David Elliman

Clumsiness in Children‐Do they Grow out Of It? A 10‐Year Follow‐Up Study

The question of whether problems of motor co‐ordination in early childhood recede with age has rarely been addressed. This paper reports the findings from a follow‐up study of 17 children, identified by their teachers as having poor motor co‐ordination at age six. Now age 16, these children and their matched controls completed a battery of assessments. The results suggest that the majority of children still have difficulties with motor co‐ordination, have poor self‐concept and are experiencing problems of various kinds in school. However, there are individual differences in the extent to which the children have learned to cope with their continuing difficulties over the years.

Safety and immunogenicity of three lots of meningococcal serogroup C conjugate vaccine administered at 2, 3 and 4 months of age.

The reactogenicity and immunogenicity of meningococcal serogroup C conjugate (MenC) vaccine was assessed in 322 infants vaccinated at 2, 3, and 4 months of age, with concomitant administration of mixed diphtheria-tetanus-whole-cell pertussis vaccine and Haemophilus influenzae type b conjugate vaccine (DTwP-Hib) and oral polio vaccine. All infants in whom post-vaccination meningococcal C anticapsular IgG levels were assayed (n = 265) attained > or = 2 microg ml(-1). Serum bactericidal titres were assayed for a proportion of subjects (n = 171), 98% of whom obtained a reciprocal titres > or = 8. Local reactions were less frequent at the MenC injection site than at the DTP-Hib site. Systemic events were frequent, but consistent with established DTwP-Hib experience. The study demonstrates that MenC vaccine is immunogenic and well tolerated in infants at manufacturing scale production levels.

Manual of Childhood Infections

Manual of childhood infection , Manual of childhood infection , کتابخانه دیجیتال جندی شاپور اهواز

Safety and efficacy of combination vaccines

For 130 years or more after Jenner introduced a vaccine for smallpox this was the only vaccine in general use. Ten vaccines are now included in the routine childhood vaccination programme in the United Kingdom, with multiple doses of most. The use of combination vaccines reduces distress to the recipients and is likely to increase uptake rates. Many combinations are as efficacious as the separate vaccines, but the increasing number of antigens could theoretically pose problems in terms of reduced immunogenicity or increased reactogenicity.nnGood post-marketing surveillance will become important in monitoring both the clinical efficacy of combination vaccines and adverse effects. With respect to clinical efficacy this may be a particular problem with combination conjugate vaccines. Using combination vaccines in the routine childhood programme in the United Kingdom amounts to giving 11 injections (24 in the United States), whereas, if given separately, 27 (almost 70 in the United States) would be needed. The alternative approaches are combining as many antigens into as few injections as possible, giving multiple simultaneous injections, or giving the required vaccines over several visits. Generally parents tend to have fewer concerns than health professionals about multiple injections. 1 2 However, it …

Measles, Mumps and Rubella Vaccine, Autism and Inflammatory Bowel Disease

Measles, mumps and rubella (MMR) vaccine has been used for almost 30 years in the US, 20 years in Sweden and Finland, and over 10 years in most of the rest of Europe. During this time, it has brought about a dramatic reduction in the morbidity and mortality due to measles and mumps, as well as a considerable reduction in the number of babies with the congenital rubella syndrome.In spite of extensive evidence confirming the efficacy and safety of the vaccine, concerns have recently been raised about a possible link with autism and bowel problems. These arose principally from a research group in the UK, but have now spread to other countries. In the UK this has caused a fall in the uptake of the vaccine with fears of possible outbreaks of measles and mumps in some groups of children. Over the last 3 years a number of studies have addressed this possible link between MMR and autism and inflammatory bowel disease. Studies from the US, UK, Sweden, and Finland have all failed to demonstrate a link. Amongst others, the American Academy of Pediatrics, the Royal College of Paediatrics and Child Health, the Institute of Medicine, and the World Health Organization have all considered the evidence and endorsed the continuing use of the vaccine. No regulatory body in the world has changed its policy as a result of this hypothesized link.Professionals and parents can be assured that MMR is well tried and tested and one of the most successful interventions in healthcare.