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Preventive Medicine Nov 2013Hepatitis B birth dose vaccination is a critical step in preventing perinatal hepatitis B virus infection. This study assesses the prevalence of children who missed the...
OBJECTIVES
Hepatitis B birth dose vaccination is a critical step in preventing perinatal hepatitis B virus infection. This study assesses the prevalence of children who missed the birth dose of hepatitis B vaccination and identifies socio-demographic factors associated with non-receipt of the birth dose among children in the United States.
METHODS
A survey observation study was conducted with the national representative sample of 17,053 U.S. children aged 19-35 months obtained from the 2009 National Immunization Survey. Categorical data analysis and multivariable logistic regression in the context of complex sample survey were applied to evaluate the prevalence and determine the independent risk factors.
RESULTS
39.2% of children missed the birth dose of hepatitis B vaccination. Children who reside in states without a universal hepatitis B vaccine supply policy, are not covered by health insurance, and have only 1 vaccination provider are significantly associated with non-receipt of the birth dose hepatitis B vaccination.
CONCLUSIONS
Children who reside in states without a universal hepatitis B vaccine supply policy, and who are not covered by health insurance are two important modifiable risk factors for not receiving the birth dose hepatitis B vaccination. Future intervention studies could be needed to help control those modifiable risk factors.
Topics: Child, Preschool; Female; Health Services Accessibility; Health Surveys; Hepatitis B; Hepatitis B Vaccines; Humans; Immunization Programs; Infant; Infant, Newborn; Male; Population Surveillance; Risk Factors; Socioeconomic Factors; Uncompensated Care; United States; Utilization Review
PubMed: 23988497
DOI: 10.1016/j.ypmed.2013.08.012 -
AIDS Education and Prevention :... Aug 2018HIV pre-exposure prophylaxis (PrEP) is being adopted by members of key populations, such as gay and bisexual men (GBM). Since adherence to a daily PrEP regimen ensures a...
HIV pre-exposure prophylaxis (PrEP) is being adopted by members of key populations, such as gay and bisexual men (GBM). Since adherence to a daily PrEP regimen ensures a maximum protection, it is critical to understand GBM's behavioral responses to having missed PrEP doses. We report on qualitative interviews with GBM taking PrEP. We identified three behavioral responses: (1) 59% continued with their next scheduled dose; (2) 49% described "making up" for a missed dose by taking medication as soon as possible; and (3) 11% reported "doubling" the next PrEP dose. Participants provided potentially contradictory narratives about their sexual behavior after a missed dose: (1) 54% described making no changes; (2) 49% described adjusting their sexual behavior to reduce HIV risk; and (3) 10% said their decision would be contingent upon how many doses were missed. For PrEP prescribers, our data provide a useful lens to understand patients' lived experiences with PrEP.
Topics: Adult; Bisexuality; HIV Infections; Homosexuality, Male; Humans; Interviews as Topic; Male; Medication Adherence; New York City; Pre-Exposure Prophylaxis; Qualitative Research; Sexual Behavior
PubMed: 30148670
DOI: 10.1521/aeap.2018.30.4.275 -
Clinical Pharmacology in Drug... Mar 2018Given the potential consequences of antiepileptic therapy nonadherence, missed-dose scenarios of 12- to 48-hour dose delays (4-hour intervals) for eslicarbazepine...
Given the potential consequences of antiepileptic therapy nonadherence, missed-dose scenarios of 12- to 48-hour dose delays (4-hour intervals) for eslicarbazepine acetate monotherapy were evaluated using simulated plasma concentrations of a population pharmacokinetic model (representing 493 subjects). When 1600-mg doses were delayed 12 to <16 or 36 to <44 hours, simulations showed immediate administration of 1600 mg followed by the same dose at the scheduled time maintained plasma concentrations within the target concentration range. With 16- to 24- or 44- to 48-hour delays, administration of 2400 mg at the scheduled time followed by resumption of 1600 mg/day maintained plasma concentrations within the target concentration range. For exploratory purposes, the population pharmacokinetic model was refined to predict (n = 6 subjects) and also to allow for simulation of cerebrospinal fluid concentrations. Based on the plasma concentration simulations conducted herein, potential dosing recommendations were developed that suggest a missed ESL dose should be taken when remembered, and the usual dose regimen resumed. If it is remembered within 4 hours of the next dose, 1.5 times the usual dose should be taken immediately, the scheduled dose for that day should be skipped, and the usual regimen resumed the next day.
Topics: Adult; Anticonvulsants; Computer Simulation; Dibenzazepines; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Evaluation, Preclinical; Female; Humans; Male; Middle Aged; Seizures; Time Factors
PubMed: 28881418
DOI: 10.1002/cpdd.382 -
International Journal of Science and... Mar 2018An important standard for childhood immunization is simultaneous administration of all age-eligible doses of vaccines. Vaccination coverage for ≥4 doses of...
An important standard for childhood immunization is simultaneous administration of all age-eligible doses of vaccines. Vaccination coverage for ≥4 doses of pneumococcal conjugate vaccine (PCV) for children 19-35 months has not achieved the objective of 90% in the United States, and the fourth dose of PCV is commonly missed in the series. Research has not been conducted on the factors associated with missed opportunities for simultaneous administration of the fourth dose of PCV. A missed opportunity for simultaneous administration of the fourth dose of PCV is characterized as failing to administer an age-appropriate fourth dose of PCV to children when in the same provider visit the children did receive other age-eligible vaccines. During the period of 2008-2015, 4.5% to 7.8% of young children in the United States experienced missed opportunities for simultaneous administration of the fourth dose of PCV; across all selected factors, the proportion of missed opportunities varied from 4.1% to 11.3%. The timeliness of the first through the third doses of PCV vaccination, and age group of mothers were factors significantly related to missed opportunities for simultaneous administration of the fourth dose of PCV; the adjusted prevalence ratios ranged from 1.2 to 2.0. Missed opportunities could be reduced by provider implementation of systems to ensure that all recommended vaccines are offered at each visit. Systems tools providers could use to reduce missed opportunities include patient recall, provider reminders, standing orders, extended office hours, and use of immunization information systems (IIS).
PubMed: 32043024
DOI: No ID Found -
The Journal of Infection Feb 2019To determine whether missing the HepB birth dose vaccine is a risk factor for incomplete vaccination later in childhood.
OBJECTIVES
To determine whether missing the HepB birth dose vaccine is a risk factor for incomplete vaccination later in childhood.
METHODS
This was a retrospective cohort study of infants born over one year at an academic medical center. The "not vaccinated at birth" group consisted of all infants who did not receive the HepB birth dose vaccine by seven days of life, while the "vaccinated at birth" group included infants who did receive the birth dose. The primary outcome was vaccination status at 18 months of age, determined from the state vaccination registry.
RESULTS
Infants "not vaccinated at birth" had lower vaccination rates. At 18 months, 44% of the "vaccinated at birth" group received all recommended vaccines, compared with 23% of the "not vaccinated at birth" group (p < 0.001); at 24 months, rates were 65% and 45%, respectively (p < 0.001). Over 80% of the variability in vaccination completions were related to a single latent variable, which is most likely vaccine hesitancy/refusal.
CONCLUSIONS
Infants who miss the HepB birth dose vaccine are at risk for under-immunization by 18 and 24 months of age. This suggests that parents likely form opinions about vaccines long before the birth of their child; therefore, efforts to influence attitudes must begin earlier.
Topics: Child, Preschool; Data Interpretation, Statistical; Databases, Factual; Female; Hepatitis B Vaccines; Humans; Immunization Programs; Immunization Schedule; Infant; Infant, Newborn; Male; North Carolina; Retrospective Studies; Risk Factors; Vaccination; Vaccination Refusal
PubMed: 30292782
DOI: 10.1016/j.jinf.2018.09.014 -
Vaccine Jan 2024Reaching urban poor populations poses challenges for equitable immunization coverage. Furthermore, COVID disrupted routine immunization services. In Mumbai, India, first...
Reaching urban poor populations poses challenges for equitable immunization coverage. Furthermore, COVID disrupted routine immunization services. In Mumbai, India, first dose diphtheria tetanus pertussis containing vaccine (DTPCV1)coverage dropped from 88% (2019) to 76% (2021). We identified and characterized 125 zero-dose (those withoutDTPCV1)migrant children in urban Mumbai in October 2022. Almost half were born elsewhere than Mumbai; 53% resided at their present location for less than a year. More than half were 12-59 months of age, well-beyond the age for first routine childhood immunizations.Three of four zero dose children had received birth dose vaccination in the hospital; but failed to receive DTPCV1. Vaccine hesitancy, awareness gaps and operational issues were common reasons for non-vaccination. Despite frequent visits to health facilities for illness,only a third of facility staff asked or advised parents about vaccination.Missed opportunities were much more common in private than government facilities.For the vast majority (88%), residential sites were included in local routine immunization micro-plans and distances to immunization sites were short (less than 1 km for 94 % of families).However, planned session frequency was inadequate half of the time. Expanded efforts to reach migrant urban poor children are needed to ensure vaccine equity.
Topics: Child; Humans; Infant; COVID-19; Vaccination; Immunization; Diphtheria-Tetanus-Pertussis Vaccine; Immunization Programs; India
PubMed: 38016846
DOI: 10.1016/j.vaccine.2023.11.027 -
European Journal of Public Health Dec 2023Missed opportunities constitute a main driver of suboptimal seasonal influenza vaccination (SIV) coverage in older adults. Vaccine co-administration is a way to reduce...
BACKGROUND
Missed opportunities constitute a main driver of suboptimal seasonal influenza vaccination (SIV) coverage in older adults. Vaccine co-administration is a way to reduce these missed opportunities. In this study, we quantified missed opportunities for SIV, identified some of their socio-structural correlates and documented SIV co-administration patterns.
METHODS
In this registry-based retrospective cohort study, we verified the SIV status of all subjects aged ≥65 years who received at least one dose of coronavirus disease 2019 (COVID-19), pneumococcal or herpes zoster vaccines during the 2022/23 influenza season. The frequency of concomitant same-day administration of SIV with other target vaccines was also assessed.
RESULTS
Among 41 112, 5482 and 3432 older adults who received ≥1 dose of COVID-19, pneumococcal and herpes zoster vaccines, missed opportunities for SIV accounted for 23.3%, 5.0% and 13.2%, respectively. Younger, male and foreign-born individuals were generally more prone to missing SIV. The co-administration of SIV with other recommended vaccines was relatively low, being 11.0%, 53.1% and 17.1% in COVID-19, pneumococcal and herpes zoster cohorts, respectively.
CONCLUSIONS
A sizeable proportion of older adults who received other recommended vaccines during the last influenza season did not receive SIV. This share of missed opportunities, which are subject to some social inequalities, may be addressed by increasing vaccine co-administration rates and implementing tailored health promotion interventions.
Topics: Humans; Male; Aged; Influenza Vaccines; Influenza, Human; Retrospective Studies; Vaccination; Pneumococcal Vaccines; Herpes Zoster; Herpes Zoster Vaccine; COVID-19; Italy
PubMed: 37632235
DOI: 10.1093/eurpub/ckad155 -
Expert Review of Clinical Pharmacology Sep 2021Rivaroxaban is an oral anticoagulant widely used for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). During long-term anticoagulant therapy,...
BACKGROUND
Rivaroxaban is an oral anticoagulant widely used for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). During long-term anticoagulant therapy, delayed or missed doses are common. This study aimed to explore appropriate remedial dosing regimens for non-adherent rivaroxaban-treated patients.
METHODS
Monte Carlo simulation based on a previously established rivaroxaban population pharmacokinetic/pharmacodynamic (PK/PD) model for patients with NVAF was employed to design remedial dosing regimens. The proposed regimens were compared with remedial strategies in the European Heart Rhythm Association (EHRA) guide by assessing deviation time in terms of drug concentration, factor Xa activity, and prothrombin time.
RESULTS
The proposed remedial dosing regimens were dependent on delay duration. The missed dose should be taken immediately when the delay does not exceed 6 h; a half dose is advisable when the delay is between 6 and 20 h. A missed dose should be skipped if less than 4 h remains before the next dose. The proposed regimens resulted in shorter deviation time than that of the EHRA guide.
CONCLUSION
PK/PD modeling and simulation provide valid evidence on the remedial dosing regimen of rivaroxaban, which could help to minimize the risk of bleeding and thromboembolism.
Topics: Aged; Atrial Fibrillation; Computer Simulation; Dose-Response Relationship, Drug; Factor Xa Inhibitors; Hemorrhage; Humans; Medication Adherence; Middle Aged; Models, Biological; Monte Carlo Method; Rivaroxaban; Thromboembolism; Time Factors
PubMed: 34058934
DOI: 10.1080/17512433.2021.1937126 -
Drug Metabolism and Personalized Therapy Dec 2022To determine the impacts of missed phenobarbital (PB) doses on its pharmacokinetics and to investigate the appropriate replacement dosing scheme for various PB missed...
OBJECTIVES
To determine the impacts of missed phenobarbital (PB) doses on its pharmacokinetics and to investigate the appropriate replacement dosing scheme for various PB missed dose scenarios.
METHODS
Monte Carlo simulations were performed using parameters from the selected population pharmacokinetic study. The impacts of missed PB dose and the proper replacement dosing scheme were assessed based on the percent deviation of simulated concentrations outside the reference range from the full adherence scenario.
RESULTS
The impact of missed PB dose on its concentrations depended on the daily dose. The replacement with a respective regular dose and one and a half regular dose was appropriate for the one and two missed doses scenarios for patients receiving PB monotherapy. For patients receiving PB with valproic acid or phenytoin, the same replacement scheme was still appropriate. The results also indicated that weight did not influence the proper replacement dosing scheme.
CONCLUSIONS
The impacts of missed PB doses on its pharmacokinetics were identified and the proper replacement dosing schemes for different missed dose scenarios were proposed. These schemes should be implemented based on the clinician's justification of the patient's seizure control.
PubMed: 36476276
DOI: 10.1515/dmpt-2022-0104 -
Drug Metabolism and Personalized Therapy Jun 2022To determine the impacts of missed phenobarbital (PB) doses on its pharmacokinetics and to investigate the appropriate replacement dosing scheme for various PB missed...
OBJECTIVES
To determine the impacts of missed phenobarbital (PB) doses on its pharmacokinetics and to investigate the appropriate replacement dosing scheme for various PB missed dose scenarios.
METHODS
Monte Carlo simulations were performed using parameters from the selected population pharmacokinetic study. The impacts of missed PB dose and the proper replacement dosing scheme were assessed based on the percent deviation of simulated concentrations outside the reference range from the full adherence scenario.
RESULTS
The impact of missed PB dose on its concentrations depended on the daily dose. The replacement with a respective regular dose and one and a half regular dose was appropriate for the one and two missed doses scenarios for patients receiving PB monotherapy. For patients receiving PB with valproic acid or phenytoin, the same replacement scheme was still appropriate. The results also indicated that weight did not influence the proper replacement dosing scheme.
CONCLUSIONS
The impacts of missed PB doses on its pharmacokinetics were identified and the proper replacement dosing schemes for different missed dose scenarios were proposed. These schemes should be implemented based on the clinician's justification of the patient's seizure control.
PubMed: 35708353
DOI: 10.1515/dmdi-2022-0104