Survey on HBV Immunisation Status among the Dental Practitioners

Introduction: There are more than 2 billion people worldwide who have evident recent or past HBV infection and chronic cases. Hepatitis B, C and D are transmitted by parental contact with infected body fluids including blood, semen, saliva , sweat and tears , invasive medical procedures using equipment which are contaminated with the virus , vertical transmission. Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with immunisation such as from AIDS/HIV and those born premature. It is also recommended that health-care workers be vaccinated. In healthy people routine immunisation results in more than 96% of the people being protected. Aim: The aim of this study is to know the immunisation status and knowledge and awareness among dental practitioners. Materials and Methods: A survey was designed to analyse the result. The questionnaire was prepared in Google Forms (online survey link) and was distributed to 100 dental practitioners. The responses were then collected and statistically analysed using SPSS software. Results and Discussion: After discussing the results of the present study, it was seen that many were aware of hepatitis B vaccine. Limitations of this are that the population is small. Limitations seen in this study can be included in future research for better spread of awareness among the general public. Conclusion: From the study we can conclude that the majority of the dental practitioners are aware of hepatitis B vaccine and are aware of their vaccination status of hepatitis B.

Fatal Tetanus in a Patient with Carcinoma of the Breast – A Case Report

Tetanus in patients with malignant wounds can be fatal. We report a case of a patient with carcinoma of the breast, with a malignant wound. She had applied native medication and approached us for pain management. She developed typical features of tetanus which despite prompt detection and management by the palliative care team, turned fatal. We further discuss the need to keep the possibility of the diagnosis in mind, educate the caregivers to be aware of the possibility of a toxic infection like tetanus that can occur in patients with open wounds, ascertain the immunisation status if possible and conclude by reiterating the conclusions of other authors that prophylactic tetanus immunisation for those with malignant wounds could be effective in reducing the resultant morbidity-mortality.

Promoting Vaccination from a Human Rights and Equity Perspective: Lessons from the Israeli “Green Pass”

Israel’s vaccination percentage was among the highest recorded worldwide. The Israeli government opted for a model using a proof-of-vaccine document (“Green Pass”). However, the “Green Pass” policy raises practical, legal and ethical concerns. While immunisation passports could be utilised to protect one’s health, significant legal difficulties arise from their usage as a vaccination encouragement scheme. Protecting health is a proper purpose, particularly as minimising the pandemic ameliorates the human rights violations that stem from the COVID-19 response, enables individuals to return to their daily lives and enhances economic activity. However, any privileges or restrictions guided by one’s COVID-19 immunisation status must be designed with the utmost attention to prevent a disproportionate violation of the human rights of the non-vaccinated and the public at large. Furthermore, as “Green Pass” policies might entrench existing discriminatory structures, ensuring equality is vital in moving forward. By exploring two case studies – labour rights and the right to privacy – we demonstrate the legal and public implications of the “Green Pass” regime. Despite the removal of the “Green Pass” in Israel, discussions continue regarding its modified reimplementation. The wider implications of the model might extend beyond its specific legal arrangements and limited temporal phase, requiring us to bring long-term public health into consideration.

Immunisation status against major diseases preventable with vaccines in multiple sclerosis patients

Background Multiple sclerosis (MS) patients are more susceptible to infections than the general population due to the utilization of immunosuppressive drugs (DMDs) which require particular attention to the occurrence of infectious events. So, immunisation policies are mandatory or recommended. Methods In this pilot study, subjects receiving a diagnosis of relapsing-remitting MS since 2011 at a MS center in central Italy were enrolled. The immunization status against major infectious agents and safety of most used vaccines were recorded. Results 103 patients (67% females), mean age 42 years, with no or mild disability (85%) were examined. The majority received vaccines against poliomyelitis (92%), hepatitis B (47%), tetanus and diphtheria (89%), but a small percentage got boosters every 10 years (31% for tetanus and 28% for diphtheria); other vaccines evaluated: pertussis (37%), mumps (23%), meningococcus B, C (5%), flu (1%). Evaluating immunization status due to vaccines or illnesses, a significant percentage of patients using immunosuppressive drugs was susceptible to infections, such as measles (44%), chicken pox (32%) and rubella (65%). Only 17% of patients were vaccinated after diagnosis and, regarding vaccine safety, only 1 had a relapse within 6 months following measles, mumps and rubella vaccine. Conclusions This study shows a very low number of vaccinations among patients, confirming the need of preventive information on their importance and safety for MS patients: major adverse events of therapy in MS include severe infections and the majority of patients are female in reproductive age. This pilot phase was followed by an ongoing study involving 25 Italian MS Centers and 3000 patients that will provide in 2022 useful results on vaccination policies and safety. The knowledge of immunisation status is crucial for the clinical practice in the management of DMDs, and for the public health policies for a vaccine campaign targeted to MS patients. Key messages Lack of information on vaccine safety bring to a low adherence to immunization program. The immunization status of patients is essential for a correct management of therapies.

Discrepancies between Vaccine Documentation and Serologic Status for Diphtheria, Tetanus, and Hepatitis B in Internationally Adopted Children

Internationally Adopted Children (IAC) often show suboptimal immunisation coverage, but available data are discordant. Data at the first evaluation of 2073 IAC (median age: 6 years) referred to the Meyer Children’s University Hospital (Florence, Italy) in 2009–2019 were analysed in order to evaluate their immunisation status against diphtheria, tetanus, and hepatitis B. Negative antibody titres were observed in 11.5% of the IAC for diphtheria, 18.6% for tetanus, and 39.0% for hepatitis B. At multivariate analysis, originating from Africa was an independent risk factor for seronegativity for the three diseases (p < 0.001), while age below four years was an independent factor associated with protective immunity, only considering hepatitis B (p < 0.001). Vaccine documentation was an additional factor independently associated with protective immunity. However, a discrepancy between documentation (indicating previous vaccinations) and serology (showing negative antibody titres) was evidenced in 3.8% of the children for diphtheria, 12.6% for tetanus, and 29.6% for hepatitis B. This finding suggests that although vaccine documentation may reflect the presence of protective antibody titres, it should not be accepted as absolute evidence of protective immunity, underlining the importance of a complete assessment of immunisation status in IAC, particularly in those originating from Africa and aged over four years.