Content:
- Editorial
- Vaccination coverage data for selected preventable diseases in children for 2022 in the Czech Republic – Hana Cabrnochová, Roman Chlíbek, Ladislav Dušek
- Prospects for vaccination against tuberculosis – Roman Prymula, Lenka Teska Arnoštová
- Tuberculosis as an occupational disease – Blanka Kupsová, Lucie Siráková, Vladimír Pavlík, Jan Horáček, Jan Smetana, Roman Chlíbek
- Long-term rehabilitation care in connection with post-vaccination reaction – Lenka Tománková
- Progress Toward Poliomyelitis Eradication – Vanda Boštíková
- XVIII. Hradecké vakcinologické dny
- Doporučení České vakcinologické společnosti ČLS JEP k očkování proti onemocnění covid-19
Editorial
Vážení čtenáři, kolegové a kolegyně,
v uplynulém roce jsme byli svědky značného pokroku ve výzkumu a implementaci nových vakcín, ať už bylo naším cílem bojovat proti starým známým nemocem, anebo čelit novým výzvám, které přinesla doba. Příkladem jsou vakcíny proti covidu-19 a RSV. Toto úsilí stále definuje naši schopnost reagovat na globální zdravotní hrozby a ochránit nejzranitelnější mezi námi – což bude vždy v srdci naší mise.
Abychom byli schopni objektivizovat implementaci jednotlivých vakcín do praxe, byla zvolena metoda Health Technology Assesment (HTA). Úloha HTA je klíčová pro zajištění skutečnosti, že vakcíny jsou implementovány tak, aby byly bezpečné, efektivní a účinné, přičemž jsou také eticky přijatelné a organizačně realizovatelné. Tomuto záměru jistě není co vytknout. Je však třeba zdůraznit, že tato metoda je metodou pomocnou. V praxi jednotlivých zemí se často stává, že i když HTA nedopadne pozitivně, přesto je vakcína z různých důvodů zavedena. Je však mnohem méně časté, aby při pozitivním výsledku zavedena nebyla. Důvodem je naprosto zcestné nastavení hlasů v NIKO, kdy pojišťovny přehlasují svými devíti hlasy prakticky vše. V tomto modelu a rozložení je diskutabilní, jestli má smysl vůbec o něco usilovat.
V roce 2024 nás nepochybně čekají výzvy, stejně jako příležitosti pro změny a zlepšení. Jsem přesvědčený, že díky kontinuálnímu dialogu mezi ministerstvem, pojišťovnami, lékařskou komunitou, veřejným zdravotnictvím a odbornými společnostmi můžeme přispět k lepšímu modelu zavádění nových vakcín do praxe. Věřme, že v tomto roce uděláme další důležité kroky k tomuto cíli a i antigenní složení budeme znát v souladu se zákonem vždy včas před koncem kalendářního roku.
Děkuji vám za vaši neustálou podporu a zájem o časopis Vakcinologie. Těším se na to, co přinese tento nový rok, a jsem si jist, že společnými silami pokročíme ještě dál. Přeji vám příjemné čtení.
Za redakční radu prof. MUDr. Roman Prymula, CSc., Ph.D.
Vaccination coverage data for selected preventable diseases in children for 2022 in the Czech Republic
Summary:
Introduction: Vaccination coverage is influenced by a number of factors, such as the reimbursement of the vaccine, its availability, the active role of vaccinating physicians and the public’s interest in specific reimbursed vaccinations. In the case of vaccinations that are not mandatory by law, the condition for reimbursement of vaccination is the fulfilment of a specific period for its implementation. The timing of mandatory vaccinations is regulated by legislation, independent of reimbursement. In addition to the continuing incidence of COVID-19, 2022 was also accompanied by increased morbidity in children, which may have been the reason for the decline in vaccination rates over the monitored period.
Material and Methods: We monitor the vaccination coverage of selected preventable infections on the basis of an evaluation of data from health insurance companies on the number of reported vaccination doses paid from public health insurance funds, both for vaccinations that are legally mandatory and optional. We analyse data and evaluate vaccination coverage on the basis of set criteria for specific vaccinations according to the date of birth of the vaccinated in selected age groups.
Results: There was no decrease in vaccination coverage with the combined vaccine against diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and invasive infections caused by Haemophilus influenzae type b (hexavalent vaccine) in infants in the first year of life. For children born in 2020, 2021 and preliminarily also in the year 2022, it is possible to state a vaccination coverage of over 96 % in the case of vaccination with at least one dose of hexavalent vaccine in the first year of life. For measles, rubella and mumps vaccination with the combined vaccine, an increase in vaccination coverage was again above 90 % (90.3 % and 92.6 %) in those born in 2018 and 2019 monitored up to two years of age. However, for those born in 2020, the vaccination rate dropped to 88.4 %. A slight decrease in vaccination coverage can also be seen in older children in the case of booster vaccination at 5 years of age with a vaccine against diphtheria, tetanus, pertusis and at 10 years of age in combination with a booster vaccination against poliomyelitis. The introduction of a new vaccination for infants against invasive meningococcal infections caused by serogroup B was met with interest and a gradual increase in vaccination coverage for children born in 2021 under one year of age to 70.7 %. For those born in 2022, the vaccination rate of the pneumococcal conjugate vaccine in infants has preliminarily risen to 78 %. For vaccination against human papillomavirus in females who reached 13 years of age in 2021 and were vaccinated in this and the following year, a vaccination rate of 69.2 % was achieved, and we assume a similar number for females who were 13 years old in 2022. For males, there is an increase in vaccination coverage to 42.5 % in 2021. For males vaccinated in 2022 and the following year, the prediction according to the number of vaccinated is up to 48 %.
Conclusion: Data for 2022 confirms persistently high vaccination coverage among infants in the case of hexavalent vaccine and a continuing increase in vaccination coverage against pneumococcal and meningococcal infections. In 2022, however, there has been a decrease in the vaccination coverage of children in the second year of life against measles, rubella and mumps and a slight decrease in the case of booster vaccination of 5- and 10-year-old children. In the case of vaccination against human papillomavirus in boys, there is an increase in vaccination coverage, for girls the number remains at less than 70 % for 2022.
Keywords:
vaccination coverage, mandatory vaccinations, hexavalent vaccine, vaccination against diphtheria, tetanus, pertussis and polio, measles, rubella and mumps vaccination, vaccination against pneumococcal infections, vaccination against human papillomavirus, vaccination against meningococcal infections
Hana Cabrnochová,1 Roman Chlíbek,2 Ladislav Dušek3
1Očkovací centrum pro děti, Pediatrická klinika 1. LF UK a FTN Praha
2Katedra epidemiologie, Vojenská lékařská fakulta Univerzity obrany, Hradec Králové
3Ústav zdravotnických informací a statistiky ČR, Praha
Prospects for vaccination against tuberculosis
Summary:
Vaccination against tuberculosis (TB) is done using the Bacillus Calmette-Guérin vaccine (BCG). This vaccine is named after the French doctors who developed it. However, the BCG vaccine is not completely effective in preventing TB infection, but it is able to protect against severe forms of the disease, especially in children. BCG vaccination is usually administered in areas with a higher incidence of tuberculosis, particularly in countries with a high TB burden. In many countries, the BCG vaccine is part of the routine immunization program for newborns or children. It is important to note that the BCG vaccine may not provide complete protection against tuberculosis infection and is primarily focused on preventing severe forms of the disease, such as tuberculous meningitis and tuberculosis in children. Because the BCG vaccine has limited effectiveness in preventing tuberculosis infection in adults and its effectiveness may vary in different parts of the world, preventive measures such as avoiding risk factors and contact with sick individuals are still important. The treatment of active tuberculosis involves antibiotic therapy, with the BCG vaccine not being suitable for treating the active form of the disease. Development of new TB vaccines is underway, with several organizations and research groups worldwide investing in the development of new TB vaccines. However, none of the new vaccines have been fully approved for regular use yet.
Keywords:
TBC, tuberculosis, BCG vaccine, history, vaccination
Roman Prymula,1,2 Lenka Teska Arnoštová,3
1Ústav preventivního lékařství, Lékařská fakulta Univerzity Karlovy, Hradec Králové
2RIBS Hradec Králové
3Centrum zdravotnického práva, Právnická fakulta Univerzity Karlovy, Praha
Tuberculosis as an occupational disease
Summary:
Tuberculosis (TB) is a notifiable disease. Data on patients are collected and evaluated in the TB Registry, which is linked to the TB Information System. This case report describes a case of TB recognised as an occupational disease, diagnosed quite incidentally by a female doctor during an initial occupational health examination in a hazardous environment. The early detection of TB in high-risk workers, the occupational representation of TB as an occupational disease and the evolution of the number of TB patients are also discussed. Vaccination is also highlighted, but it does not fully protect against transmission of this infection.
Keywords:
tuberculosis, occupational disease, health care, TB screening
Blanka Kupsová,1 Lucie Siráková,2 Vladimír Pavlík,1 Jan Horáček,1 Jan Smetana,2 Roman Chlíbek,2
1Katedra vojenského vnitřního lékařství a vojenské hygieny, Vojenská lékařská fakulta Hradec Králové, Univerzita obrany
2Katedra epidemiologie, Vojenská lékařská fakulta Hradec Králové, Univerzita obrany
Long-term rehabilitation care in connection with post-vaccination reactionLenka Tománková
Summary:
Every administration of medicine, vaccine and procedure is associated with the risk of an unwanted side reaction, even for preventive reasons. Peripheral paresis of the facial (cheek) nerve is among very rare adverse reactions after vaccination. The disability is usually of a temporary nature, but on the example of the case study of a seven-year-old boy, it can be seen a permanent consequence requiring long-term rehabilitation care, aimed not only at alleviating the asymmetry in the face, but also at correctly influencing the posture of the whole body during the growth period.
Keywords:
vaccination, adverse reactions, paresis of the facial nerve, complex rehabilitation in children
Lenka Tománková
Jihomoravské dětské léčebny, Dětská léčebna pohybových poruch Boskovice
Progress Toward Poliomyelitis Eradication
Since the inception of the Global Polio Eradication Initiative (GPEI) in 1988, Pakistan remains one of only two countries (along with Afghanistan) with ongoing endemic transmission of wild poliovirus (WPV). Wild poliovirus 1 (WPV1) transmission has never been interrupted in Pakistan, one of the two countries with continued endemic transmission.
WHO recommends the continued maintenance of an effective national surveillance system for acute flaccid paralysis with complete case investigation, including virological testing of stool samples in accredited laboratories. In many countries there is a reduction in vaccination coverage at the population level, a continuous migration of more people and, not least, late identification of circulating wild viruses.
Keywords:
polio, poliovirus type 1 and type 2, endemicity, Pakistan, vaccination
Vanda Boštíková
Katedra epidemiologie, Vojenská lékařská fakulta, Univerzita obrany, Hradec Králové