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International Journal of Epidemiology
Published: 31 August 2017
The duration of protection of school-aged BCG vaccination in England: a population -based case–control study
Punam Mangtani Patrick Nguipdop-Djomo Ruth H Keogh Jonathan AC Sterne Ibrahim Abubakar Peter G Smith Paul EM Fine Emilia Vynnycky John M Watson David Elliman … Show more
, dyx141, https://doi.org/10.1093/ije/dyx141
Background: Evidence of protection from childhood Bacillus Calmette-Guerin (BCG) against tuberculosis (TB) in adulthood, when most transmission occurs, is important for TB control and resource allocation.
Methods: We conducted a population-based case–control study of protection by BCG given to children aged 12–13 years against tuberculosis occurring 10–29 years later. We recruited UK-born White subjects with tuberculosis and randomly sampled White community controls. Hazard ratios and 95% confidence intervals (CIs) were estimated using case–cohort Cox regression, adjusting for potential confounding factors, including socio-economic status, smoking, drug use, prison and homelessness. Vaccine effectiveness (VE = 1 – hazard ratio) was assessed at successive intervals more than 10 years following vaccination.
Results: We obtained 677 cases and 1170 controls after a 65% response rate in both groups. Confounding by deprivation, education and lifestyle factors was slight 10–20 years after vaccination, and more evident after 20 years. VE 10–15 years after vaccination was 51% (95% CI 21, 69%) and 57% (CI 33, 72%) at 15–20 years. Subsequently, BCG protection appeared to wane; 20–25 years VE = 25% (CI –14%, 51%) and 25–29 years VE = 1% (CI –84%, 47%). Based on multiple imputation of missing data (in 17% subjects), VE estimated in the same intervals after vaccination were similar [56% (CI 33, 72%), 57% (CI 36, 71%), 25% (–10, 48%), 21% (–39, 55%)].
Conclusions: School-aged BCG vaccination offered moderate protection against tuberculosis for at least 20 years, which is longer than previously thought. This has implications for assessing the cost-effectiveness of BCG vaccination and when evaluating new TB vaccines.
Published: August 25, 2017
Religion and HPV vaccine-related awareness, knowledge, and receipt among insured women aged 18-26 in Utah
J Bodson, A Wilson, EL Warner, D Kepka –
We investigate the associations between religious practice and human papillomavirus (HPV) vaccine-related awareness, knowledge, and receipt among young women in Utah.
We surveyed 326 insured women aged 18–26 by mail. Fisher’s Exact Tests and multivariable logistic regression models were used to evaluate the relations between religious practice and HPV vaccine-related outcomes. Data collection occurred January-December 2013; analyses were conducted June-September 2015.
Multivariable analyses reveal that when controlling for age, educational attainment, and marital status, participants who practiced an organized religion were significantly less likely to have heard of HPV (aOR=0.25, p=0.0123), to have heard of the HPV vaccine (aOR=0.41, p=0.0368), to know how HPV is spread (aOR=0.45, p=0.0074), to have received a provider recommendation for the HPV vaccine (aOR=0.36, p=0.0332), and to have received at least one (aOR=0.50, p=0.0073) or all three (aOR=0.47, p=0.0026) doses of the HPV vaccine. Bivariate analyses produce parallel results.
Results indicate that religious young women in Utah are not only under-vaccinated, but are also under-informed about HPV and the HPV vaccine. These results suggest that suboptimal vaccine coverage among religious young women may present a serious health risk for the community. Strategies for educational interventions targeted to this population are discussed.