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Influenza is a major cause of illness and death worldwide. The human influenza virus spreads rapidly (average reproduction number of 1.28), typically infects 5%-10% of the population during seasonal epidemics, [...]

Objective To rapidly increase childhood immunization through a preventive, multi-antigen, vaccination campaign in Mambere-Kadei prefecture, Central African Republic, where a conflict from 2012 to 2015 reduced vaccination coverage. Methods The three-round campaign took place between December 2015 and June 2016 using: (i) oral poliomyelitis vaccine (OPV); (ii) combined diphtheria, tetanus and pertussis (DTP) vaccine, Haemophilus Influenza type B (Hib) and hepatitis B (DTP-Hib-hepatitis B) vaccine; (iii) pneumococcal conjugate vaccine (PCV); (iv) measles vaccine; and (v) yellow fever vaccine. Administrative data were collected on vaccines administered by age group and vaccination coverage surveys were carried out before and after the campaign. Findings Overall, 294 054 vaccine doses were administered. Vaccination coverage for children aged 6 weeks to 59 months increased to over 85% for the first doses of OPV, DTP-Hib-hepatitis B vaccine and PCV and, in children aged 9 weeks to 59 months, to over 70% for the first measles vaccine dose. In children aged 6 weeks to 23 months, coverage of the second doses of OPV, DTP-Hib-hepatitis B vaccine and PCV was over 58% and coverage of the third doses of OPV and DTP-Hib-hepatitis B vaccine was over 20%.' Moreover, 61% (5804/9589) of children aged 12 to 23 months had received two PCV doses and 90% (25933/28764) aged 24 to 59 months had received one dose. Conclusion A preventive, multi-antigen, vaccination campaign was effective in rapidly increasing immunization coverage in a post-conflict setting. To sustain high coverage, routine immunization must be reinforced. Objectif Augmenter rapidement le taux de vaccination des enfants grace a une campagne de vaccination combinee preventive dans la prefecture de Mambere-Kadei, en Republique centrafricaine, ou le conflit qui a sevi de 2012 a 2015 a faitdiminuer la couverture vaccinale. Methodes Cette campagne en trois phases s'est deroulee entre decembre 2015 et juin 2016 avec les vaccins suivants: (i) vaccin antipoliomyelitique oral (VPO); (ii) vaccin combine contre la diphterie, le tetanos et la coqueluche (DTC), vaccin contre I'Haemophilus influenza type B (Hib) et l'hepatite B (DTC-Hib-hepatite B); (iii) vaccin pneumococcique conjugue (VPC); (iv) vaccin contre la rougeole; et (v) vaccin contre la fievre jaune. Des donnees administratives ont ete recueillies au sujet des vaccins administres par tranche d'age, et des enquetes sur la couverture vaccinale ont ete realisees avant et apres la campagne. Resultats Au total, 294 054 doses de vaccins ont ete administrees. La couverture vaccinale des enfants ages de 6 semaines a 59 mois a depasse 85% pour les premieres doses de VPO, de vaccin DTC-Hibhepatite B et de VPC et, chez les enfants ages de 9 semaines a 59 mois, elle a depasse 70% pour la premiere dose du vaccin contre la rougeole. Chez les enfants ages de 6 semaines a 23 mois, la couverture assuree par la deuxieme dose de VPO, de vaccin DTC-Hib-hepatite B et de VPC etait superieure a 58% et celle de la troisieme dose de VPO et de vaccin DTC-Hib-hepatite B etait superieure a 20%. Par ailleurs, 61% (5804/9589) des enfants ages de 12 a 23 mois avaientrecu deux doses de VPC et 90% (25 933/28 764) de ceux ages de 24 a 59 mois en avaient recu une dose. Conclusion Une campagne de vaccination combinee preventive s'est averee efficace pour augmenter rapidement la couverture vaccinale dans une region sortant d'un conflit. La vaccination systematique doit etre renforcee pour maintenir cette couverture elevee. Objetivo Incrementar rapidamente la inmunizacion infantil a traves de una campana de vacunacion preventiva multiantigenica en la prefectura de Mambere-Kadei, Republica Centroafricana, donde un conflicto entre 2012 y 2015 redujo la cobertura de vacunacion. Metodos La campana de tres rondas tuvo lugar entre diciembre de 2015 y junio de 2016 utilizando: (i) vacuna oral contra la poliomielitis (OPV); (ii) vacuna combinada contra la difteria, el tetanos y la tos ferina (DTP), vacuna contra Haemophilus influenza tipo B (Hib) y hepatitis B (DTP-Hib-hepatitis B); (iii) vacuna antineumococica conjugada (PCV); (iv) vacuna contra el sarampion; y (v) vacuna contra la fiebre amarilla. Se recopilaron datos administrativos sobre las vacunas administradas por grupo de edad y se realizaron encuestas de cobertura de vacunacion antes y despues de la campana. Resultados En general, se administraron 294.054 dosis de vacuna. La cobertura de vacunacion para ninos de 6 semanas a 59 meses aumento a mas del 85% para las primeras dosis de OPV, vacuna DTP-Hib-hepatitis B y PCV y, en ninos de 9 semanas a 59 meses, a mas del 70% para la primera dosis de vacuna contra el sarampion. En ninos de 6 semanas a 23 meses, la cobertura de las segundas dosis de OPV, vacuna DTP-Hib-hepatitis B y PCV fue mas del 58% y la cobertura de la tercera dosis de vacuna OPV y DTP-Hib-hepatitis B fue superior al 20%. Ademas, el 61 % (5804/9589) de los ninos de 12 a 23 meses habian recibido dos dosis de PCV y el 90% (25933/28764) de entre 24 y 59 meses habian recibido una dosis. Conclusion Una campana de vacunacion preventiva, con multiples antigenos, fue efectiva en el rapido aumento de la cobertura de inmunizacion en un contexto posterior al conflicto. Para mantener una cobertura alta, se debe reforzar la inmunizacion rutinaria., Abstracts in [phrase omitted] and Espanol at the end of each article. [phrase omitted] Introduction The conflict in the Central African Republic between the end of 2012 and 2015 had [...]

Objectives: To explore the views of general practitioners and practice nurses about barriers to influenza vaccination among under 65 high-risk patients and strategies to overcome those barriers. Methods: Focus group discussions with general practitioners and practice nurses. Results: Barriers identified included: lack of awareness among patients about influenza vaccination; GP workload; poor GP motivation; lack of practice nurses; lack of patient recall systems; cost of vaccine; and lack of media campaign. Strategies proposed included: public education campaigns; free supply of vaccine; dissemination of evidence to motivate GPs; incentives to establish recall systems; and greater involvement of practice nurses in the process. Conclusion: Influenza vaccination has not been well accepted by people aged less than 65 years. Implementation of proposed strategies has the potential to improve the vaccination coverage. Implications: An improvement in influenza vaccination coverage among people less than 65 years who are in high-risk groups has the potential to reduce hospitalisation and health care costs. Key words: Influenza vaccination; adult and middle aged; health knowledge, attitude and practice. doi:10.1111/j.1753-6405.2007.00143.x

An attempt is made to investigate the effect of annual influenza revaccination on mortality in community-dwelling elderly persons. Results of the investigation states that overall, influenza vaccination is estimated to prevent 1death for every 302 vaccinees at a vaccination coverage that varied between 64% and 74%.