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Respiratory syncytial virus (RSV) is a well-known infant pathogen transmitted mainly by droplets. It is a leading cause of upper respiratory tract infections in children, usually with a mild course of illness. RSV has also been a threat to older people, especially those with underlying medical conditions. For a long time, prevention was limited to passive immunoprophylaxis with palivizumab for high-risk infants. There was a strong need to find other treatment or prevention methods against RSV infections. In addition, after the coronavirus disease 2019 (COVID-19) pandemic, some significant changes in RSV epidemiology have been observed. Researchers noticed the shift in RSV seasonality and age distribution and the increased number of cases in older infants and adults. All of these made the need to find other medical options even stronger. Fortunately, two protein-based vaccines against RSV have successfully passed all phases of clinical trials and have been approved for use by adults and older people. One of them is also approved for infants from birth to 6 months of age (after maternal immunisation during pregnancy) and for pregnant women between 24 and 36 weeks of pregnancy. Also, a new passive immunisation option named nirsevimab (a highly potent monoclonal antibody with a long half-life) is now available for the paediatric group. In this review, we will discuss the previous and current RSV prevention methods in the light of structural discoveries of RSV antigens. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) was the predominant cause of death from a single infectious agent worldwide before the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic. Although TB vaccines have been successfully used for about 100 years, their full effect is still unknown. In previous studies, a reduced incidence and mortality from a coronavirus disease in TB-vaccinated populations were reported. In this article, we present the secondary analysis of a randomised controlled trial, reporting the results of a serological assessment evaluating the effect of the Bacillus Calmette–Guérin (BCG) vaccine on SARS-CoV-2. Participants—healthcare workers—were assessed 1–2 and 8 months after the second dose of the coronavirus disease 2019 (COVID-19) vaccine. We found no associations between antibody concentration, BCG revaccination, and additional characteristics, such as age, gender, or Body Mass Index. The effect of BCG vaccination on the immunological response against SARS-CoV-2 requires further research. [ABSTRACT FROM AUTHOR]

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the disease termed coronavirus disease 2019 (COVID-19), emerged in China in early December 2019. The virus has rapidly spread causing a global pandemic with a major burden on the health care system and economy. The outbreak was declared a public health emergency by the World Health Organisation on January 30, 2020. The presented guidelines describe the basic principles of outpatient care for children during the COVID-19 pandemic caused by SARS-CoV-2. The guidelines were developed based on the conducted literature review, content from websites of scientific societies, and international recommendations. This paper presents guidelines concerning the outpatient care for sick children, children with a documented SARS-CoV-2 infection, or for children of mothers with confirmed COVID-19. Moreover, the guidelines discuss aspects associated with vaccinations, preventive visits for healthy children, and the monitoring of a child's safety and mental health status. [ABSTRACT FROM AUTHOR]

Vaccinations in Poland and other industrialized countries have been in the firing line for more than two decades. Members of the "anti-vaccine movement" and alternative medicine supporters are openly reluctant to this form of preventing infectious diseases, however their arguments are not based on reliable medical data. Contrary to false theories, the threat of infectious diseases is not lower than in the past. What is more, it has escalated in recent years as a result of the increasing number of parents who avoid vaccinations. Nevertheless, erroneous arguments find a breeding ground among parents or guardians of children covered by vaccination programs undermining trust in vaccines in general. In this situation, it is the responsibility of: physicians who provide preventive care for children, administrative bodies responsible for implementing immunization but also medical schools and other healthcare institutions, on the one hand to raise the level of social awareness about the meaning of vaccination, and on the other to effectively oppose the anti-vaccine propaganda. The way to achieve these goals is to thoroughly understand social needs and constantly improve the professional qualifications of primary care physicians, midwives, community nurses and doctors of different specialties who have daily contact with children and their parents. The key area of focus should also be to place greater emphasis on education about the prevention of infectious diseases among students of all medical school faculties.

Introduction: patients treated with hematopoietic stem cell transplantation (HSCT) lose immune memory accumulated through a lifetime. They are at increased risk of developing infections with microorganisms such as Haemophilus influenza, Streptococcus pneumoniae and others for which vaccines are available. Therefore, all patients after HSCT should be routinely revaccinated. Systemic reimmunization after HSCT is a relatively neglected area especially in countries which have not national recommendations and there is lack of systemic regulations in health care system., Objective: the rate of immunization before transplantation and the persistence of vaccine-specific antibodies after HSCT was assessed., Study Design: a group of38 children after stem cell transplantation (19 autologous, 19 allogeneic) was studied., Results: only a few patients completed standard vaccination protocol before HSCT. At the median time of 29 (range: 6-67) months after autologous and 13 (range: 8-33) months after allogeneic HSCT, when the revaccination was commenced, the majority of children had concentration of antibody lower than the minimum protective thresholds. That was 82% for tetanus, 71% for Hib and varicella, 46% for HBV and 38% for diphtheria., Conclusions: all HSCT recipients should be routinely revaccinated to stimulate the immunity to the vaccine-preventable diseases.

Unlabelled: The aim of the study was the evaluation of safety and efficacy of vaccination in children after stem cell transplantation., Patients and Methods: 21 patients, 1.4-22 (average 7.8) years old, 13 boys and 8 girls after autologous (11-52%) and allogeneic (10-48%) transplantation were included in the vaccination protocol. Indications for transplantation were: neoplastic disease--16, immunodeficiencies--3 and aplastic anaemia 2 cases. Time between transplantation and beginning of vaccination protocol was 0.8-4 (average 1.5) years. Vaccination protocol was constructed on the basis of the European Group for Blood and Marrow Transplantation indications. We have evaluated: (1) quality of recipient immune reconstitution and protection against common pathogens (2) immunogenicity of revaccination schedule; (3) safety of the vaccination programme., Results: With the exception of one patient presenting with repeated fever, lymph node enlargement, muscle and joint pain, no important side effects were observed. Meningococcial meningitis developed in one patient who refused vaccination. The mean concentrations of antibodies in the plasma before and after vaccination were as follows: anti-diphteria (54; 2285), anti-tetanus (136; 3149) and anti-hepatitis B virus (anti-HBs: 24; 474) IU/ml., Conclusions: (1) Vaccination in patients after transplantation is efficient and well tolerated. (2) Significant increase of antibody level was detected. (3) Any delay in beginning the vaccination can result in life threatening complications.

Aim: The aim of the study was to become familiar with parents' and Medical Health Care specialists knowledge and attitude towards vaccinations. The influence of information, provided to patients from various sources, on general opinion about immunization and its coverage within the last year were evaluated., Materials and Methods: Analysis of questionnaires about vaccinations performed among 151 parents and 180 Medical Health Care specialists., Results: Medical Health Care specialists knowledge was considerably higher in comparison to questioned parents. Surprisingly enough, only approximately 90% of Medical Health Care workers knew about prophylaxis of Hib infections. A doctor is the main and the most reliable source of information for parents. Significant impact on parents' attitude to vaccinations is made not only by campaigns promoting vaccinations, but also by widespread opinions about their harmfulness., Conclusions: The doctor is the major source of reliable information about vaccinations for parents. Therefore, there is the need of continuous improvement of Medical Health Care specialists knowledge, but also the ability of successfully communicating it to parents.

Controversies on vaccinations refer to two fundamentally different areas. The public contestation refers first of all to the objective need, efficiencies and the safety of vaccinations. Results of reliable research and their metaanalyses published over the recent years confirmed none of claimed by antivaccinists dispraise including causalities among the vaccination and the autism, autoimmune or allergic diseases. The second area, wherein one observes disagreements on the subject of vaccinations, is discussions on of the efficiency of each vaccine, schemata of vaccinations, or else economic advantages from their usage. Result these discussions is the progress in the optimization of schemata, efficiencies and safeties of vaccinations. The more and more greater attention it goes at the standardization of the definition of events and the supervision over undesirable connected symptoms with the usage of vaccinations.

Introduction: The Paediatric Expert Group on the Immunization Programme was established in January 2007. It is an independent advisory body to the Minister of Health. The Expert Group consists of paediatricians from various sub-specialities. Most of them are members of the Polish Society of Vaccinology (Table I). The Group started their activities informally in 2005. The first project concerned changes in immunization against tuberculosis and prophylaxis of measles, mumps and rubella. The project was fully implemented in 2006. The changes initiated three years ago, gradually implemented in the Immunization Programme are a result of wide cooperation with the Ministry of Health, Department of Health Policy Chief Sanitory Inspector, as well as the Institute of Tuberculosis and Pulmonary Diseases. The aim of the Paediatric Expert Group on the Immunization Programme is to present a unified policy in matters related to vaccination, leading to rapid changes in the prophylaxis of infective diseases which are still a threat to the life and health of children.

The immunological system of premature newborns /preterm infants/ is a special challenge for specialists in infectious diseases prevention. The early beginning of immunization in this group is relevant to the necessity of the protection of the premature newborns, who have weaker immunity for infectious diseases than the group of infants born at term. But on the other hand there is justified fear for weaker protection and appearance of unexpected adverse events after immunization in this group of infants. In the review of medical literature covering these problems special attention was paid to the postimmunization response of premature newborns and to the antigens of the following diseases: tetanus, diphtheria, pertussis, poliomyelitis and pneumococci. Such factors as corticotherapy, blood transfusion or blood products may influence the immunization response. We also assessed the safety of immunisation for this group of high risk infants.

Stem cell transplantation is a procedure often used in treatment of proliferative and non-prolifarative diseases. Recipient's immunological system has been damaged during pretransplant and conditioning therapy: deprived from B- and T-cell mediated immunological response and memory cells. One of the prophylactic procedures against post-transplant infections in recipients is efficient and safe revaccination. In Poland so far there is no uniform revaccination schedule for stem cell transplantation recipients.

The combined vaccine against diphtheria, tetanus and pertussis containing the whole cell component of pertussis (DPTw) is characterized by high effectiveness but is also one of the most reactogenic vaccines. Adverse events following this vaccine includes a hypotonic-hyporesponsive episode, however this episode is not well known to general practitioners and pediatricians, so the data about its incidence are not reliable. The aim of this study was to characterize the clinical features of HHE following DTPw vaccine, to estimate the ability to diagnose this syndrome by GPs and pediatricians and to assess the registration system of HHE in Poland. The studied group consisted of 49 children, patients of the Regional Consultation Polyclinic in Kraków in the years 1997-2002, in whom HHE was diagnosed. The following were analysed: sex and age, interval between vaccination and HHE, relationship to the number of DTPw doses, duration of HHE and, based on the referral, the diagnosis made by a GP. The average age of children at the moment of HHE was 3.4 months, but 46/49 children were under 6 months. The symptoms of HHE occurred after a few minutes to 48 hours after vaccination and in two children similar episodes were observed on the 6th day after vaccination, which is not consistent with the definition of HHE. Most often HHE was observed after the first (21/49) and the second (16/49) dose of DTPw. In two children HHE occurred twice, after two consecutive doses of DTPw. In four cases only GPs referring patients have diagnosed HHE. Thirty children from the studied group were further vaccinated against diphtheria, tetanus and pertussis. 61 doses of DTPa (a vaccine with acellular pertussis component) were used and in no case was the adverse event observed. Based on the results obtained it has been concluded that some difficulties are observed in the diagnosis of HHE made by GPs and pediatricians, therefore the number of HHE cases registered in Poland decreased. Hypotonic-hyporesponsive episode should be taken into consideration in differential diagnosis of the nervous system diseases. Therefore, it is extremely important to ask parents about the history of vaccinations in their children.

A retrospective study was conducted among 205 children chosen from a group of 2728 children hospitalised in Neuroinfection Department of the John Paul 2nd Hospital In Cracow between 1/1/2002 and 6/30/2004. The data was taken from medical documentation from the Neuroinfection Department and Province Dispensary of Inoculation in the Hospital. Patients was divided into two groups: first one contained children from group of increased risk, patients hospitalised electively in the Dispensary to be under observation in hospital environment on day of execution of inoculation; and second one contained children sent to the Neuroinfection Department from other institutions in consequence of showed symptoms of adverse event following immunization (AEFI) Within both groups' causes of hospitalisation was determined and given types of vaccinations was qualified as the most often cause of hospitalisation. It appeared that predominantly cause of hospitalisation was misgivings about course of the inoculation process for children with neurological diseases, which had been inoculated DTaP according to plan. However the most often to cause AEFI was vaccination DTP with full-cell pertussis component.