| 1. |
- Chrapkowska, Cecilia, et al.
(author)
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Validation of the new Swedish vaccination register – Accuracy and completeness of register data
- 2020
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In: Vaccine. - : Elsevier BV. - 0264-410X .- 1873-2518. ; 38:25, s. 4104-4110
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Journal article (peer-reviewed)abstract
- Objective: The aims of this study are to validate infant vaccination data in the Swedish Vaccination Register (SVR) to the Swedish administrative coverage reports, and to assess differences in register-based vaccination coverage estimates between providers using different data reporting methods. Methods: The study population included all infants born in Sweden with a Swedish Personal Identity Number during 2014 and 2015 (n = 230,220). Data on all National Immunisation Programme vaccinations administered before 24 months of age were collected from the SVR and from administrative coverage reports. Information regarding data registration methods in the SVR were collected from national and regional authorities. Coverage from health care providers using single registration methods, where vaccination data were transferred automatically from the electronic health care record to the SVR, was compared to that from providers using double registration methods where data had to be added into the SVR in a separate process. Results: For 98,4% of the study population at least one vaccination was recorded in the SVR. The coverage of 3-dose DTP-containing (87,1%) and 1 dose MMR (91,1%) in the register did not reach administrative data coverage (97,4% for 3-dose DTP-containing and 97,0% for MMR). Single registration procedures yielded significantly higher coverage than double registration procedures (92,24% vs 87,10%, p < 0,0001). A regional switch from double to single registration increased coverage from 80,0 to 95,2%. Conclusions: The SVR is a valuable data source for vaccination coverage monitoring. For research purposes, the SVR provides valuable data, since every health care provider is obliged to register all vaccine doses given within the national immunisation program. The SVR shows a high completeness validated by comparison to a very well-functioning administrative data system. Single-registration procedures give more complete data and should be supported by health systems while creating health care registers.
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| 2. |
- Kahn, Fredrik, et al.
(author)
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Primary diphtheria immunisation of adolescents and adults with low-dose vaccine, a survey of historic evidence from the literature
- 2023
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In: Acta Paediatrica, International Journal of Paediatrics. - : Wiley. - 0803-5253. ; 112:2, s. 242-245
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Journal article (peer-reviewed)abstract
- The Public Health Agency of Sweden carried out a literature review on diphtheria vaccinations for seronegative people above 6 years of age with an uncertain vaccine history. The aim was to harmonise national Swedish recommendations with the current World Health Organization recommendations. There was no firm conclusion about dosage. Some low-dose vaccines used in the past had suboptimal potency, while others evoked adequate levels of antitoxin after three primary doses. We concluded that low-dose diphtheria vaccines that have been approved by a national medical products agency can be used for primary vaccination against diphtheria for individuals above 6 years of age.
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| 3. |
- Nilsson, Lennart, et al.
(author)
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Att förebygga kikhosta hos spädbarn : Systematisk litteraturöversikt
- 2015
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Reports (other academic/artistic)abstract
- Allmän barnvaccination mot kikhosta återinfördes i Sverige 1996 och sedan dess har antalet rapporterade fall av kikhosta minskat dramatiskt. Sjukdomen förekommer dock fortfarande bland ovaccinerade spädbarn och bland ungdomar och vuxna. Den högsta sjukdomsincidensen i Sverige ses bland spädbarn under sex månaders ålder. Kikhosta är en allvarlig och livshotande sjukdom för spädbarn och hårdast drabbas de allra yngsta som inte har fått sin första vaccindos vid tre månaders ålder. Drygt 70 procent av dem som insjuknar behöver sjukhusvård.Flera länder har under de senaste åren rapporterat en ökning av kikhostefall i befolkningen och dödsfall på grund av kikhosta hos spädbarn. För att minska sjukdomsbördan hos spädbarnen har rekommendationer i dessa länder innefattat vaccination av vuxna runt det nyfödda barnet (kokongvaccination), vaccination av modern under sista trimestern av graviditeten och vaccination av hälso- och sjukvårdspersonal. Dessutom har man i vissa länder rekommenderat vaccination av vuxna vart tionde år.Folkhälsomyndigheten har gjort en systematisk litteraturöversikt med syfte att finna evidens enligt GRADE-metodiken för preventiva strategier som minskar förekomsten av kikhosta hos barn yngre än sex månader. De preventiva strategier som har utvärderats är a) striktare följsamhet till tidpunkten för eller tidigareläggning av första vaccindosen, b) neonatal vaccination, c) kokongvaccination, d) vaccination av gravida, e) vaccination vid 4–7 års ålder, f) vaccination vid 13–19 års ålder, och g) postexpositionsprofylax med antibiotika.Litteraturöversikten visar någon grad av evidens för att alla de utvärderade strategierna bidrar till att skydda spädbarn mot kikhosta, förutom tonårsvaccination. Det finns två vårdinsatser som redan stöds av befintliga föreskrifter och rekommendationer men som bör följas mer strikt.Tidpunkten för första vaccindosen har betydelse för skydd mot kikhosta hos spädbarn. Uträkningar från bland annat det svenska uppföljningsprogrammet talar för en väsentlig minskning av kikhosta hos barn under sex månaders ålder om första vaccindosen ges strikt vid angiven tid enligt vaccinationsschemat eller inom två veckor före den tidpunkten.Det är viktigt att vara uppmärksam på hosta i närfamiljen under barnets första levnadsmånader. Frikostig provtagning, snabb diagnostik och behandling kan förhindra dödsfall i kikhosta hos spädbarn. Tidigt insatt postexpositionsprofylax med antibiotika till spädbarn ger ett gott skydd mot klinisk kikhosta.Dessutom finns två strategier som ytterligare kan minska förekomsten av kikhosta hos spädbarn under 6 månader:KokongvaccinationVaccination av gravida.Kokongvaccination har i några länder visat effekt vid hög anslutning och kostnadsfri vaccination. Vaccination mot kikhosta under graviditet rekommenderas i flera länder. I England har vaccination av gravida erbjudits i cirka tre års tid i vaccinationsprogram och visat god effekt bland spädbarn till vaccinerade mödrar. Uppföljning av programmet och utvärdering av långtidseffekterna pågår och resultaten publiceras allteftersom.
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| 4. |
- Nilsson, Lennart, et al.
(author)
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Pertussis vaccination in infancy lowers the incidence of pertussis disease and the rate of hospitalisation after one and two doses: Analyses of 10 years of pertussis surveillance
- 2012
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In: Vaccine. - : Elsevier. - 0264-410X .- 1873-2518. ; 30:21, s. 3239-3247
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Journal article (peer-reviewed)abstract
- Objectives: Shortly after pertussis vaccination was reintroduced in Sweden in 1996, an intensified pertussis disease surveillance programme was set up. In this study, we report on in-depth analyses of age-dose-number-specific incidences and the rate of pertussis hospitalisation for children with no, 1 or 2 doses of an acellular pertussis vaccine before pertussis disease. Vaccine coverage, the timeliness of childhood vaccination and the effect of later than scheduled pertussis vaccination(s) are also examined. less thanbrgreater than less thanbrgreater thanStudy design: Children with notified laboratory-confirmed (culture or PCR) pertussis disease were evaluated among the surveillance population of about 1 million infants, born between 1996 and 2007 and followed for pertussis disease from October 1997 to December 2007, for nearly 6 million person-years. Birth and vaccination dates of the diseased children are known from the surveillance programme. To estimate denominators of the age-dose-number-specific pertussis incidences, we used birth and vaccination dates from a vaccine trial with more than 72,000 infants combined with national pertussis vaccine coverage data for children in the surveillance population. less thanbrgreater than less thanbrgreater thanResults: For infants from 3 to andlt;5 months of age, the incidence of pertussis disease with at least 14 days of cough decreased from 264/100,000 for unvaccinated infants to 155/100,000 for infants with one dose of a pertussis vaccine prior to onset of the disease. In the age range 5 to andlt;12 months, the age-dose specific incidences were 526, 95, and 24/100,000 for infants with no, 1 and 2 doses, respectively. The rate of hospitalisation for infants with 1 dose of a pertussis vaccine prior to onset of the disease was significantly lower than for unvaccinated infants of the same age. less thanbrgreater than less thanbrgreater thanFor many infants, there is a delay in administration of the vaccine doses according to the regular 3-5-12 month schedule (which has been the case for many years). Hypothetically, if all infants had been vaccinated exactly on schedule, we would expect about 28% fewer pertussis cases with at least 14 days of cough and 38% fewer hospitalisations due to pertussis, of cases possible to influence by vaccinations on schedule. less thanbrgreater than less thanbrgreater thanConclusion: Pertussis vaccination had a significant effect among infants already after the first dose. This is particularly important for premature infants and infants with severe respiratory and cardiac diseases. A moderate decrease in the incidence of pertussis disease in infants and rate of hospitalisation could be expected if primary vaccinations were carried out closer to the scheduled time than is currently the practice in Sweden.
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| 5. |
- Thulin Hedberg, Sara, et al.
(author)
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Invasive meningococcal disease in Sweden 2016
- 2017
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In: 14th Congress of the EMGM, European Meningococcal and Haemophilus Disease Society. - Prague : The European Meningococcal and Haemophilus Disease Society EMGM. - 9788090666238 ; , s. 69-69
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Conference paper (other academic/artistic)abstract
- Invasive meningococcal disease (IMD) is notifiable in Sweden. The reporting system comprises of mandatory notification of cases and mandatory laboratory notification of samples to the Public Health Agency of Sweden, Stockholm. All samples are sent to the National Reference Laboratory for Pathogenic Neisseria, Örebro for further typing and surveillance.In 2016, 62 cases of IMD (incidence 0.6/100 000 population) were reported in Sweden. Among the patients 58 % were females and 42 % males, aged from 1 month to95 years with mean age of 42 years. The incidence was highest, as in previous years, in the age group 15-19 years (2.1/100 000 population) followed by elderly ≥80 years (1.8/100 000 population) and infants ≤1 year (1.7/100 000 population). The case fatality rate increased in 2016 to 12.9 % compared with 7.5 % in 2015, eight people died from the disease (MenW, n=3; MenY, n=2; MenB, n=2 and MenC n=1). None of the IMD cases in 2016 had any epidemiological linkage.All 62 cases of IMD were laboratory confirmed: 54 were culture-confirmed, three PCR-confirmed and in five cases further typing data are missing because no samples were sent to the National Reference Laboratory for Pathogenic Neisseria. The serogroup distribution was MenW (n=18, 31.5 %), MenY (n=18, 31.5 %), MenB (n=10, 17.5 %), MenC (n=10, 17.5 %) and one non-groupable isolate. The W:P1.5,2:F1-1:ST11 (cc11) (n=15) were predominant among the culture-confirmed meningococci during 2016 followed by Y:P1.5-2,10-1:F4-1:ST23 (cc23) (n=7) och Y:P1.5-1,2-2:F5-8:ST23 (cc23) (n=6). Antibiotic susceptibility testing was performed with Gradient test (Etest, BioMerieux). Decreased susceptibility to penicillin was seen in 30 % of the isolates (MIC >0,064 mg/L) of which one was resistant (MIC=0.5 mg/L). One of the isolates with decreased susceptibility to penicillin was also resistant to ciprofloxacin (MIC=0.125 mg/L). All other isolates were susceptible to cefotaxime, chloramphenicol, ciprofloxacin, rifampicin and meropenem. No β-lactamase producing isolates has so far been found in Sweden.To conclude, the incidence of IMD continues to be relatively low in Sweden, however, a shift in the serogroup distribution of N. meningitidisin Sweden is ongoing; the previously dominating disease-causing MenB and MenC have been replaced, first by MenY which emerged in 2009 and since 2015 also by MenW. MenW has gone from only causing invasive disease in a few, 0-6 cases per year from 1990 onwards, to now being the dominating serogroup together with MenY in Sweden 2016.
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| 6. |
- Wang, Jiangrong, et al.
(author)
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Mode of HPV vaccination delivery and equity in vaccine uptake : A nationwide cohort study
- 2019
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In: Preventive Medicine. - : Elsevier BV. - 0091-7435 .- 1096-0260. ; 120, s. 26-33
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Journal article (peer-reviewed)abstract
- Ten years after its introduction, equity in human papillomavirus (HPV) vaccine uptake remains unattained, not least for the groups at highest risk of cervical cancer. In Sweden, three different delivery modes of the vaccine have been in effect since May 2007. We used this as a natural experiment to investigate girls’ HPV vaccine uptake in relation to parental country of birth and socioeconomic characteristics, by mode of delivery. Our nationwide study cohort comprised 689,676 girls born between 1990 and 2003. Data on HPV vaccination of the girls and parental birth/socioeconomic characteristics were retrieved from national registers. We examined the association between girls’ vaccine uptake and parental characteristics, stratified by mode of delivery. The cumulative uptake of at least one dose of HPV vaccine was 37%, 48% and 79% for subsidised opportunistic, free-of-charge catch-up outside-school and free-of-charge school-based vaccination, respectively. In the subsidised vaccination, having parents born outside of Sweden, with low education and low family income was strongly associated with lower uptake [HR (95% confidence interval (CI)) = 0.49 (0.48–0.50), 0.32 (0.31–0.33), 0.53 (0.52–0.54), respectively]. The associations were partially reduced in catch-up outside-school, and strongly reduced in school-based vaccination delivery [HR (95% CI) =0.82 (0.81–0.83), 0.92 (0.91–0.94), 0.87 (0.85–0.88), respectively]. Free-of-charge school-based HPV vaccination achieved the highest uptake and displayed the least disparity in country of birth and socioeconomic background of the parents. This appears to be the most effective and equitable delivery mode for reaching high population vaccination coverage, including high-risk groups for cervical cancer.
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