weeks completed weeks of gestation. An estimated 15 million infants are born preterm globally, disproportionately affecting low and middle income countries (LMIC). It contributes directly to estimated one million neonatal deaths annually and is a significant contributor to childhood morbidity. However, in many clinical settings, the information available to calculate completed weeks of gestation varies widely. Accurate dating of the last menstrual period (LMP), as well as access to clinical and ultrasonographic evaluation are important components of gestational age assessment antenatally. This case definition assign levels of confidence to categorisation of births as preterm, utilising assessment modalities which may be available across different settings. These are designed to enable systematic safety evaluation of vaccine clinical trials and post-implementation programmes of immunisations in pregnancy. |
Respiratory illness in households of school-dismissed students during influenza pandemic, 2009
Cohen NJ , Callahan DB , Gonzalez V , Balaban V , Wang RT , Pordell P , Beato R , Oyervides O , Huang WT , Massoudi MS . Emerg Infect Dis 2011 17 (9) 1756-7 TO THE EDITOR: In response to the emergence of pandemic (H1N1) 2009 virus (1), the Centers for Disease Control and Prevention (CDC) issued interim guidance for preventing spread of the pandemic virus in schools. Initial guidance recommended that dismissal of students be considered for schools with confirmed cases of pandemic (H1N1) 2009 infection. The guidance was subsequently revised to recommend monitoring for respiratory illness and exclusion of ill students until they were noninfectious, rather than dismissal. |
Adherence to the Advisory Committee on Immunization Practices recommendation to prevent injuries from postvaccination syncope: a national physician survey
Huang WT , Suh C , Campagna E , Broder KR , Daley MF , Crane LA , Stokley S , Kempe A . Am J Prev Med 2011 41 (3) 317-21 BACKGROUND: Little is known about physicians' adherence to the 2006 Advisory Committee on Immunization Practices (ACIP) recommendation that providers strongly should consider observing vaccine recipients for 15 minutes to prevent injuries from postvaccination syncope. PURPOSE: To assess physicians' knowledge, attitudes, and practices toward observing adolescents for 15 minutes postvaccination. METHODS: A survey was administered during October 2008-January 2009 to 425 pediatricians (Peds) and 424 family medicine physicians (FPs) from a nationally representative network. Adherence was defined as reporting routinely observing patients for ≥15 minutes after vaccination. Data analysis was completed in 2009. RESULTS: The overall response rate was 73%. A minority of physicians (37% Peds, 24% FPs) were aware that ACIP strongly encourages observing patients for 15 minutes postvaccination, but most physicians (69% Peds, 84% FPs) thought that their practice easily could adhere to this recommendation. Lack of room space (76% Peds, 65% FPs) was the most frequently reported barrier. Seventeen percent of physicians reported adherence to postvaccination observation. Practice in a hospital, university, or community health center compared with private practice (RR=1.64, 95% CI=1.05, 2.40); awareness of the ACIP syncope recommendation (RR=5.55, 95% CI=3.60, 9.37); and believing that postvaccination syncope can result in serious injuries (RR=1.74, 95% CI=1.06, 4.22) were independently associated with self-reported adherence. CONCLUSIONS: Few physicians are aware of recommendations for postvaccination observation for syncope and even fewer adhere to them. Strategies to improve this should be developed and tested. |
Effect of school closure from pandemic (H1N1) 2009, Chicago, Illinois, USA
Jarquin VG , Callahan DB , Cohen NJ , Balaban V , Wang R , Beato R , Pordell P , Oyervides O , Huang WT , Lipman H , Fishbein D , Massoudi MS . Emerg Infect Dis 2011 17 (4) 751-3 TO THE EDITOR: On April 28, 2009, the Chicago Department of Public Health received notification of 1 student at an elementary school with a probable pandemic (H1N1) 2009 virus infection; the infection was subsequently laboratory confirmed. This case was one of the first pandemic (H1N1) 2009 cases in Chicago. To prevent transmission of influenza and with guidance from the Chicago Department of Public Health, the school closed on April 29; it reopened on May 6 after the Centers for Disease Control and Prevention (CDC) revised its recommendations (1). We conducted an investigation to evaluate psychosocial and economic effects of the school closure on the students' families and to assess whether students complied with mitigation recommendations. In the early pandemic, Chicago's number of pandemic (H1N1) 2009 cases was one of the highest in the United States (2). |
Nonhygienic behavior, knowledge, and attitudes among interactive splash park visitors
Nett RJ , Toblin R , Sheehan A , Huang WT , Baughman A , Carter K . J Environ Health 2010 73 (4) 8-14 Nonhygienic behavior likely contributed to three recreational waterborne illness (RWI) outbreaks at Idaho splash parks. The study described in this article examined the influence of signage and hygiene attendant presence on rates of nonhygienic behavior among children at splash parks and knowledge and attitudes of their adult supervisors. Investigators observed children for nonhygienic behaviors at four Idaho splash parks, two with signage and attendants. Supervisors were surveyed (N = 551) using an eight-item survey. Individually observed children (N = 145) were often seen exposing their buttocks to splash feature water and placing an open mouth to water. The rate of nonhygienic behaviors was not lower at parks with signage or staff. Supervisors reported bathing children before splash park entry infrequently. Signage and hygiene attendants do not adequately limit nonhygienic behaviors at splash parks, and supervisors have insufficient understanding of RWI. These findings have implica.tions for developing splash park regulations and RWI prevention efforts. |
Safety assessment of recalled Haemophilus influenzae type b (Hib) conjugate vaccines-United States, 2007-2008
Huang WT , Chang S , Miller ER , Woo EJ , Hoffmaster AR , Gee JE , Clark TA , Iskander JK , Ball R , Broder KR . Pharmacoepidemiol Drug Saf 2010 19 (3) 306-10 PURPOSE: On 13 December 2007, Merck & Co., Inc. voluntarily recalled 1.2 million doses of Haemophilus influenzae type b (Hib) vaccines that had been distributed since April 2007 for concerns regarding potential Bacillus cereus contamination. Enhanced postrecall surveillance was conducted to detect vaccine-associated B. cereus infections. METHODS: We reviewed reports involving recalled Hib vaccines received by the Vaccine Adverse Event Reporting System (VAERS) during 1 April 2007-29 February 2008. For each reported death, autopsy review sought evidence of B. cereus infections. For each specified outcome, the proportional reporting ratios (PRRs) were calculated to compare the recalled Hib vaccines with the manufacturer's nonrecalled Hib vaccines in the VAERS databases. On 20 December 2007, we used the Epidemic Information Exchange (Epi-X) to solicit nongastrointestinal vaccine-associated B. cereus infections, and requested B. cereus isolates for genotyping to compare with the manufacturing facility isolate. RESULTS: VAERS received 75 reports involving recalled Hib vaccines; none described a confirmed B. cereus infection. Comparative analyses did not reveal disproportionate reporting of specified outcomes for recalled Hib vaccines. The Epi-X posting triggered one report of vaccine-associated B. cereus bacteremia from a child who received a nonrecalled Hib vaccine manufactured by Merck; the genotypes of isolates from the patient and the manufacturing facility differed. CONCLUSIONS: No evidence of vaccine-associated B. cereus infection had been found in recipients of recalled Hib vaccines. Conducting laboratory surveillance through Epi-X was feasible and may enhance public health response capacities for future vaccine safety emergencies. Published in 2010 by John Wiley & Sons, Ltd. |
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