Search

Objectives: Populations are aging worldwide. This paper summarizes some of the challenges and opportunities due to the increasing burden of infectious diseases in an aging population.Results: Older adults typically suffer elevated morbidity from infectious disease, leading to increased demand for healthcare resources and higher healthcare costs. Preventive medicine, including vaccination can potentially play a major role in preserving the health and independence of older adults. However, this potential of widespread vaccination is rarely realized. Here, we give a brief overview of the problem, discuss concrete obstacles and the potential for expanded vaccination programs to promote healthy aging.Conclusion: The increasing healthcare burden of infectious diseases expected in aging populations could, to a large extent, be reduced by achieving higher vaccination coverage among older adults. Vaccination can thus contribute to healthy aging, alongside healthy diet and physical exercise. The available evidence indicates that dedicated programs can achieve substantial improvements in vaccination coverage among older adults, but more research is required to assess the generalizability of the results achieved by specific interventions (see Additional file 1). [ABSTRACT FROM AUTHOR]

This paper argues that significant aspects of the vaccination debate are 'deep' in a sense described by Robert Fogelin and others. Some commentators have suggested that such disagreements warrant rather threatening responses. I argue that appreciating that a disagreement is deep might have positive implications, changing our moral assessment of individuals and their decisions, shedding light on the limits of the obligation to give and respond to arguments in cases of moral disagreement, and providing an incentive to seek alternative ways of going on in the face of intractable moral disagreement. Non-coercive, non-reasoned strategies have been used or recommended to increase vaccination rates. Such strategies look problematic when judged by the standards of ideal moral and rational argumentation, but more acceptable if seen as responses to deep disagreements. [ABSTRACT FROM AUTHOR]

Viral hepatitis A and B virus are considered an important public health problem in most of South American countries. Its distribution and prevalence are highly heterogeneous all over the continent, depending on geographic, socioeconomic and cultural factors. The hepatitis A virus is transmitted through the oro-fecal route. Although it usually causes a self-limited disease, it is still responsible for some cases of fulminant hepatitis in children and adults. The universal vaccination program against hepatitis A in infants in some countries such as in Argentina, has brought significant reduction in cases of acute liver failure and liver transplantation. Hepatitis B virus (HBV) infection is transmitted through percutaneous and mucosal exposure to infective body fluids. Sexual transmission seems to prevail in most countries, but vertical and horizontal transmission in the early life predominates in highly endemic areas, such as the Amazonia. Around 20 % of HBV carriers in Amazonian are also infected with delta virus. Universal and high risk groups HBV immunization programs implemented in different countries drastically decreased HAV and HBV morbidity and mortality. However, the goal to eliminate both virus infections from this region has not been achieved yet. It is necessary to insure that the existent programs are sustained over time. [ABSTRACT FROM AUTHOR]

Vaccination may be mandated by regulation, as in some national infant vaccination programs, encouraged by health authorities, as in 'Flu vaccine campaigns for adults aged 60 years and older, or linked to the informed decision of individuals. Other methods include promotion by incentives to general practitioners, and recommendations from healthcare workers. All these factors contribute to variable vaccine coverage between countries and between different age and socio-economic groups. Many other factors, including providers' patient-oriented interventions and reimbursement issues play an important role in determining the level of vaccine uptake in a given population for a particular disease. However, the first step in vaccination campaigns is to give motivating information to healthcare workers that the benefits of being vaccinated outweigh possible inconvenience or adverse reactions. The information must be complete and accurate. When it has been ascertained that this information is understood and accepted, a system providing cheap and easy vaccination must be organised. Special groups such as the house-bound will need particular attention, appropriate information, and be included in free vaccination schemes. It should be acknowledged that social pressure often influences (positively or negatively) the decision of the individual. Lastly, a massive but objective information campaign is needed for the whole population, each and every visit to a health clinic being treated as an opportunity to check vaccination status and to vaccinate immediately if necessary. Simultaneous vaccination with two or more vaccines increases the chances of reaching the required population cover. [ABSTRACT FROM AUTHOR]

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An aim of vaccination programs is near-complete coverage. One method for achieving this is for health facilities providing these services to operate frequently and for many hours during each session. However, if vaccine vials are not fully used, the remainder is often discarded, considered as waste. Without an active appointment schedule process, there is no way for facility staff to control the stochastic demand of potential patients, and hence reduce waste. And yet reducing the hours of operation or number of sessions per week could hinder access to vaccination services. In lieu of any formal system of controlling demand, we propose to model the optimal number of hours and sessions in order to maximize outputs, the number and type of vaccines provided given inputs, using Data Envelopment Analysis (DEA). Inputs are defined as the amount of vaccine wastage and the number of full-time equivalent staff, size of the facility, number of hours of operation and the number of sessions. Outputs are defined as the number and type of vaccines aimed at children and pregnant women. This analysis requires two models: one DEA model with possible reallocations between the number of hours and the number of sessions but with the total amount of time fixed and one model without this kind of reallocation in scheduling. Comparing these two scores we can identify the "gain" that would be possible were the scheduling of hours and sessions modified while controlling for all other types of inefficiency. By modeling an output-based model, we maintain the objective of increasing coverage while assisting decision-makers determining optimal operating processes. [ABSTRACT FROM AUTHOR]

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)