Research project: Maternal influenza immunization - Essay Example

Running head: RESEARCH PROJECT Research project: Maternal influenza immunization here The of the here Influenza represents a serious infection disease that can cause a variety of symptoms, and from an epidemiologic viewpoint, cause the most destructive pandemics in human history, such as the 1918-1920 pandemic of the Spanish flu. Modern epidemiology successfully deals with the issue of influenza pandemics, yet influenza represents a serious medical disease as it has devastating effects on pregnant women and infants. It can cause serious pneumonic complications that can quickly result in death, which makes infants, as a result of their poorly developed immune system, the population with the highest influenza infection and hospitalization rates in pediatrics (Munoz, 2003). According to Izurieta and Thompson (2000) "During the periods in which influenza viruses predominate, the rates of hospitalization for acute respiratory disease among children without high-risk conditions were approximately 12 times as high among those younger than 2 years of age than among older children and were similar to the rates among children with high-risk medical conditions who were 5 to 17 years of age"(239). According to the same authors, the findings support the current recommendations of the Advisory Committee on Immunization Practices and the American Academy of Pediatrics to vaccinate children on an annual basis (Izurieta, Thompson, 2000). In that regard, various strategies exist to battle influenza infection rates amongst infants. According to Healy and Baker (2006) "Maternal immunization, with the passage of protective antibody to infants, is a potential strategy to prevent infection in infants" (275). Certain studies have shown that the influenza vaccine that was administered in the second or third trimester of gestation was safe in the study population (Munoz, 2005, p.1105). We will explore, in this aspect, the effectiveness of maternal immunization in mothers and infants. The immunization process is explored from two main aspects: the immunogenicity of pneumococcal vaccines, as pneumonia is one of the most severe complications of influenza infections in infants and mothers, and the clinical effectiveness of the influenza vaccine. This represent a prospective, controlled, blinded, randomized trial, where the pneumococcal vaccine is given to a group of mothers, some who have received the influenza vaccine, and others that have not. At the same time no infants should receive the influence vaccine. In this study, infected infants will be considered those of age less than 24 weeks and have a positive influenza laboratory result. Clinician-confirmed cases and swabs taken from infants for influenza-antigen testing will also be considered. Respiratory illness with fever or of documented fever of more than 38C, clinic visits with respiratory illness, and episodes of diarrhea found in both mothers and infants will be considered. The number of cases will show the effectiveness of the influenza vaccines, as well as pneumococcal vaccine, as well as the combination of both, to give us a more clear picture of the effectiveness of immunization. Mothers that have had complicated pregnancies and deliveries, abortions and hypersensitivity to the vaccines will be excluded from the project. The mothers used in the project should provide a signed consent form, and, when considering the pneumococcal vaccine, then they are assigned in one of four groups. The first two groups would receive the pneumococcal vaccine, while in the second two groups, the mother will receive the influenza vaccine only. When the influenza vaccination is concerned, the subjects are placed and analyzed in two groups: the control group and the group that received the influenza vaccine. Using a computer, the subjects are randomized and placed in the specific groups. Blood samples are also taken from mother before and after immunization. Samples are also taken from infants, and all of them should have received immunizations at 6, 10 and 14 weeks. We can hypothesize that the mothers that have received both vaccines would show a lower incidence of influenza infection, as well as complications from it. Infants results should be similar to those found in the mother population, as they also received the vaccine, not only through intravenous administration, but through breast feeding as well. The mothers can be interview at 8, 24, 48 and 72 hours after immunization, and then they can be followed 1 or 2 weeks after immunization. The detection of disease is made with the assistance of the infant's families, and mothers are given thermometers to measure temperature. Also, they are instructed to bring the infants at the first sign of disease. There, tests, such as influenza-antigen tests, and treatment are administered, and in certain cases, such as acute febrile respiratory illness, throat swabs are taken from infants and tested. As the result have shown, the hypothesis is proven correct, with the influenza vaccine having reduced by 63% the laboratory-proven influenza illness in infants up to 6 months of age and reducing by 29% in infants and 36% in mothers, the rate of respiratory illness with fever. One must consider however, that the study is made between groups who had received maternal influenza vaccine and the pneumococcal vaccine and not between active immunization and placebo. The pneumococcal vaccine allows for the reduced number of cases of respiratory illness and that could influence the effectiveness of the maternal influenza vaccine. However, randomizing the infants assures that the effects of the pneumococcal vaccine is distributed equally amongst the infant population, making the effects similar in both groups and therefore, to have a minimal influence on the maternal influenza vaccine. As expected, the maternal influenza vaccine provides protection for both the mother and the child, as there is a reduction of influenza cases in 7 mothers and 14 infants for every 100 influenza immunizations (Kelly, Andrews, 2004, p.2192). The research also shows that influenza immunization of fewer than 16 mothers prevented one laboratory-proven influenza illness in the young infants. The effects of the study can be easily seen and it is a clear indication of the effectiveness of the influenza vaccine, as well as other vaccines in preventing influenza and respiratory complications. Therefore, supporting the strategy of maternal immunization is vital in preventing influenza in the most vulnerable population. It also represents a much cheaper and cost effective way in dealing with the influenza problem and other problems that arise from the disease, making it most appropriate for countries in the tropical regions, which have a problem with supplying the appropriate medicine for fighting influenza and other respiratory infections. The study also sheds light on the need for other studies that need to be carried out in order to improve the effectiveness of scope of the maternal immunization projects. References: 1. Healy CM, Baker CJ (2006). Prospects for prevention of childhood infections by maternal immunization. Current opinion in infectious diseases, 19:271-276 2. Izurieta, Hector S.,Thompson William W. (2000). Influenza and the Rates of Hospitalization for Respiratory Disease among Infants and Young Children. New England Journal of Medicine, 342: 232-239 3. Kelly H, Attia J, Andrews R, Heller RF (2004). The number needed to vaccinate (NNV) and population extensions of the NNV: comparison of influenza and pneumococcal vaccine programmes for people aged 65 years and over. Vaccine, 22: 2192-2198 4. Munoz FM (2005). Safety of influenza vaccination during pregnancy. American Journal of Obstetrics and Gynecology, 192:1098-1106 Read More