Augustyniak M

The effectiveness of rotavirus vaccine in preventing acute gastroenteritis during rotavirus seasons among Polish children

Introduction Rotavirus is the main etiological cause of intestinal infections in children. Voluntary rotavirus vaccines were included in the Polish vaccination schedule in 2007. The aim of this study was to assess the effectiveness of a completed rotavirus vaccination course in preventing acute gastroenteritis in Polish infants during their first five years of life. Material and methods This was a retrospective cohort study conducted in Lesser Poland (Malopolska Province). The sample population included a group of 303 children who received the completed rotavirus vaccination course and 303 children not vaccinated against rotavirus. The date of the childs acute gastroenteritis diagnosis and his or her vaccination history were extracted from the physicians’ records. Each kind of diagnosed acute gastroenteritis during winter-spring rotavirus seasons was treated as the endpoint. The relative risk of having gastrointestinal infection was assessed using the hazard ratio from the Cox proportional hazards regression model. Results In the examined group, 96 (15.8%) children had winter-spring gastrointestinal infections. In the non-vaccinated children, the cumulative incidence of these infections in the first 5 years of life was 20.8%, whereas in the children vaccinated with Rotarix it was only 10.9%. Those who were vaccinated with Rotarix had a 44% reduction in the risk of a winter-spring acute gastroenteritis infection compared to those not vaccinated with Rotarix (p = 0.005). Birth weight less than 2500 g increased the risk of the infection twofold and also reached statistical significance (p = 0.044). Conclusions The results showed that Rotarix is effective in preventing acute gastroenteritis in Polish children during rotavirus seasons.

Whole-cell pertussis vaccine (DTwP) has no influence on allergic diseases and atopic sensitization in children

Introduction Vaccine opponents indicate that the infant’s immune system is inadequately developed to handle multiple vaccines which may overwhelm the immune system, leading to allergic diseases. Aim To verify the association between the vaccine antigen overload derived from DTwP and the development of atopic sensitization and allergic diseases. Material and methods Data from an earlier established birth cohort in Krakow, followed up to the 6th year of life were used. Allergic diseases such as eczema, hay fever and asthma were diagnosed by a physician and reported every half a year from the 1st to 6th year of life by the child’s parent. Skin prick tests (SPT) were performed in children at 5 years of age. The data on infants’ vaccination were extracted from the physician’s records. The status of vaccine antigen exposure was based on different types of vaccines against pertussis (DTwP or DTaP) in a primary course. Results were determined by multiple logistic regression, adjusted to potential confounders. Results The analyzed population consisted of 234 children: 53.4% – boys and 46.6% – girls. Infants up to the age of 8 months were vaccinated with the primary course against pertussis, with DTwP – 60.7%, DTaP – 32.9% and further 6.4% with a mixed course (DTwP + DTaP). There were no significant relationships between any of vaccination groups and allergic disease and allergen sensitivity in the multiple logistic regression model with adjustment to potential confounders. Conclusions The exposure to a large number of vaccine antigens derived from DTwP has no influence on the development of allergic diseases and atopic sensitization in children.

Rubella outbreak in Poland in 2013 – an analysis of surveillance data at the national and province level

Abstract Introduction. Poland is a member of the WHO European Region where a complete eradication of measles and rubella is planned to be finished by 2015. Poland accounted for 99% of all reported rubella cases in 27 EU/EEA countries in 2013. It is a good time to evaluate whether the established Polish vaccination strategy was sufficient to reach the goal of rubella elimination in the near future. Aim. The aim of this study was to analyze the epidemiology of rubella in Poland when the disease outbreak took place in 2013, to determine the reasons of that situation and to find the solution for future rubella elimination strategies. Material and methods. To analyze the epidemiology of rubella in Poland during the disease outbreak in 2013 the authors used rubella surveillance data collected by the Provincial and National Notifiable Disease Reporting System in 2004-2013. The information at the provincial level derived from one of the 16 provinces (Malopolska). The data on MMR vaccination coverage in 2003-2012 derived from the National Surveillance System. The percentages of rubella cases and vaccine coverage between Poland with Malopolska province were compared. Results. The outbreak started in late 2012 and continued through 2013, when 38548 rubella cases (incidence rate 100.1/ 100 000) were notified. Geographically, rubella cases were reported from the entire country, with the highest incidence rate in Malopolska province (254.9/100 000). Only 5 cases from Malopolska and 120 in whole country were laboratory confirmed, the remaining 99.7% were reported solely on the basis of clinical signs. The vaccination coverage was not sufficient to protect the population against rubella outbreak in Poland, especially among adolescents and young adult males. Conclusions. The strengthening of routine immunization program and implementation of some additional vaccination campaigns in young adults as well as laboratory confirmation of all suspected cases are the challenges that will have to be met to eliminate rubella in Poland