Search results

Hepatitis A is a prevalent disease that is largely preventable by vaccine usage. The vaccine for this illness is highly underused in most regions. In an attempt to find the strategies that are most beneficial in regard to quality-adjusted life years (QALYs) and cost in current environments, the purpose of this paper is to conduct cost-effectiveness analyses to investigate vaccination strategies in a more economically developed country (MEDC), generally known as a “developed” area: the USA, and a less economically developed country (LEDC), generally known as a “developing” area: the state of Rio de Janeiro, Brazil.

This study used a dynamic transmission model for comparative effectiveness analyses. The model ran two different scenarios. The two regions studied have different policies and strategies for Hepatitis A vaccination currently, and also used different strategies in 2009. In the USA, a universal vaccination policy was modeled, along with a scenario in which it was removed. In Rio de Janeiro, a no vaccination policy was modeled, along with a scenario in which a universal vaccination policy was effected.

The comparison of resulting incremental cost-effectiveness ratio values to accepted threshold values showed universal vaccination to be cost-effective in both the USA and Rio de Janeiro as compared to no vaccination. When episode and vaccination costs and vaccination efficacy were varied, this still remained true. Universal vaccination was found to result in lower incidence of Hepatitis A in both the USA and Rio de Janeiro. Over the twenty-year time horizon, universal vaccination is projected to prevent 506,945 cases of symptomatic Hepatitis A in the USA and 42,318 cases of Hepatitis A in Rio de Janeiro. Other benefits include a projected increase in cumulative QALYs through the use of universal vaccination.

This analysis showed universal vaccination to be cost-effective as compared to no vaccination, and portions of the study’s approach had not previously been applied in tandem to investigate Hepatitis A interventions. The results may help foster higher compliance rates for Hepatitis A vaccination and even greater per-person economic benefits of universal vaccination, particularly in the USA. The purpose of this study is also to encourage elevated levels of surveillance on age of infection in developing regions and consistent reevaluation utilizing dynamic transmission models in both the USA and Brazil, as well as other rapidly developing regions, in order to prevent future epidemics and costs associated with the disease.

Many world regions are developing quickly and experiencing increasing levels of sanitation, causing an epidemiological shift of hepatitis A in these areas. The shift occurs when children avoid being infected with the disease until a later age due to cleaner water sources, food, and hygiene practices in their environment; but if they are infected at later age, the disease is much more severe and lost productivity costs are higher. The purpose of this paper is to examine what could occur if an epidemiological shift of the disease continues in these regions, and what type of future burden hepatitis A may have in a hypothetical rapidly developing country.

Initially, annual hepatitis A mortality was regressed on the Human Development Index (HDI) for each country classified as an emerging and growth-leading economy (EAGLE) to provide an overview of how economic development and hepatitis A mortality related. Data from the various EAGLE countries were also fit to a model of hepatitis A mortality rates in relation to HDI, which were both weighted by each country’s 1995–2010 population of available data, in order to create a model for a hypothetical emerging market country. A second regression model was fit for the weighted average annual hepatitis A mortality rate of all EAGLE countries from the years 1995 to 2010. Additionally, hepatitis A mortality rate was regressed on year.

Regression results show a constant decline of mortality as HDI increased. For each increase of one in HDI value in this hypothetical country, mortality rate declined by 2.3016 deaths per 100,000 people. The hypothetical country showed the HDI value increasing by 0.0073 each year. Also, results displayed a decrease in hepatitis A mortality rate of 0.0168 per 100,000 people per year. Finally, the mortality rate for hepatitis A in this hypothetical country is projected to be down to 0.11299 deaths per 100,000 people by 2030 and its economic status will fall just below the HDI criteria for a developed country by 2025.

The hypothetical country as a prototype model was created from the results of regressed data from EAGLE countries. It is aimed to display an example of the health and economic changes occurring in these rapidly developing regions in order to help understand potential hepatitis A trends, while underscoring the importance of informed and regular policy updates in the coming years. The author believes this regression provides insight into the patterns of hepatitis A mortality and HDI as these EAGLE countries undergo rapid development.

This study aimed to determine the prevalence and risk factors of hepatitis B virus (HBV) infection among medical laboratory science students (MLSSs) in the University of Health and Allied Sciences (UHAS), Ghana.

A cross-sectional study design was employed to recruit a total of 178 students into the study. A self-administered questionnaire was used to gather relevant information on risk factors, and a hepatitis B diagnostic test kit was used to test for HBV infection. Descriptive, chi-square test, bivariate and multiple logistic regression statistical analysis were computed. Significance was observed at p < 0.05.

The prevalence of HBV infection among MLSSs was 6.7%. Torn gloves and splash of blood and body fluids contributed to 43.0% and 28.0% of all the risk factors of HBV infection, respectively. Also, 43.3% of students had received at least one dose of the hepatitis B vaccination. Sharp object-related injury and torn gloves increased the odds of HBV infection, while vaccination decreased the odds of HBV infection.

This study reveals the prevalence of HBV among MLSSs, who are recognized as being among the high-risk student populations aside from student nurses.

The environmental and demographic characteristics of closed institutions, particularly prisons, precipitate morbidity during hepatitis A virus (HAV) outbreaks. Given the high prevalence of chronic liver disease and other risk factors in the prison setting, the purpose of this paper is to examine HAV-immunity and its associated factors in this population.

The cross-sectional study was conducted in 2009: a serology screening for HAV IgG was carried out among 116 inmates in Switzerland’s largest pre-trial prison. Other participant characteristics were collected through a structured face-to-face questionnaire with a physician.

In terms of significant demographics, Africa (53.5 percent) and the Balkans/Eastern Europe (36.2 percent) were the main regions of origin; a minority of inmates were from Western Europe (6.9 percent), Latin America (2.6 percent) or Asia (0.9 percent). The authors identified hepatitis A antibody-negative serology (lack of immunity) in five out of 116 prisoners (4.3 percent, 95 percent CI 1.4-9.7). Among participants of European origin alone, five out of 50 inmates were hepatitis A antibody-negative (10 percent, 95 percent CI 3.3-21.8), whereas the 66 inmates from other all continents were hepatitis A antibody-positive (immune) (p=0.026).

In this prison population composed of mostly African migrants, hepatitis A immunity was high. This reaffirms that region of origin is highly associated with childhood immunity against HAV. HAV vaccination should take into account a patient’s area of origin and his/her risk factors for systemic complications, if ever infected. This targeted strategy would offer herd immunity, and seek out the most vulnerable individuals who are potentially at risk of new exposure in this precarious setting.

Payment for healthcare services in the USA has shifted from fee for service to compensation based on value and quality. The indicators used for payments are a variety of clinical measures, including administration of vaccines to patients. The purpose of this paper is to describe the implementation of programs in health systems to improve vaccination rates and patient outcomes.

A search of the literature was conducted to find examples of vaccine programs in US health systems, and also to identify policies to improve immunization rates.

Successful programs for improving vaccination rates require advocacy and support of leadership, a systematic and multidisciplinary approach, and an evaluation of local resources and capacity. Numerous examples exist of medical, nursing, and pharmacy led programs that improve vaccination rates. The department in charge has relied on the support of other groups to ensure the success.

Mandatory vaccination of healthcare personnel (HCP) in the health system has been a growing trend in the USA. Although there has been some resistance to mandatory vaccinations for HCP, the standards and requirements have resulted in improved rates in health systems, which ultimately improve efficiency and protects patients.

This review describes considerations for implementing a successful vaccination program in a health system and provides examples of specific strategies. An overview of mandatory vaccinations for HCP is also described.

This paper aims to estimate the delay or timely effects of the national vaccination strategy for COVID-19 on Italian gross domestic product (GDP). By adopting a knowledge management lens, the study highlights the importance of “time” for Italian recovery. Indeed, recovering an adequate growth rate is crucial for the future of employment, well-being and management of Italian public debt.

This study applies an epidemiological model of a universal access vaccination programme against COVID-19. The economic model is based on the time-shift of available quarterly projections deriving from the expected delay or acceleration of the national vaccination plan against COVID-19.

The basic concept underlying the scenario analysis is that the sustainability of the expected recovery of the Italian economy due to the COVID-19 shock, and consequently the growth of the GDP, is time-dependent on the rollout of the national vaccination plan.

A delay in the vaccination campaign could have a twofold negative impact on the growth of the Italian gross product: it reduces the quarterly growth over the previous year in the short term and it delays the quarterly upwards trend over the next two years. Policymakers and practitioners are called to promptly face new dynamic scenarios due to public and economic policies to fight the COVID-19 crisis.

To the best of the authors’ knowledge, this is the first attempt of research that focuses attention on the synchrony between the economic time necessary for recovery and the real-time necessary to achieve vaccination coverage for the restart of production activities.

The purpose of this paper is to provide education on blood-borne viruses (BBVs) to prison staff to help reduce stigma within the prisons, improve the care prisoners receive and reduce the risk of occupational transmission.

An e-module was used to improve staff understanding of hepatitis B (HBV), hepatitis C (HCV) and HIV at a prison in Wales, UK. An assessment was used to gather data on prison staff understanding of BBVs prior to undertaking the e-module.

In total, 530/697 (76 per cent) prison staff completed the BBV e-module. Average pre- and post-course assessment scores were 8.6/11 and 10.85/11, respectively. Most staff understood the modes of hepatitis transmission, however, gaps in understanding were highlighted. In total, 22 per cent of staff believed HBV and HCV were airborne, 9 per cent believed transmission occurred through sharing cutlery. In total, 31 per cent of staff believed prisoners with hepatitis should declare their status to the prison.

The e-module significantly improved staff understanding of BBVs and should be incorporated into future prison training packages. Future education should include how BBVs are not transmitted with an emphasis on casual contact. Medical confidentiality in prisons should also be addressed. Improving understanding will help reduce the stigma of BBVs within prison and improve the multidisciplinary care the prisoner receives.

To the authors knowledge this is the first published evaluation of a BBV learning package for custodial staff. Evaluation of this educational package demonstrates a unique and valuable insight into the general understanding of BBVs by prison staff in Wales, UK.

Much of the discussion surrounding the antivaccine movement focuses on the decision of parents to not vaccinate their children and the resulting danger posed to others. However, the primary risk is borne by the child left unvaccinated. Although living in a developed country with high vaccination rates provides a certain amount of protection through population immunity, the unvaccinated child is still exposed to a considerably greater risk of preventable diseases than one who is vaccinated. I explore the tension between parental choice and the child’s right to be free of preventable diseases. The chapter’s goal is twofold: to advocate for moving from a dyadic framework – considering the interests of the parents against those of the state – to a triadic one, in which the interests of the child are given as much weight as those of the parent and the state; and to discuss which protections are available, and how they can be improved. Specific legal tools available to protect that child are examined, including tort liability of the parents to the child, whether and to what degree criminal law has a role, under what circumstances parental choice should be overridden, and the role of school immunization requirements in protecting the individual child.

The Covid-19 pandemic has persisted for almost three years. States have since then enforced laws, policies and measures believed to be the most effective to handle the global pandemic. Along this line, the Indonesian Government opted to implement mandatory vaccination and refusal of which entails monetary penalties. Hence, this study aims to analyze two legal issues that touch upon the realm of International Human Rights Law: first, whether state has the authority to implement the said mandatory vaccine program to those who refuse to be vaccinated, and second, how is the more appropriate legal policy to obligate vaccination but without coercive sanction.

This is a normative legal research that uses a qualitative method with case studies, conceptual, historical and comparative approaches. A descriptive-analytical deduction process was used in analyzing the issue.

The results present, as part of state’s right to regulate, it has the authority to enact mandatory vaccination with monetary penalties to fulfil its obligation to protect public health in times of emergency; this is legal and constitutional but only if it satisfies the requirements under the International Human Rights Law: public health necessity, reasonableness, proportionality and harm avoidance. Alternatively, herd immunity is achievable without deploying unnecessary coercive sanctions, such as improving public channels of communication and information, adopting legal policies that incentivize people’s compliance like exclusion from public services, subsidies revocation, employment restrictions, higher health insurance premiums, etc.

This study analyzes in depth the following issues: of whether the government has the authority to apply mandatory vaccination laws enforced through monetary penalties for those who refused to be vaccinated and how does the government implement the appropriate legal policy to enforce mandatory vaccination without imposing penalties for non-compliance while maintaining a balance between the interests of protecting public health and the human rights of individuals to choose medical treatment for themselves, including whether they are willing to be vaccinated. Hence, the political affairs, economic matters and other non-legal related issues are excluded from this study.

This paper hence offers a suggestive insight for state in formulating a policy relating to the mandatory vaccination program. Although the monetary penalties do not directly violate the rule of law, a more non-coercive approach to the society would be more favorable.

Repeated influenza outbreaks are surprisingly rare in prison settings worldwide, a factor that has made it superfluous, to date, to develop contingency plans for responding to prison‐based influenza epidemics. However, the influenza outbreak that occurred in an Australian prison in 2000 has highlighted the appropriateness of developing an outbreak plan, not least because of the security implications of a widespread prison influenza epidemic. Using reported attack rates and morbidity profiles of the 2000 Australian prison influenza outbreak to develop scenarios, the authors estimated the cost ‐ benefit of mass vaccination and antiviral chemotherapy approaches for the control of hypothetical widespread influenza outbreaks in New South Wales prisons, occurring at an average frequency of once every 10 years. It was concluded that, from the perspectives of maintaining prison security as well as health care services’ provision to prisoners, early antiviral chemotherapy for symptomatic individuals will have more favourable cost ‐ benefit ratios than a mass vaccination approach for controlling prison‐based influenza outbreaks that occur in line with this model.