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1.
Stephanie Pepin Martin Dupuy Charissa Fay Corazon Borja-Tabora May Montellano Lulu Bravo Jaime Santos Jo-Anne de Castro Doris Maribel Rivera-Medina Clare Cutland Miguel Ariza Javier Diez-Domingo Celia Diaz Gonzalez Federico Martinón-Torres Efimia Papadopoulou-Alataki Maria Theodoriadou Marie Pierre Kazek-Duret Sanjay Gurunathan Iris De Bruijn 《Vaccine》2019,37(13):1876-1884
Background
A quadrivalent split-virion inactivated influenza vaccine (VaxigripTetra?, Sanofi Pasteur; IIV4) containing two A strains (H1N1 and H3N2) and B strains from both lineages (Victoria and Yamagata) was approved in Europe in 2016 for individuals aged?≥?3?years. This study examined the efficacy and safety of IIV4 in children aged 6–35?months.Methods
This was a phase III randomised controlled trial conducted in Latin America, Asia, Africa, and Europe during the Northern Hemisphere 2014/2015 and 2015/2016 and Southern Hemisphere 2014 and 2015 influenza seasons. Healthy children aged 6–35?months not previously vaccinated against influenza were randomised to receive two full doses 28?days apart of IIV4, placebo, the licensed trivalent split-virion inactivated vaccine (IIV3), an investigational IIV3 containing a B strain from the alternate lineage. The primary objective was to demonstrate efficacy against influenza illness caused by any strain or vaccine-similar strains.Results
The study enrolled 5806 participants. Efficacy, assessed in 4980 participants completing the study according to protocol, was demonstrated for IIV4. Vaccine efficacy was 50.98% (97% CI, 37.36–61.86%) against influenza caused by any A or B type and 68.40% (97% CI, 47.07–81.92%) against influenza caused by vaccine-like strains. Safety profiles were similar for IIV4, placebo, and the IIV3s, although injection-site reactions were slightly more frequent for IIV4 than placebo.Conclusions
IIV4 was safe and effective for protecting children aged 6–35?months against influenza illness caused by vaccine-similar or any circulating strains.Clinical trial registration
EudraCT no. 2013-001231-51. 相似文献2.
Cristina Andrés Paula Peremiquel-Trillas Laura Gimferrer Maria Piñana Maria Gema Codina José Ángel Rodrigo-Pendás Magda Campins-Martí María Carmen Martín Francisco Fuentes Susana Rubio Tomàs Pumarola Andrés Antón 《Vaccine》2019,37(18):2470-2476
Background
Influenza viruses (FLUV) are continuously evolving, which explain the occurrence of seasonal influenza epidemics and the need to review the vaccine strain composition annually. The aim is to describe the genetic diversity and clinical outcomes of FLUV detected at a tertiary university hospital in Barcelona (Spain) during the 2012–2016 seasons.Methods
The detection of FLUV from patients attended at the Emergency Department or admitted to the hospital was performed by either immunofluorescence or PCR-based assays. A specific real-time one-step multiplex RT-PCR was performed for influenza A (FLUAV) subtyping. The complete coding haemagglutinin domain 1 (HA1) and neuraminidase (NA) (2015–2016) protein sequences from a representative sampling were molecular characterised.Results
A total 1774 (66.1%) FLUAV and 910 (33.9%) influenza B (FLUBV) cases were laboratory-confirmed. The hospitalisation rate was different between seasons, being the highest (81.4%) during the 2014–2015 season. FLUV were genetically close to vaccine strains except to the 2014–2015, in which most characterised A(H3N2) viruses belonged to a genetic group different from the vaccine strain. During the 2015–2016 season, B/Victoria-like viruses were the most predominant, but this component was not included in the trivalent vaccine used. Mutations D222G or D222N in HA1-domain were found in 3 A(H1N1)pdm09 strains from ICU-admitted cases. Three A(H1N1)pdm09 strains carried the NA H275Y (2) and S247N (1) mutations, respectively related to resistance or decreased susceptibility to oseltamivir.Conclusions
The circulation of drifted A(H3N2) strains during the 2014–2015 season was related to the high hospitalisation rate due to the mismatch with the vaccine strains. The predominance of a FLUBV lineage not included in the trivalent influenza vaccine during the 2015–2016 season highlights the need to use a tetravalent influenza vaccine. Virological surveillance of viral variants carrying protein changes that alter tropism and susceptibility to antivirals features should be strengthened in hospital settings. 相似文献3.
Mohamed-Lemine Cheikh-brahim Ahmed Jorg Heukelbach Abdellahi Weddih Abdelkarim Filali-Maltouf Mariem Sidatt Khattry Makhalla Sid&#x;Ahmed Dahdi Aly Cheybany Cheikh Ahmed Mohamed Val El-Mami Jacqueline E. Tate Umesh D. Parashar Mohammed Benhafid 《Vaccine》2019,37(11):1407-1411
Introduction
Rotavirus vaccine was introduced in Mauritania in December 2014. We investigated hospitalizations with diarrhea during pre and post-vaccination periods among children aged 0–5?years in Nouakchott, the capital of Mauritania.Methods
We conducted a retrospective review of hospital admission registries from November 1st 2012 through October 31th 2017 at all referral hospitals in Nouakchott. We described admissions of children aged 0–5?years by diagnosis, data of admission, age and sex, and compared the proportion of all childhood hospitalizations with diarrhea before and after rotavirus vaccine introduction.Results
In total, 6552 (19%) of all 34,329 hospitalizations in 0–5?year-olds had diarrhea. Of these, 3523/16,952 (20.7%) were recorded during the pre-vaccine period, 1373/6897 (19.9%) during the transition period (November 2014-October 2015), and 1656/10,480 (15.8%) during the post-vaccination period. The proportion of all childhood hospitalizations with diarrhea during the pre-vaccine period was 22.6% among males and 18.7% among females. Approximately one third (32.3%) of hospitalizations with diarrhea occurred in children aged 6–11?months. During the post-vaccination period, the proportion of hospitalizations with diarrhea declined by 24%, and the highest reduction (74%) was observed in children aged 2 to 5?years (P?<?0.001).Conclusions
The proportion of childhood hospitalizations with diarrhea in Nouakchott was reduced by about one fourth after introduction of rotavirus vaccination in Mauritania, indicating a major impact for public health for children in the capital city. 相似文献4.
Background
Pregnant women are at increased risk of hospitalization, serious complications, poor pregnancy outcomes, and mortality from influenza. Prior research suggests that there are racial/ethnic disparities in vaccination coverage and that a healthcare provider vaccination recommendation is associated with significantly higher vaccine uptake than without such a recommendation. The purpose of this study is to examine racial/ethnic disparities in healthcare providers’ recommendations for pregnant women to receive the influenza vaccine and in vaccine uptake.Methods
This cross-sectional population-based study analyzed data from the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS) during 2012–2015 (n?=?130161). Both healthcare provider recommendation and vaccine uptake were assessed dichotomously. Logistic regression was conducted to ascertain adjusted odds ratios and 95% confidence intervals, controlling for maternal age, marital status, education, prenatal care utilization, and smoking status.Results
Influenza vaccine uptake during pregnancy ranged from 39.1% among non-Hispanic (NH) Black women to 55.4% among NH Asian women. In the adjusted analysis, NH Black and NH Asian women had 19% (95% CI 0.75–0.86) and 34% (95% CI 0.61–0.72) decreased odds of receiving a provider recommendation for influenza vaccine during pregnancy, respectively, compared to NH White women. For influenza vaccine uptake, NH Black women were 30% less likely (95% CI 0.65–0.74) to receive influenza vaccine during pregnancy compared to NH White women.Conclusions
Our findings indicate that there are racial/ethnic disparities in healthcare provider recommendation and influenza vaccine uptake among pregnant women in the United States. Targeted efforts toward providers and interventions focusing on pregnant women may be warranted to reduce the disparity. 相似文献5.
Annette K. Regan James E. Fielding Monique B. Chilver Kylie S. Carville Cara A. Minney-Smith Kristina A. Grant Chloe Thomson Trish Hahesy Yi-Mo Deng Nigel Stocks Sheena G. Sullivan 《Vaccine》2019,37(19):2634-2641
Background
We estimated the effectiveness of seasonal inactivated influenza vaccine and the potential influence of timing of immunization on vaccine effectiveness (VE) using data from the 2016 southern hemisphere influenza season.Methods
Data were pooled from three routine syndromic sentinel surveillance systems in general practices in Australia. Each system routinely collected specimens for influenza testing from patients presenting with influenza-like illness. Next generation sequencing was used to characterize viruses. Using a test-negative design, VE was estimated based on the odds of vaccination among influenza-positive cases as compared to influenza-negative controls. Subgroup analyses were used to estimate VE by type, subtype and lineage, as well as age group and time between vaccination and symptom onset.Results
A total of 1085 patients tested for influenza in 2016 were included in the analysis, of whom 447 (41%) tested positive for influenza. The majority of detections were influenza A/H3N2 (74%). One-third (31%) of patients received the 2016 southern hemisphere formulation influenza vaccine. Overall, VE was estimated at 40% (95% CI: 18–56%). VE estimates were highest for patients immunized within two months prior to symptom onset (VE: 60%; 95% CI: 26–78%) and lowest for patients immunized >4?months prior to symptom onset (VE: 19%; 95% CI: ?73–62%).Discussion
Overall, the 2016 influenza vaccine showed good protection against laboratory-confirmed infection among general practice patients. Results by duration of vaccination suggest a significant decline in effectiveness during the 2016 influenza season, indicating immunization close to influenza season offered optimal protection. 相似文献6.
7.
Stephanie Pepin Sandrine I. Samson Fabian P. Alvarez Martin Dupuy Viviane Gresset-Bourgeois Iris De Bruijn 《Vaccine》2019,37(13):1885-1888
Background
A multi-season phase III trial conducted in the Northern and Southern Hemispheres demonstrated the efficacy of a quadrivalent split-virion inactivated influenza vaccine (IIV4) in children 6–35?months of age.Methods
Data collected during the phase III trial were analysed to examine the vaccine efficacy (VE) of IIV4 in preventing laboratory-confirmed influenza in age subgroups and to determine the relative risk for IIV4 vs. placebo for severe outcomes, healthcare use, and parental absenteeism from work associated with laboratory-confirmed influenza.Results
VE (95% confidence interval [CI]) to prevent laboratory-confirmed influenza due to any A or B strain was 54.76% (40.24–66.03%) for participants aged 6–23?months and 46.91% (23.57–63.53%) for participants aged 24–35?months. VE (95% CI) to prevent laboratory-confirmed influenza due to vaccine-similar strains was 74.51% (53.55–86.91%) for participants aged 6–23?months and 59.78% (19.11–81.25%) for participants aged 24–35?months. Compared to placebo, IIV4 reduced the risk (95% CI) by 31.28% (8.96–89.34%) for acute otitis media, 21.76% (6.46–58.51%) for acute lower respiratory infection, 40.80% (29.62–55.59%) for healthcare medical visits, 29.71% (11.66–67.23%) for parent absenteeism from work, and 39.20% (26.89–56.24%) for antibiotic use.Conclusion
In children aged 6–35?months, vaccination with IIV4 reduces severe outcomes of influenza as well as the associated burden for their parents and the healthcare system. In addition, vaccination with IIV4 is effective at preventing against influenza in children aged 6–23 and 24–35?months.Trial registration: EudraCT no. 2013-001231-51. 相似文献8.
Abdinasir Abubakar Nada Melhem Mamunur Malik Ghassan Dbaibo Wasiq Mehmood Khan Hassan Zaraket 《Vaccine》2019,37(12):1601-1607
Background
The World Health Organization recommends annual influenza vaccination, especially in high-risk groups. Little is known about the adoption and implementation of influenza vaccination policies in the Eastern Mediterranean Region.Methods
A survey was distributed to country representatives at the ministries of health of the 22 countries of the Region between December 2016 and February 2017 to capture data on influenza immunization policies, recommendations, and practices in place.Results
Of the 20 countries that responded to the survey, 14 reported having influenza immunization policies during the 2015/2016 influenza season. All countries with an influenza immunization policy recommended vaccination for people with chronic medical conditions, healthcare workers and pilgrims. Two of the 20 countries did not target pregnant women. Eight countries used the northern hemisphere formulation, one used the southern hemisphere formulation and nine used both. Vaccination coverage was not monitored by all countries and for all target groups. Where reported, coverage of a number of target groups (healthcare workers, children) was generally low. Data on the burden of influenza and vaccine protection are scarce in the Region.Conclusions
Despite widespread policy recommendations on influenza vaccination, attaining high coverage rates remains a challenge in the Eastern Mediterranean Region. Tackling disparities in influenza vaccine accessibility and strengthening surveillance systems may increase influenza vaccine introduction and use. 相似文献9.
Darios Getahun Michael J. Fassett Morgan R. Peltier Harpreet S. Takhar Sally F. Shaw Theresa M. Im Vicki Y. Chiu Steven J. Jacobsen 《Vaccine》2019,37(13):1785-1791
Objective
Influenza vaccination during pregnancy is known to prevent severe influenza illness but its effects on other outcomes and the extent to which its safety is affected by timing of vaccination, maternal race/ethnicity and the type of vaccine is less clear. Therefore, we examined this in a large retrospective cohort.Methods
We analyzed medical and vaccination records from the Kaiser Permanente Southern California (KPSC) records and from the Kaiser Immunization Tracking System (2008–2016). The study included women who were pregnant with singletons during the influenza season. Odds ratios (OR) and their 95% confidence intervals (CI) were used to quantify the associations between immunization status during pregnancy and prenatal and postnatal outcomes after adjusting for confounders.Results
Of the 247,036 women in these analyses, 53% were vaccinated during their pregnancy. No association between influenza vaccination during pregnancy and adverse prenatal and neonatal outcomes were observed. Influenza vaccination is associated with reduced risk of influenza (OR: 0.49, 95% CI: 0.39–0.62), maternal fever (OR: 0.40, 95% CI: 0.35–0.45), preeclampsia (OR: 0.93, 95% CI: 0.90–0.96), placental abruption (OR: 0.89, 95% CI: 0.82–0.96), stillbirth (OR: 0.88, 95% CI: 0.78–0.99), and NICU admission (OR: 0.89, 95% CI: 0.87–0.92). Both active and inactive vaccines were found to be safe in vaccinated pregnant women regardless of timing of vaccination.Conclusions
This study found no evidence of adverse maternal and infant outcomes associated with seasonal influenza vaccine during pregnancy. On the contrary, vaccinated women were less likely to have adverse outcomes than unvaccinated women. The lack of increased adverse outcomes associated with influenza vaccination suggests that the benefits of vaccination during pregnancy to the woman and her child far outweigh any risk, if there is one, from the vaccination. 相似文献10.
Penina Haber Pedro L. Moro Carmen Ng Graça M. Dores Paige Lewis Maria Cano 《Vaccine》2019,37(11):1516-1520
Background
Trivalent adjuvanted influenza vaccine (aIIV3; Fluad®) was approved in the United States (U.S.) in 2015 for adults aged ≥65?years and has been in use since the 2016–17 influenza season.Methods
We analyzed U.S. reports for aIIV3 submitted from July 1, 2016 through June 30, 2018 to the Vaccine Adverse Event Reporting System (VAERS), a national spontaneous reporting system. Medical records were reviewed for serious reports. Among individuals ≥65?years of age, the relative frequency of the most commonly reported adverse events (AEs) after aIIV3 were compared with non-adjuvanted inactivated influenza vaccines given to adults aged ≥65?years, high-dose trivalent influenza vaccine (IIV3-HD) and trivalent or quadrivalent vaccines (IIV3/IIV4). Data mining analyses were undertaken to identify whether AEs for aIIV3 occurred disproportionately more than expected compared to all influenza vaccines.Results
VAERS received 630 reports after aIIV3, of which 521 (83%) were in adults aged ≥65?years; 79 (13%) in persons <65?years and in 30 (5%) reports age was missing; 19 (3%) reports were serious, including two deaths (0.4%) related to myocardial infarction and Sjogren’s syndrome. The most common AEs reported in adults aged ≥65?years were injection site pain (21%) and erythema (18%), with similar proportions reported for IIV3-HD (17% and 19%, respectively) and for IIV3/IIV4 (15%, each). Except for reports related to vaccination of inappropriate age (n?=?79) and syringe malfunction (n?=?6), data mining did not identify other disproportionately reported AEs.Conclusions
Although our review of aIIV3 in VAERS did not identify any unexpected health conditions of concern, we observed more than twice the expected number of reports with administration of the vaccine to persons outside of the age range for which the vaccine is approved in the U.S. Health care providers should be educated on the age groups for whom aIIV3 is recommended. 相似文献11.
Yanbing Zeng Zhipeng Yuan Jiahui Yin Yaofeng Han Cheng-I. Chu Ya Fang 《Vaccine》2019,37(11):1449-1456
Background
The impact of influenza in children under 5 can be severe and fatal. However, the influenza vaccination uptake in China remains suboptimal. The objectives of this study were to investigate parents’ perceptions on influenza vaccination and to assess vaccination promotional factors.Methods
A cross-sectional survey among 1506 parents with children in kindergarten was conducted in two areas with different policies: self-paid vaccination and free vaccination. The questionnaire was based on the structure of the Health Belief Model (HBM). Multiple logistic regression was used to analyze the determinants of parental vaccination intention. Odds ratios (OR) and respective 95% confidence intervals (95% CI) are reported.Results
Within the free policy group versus the non-free group, vaccination intention rates were 76.3% versus 83.4%, and vaccination rates were 34.2% versus 3.1%. Results from multivariate analysis showed that parents with high scores for perceived susceptibility (OR?=?1.44; 95% CI: 1.09–1.91), perceived benefits (OR?=?1.80; 95% CI: 1.30–2.50) and cues to action (OR?=?3.32; 95% CI: 2.47–4.46) were more likely to get their children vaccinated, while those perceived more barriers (OR?=?0.50; 95% CI: 0.37–0.68) had lower vaccination intention. More knowledge (OR?=?1.74; 95% CI: 1.18–2.56) and preferable attitudes (higher perceived necessity: OR?=?1.84; 95% CI: 1.53–2.22; less safety worry: OR?=?1.35; 95% CI: 1.10–1.66) were associated with significantly higher vaccination intention. Adjusted for parents’ gender, age, education, income and children’s age, the same significant factors were found. Parental intention was found to be influenced by different vaccination policies. Under a free policy, past influenza vaccination uptake (OR?=?4.52; 95% CI: 1.07–19.02) greatly promoted parents’ willingness to vaccinate their children.Conclusion
Parents had high intention to get their kindergarten children vaccinated with the influenza vaccine in spite of the low uptake rate. Our results indicate that offering free influenza vaccines and parental education over the next years may increase the influenza vaccination rate. 相似文献12.
Sung-Ching Pan Szu-Min Hsieh Chih-Feng Lin Yu-Shen Hsu Mingi Chang Shan-Chwen Chang 《Vaccine》2019,37(14):1994-2003
Background
A nasal influenza vaccine has been available only in a live attenuated form, which limits the range of recipients to immune-competent individuals. The present study evaluated a newly developed intranasal inactivated influenza vaccine with a novel adjuvant, heat-labile enterotoxin (LT) derived from E. coli (LTh(αK)).Methods
The study was a randomized, double-blind, controlled phase I trial to evaluate the safety and immunogenicity of an intranasal vaccine containing the trivalent influenza HA antigen (7.5?µg each of A/California/7/09 (H1N1)-like virus, A/Victoria/210/2009 (H3N2) virus, and B/Brisbane/60/2008-like virus) in combination with 4 different doses of adjuvant LTh(αK) (7.5, 15, 30 or 45?μg) and 22.5?μg of influenza HA antigen alone (control vaccine). The vaccine was intranasally administered on Days 0 and 7. A safety evaluation commenced for 180?days, and hemagglutination inhibition (HI) antibody titers and nasal HA-specific IgA titers on Day 0 and Day 28 were assessed to determine whether an immunogenic response was elicited.Results
From November 2012 to September 2013, a total of 36 subjects were enrolled. Twenty-four subjects received an adjuvanted vaccine, and 12 subjects received a control vaccine. The most common adverse event (AE) was mild nasal discomfort, and systemic AEs were mild fatigue and headache. Only two subjects discontinued the study because of an AE (one had grade 3 fever, and one had nodal arrhythmia). In the group with 45?μg of LTh(αK), the seroprotection rates were 100%, 100% and 80%, and the nasal IgA conversion factors were 7.90, 7.46 and 12.27 for the A/H3N2, A/H1N1 and split B strains, respectively. Adjuvant LTh(αK) vaccine showed a significant enhancement in mucosal immunity in split B -specific IgA.Conclusion
The intranasal inactivated influenza vaccine is generally safe, and the LTh(αK)-adjuvanted vaccine is more immunogenic than non-adjuvanted control vaccine.ClinicalTrials.gov Identifier: NCT03293732. 相似文献13.
Background
The current Ebola outbreak in Eastern Democratic Republic of the Congo (DRC) is the second largest in history and the first in which the recombinant Vesicular Stomatitis Virus – Zaire Ebolavirus (rVSV-ZEBOV) vaccine has been used at scale. We assessed side-effects, satisfaction, and attitudes toward the new vaccine.Methods
Cross-sectional survey questionnaire from a convenience sample of 90 vaccine recipients and 96 community controls in Eastern DRC.Results
Side-effects were reported in 75/90 (83%) vaccine recipients but only 5 (7%) and 4 (5%) reported arthralgia and rash, respectively. 76/90 (84%) vaccinees were classified as “promoters” (would recommend vaccine to others) and 6/90 (7%) as “detractors.” 69/96 (72%) of unvaccinated community controls would wish to be vaccinated if supply were available. 153/186 (82%) would accept vaccination for family members.Conclusions
The rVSV-ZEBOV vaccine was well tolerated, with high acceptability in the community during the current outbreak in the DRC. 相似文献14.
Daniel A. Norman Margie Danchin Paul Van Buynder Hannah C. Moore Christopher C. Blyth Holly Seale 《Vaccine》2019,37(16):2244-2248
Background
Influenza vaccination is recommended and funded for Australian children with medical comorbidities that increase their risk of severe influenza. Despite this, influenza vaccine coverage remains low within this population. We examined caregivers’ attitudes and practices for influenza vaccination in children with medical comorbidities.Methods
Cross-sectional surveys were conducted with caregivers of children (6?months to <18?years old) with medical comorbidities attending sub-speciality paediatric outpatient clinics at the Royal Children’s Hospital (Melbourne), Princess Margaret Hospital (Perth), and Leading Steps private paediatric clinic (Gold Coast). Multivariate linear regression was used to identify surveys responses predictive of receipt of influenza vaccination in 2017.Results
From the 611 surveys collected, 556 were suitable for analysis. Caregiver reported 2017 influenza vaccine coverage was 52.2% in children with medical comorbidities. Caregivers who believed influenza vaccines to be ≥50% effective were more likely to vaccinate their children (adjusted Odds Ratio [aOR]:3.79 (2.41; 5.96). Those who expressed concerns about vaccine side effects were less likely to vaccinate their children (aOR: 0.49 [95% CI: 0.30; 0.80]). Influenza vaccine uptake was significantly more likely for children who had been previously recommended influenza vaccination by their hospital-based physician (aOR: 4.33 [95% CI: 2.58; 7.27]) and had previously received a hospital-based vaccination (aOR: 3.11 [95% CI 1.79; 5.40]). Hospital-based physicians were also caregivers’ most commonly reported source of trusted vaccination information (63.5%). Whilst only 29.3% of caregivers reported their child had been recommended influenza vaccination during a previous admission, 80.1% of caregivers stated they were receptive to their child receiving potential future influenza vaccinations during hospitalisations.Conclusions
Reported influenza vaccination coverage in children with medical comorbidities remains inadequate. An important finding of this study is that influenza vaccination recommendation by children’s hospital physicians and previous vaccine receipt in hospital was associated with vaccine uptake. Opportunities for vaccination, especially during hospitalisation, must be examined. 相似文献15.
Sarah E Wilson Laura C Rosella Jun Wang Ariane Renaud Nicole Le Saux Natasha S Crowcroft Shalini Desai Tara Harris Shelly Bolotin Jonathan Gubbay Shelley L Deeks 《Vaccine》2019,37(17):2408-2414
Background
Ontario implemented a publicly-funded rotavirus (RV) immunization program in 2011. Our objectives were to evaluate its impact on hospitalizations and emergency department (ED) visits for acute gastroenteritis (AGE) five years after implementation.Methods
We performed a population-based longitudinal retrospective cohort study to identify hospitalizations and ED visits for RV-AGE and overall AGE in all age groups using ICD-10 codes between August 1, 2005 and March 31, 2016. A negative binomial regression model that included the effect of time was used to calculate rates, rate ratios (RRs) and 95% confidence intervals (CIs) for AGE before and after the program’s implementation, after adjusting for age, seasonality and secular trends. We examined the seasonality of RV-AGE hospitalizations among children under five before and after the program and explored its equity impact.Results
Following program implementation, RV-AGE hospitalizations and ED visits among children under five years declined by 76% (RR 0.24, 95% CI 0.20–0.28) and 68% (RR 0.32, 95% CI 0.21–0.50), respectively. In addition, hospitalizations and ED visits for overall AGE declined by 38% (RR 0.62, 95% CI 0.59–0.65) and 26% (RR 0.74, 95% CI 0.73–0.76), respectively, among children under age five. Significant reductions in both outcomes were also found across a range of age-strata. In the pre-program period, the mean monthly hospitalization rate for RV-AGE among children residing in the most marginalized neighbourhoods was 33% higher than those residing in the least marginalized (RR 1.33, 95% CI 1.17–1.52), this disparity was not evident in the program period (RR 0.95, 95% CI 0.69–1.32). We found no evidence of a seasonal shift in rotavirus pediatric hospitalizations.Interpretation
The introduction of routine infant rotavirus immunization has had a substantial population impact in Ontario. Our study confirms herd effects and suggests the program may have reduced previous inequities in the burden of pediatric rotavirus hospitalizations. 相似文献16.
Su He Wang Douglas Smith Zhengyi Cao Jesse Chen Hugo Acosta Jessica A. Chichester Vidadi Yusibov Stephen J. Streatfield Ali Fattom James R. Baker 《Vaccine》2019,37(12):1591-1600
Background
Highly pathogenic H5N1 influenza viruses remain a pandemic risk to the world population. Although vaccines are the best solution to prevent this threat, a more effective vaccine for H5 strains of influenza has yet to be developed. All existing vaccines target only serum antibody against influenza as the primary outcome, while mucosal immunity has not been addressed. To address these shortcomings we have used an effective mucosal adjuvant system to produce a prototype vaccine that provides antibody, cellular and mucosal immunity to multiple serotypes of H5.Methods
Plant-derived recombinant H5 (rH5) antigen was mixed with a novel nanoemulsion NE01 adjuvant. The rH5-NE01 vaccine was administered intranasally to CD-1 mice and ferrets. Immunogenicity of this immunization was evaluated through rH5-specific antibody and cellular immune responses. Hemagglutination inhibition (HI) and virus neutralization (VN) assays were performed. Protection against H5N1 virus challenge was evaluated in ferrets.Results
Intranasal immunization with rH5-NE01vaccine induced high titers (>106) of rH5-specific IgG in mice. In mice and ferrets this vaccine also achieved titers of ≥40 for both HI and VN. Additionally, the levels of rH5-specific IgA were significantly increased in bronchial secretions in these animals. The rH5-NE01 vaccine enhanced rH5-specific cellular immune responses including IFN-γ and IL-17. Ten-day survival post challenge was 100% in ferrets that received rH5-NE01compared to 12.5% in the PBS group. Furthermore, this vaccine prevented weight loss and increases in body temperature after H5N1 challenge as compared to the controls. Moreover, H5N1 virus in nasal wash of rH5-NE01-vaccinated ferrets was significantly decreased compared to controls.Conclusion
Intranasal immunization with rH5 antigen formulated with NE01 adjuvant elicited strong, broad and balanced immune responses that effectively protect against H5N1 influenza virus infection in the ferret model. The ease of formulation of rH5-NE01 makes this novel combination a promising mucosal vaccine candidate for pandemic influenza. 相似文献17.
Zeyuan Wang Zhuotian Li Xiang Su Yiyi Qiao Weifeng Fan Haibin Li Baolan Shi Tao Qin Sujuan Chen Daxin Peng Xiufan Liu 《Vaccine》2019,37(13):1736-1742
Background
Antigenic drift of H9N2 low pathogenic avian influenza viruses (AIV) may result in vaccination failure in the poultry industry and thus a cross-protective vaccine against H9N2 AIV is highly desirable.Methods
A series of H9N2 recombinant viruses with the internal genes of A/Puerto Rico/8/34 (H1N1, PR8) were generated, based on the compatibility between HA and NA, the effect of HA deglycosylation, and protective antigenic epitopes in HA. After evaluation of their biological and immunological characteristics, three recombinant AIVs with the internal genes of the Y280-like strain SN were selected for protective efficacy studies.Results
The recombinant viruses rHASNNA3, rHASN-△200, rHASN-△287, and rHASN-R92G-E93K displayed good cross reactivity and induced higher neutralization antibody titers against both SN and the F98-like strain YZ4. Furthermore, those recombinant viruses had a higher EID50 in chicken embryos after the replacement of internal-gene backbone from PR8 to SN. The rSNHA-△200 induced better protection in immunized chickens against challenge of homologous and heterologous H9N2 avian influenza viruses when compared with the wild type strain.Conclusion
The recombinant virus rSNHA-△200 can be used as a potential broad-spectrum vaccine against H9N2 avian influenza. 相似文献18.
Carlos Fritzsche Lisa Bergmann Micha Loebermann Aenne Glass Emil C. Reisinger 《Vaccine》2019,37(16):2278-2283
Objectives
The aim of this study was to evaluate the impact of various factors that may influence the immunologic response to hepatitis A mono-vaccine or hepatitis A/B co-vaccine (Twinrix®) in HIV-infected patients.Design
Retrospective cross-sectional study.Methods
HIV positive patients with a full course of hepatitis A vaccine were tested for HAV antibodies. The seroconversion rates were determined, and the influence of several factors including CD4 cell counts, CD4/CD8 ratio, plasma viral load, type of vaccine, and antiretroviral therapy at the time of vaccine, was evaluated.Results
After vaccination, 80.2% of the patients developed anti-HAV antibodies, 81.5% in the mono-vaccine group and 79.2% in the hepatitis A/B co-vaccine group. In the mono-vaccine group, factors significantly associated with a better response to the vaccine were higher CD4 cell count, higher CD4/CD8 ratio, and shorter time interval from vaccine to serological control. In patients who received the hepatitis A/B co-vaccine, younger age and female sex were significantly associated with better vaccine response. Multivariable logistic regression analysis revealed time interval from vaccine to serological control of more than 5?years vs. less than 1?year to be significantly associated with decrease of seroconversion after HAV vaccine.Conclusions
The response to hepatitis A vaccine is impaired in HIV positive patients. HIV patients, at least those older than 30, should be tested for seroconversion after receiving the hepatitis A vaccine. As hepatitis A titers may rapidly decline, control serology during follow-up should be proposed, possibly within two years. However, vaccine type does not play a role in vaccine response. 相似文献19.
Fangjun Zhou Jing Xu Carla L. Black Helen Ding Bo-Hyun Cho Peng-Jun Lu Megan C. Lindley 《Vaccine》2019,37(14):1972-1977
Background
Infants younger than 6?months are at increased risk of complications and mortality from pertussis infection. In October 2012, the Advisory Committee on Immunization Practices revised its recommendation to include a Tdap dose during each pregnancy, ideally between 27 and 36?weeks gestation.Objective
Assess trends in Tdap vaccination coverage among privately insured pregnant women from 2009 to 2016 including timing of Tdap vaccination (before, during, or after pregnancy), trimester of vaccination for women vaccinated during pregnancy, and missed vaccination opportunities for unvaccinated women. Identify factors associated with vaccination during the optimal period of 27–36?weeks gestation.Study design
Retrospective analysis of privately insured women 15–49?years who delivered live births during 2009–2016 conducted using 2009–2016 MarketScan data. Tdap vaccination coverage and the timing of Tdap vaccine administration were assessed for women continuously enrolled from 6?months before pregnancy to 1?month after delivery. Multivariable logistic regression was performed to identify factors independently associated with receipt of Tdap vaccine at 27–36?weeks gestation.Results
Tdap vaccination coverage during pregnancy increased from 0.4% in 2009 to 6.2% in 2012 and to 53.2% in 2016. The proportion of vaccinated women receiving Tdap at 27–36?weeks gestation increased from <10% in 2009 to nearly 90% in 2016, with most vaccination occurring at 27–32?weeks gestation. Women of older age, residing in a metropolitan statistical area, residing outside the South, and having a capitated health insurance plan were more likely to receive Tdap at 27–36?weeks gestation than their counterparts. Among women not vaccinated during pregnancy, 77.7% had a pregnancy-related medical claim between 27 and 36?weeks gestation.Conclusion
Tdap vaccination coverage during pregnancy increased significantly from 2009 to 2016, with the greatest increase occurring after the revised Advisory Committee on Immunization Practices recommendation. Most women who did not receive Tdap vaccine had a missed vaccination opportunity during pregnancy, indicating potential for much higher vaccination coverage and consequent infant protection against pertussis. 相似文献20.
