Dataset Information

Underreporting of the 5-year tetanus, diphtheria, pertussis and polio booster vaccination in the Danish Vaccination Register.

ABSTRACT:

Background

In Denmark, vaccination coverage is measured using the Danish Vaccination Register (DDV). In general, the vaccination coverage is high, but for some vaccinations, the coverage is suboptimal with geographical variation. This study aims to validate the vaccination coverage of the 5-year booster and identify overall reasons for non-vaccination in Copenhagen.

Methods

We validated the coverage of the 5-year tetanus, diphtheria, pertussis and polio booster for children born in 2010 and living in Copenhagen municipality in 2018, an area with low coverage (current estimate: 89%). We identified all children born in 2010 in the Civil Registration System and sent an electronic questionnaire to parents of children without a record of the 5-year booster in the DDV.

Results

Parents of 692 children were contacted and 49% participated. Of those, 186 (55%) reported that the child was vaccinated: 61% by their general practitioner and 34% abroad. The most common reason for non-vaccination was forgetfulness (31%), 26% did not want their child vaccinated and 17% had migrated from abroad and were not aware of the vaccination schedule. Considering only children with documentation for the vaccination, the corrected vaccination coverage was 91%.

Conclusions

We conclude that the coverage of the 5-year booster in Copenhagen is currently underestimated and should be adjusted by 2%. We recommend increased awareness from general practitioners and tailored communication about the vaccination programme targeting immigrants in Denmark.

SUBMITTER: Voss SS

PROVIDER: S-EPMC7654036 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Underreporting of the 5-year tetanus, diphtheria, pertussis and polio booster vaccination in the Danish Vaccination Register.

Voss Sidsel Skou SS Glode Helmuth Ida I Hiul Suppli Camilla C Valentiner-Branth Palle P

BMC public health 20201110 1

<h4>Background</h4>In Denmark, vaccination coverage is measured using the Danish Vaccination Register (DDV). In general, the vaccination coverage is high, but for some vaccinations, the coverage is suboptimal with geographical variation. This study aims to validate the vaccination coverage of the 5-year booster and identify overall reasons for non-vaccination in Copenhagen.<h4>Methods</h4>We validated the coverage of the 5-year tetanus, diphtheria, pertussis and polio booster for children born i ...[more]

PMID: 33172419

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Project description:BackgroundImmune thrombocytopenia (ITP) is a rare autoimmune disorder characterized by low platelet counts and increased bleeding risk. The disease may be induced by other disorders, including malignancies, autoimmune diseases, infectious agents or drugs. However, ITP has also been described following vaccinations, such as the measles-mumps-rubella vaccination. In rare cases, ITP may occur in children who received a DTaP-IP (diphtheria, tetanus, acellular pertussis vaccine and inactivated poliovirus) vaccine. Hereinafter, we report the first well-documented cases of ITP in an adult patient in the temporal context of a DTaP-IP vaccination.Case presentationThis case report attempts to capture the life-threatening picture of a 36-year-old otherwise healthy Caucasian woman with newly diagnosed severe immune thrombocytopenia in the temporal context of a DTaP-IP vaccination. Four days after receiving the vaccine, the women presented to her primary care physician with malaise, fever and recurrent epistaxis. Clinical examination revealed oral petechiae, ecchymoses, and non-palpable petechiae on both legs. The patient was immediately referred to a local hematology unit where she developed hematuria and an intestinal bleeding (WHO Bleeding Grade III) requiring multiple transfusions. After receiving oral corticosteroids and intravenous immunoglobulins, her platelets gradually recovered. Common causes of secondary ITP were ruled out by laboratory investigations, bone marrow and peripheral blood examinations. This raises the possibility of a (secondary) vaccination-associated thrombocytopenia. To the best of our knowledge, this is the first well-documented case of a DTaP-IP vaccination-related ITP in an adult patient in the English literature.ConclusionAlthough a causal connection between both entities may not be established, we would like to raise awareness in clinicians that ITP following DTaP-IP vaccinations is potentially not limited to children, but may also occur in adults. Users of DTaP-IP booster vaccines should be alert of the possibility of such adverse reactions.

Project description:BackgroundDiphtheria, Tetanus, and whole-cell Pertussis (DTwP) vaccination-associated seizures form the commonest type of serious adverse event following immunization in India and are an important reason for vaccine hesitancy. Our study explored the genetic explanation of DTwP vaccination-associated seizures or subsequent epilepsies.MethodsBetween March 2017 and March 2019, we screened 67 children with DTwP vaccination-associated seizures or subsequent epilepsies, and of those, we studied 54 without prior seizures or neurodevelopmental deficits. Our study design was cross-sectional with a 1-year follow-up having both retrospective and prospective cases. We performed clinical exome sequencing focused on 157 epilepsy-associated genes and multiplex ligation-dependent probe amplification of the SCN1A gene at enrolment. We applied the Vineland Social Maturity Scale for neurodevelopmental assessment at follow-up.FindingsOf 54 children enrolled and underwent genetic testing (median age 37.5 months, interquartile range 7.7-67.2; diagnosis at enrolment: epilepsy 29, febrile seizure 21, and febrile seizure-plus 4), we found 33 pathogenic variants of 12 genes. Of 33 variants, 13 (39%) were novel. Most pathogenic variants were found in SCN1A gene (n = 21/33; 64%), SCN8A in 2 children, and 10 children had one variant in CDKL5, DEPDC5, GNAO1, KCNA2, KCNT1, KCNQ2, NPRL3, PCDH19, RHOBTB2, and SLC2A1. Five or more seizures (odds ratio [OR] = 5.3, confidence interval [CI]: 1.6-18.4, p = 0.006), drug-resistant epilepsy (OR = 9.8, 95% CI: 2.6-30.7, p = 0.001) and neurodevelopmental impairment (social quotient < 70) (OR = 5.6, 95% CI: 1.65-17.6, p = 0.006) were significant predictors of genetic diagnosis.InterpretationOur study provides proof-of-concept for genetic aetiology in children with DTwP vaccination-associated seizures or subsequent epilepsies and has important implications for vaccination policies in developing countries.FundingInternational Pediatric Association Foundation, Inc. (IPAF): İhsan Doğramaci research award 2016/2017; Indian Council of Medical Research (ICMR), New Delhi, India: No.3/1/3/JRF-2016/HRD/LS/71/10940.

Dataset Information

Underreporting of the 5-year tetanus, diphtheria, pertussis and polio booster vaccination in the Danish Vaccination Register.

Background

Methods

Results

Conclusions

Publications

Underreporting of the 5-year tetanus, diphtheria, pertussis and polio booster vaccination in the Danish Vaccination Register.

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