Children’s Vaccine Initiative

Mitchell, V. S., N. M. PhUipose, and J. P. Sanford, eds. 1993. The Children s Vaccine Initiative Achieving the Vision. Washington, DC National Academy Press. 

In the poorer countries of the world, where infectious diseases remain the primary cause of death, expense, inadequate health-care infrastructure, and lack of refrigeration limit the utility of vaccines. In these locations, entry of virtually all of these infectious diseases occurs through the host s mucosal surfaces in the gut, and respiratory and reproductive tracts. In 1992, an assembly of philanthropic organizations, in conjunction with the World Health Organization, set about the task of establishing the Children s Vaccine Initiative, whose focus is to advance the development of new technologies that will make novel oral vaccines accessible and... 

At the 1990 International Task Force for Vaccine Development meeting in New York, a children s vaccine initiative (CVI) was set up with the aim of developing an ideal vaccine. The following criteria were established although the list may not be totally inclusive. 

Children s Vaccine Initiative (CVI) and Global Programme on Immunization of the World Health Organization (WHO). Informal Consnltation on control of pertussis with whole cell and acellnlar vaccines. Report on a meeting May 18-19, 1998. Geneva World Health Organization, 1999. 

The vaccination rate in adults is much lower than that in children. Only 50% to 60% of adults who meet criteria have received pneumococcal or influenza vaccination. Comprehensive initiatives need to be implemented to increase the adult vaccination rate. Some proven concepts are providing reminders to patients that vaccines are due and implementation of standing orders for vaccines. This latter concept allows nurses and pharmacists to screen patients to see if pneumococcal, influenza, or other vaccines are needed and to vaccinate without a physician s order. 

Most patients present initially with edema, frequently acute in onset, following a nonspecific upper respiratory tract infection, allergic reaction, or vaccinations, which might have activated the T lymphocytes. Nephrotic syndrome with massive proteinuria (substantially more than 40 mg/m per hour for children and 3 g/day for adults), edema, hypoalbuminemia, and hyperlipidemia is common. The patient s weight may be increased dramatically because of sodium and fluid retention. Nephrotic features such as gross hematuria are uncommon. However, microscopic hematuria may be seen in up to 20% to 25% of patients. Hypertension and decreased renal function are uncommon in children but are more common in older adults. In some patients, volume depletion may result in mild to moderate azotemia. 

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