Re: [Gnumed-devel] one more vaccinations detail

[Hilmar Berger]

On Sat, 11 Sep 2004 12:01:46 +0200
Karsten Hilbert <address@hidden> wrote:

> > Your original question remains unanswered. In Australia the three shots can 
> > be 
> > separated by any time
> Aha ! So, it isn't unanswered after all :)
For hepatitis this seems quite clear:
http://www.cdc.gov/ncidod/diseases/hepatitis/a/quick_faq.pdf

> So all the anecdotal/incidental/intuitive/logical evidence we
> gathered so far points to considering any given shot as valid.
> So much the better since that's far easier to code (and is
> exactly what the current code does...).
... but given the fact that the immunogenicity of vaccines is different and the 
immunity might depend on the peak antibody level reached after the given series 
("The magnitude of the antibody response induced by the primary vaccination 
series is predictive of antibody persistence, and a logarithmic decline of 
antibody levels occurs over time.", 
http://www.cdc.gov/mmwr/preview/mmwrhtml/00033405.htm) I would not say that 
this is valid for all vaccinations (why do we booster tetanus, then ?). 

This is one point where the implemented logic should be based on evidence, i.e. 
if we want to automatically deduce the recommended action we will have to find 
facts/expert opionion for every case first. 

Hilmar