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      Influenza vaccination dilemmas

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          Abstract

          Influenza is one of the most common respiratory diseases in the world, annually causing over one million of deaths. It is triggered by one of the influenza viruses (A, B, or C). In most cases, it occurs in epidemic form, but it can also appear in pandemic form, and very occasionally, it occurs in sporadic form. In the temperate zones, influenza occurs during the winter months of a year. In the tropics, however, it occurs throughout the year, although the highest number of patients is registered during the rainy seasons. In young and otherwise healthy individuals influenza is a mild disease; however, if affecting individuals with a weakened immune system, it can lead to health complications and even to death. The only effective preventive measure to preclude the disease is vaccination. There is still no consensus on whether the vaccination should be compulsory or recommended and which population groups should be vaccinated. In most European countries, the vaccination is recommended for some population groups, while in the United States the vaccination is recommend to all individuals above six months of age.

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          Most cited references28

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          Influenza vaccination of healthcare workers: a literature review of attitudes and beliefs.

          Influenza vaccination coverage among healthcare workers (HCW) is insufficient despite health authority recommendations in many countries. Numerous vaccination campaigns encouraging HCW to be vaccinated have met with resistance. We reviewed published influenza vaccination programs in healthcare settings to understand the reasons for their success and failure, as well as the attitudes and beliefs of HCW. Relevant articles published up to June 2004 were identified in the MEDLINE/Pubmed database. Thirty-two studies performed between 1985 and 2002 reported vaccination rates of 2.1-82%. Vaccination campaigns including easy access to free vaccine and an educational program tended to obtain the highest uptake, particularly in the USA. Yet, even this type of campaign was not always successful. Two main barriers to satisfactory vaccine uptake were consistently reported: (1) misperception of influenza, its risks, the role of HCW in its transmission to patients, and the importance and risks of vaccination (2) lack of (or perceived lack of) conveniently available vaccine. To overcome these barriers and increase uptake, vaccination campaigns must be carefully designed and implemented taking account of the specific needs at each healthcare institution.
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            Safety of immunization during pregnancy: a review of the evidence of selected inactivated and live attenuated vaccines.

            Vaccine-preventable infectious diseases are responsible for significant maternal, neonatal, and young infant morbidity and mortality. While there is emerging scientific evidence, as well as theoretical considerations, indicating that certain vaccines are safe for pregnant women and fetuses, policy formulation is challenging because of perceived potential risks to the fetus. This report presents an overview of available evidence on pregnant women vaccination safety monitoring in pregnant women, from both published literature and ongoing surveillance programs. Safety data were reviewed for vaccines against diseases which increase morbidity in pregnant women, their fetus or infant as well as vaccines which are used in mass vaccination campaigns against diseases. They include inactivated seasonal and pandemic influenza, mono- and combined meningococcal polysaccharide and conjugated vaccines, tetanus toxoid and acellular pertussis combination vaccines, as well as monovalent or combined rubella, oral poliomyelitis virus and yellow fever vaccines. No evidence of adverse pregnancy outcomes has been identified from immunization of pregnant women with these vaccines.
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              Environmental role in influenza virus outbreaks.

              The environmental drivers of influenza outbreaks are largely unknown. Despite more than 50 years of research, there are conflicting lines of evidence on the role of the environment in influenza A virus (IAV) survival, stability, and transmissibility. With the increasing and looming threat of pandemic influenza, it is important to understand these factors for early intervention and long-term control strategies. The factors that dictate the severity and spread of influenza would include the virus, natural and acquired hosts, virus-host interactions, environmental persistence, virus stability and transmissibility, and anthropogenic interventions. Virus persistence in different environments is subject to minor variations in temperature, humidity, pH, salinity, air pollution, and solar radiations. Seasonality of influenza is largely dictated by temperature and humidity, with cool-dry conditions enhancing IAV survival and transmissibility in temperate climates in high latitudes, whereas humid-rainy conditions favor outbreaks in low latitudes, as seen in tropical and subtropical zones. In mid-latitudes, semiannual outbreaks result from alternating cool-dry and humid-rainy conditions. The mechanism of virus survival in the cool-dry or humid-rainy conditions is largely determined by the presence of salts and proteins in the respiratory droplets. Social determinants of heath, including health equity, vaccine acceptance, and age-related illness, may play a role in influenza occurrence and spread.
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                Author and article information

                Journal
                JHS
                Journal of Health Sciences
                University of Sarajevo Faculty of Health Studies (Bosnia )
                2232-7576
                1986-8049
                2016
                : 6
                : 3
                : 137-142
                Affiliations
                [1 ]Institute for Public Health of Canton Sarajevo, Sarajevo Bosnia and Herzegovina
                [2 ]Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
                Author notes
                [* ]Corresponding author: Zarema Obradovic, Institute for Public Health of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina. E-mail: zobradovic9@ 123456gmail.com
                Article
                JHS-6-137
                10.17532/jhsci.2016.398
                86df5906-4972-42e0-accf-5c919e98a91f
                Copyright: © 2016 Zarema Obradović et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 October 2016
                : 14 November 2016
                Categories
                REVIEW ARTICLE

                Nursing,General medicine,Medicine,Molecular medicine,Life sciences
                vaccination,Influenza,dilemmas
                Nursing, General medicine, Medicine, Molecular medicine, Life sciences
                vaccination, Influenza, dilemmas

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