M Karami, K Holakouie Naieni, A Rahimi, A Fotouhi, H Eftekhar Ardabili,
Volume 1, Issue 3 (2-2006)
Abstract
Background & Objectives: The DPT vaccine used in Iran is manufactured by the Razi Institute. So far, there have been no studies to determine the incidence and severity of adverse reactions to this vaccine. It was this lack of reliable information, plus concern for the unfavorable effects of such reactions on compliance with the vaccination schedule, that prompted the current study on DPT side effects.
Methods: In this cohort study, 1910 children aged 0 to 6 were divided into different groups (cohorts) on the basis of factors such as injection site and then monitored for the appearance of adverse effects. Data for this study were gathered through questionnaires filled by telephone or house-to-house interviews. We interviewed parents of children attending the 46 urban health clinics in Kermanshah. These interviews produced the data needed to fill the first part of the study questionnaire. The investigators then gave each parent an "information sheet" containing the data necessary for the second part of the questionnaire. The interviewee was asked to record on this sheet any adverse effects occurring over the following 48 hours. At the end of this period, the parent was contacted via telephone to fill the second part of the questionnaire. Data thus gathered were analyzed using the Statistical Package for Social Sciences (SPSS), version 11.5.
Results: In 1910 DTP immunizations given to children 0 to 6 years of age, followed for the development of adverse events occurring within 48 hours after immunization, the cumulative incidence rates were as follows: Swelling, 40.66% (38.43-42.89%) Redness, 43.08% (40.84-45.32%) Pain, 67.32% (65.20-69.40%) Fever (>38° C) 54.14% (51.89-56.40%) Fever (>40.5° C) 1.11% (0.64-1.59%) Drowsiness, 33.35% (31.21-35.48%) Persistent crying, 13.35% (11.81-14.88%) Local reactions, 75.79% (73.86-77.73%) and Systemic Reactions, 69.84% (67.76-71.97%). Only one child developed convulsion following immunization.
Conclusions: Varying reaction rates in different studies, such as high rate of pain and persistent crying in this study, may reflect the different preparations that were used or differenced in the methods for vaccine evaluation. Moreover, because of the severity of systemic reactions, DTP vaccine should be administered in the thigh region
M Karami, Sm Zahraei, Mm Gouya,
Volume 12, Issue 4 (2-2017)
Abstract
Background and Objectives: The Haemophilus influenzae (Hib) conjugate vaccine (HibCV) using a pentavalent formulation was introduced to the Iranian routine immunization program from November 2014. Iran is preparing to include Pneumococcal conjugate vaccines (PCV), as well. Measuring and monitoring the impact of HibCV and PCV are necessary to provide evidence for introduction and sustained administration of this vaccine.
Methods: We addressed the possibility of implementing the "3-tiered approach to IB VPD surveillance" as proposed by the World Health Organization using a feasibility study. Expert opinions were asked to address published literature regarding the study design and methods of measuring the impact of newly introduced vaccines.
Results: There are different methods and study designs to measure the impact of new vaccines, including population based active surveillance systems and vaccine effectiveness studies. The results of the feasibility study and expert opinions highlighted the superiority of a sentinel hospital-based surveillance system in Iran.
Conclusion: It is necessary to conduct some systematic reviews and meta-analyses to provide evidence for the trend of Hib and Streptococcus pneumonia related diseases, i.e. invasive bacterial diseases including meningitis, pneumonia, and sepsis. To monitor indirect effects of the PCV vaccine, implementing periodic surveys on the prevalence of nasopharyngeal carriers are recommended.
