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Takano T, Hirose M, Yamasaki Y, Hara M, Okada T, Kunishima H. Investigation of the incidence of immunisation stress-related response following COVID-19 vaccination in healthcare workers. J Infect Chemother 2022; 28:735-740. [PMID: 35190259 PMCID: PMC8825314 DOI: 10.1016/j.jiac.2022.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/06/2022] [Accepted: 02/04/2022] [Indexed: 12/27/2022]
Abstract
Introduction Safe vaccination worldwide is critical to end the coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate adverse reactions to vaccination using a web-based questionnaire and examine the risk factors for the occurrence of immunisation stress-related response (ISRR). Methods We conducted a questionnaire survey using Google Form® among the employees of St. Marianna University Hospital who had received the COVID-19 vaccine between April 2021 and May 2021, 1 week after the first and second vaccinations. We developed and used a questionnaire to identify individuals with ISRR according to the World Health Organization diagnostic criteria. A generalised linear mixed model was constructed with ISRR onset as the dependent variable, subjects as the random factor, and each parameter as a fixed factor. A multivariate model was constructed using the forced imputation method with factors that were significant in the univariate analysis. Results We enrolled 2,073 and 1,856 respondents in the first and second questionnaire surveys, respectively. Fifty-five and 33 ISRR cases were identified in the first and second vaccinations, respectively. In the univariate analysis, strong pre-vaccination anxiety (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.30–4.12, p = 0·004) and history of allergy (OR, 1.6; 95% CI, 1.14–2.24, p = 0·007) were significant risk factors. Multivariate analysis also showed that strong pre-vaccination anxiety (OR, 2.1; 95% CI, 1.15–3.80, p = 0.016) and history of allergy (OR, 1.5; 95% CI, 1.09–2.15, p = 0.014) were significant risk factors. Conclusions Confirmation of allergy prior to vaccination and subsequent action are essential for addressing ISRR.
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Affiliation(s)
- Tomonori Takano
- Department of Infectious Disease, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masanori Hirose
- Division of General Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yukitaka Yamasaki
- Department of Infectious Disease, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masatoshi Hara
- Division of Cardiology and Health Service Centre, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Tomoyuki Okada
- Department of Otolaryngology and Health Service Centre, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Disease, St. Marianna University School of Medicine, Kanagawa, Japan.
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102
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Vijayan V. Vaccines for International Pediatric Travelers. Pediatr Clin North Am 2022; 69:171-184. [PMID: 34794673 DOI: 10.1016/j.pcl.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The pretravel management of the international pediatric traveler is based on provision of preventive education, chemoprophylaxis against malaria and traveler's diarrhea, as well as travel vaccinations. Immunization requirements are determined based on the traveler's pretravel immunization status, age, medical history, and destination. Immunization needs also vary depending on the exposures during the trip. Potential exposure to water, insects, or animals as well as duration of travel will help tailor risk avoidance education and travel immunizations. This review provides clinicians an overview of vaccines recommended for children traveling internationally.
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Affiliation(s)
- Vini Vijayan
- Division of Pediatric Infectious Diseases, Valley Children's Healthcare, Madera, CA, USA; Stanford University School of Medicine, Stanford, CA, USA.
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103
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Holstein R, Dawood FS, O'Halloran A, Cummings C, Ujamaa D, Daily Kirley P, Yousey-Hindes K, Fawcett E, Monroe ML, Kim S, Lynfield R, McMullen C, Muse A, Bennett NM, Billing LM, Sutton M, Thomas A, Talbot HK, Schaffner W, Risk I, Reed C, Garg S. Characteristics and Outcomes of Hospitalized Pregnant Women With Influenza, 2010 to 2019 : A Repeated Cross-Sectional Study. Ann Intern Med 2022; 175:149-158. [PMID: 34958603 DOI: 10.7326/m21-3668] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Pregnant women may be at increased risk for severe influenza-associated outcomes. OBJECTIVE To describe characteristics and outcomes of hospitalized pregnant women with influenza. DESIGN Repeated cross-sectional study. SETTING The population-based U.S. Influenza Hospitalization Surveillance Network during the 2010-2011 through 2018-2019 influenza seasons. PATIENTS Pregnant women (aged 15 to 44 years) hospitalized with laboratory-confirmed influenza identified through provider-initiated or facility-based testing practices. MEASUREMENTS Clinical characteristics, interventions, and in-hospital maternal and fetal outcomes were obtained through medical chart abstraction. Multivariable logistic regression was used to evaluate the association between influenza A subtype and severe maternal influenza-associated outcomes, including intensive care unit (ICU) admission, mechanical ventilation, extracorporeal membrane oxygenation, or in-hospital death. RESULTS Of 9652 women aged 15 to 44 years and hospitalized with influenza, 2690 (27.9%) were pregnant. Among the 2690 pregnant women, the median age was 28 years, 62% were in their third trimester, and 42% had at least 1 underlying condition. Overall, 32% were vaccinated against influenza and 88% received antiviral treatment. Five percent required ICU admission, 2% required mechanical ventilation, and 0.3% (n = 8) died. Pregnant women with influenza A H1N1 were more likely to have severe outcomes than those with influenza A H3N2 (adjusted risk ratio, 1.9 [95% CI, 1.3 to 2.8]). Most women (71%) were still pregnant at hospital discharge. Among 754 women who were no longer pregnant at discharge, 96% had a pregnancy resulting in live birth, and 3% experienced fetal loss. LIMITATION Maternal and fetal outcomes that occurred after hospital discharge were not captured. CONCLUSION Over 9 influenza seasons, one third of reproductive-aged women hospitalized with influenza were pregnant. Influenza A H1N1 was associated with more severe maternal outcomes. Pregnant women remain a high-priority target group for vaccination. PRIMARY FUNDING SOURCE Centers for Disease Control and Prevention.
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Affiliation(s)
- Rachel Holstein
- Centers for Disease Control and Prevention, Atlanta, Georgia (R.H., F.S.D., A.O., C.C., C.R., S.G.)
| | - Fatimah S Dawood
- Centers for Disease Control and Prevention, Atlanta, Georgia (R.H., F.S.D., A.O., C.C., C.R., S.G.)
| | - Alissa O'Halloran
- Centers for Disease Control and Prevention, Atlanta, Georgia (R.H., F.S.D., A.O., C.C., C.R., S.G.)
| | - Charisse Cummings
- Centers for Disease Control and Prevention, Atlanta, Georgia (R.H., F.S.D., A.O., C.C., C.R., S.G.)
| | - Dawud Ujamaa
- Centers for Disease Control and Prevention, Atlanta, Georgia, and General Dynamics Information Technology, Falls Church, Virginia (D.U.)
| | - Pam Daily Kirley
- California Emerging Infections Program, Oakland, California (P.D.K.)
| | - Kimberly Yousey-Hindes
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut (K.Y.)
| | - Emily Fawcett
- Emerging Infections Program, Georgia Department of Health, and Veterans Affairs Medical Center, Atlanta, Georgia, and Foundation for Atlanta Veterans Education and Research, Decatur, Georgia (E.F.)
| | - Maya L Monroe
- Maryland Department of Health, Baltimore, Maryland (M.L.M.)
| | - Sue Kim
- Michigan Department of Health and Human Services, Lansing, Michigan (S.K.)
| | - Ruth Lynfield
- Minnesota Department of Health, St. Paul, Minnesota (R.L.)
| | | | - Alison Muse
- New York State Department of Health, Albany, New York (A.M.)
| | - Nancy M Bennett
- University of Rochester School of Medicine and Dentistry, Rochester, New York (N.M.B.)
| | | | | | - Ann Thomas
- Oregon Health Authority, Portland, Oregon (M.S., A.T.)
| | - H Keipp Talbot
- Vanderbilt University School of Medicine, Nashville, Tennessee (H.K.T., W.S.)
| | - William Schaffner
- Vanderbilt University School of Medicine, Nashville, Tennessee (H.K.T., W.S.)
| | - Ilene Risk
- Salt Lake County Health Department, Salt Lake City, Utah (I.R.)
| | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, Georgia (R.H., F.S.D., A.O., C.C., C.R., S.G.)
| | - Shikha Garg
- Centers for Disease Control and Prevention, Atlanta, Georgia (R.H., F.S.D., A.O., C.C., C.R., S.G.)
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Houser KV, Chen GL, Carter C, Crank MC, Nguyen TA, Burgos Florez MC, Berkowitz NM, Mendoza F, Hendel CS, Gordon IJ, Coates EE, Vazquez S, Stein J, Case CL, Lawlor H, Carlton K, Gaudinski MR, Strom L, Hofstetter AR, Liang CJ, Narpala S, Hatcher C, Gillespie RA, Creanga A, Kanekiyo M, Raab JE, Andrews SF, Zhang Y, Yang ES, Wang L, Leung K, Kong WP, Freyn AW, Nachbagauer R, Palese P, Bailer RT, McDermott AB, Koup RA, Gall JG, Arnold F, Mascola JR, Graham BS, Ledgerwood JE. Safety and immunogenicity of a ferritin nanoparticle H2 influenza vaccine in healthy adults: a phase 1 trial. Nat Med 2022; 28:383-391. [PMID: 35115706 PMCID: PMC10588819 DOI: 10.1038/s41591-021-01660-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/14/2021] [Indexed: 12/13/2022]
Abstract
Currently, licensed seasonal influenza vaccines display variable vaccine effectiveness, and there remains a need for novel vaccine platforms capable of inducing broader responses against viral protein domains conserved among influenza subtypes. We conducted a first-in-human, randomized, open-label, phase 1 clinical trial ( NCT03186781 ) to evaluate a novel ferritin (H2HA-Ferritin) nanoparticle influenza vaccine platform. The H2 subtype has not circulated in humans since 1968. Adults born after 1968 have been exposed to only the H1 subtype of group 1 influenza viruses, which shares a conserved stem with H2. Including both H2-naive and H2-exposed adults in the trial allowed us to evaluate memory responses against the conserved stem domain in the presence or absence of pre-existing responses against the immunodominant HA head domain. Fifty healthy participants 18-70 years of age received H2HA-Ferritin intramuscularly as a single 20-μg dose (n = 5) or a 60-μg dose either twice in a homologous (n = 25) prime-boost regimen or once in a heterologous (n = 20) prime-boost regimen after a matched H2 DNA vaccine prime. The primary objective of this trial was to evaluate the safety and tolerability of H2HA-Ferritin either alone or in prime-boost regimens. The secondary objective was to evaluate antibody responses after vaccination. Both vaccines were safe and well tolerated, with the most common solicited symptom being mild headache after both H2HA-Ferritin (n = 15, 22%) and H2 DNA (n = 5, 25%). Exploratory analyses identified neutralizing antibody responses elicited by the H2HA-Ferritin vaccine in both H2-naive and H2-exposed populations. Furthermore, broadly neutralizing antibody responses against group 1 influenza viruses, including both seasonal H1 and avian H5 subtypes, were induced in the H2-naive population through targeting the HA stem. This ferritin nanoparticle vaccine technology represents a novel, safe and immunogenic platform with potential application for pandemic preparedness and universal influenza vaccine development.
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Affiliation(s)
- Katherine V Houser
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - Grace L Chen
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Cristina Carter
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Michelle C Crank
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Thuy A Nguyen
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Maria Claudia Burgos Florez
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Nina M Berkowitz
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Floreliz Mendoza
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Cynthia Starr Hendel
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ingelise J Gordon
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Emily E Coates
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sandra Vazquez
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Judy Stein
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Christopher L Case
- Vaccine Clinical Materials Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Heather Lawlor
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Carlton
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Martin R Gaudinski
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Commissioned Corps, U.S. Public Health Service, Rockville, MD, USA
| | - Larisa Strom
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Amelia R Hofstetter
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - C Jason Liang
- Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sandeep Narpala
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Christian Hatcher
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Rebecca A Gillespie
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Adrian Creanga
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Masaru Kanekiyo
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Julie E Raab
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sarah F Andrews
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Yi Zhang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Eun Sung Yang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lingshu Wang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kwanyee Leung
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Wing-Pui Kong
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Alec W Freyn
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raffael Nachbagauer
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter Palese
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert T Bailer
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Adrian B McDermott
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Richard A Koup
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jason G Gall
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Frank Arnold
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - John R Mascola
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Julie E Ledgerwood
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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105
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Szilagyi PG, Albertin CS, Casillas A, Valderrama R, Duru OK, Ong MK, Vangala S, Tseng CH, Humiston SG, Evans S, Sloyan M, Bogard JE, Fox CR, Lerner C. Effect of Personalized Messages Sent by a Health System's Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial. J Gen Intern Med 2022; 37:615-623. [PMID: 34472020 PMCID: PMC8858355 DOI: 10.1007/s11606-021-07023-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 06/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adult influenza vaccination rates are low. Tailored patient reminders might raise rates. OBJECTIVE Evaluate impact of a health system's patient portal reminders: (1) tailored to patient characteristics and (2) incorporating behavioral science strategies, on influenza vaccination rates among adults. DESIGN Pragmatic 6-arm randomized trial across a health system during the 2019-2020 influenza vaccination season. The setting was one large health system-53 adult primary care practices. PARTICIPANTS All adult patients who used the patient portal within 12 months, stratified by the following: young adults (18-64 years, without diabetes), older adults (≥65 years, without diabetes), and those with diabetes (≥18 years). INTERVENTIONS Patients were randomized within strata to either (1) pre-commitment reminder alone (1 message, mid-October), (2) pre-commitment + loss frame messages, (3) pre-commitment + gain frame messages, (4) loss frame messages alone, (5) gain frame messages alone, or (6) standard of care control. Patients in the pre-commitment group were sent a message in mid-October, asking if they planned on getting an influenza vaccination. Patients in loss or gain frame groups were sent up to 3 portal reminders (late October, November, and December, if no documented influenza vaccination in the EHR) about importance and safety of influenza vaccine. MAIN MEASURES Receipt of 1 influenza vaccine from 10/01/2019 to 03/31/2020. KEY RESULTS 196,486 patients (145,166 young adults, 29,795 older adults, 21,525 adults with diabetes) were randomized. Influenza vaccination rates were as follows: for young adults 36.8%, for older adults 55.6%, and for diabetics 60.6%. On unadjusted and adjusted (for age, gender, insurance, race, ethnicity, and prior influenza vaccine history) analyses, influenza vaccination rates were not statistically different for any study group versus control. CONCLUSIONS Patient reminders sent by a health system's patient portal that were tailored to patient demographics (young adults, older adults, diabetes) and that incorporated two behavioral economic messaging strategies (pre-commitment and loss/gain framing) were not effective in raising influenza vaccination rates. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov (NCT04110314).
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Affiliation(s)
- Peter G. Szilagyi
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA USA
| | - Christina S. Albertin
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA USA
| | - Alejandra Casillas
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA USA
| | - Rebecca Valderrama
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA USA
| | - O. Kenrik Duru
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA USA
| | - Michael K Ong
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA USA
| | - Sitaram Vangala
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA USA
| | - Chi-Hong Tseng
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA USA
| | | | - Sharon Evans
- Department of Information Services and Solutions, UCLA Health System, Los Angeles, CA USA
| | - Michael Sloyan
- Department of Information Services and Solutions, UCLA Health System, Los Angeles, CA USA
| | | | - Craig R. Fox
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA USA
- UCLA Anderson School of Management, Los Angeles, CA USA
- Department of Psychology, UCLA, Los Angeles, CA USA
| | - Carlos Lerner
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA USA
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106
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Chen JK, Cheng J, Liverman R, Serluco A, Corbo H, Yildirim I. Vaccination in pediatric solid organ transplant: A primer for the immunizing clinician. Clin Transplant 2022; 36:e14577. [PMID: 34997642 DOI: 10.1111/ctr.14577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/29/2022]
Abstract
Pediatric solid organ transplant (SOT) recipients are at a uniquely elevated risk for vaccine preventable illness (VPI) secondary to a multitude of factors including incomplete immunization at the time of transplant, inadequate response to vaccines with immunosuppression, waning antibody titers observed post-SOT, and uncertainty among providers on the correct immunization schedule to utilize post-SOT. Multiple guidelines are in existence from the Infectious Diseases Society of America and the American Society of Transplantation, which require use in adjunct with additional published references. We summarize the present state of SOT vaccine recommendations from relevant resources in tandem with the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices guidance utilizing both routine and rapid catch-up schedules. The purpose of this all-inclusive review is to provide improved clarity on the most optimal pre- and post-transplant vaccine management within a one-stop-shop for the immunizing clinician. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Justin K Chen
- Department of Pharmacy, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, New York, USA
| | - Jennifer Cheng
- Department of Pharmacy, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, New York, USA
| | - Rochelle Liverman
- Department of Pharmacy, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Anastacia Serluco
- Department of Pharmacy, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Heather Corbo
- Department of Pharmacy, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, New York, USA
| | - Inci Yildirim
- Section of Infectious Diseases and Global Health, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA.,Yale Institute of Global Health, Yale University, New Haven, Connecticut, USA
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107
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Lee YJ, Kim SE, Park YE, Chang JY, Song HJ, Kim DH, Yang YJ, Kim BC, Lee JG, Yang HC, Choi M, Myung SJ. SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID. Intest Res 2022; 20:171-183. [PMID: 34974674 PMCID: PMC9081989 DOI: 10.5217/ir.2021.00098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/22/2021] [Indexed: 12/04/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.
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Affiliation(s)
- Yoo Jin Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Seong-Eun Kim
- Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Yong Eun Park
- Division of Gastroenterology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ji Young Chang
- Department of Health Promotion Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyun Joo Song
- Division of Gastroenterology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University College of Korea, Jeju, Korea
| | - Duk Hwan Kim
- Digestive Disease Center, CHA Bundang Hospital, CHA University, Seongnam, Korea
| | - Young Joo Yang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Byung Chang Kim
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Jae Gon Lee
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Hee Chan Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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108
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Ledlie S, Gandhi‐Banga S, Shrestha A, Mallett Moore T, Khromava A. Exposure to quadrivalent influenza vaccine during pregnancy: Results from a global pregnancy registry. Influenza Other Respir Viruses 2022; 16:90-100. [PMID: 34520127 PMCID: PMC8692812 DOI: 10.1111/irv.12897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Fluzone® Quadrivalent (IIV4, Sanofi Pasteur) Pregnancy Registry was created to monitor vaccine safety during pregnancy (clinicaltrials.gov, NCT01945424). Here, we describe maternal, pregnancy, obstetrical and neonatal outcomes after vaccine exposure in pregnant women between August 2013 and September 2019. METHODS All women exposed to IIV4 during their pregnancy were eligible for inclusion. Outcomes were prospective (reported following vaccine exposure but before knowledge of pregnancy outcome ascertained through prenatal tests) or retrospective (prenatal tests were undertaken before the exposure was reported). RESULTS Among 239 IIV4 vaccine exposure reports received, there were 105 prospective and 10 retrospective reports of maternal adverse events (AEs). The most frequent prospectively reported maternal AEs were medication errors (expired product [n = 8, 3.8%]; extra dose [n = 7, 3.3%]) and injection site pain (n = 7, 3.3%). Among 62 prospectively reported pregnancy and obstetrical events with available follow-up information, seven AEs were reported, four (6.4%) of which were spontaneous abortions. A further seven AEs were reported among the 29 retrospective pregnancy and obstetrical events with available follow-up information. Among neonatal outcomes (15 prospective; 28 retrospective), >85% were reported as full-term births. One premature birth was reported prospectively. Four other neonatal AEs were reported, all retrospectively: two cases of talipes (club foot), one central nervous system anomaly and one atrial septal defect. All infants with available information had normal APGAR scores at 5 minutes. CONCLUSIONS The frequency of AEs following exposure to IIV4 during pregnancy did not indicate new safety concerns.
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Affiliation(s)
- Shaleesa Ledlie
- Epidemiology and Benefit RiskSanofi PasteurNorth YorkOntarioCanada
| | | | - Anju Shrestha
- Global PharmacovigilanceSanofi PasteurSwiftwaterPennsylvaniaUSA
| | | | - Alena Khromava
- Epidemiology and Benefit RiskSanofi PasteurNorth YorkOntarioCanada
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109
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Rand ML. Nursing Interventions Increase Influenza Vaccination Quality Measures for Home Telehealth Patients. J Nurs Care Qual 2022; 37:47-53. [PMID: 34224534 DOI: 10.1097/ncq.0000000000000577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Influenza vaccinations are a preventive health quality measure. Home telehealth nursing staff interventions can reduce influenza disease burden and complications. PURPOSE To improve seasonal flu vaccine rates using novel home telehealth clinical and technology interventions. METHODS A pre- and postintervention concurrent cohort study for 513 outpatients was conducted. Interventions included automated 2-way patient messaging using remote monitoring equipment, a new note template to record vaccination status in the electronic health record, and flu vaccine patient education. RESULTS Interventions resulted in vaccination rates of 70.4% for Veterans ages 19 to 65 years, and 81.7% for Veterans 66 years and older, exceeding national, regional, and local Veterans Administration targets. CONCLUSIONS Two-way messaging and standardized documentation increased rates. Declinations persisted despite education. Reasons included fear of side effects, and rarely leaving home due to the COVID-19 pandemic. Nursing interventions can increase influenza vaccination quality measures for primary care home telehealth patients.
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Affiliation(s)
- Maxine L Rand
- San Francisco Veterans Administration Health Care System, San Francisco, California
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110
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Influenza Vaccine: An Engineering Vision from Virological Importance to Production. BIOTECHNOL BIOPROC E 2022; 27:714-738. [PMID: 36313971 PMCID: PMC9589582 DOI: 10.1007/s12257-022-0115-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/06/2022] [Accepted: 06/12/2022] [Indexed: 01/26/2023]
Abstract
According to data from the World Health Organization (WHO) every year, millions of people are affected by flu. Flu is a disease caused by influenza viruses. For preventing this, seasonal influenza vaccinations are widely considered the most efficient way to protect against the negative effects of the flu. To date, there is no "one-size-fits-all" vaccine that can be effective all over the world to protect against all seasonal or pandemic influenza virus types. Because influenza virus transforms its genetic structure and it can emerges as immunogenically new (antigenic drift) which causes epidemics or new virus subtype (antigenic shift) which causes pandemics. As a result, annual revaccination or new subtype viral vaccine development is required. Currently, three types of vaccines (inactivated, live attenuated, and recombinant) are approved in different countries. These can be named "conventional influenza vaccines" and their production are based on eggs or cell culture. Although, there is good effort to develop new influenza vaccines for broader and longer period of time protection. In this sense these candidate vaccines are called "universal influenza vaccines". In this article, after we mentioned the short history of flu then virus morphology and infection, we explained the diseases caused by the influenza virus in humans. Afterward, we explained in detail the production methods of available influenza vaccines, types of bioreactors used in cell culture based production, conventional and new vaccine types, and development strategies for better vaccines.
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111
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4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2022. Diabetes Care 2022; 45:S46-S59. [PMID: 34964869 PMCID: PMC8935396 DOI: 10.2337/dc22-s004] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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112
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Humiston SG, Szilagyi PG, Bender RG, Breck A, Albertin CS, Clark D, Rand CM. Perspectives on Maternal Vaccination from Obstetrical Clinicians: A Qualitative Multi-site Study. Matern Child Health J 2022; 26:2506-2516. [PMID: 36315315 PMCID: PMC9628390 DOI: 10.1007/s10995-022-03535-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Despite the seriousness of influenza and pertussis, availability of safe and effective vaccines against them, and long-standing maternal vaccination recommendations, US maternal influenza and Tdap vaccination rates have been low. To increase vaccination rates in obstetric offices, it is important to understand clinician perspectives and office processes. We conducted in-depth interviews with nurses and providers on these topics. METHODS Interviewees worked in obstetric offices in one-of-four participating health systems in NY and CA. We audio-recorded and transcribed 20-30-min interviews. We used predetermined categories to code interviews with Dedoose, then iteratively refined codes and identified themes. RESULTS We conducted 20 interviews between 4/2020 and 9/2020: 13 providers (physician or nurse midwife) (5 NY, 8 CA); 7 office nurses (6 NY, 1 CA). In almost all offices, patient refusal of influenza vaccine was considered the major vaccination barrier; Tdap was often deferred by patients until post-delivery. Nurse-only visits for either vaccine were rare. Vaccination outside the office was uncommon; few offices systematically documented vaccines given elsewhere in a retrievable manner. Participants emphasized patient education as key to prenatal care, but the number of topics left little time for immunizations. Few interviewees could identify an office "immunization champion," knew their office vaccination rates, or had participated in vaccination quality improvement. Several interviewees indicated that they or another provider were good at persuading hesitant patients, but their method had not been shared with other clinicians. CONCLUSIONS FOR PRACTICE Multiple practical barriers and maternal vaccine hesitancy limit maternal vaccination. Quality improvement strategies are needed.
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Affiliation(s)
- Sharon G. Humiston
- Department of Pediatrics, Children’s Mercy Kansas City, UMKC School of Medicine, 2401 Gillham Road, Kansas City, MO 64106 USA
| | - Peter G. Szilagyi
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA USA
| | - Robin G. Bender
- Department of Pediatrics, University of Rochester Medical Center, University of Rochester, Rochester, NY USA
| | - Abigail Breck
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA USA
| | - Christina S. Albertin
- Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California at Los Angeles, Los Angeles, CA USA
| | - Devin Clark
- Department of Pediatrics, University of Rochester Medical Center, University of Rochester, Rochester, NY USA
| | - Cynthia M. Rand
- Department of Pediatrics, University of Rochester Medical Center, University of Rochester, Rochester, NY USA
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113
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Influenza Vaccine Effectiveness Estimates among US Department of Defense Adult Beneficiaries over Four Consecutive Influenza Seasons: A Test-Negative Design Study with Different Control Groups. Vaccines (Basel) 2021; 10:vaccines10010058. [PMID: 35062721 PMCID: PMC8781181 DOI: 10.3390/vaccines10010058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 11/17/2022] Open
Abstract
A test-negative design study with different control groups (influenza test-negative controls, non-influenza virus positive controls, and pan-negative controls) was conducted to assess inactivated influenza vaccine effectiveness (VE) in adults aged ≥18 years, 2016-2017 through 2019-2020 influenza seasons. A database was developed from the US Department of Defense Global Respiratory Pathogen Surveillance Program. VE was estimated using a generalized linear mixed model with logit link and binomial distribution, adjusted for confounding effects. A total of 7114 adults including 2543 medically attended, laboratory-confirmed influenza-positive cases were identified. Using influenza test-negative controls, the adjusted VE in adults was 40% [95% confidence interval (CI): 33-46%] overall, including 46% (95% CI: 36-55%) for influenza A(H1N1)pdm09, 32% (95% CI: 19-42%) for influenza A(H3N2), and 54% (95% CI: 44-62%) for influenza B. The age-stratified analysis showed that VE estimates against influenza A(H1N1)pdm09 (34%; 95% CI: -29-66%) and influenza A(H3N2) (6%; 95% CI: -60-45%) were low and non-significant for elderly adults ≥65 years of age. Overall VE estimates against any influenza or by influenza (sub)types in adults were consistent when using influenza test-negative controls, non-influenza virus positive controls, and pan-negative controls. Inactivated influenza vaccination provided moderate protection against influenza virus infection, based on the analysis from a large number of adults aged ≥18 years over multiple influenza seasons.
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114
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Shapiro JR, Li H, Morgan R, Chen Y, Kuo H, Ning X, Shea P, Wu C, Merport K, Saldanha R, Liu S, Abrams E, Chen Y, Kelly DC, Sheridan-Malone E, Wang L, Zeger SL, Klein SL, Leng SX. Sex-specific effects of aging on humoral immune responses to repeated influenza vaccination in older adults. NPJ Vaccines 2021; 6:147. [PMID: 34887436 PMCID: PMC8660902 DOI: 10.1038/s41541-021-00412-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/02/2021] [Indexed: 01/16/2023] Open
Abstract
Older adults (≥65 years of age) bear a significant burden of severe disease and mortality associated with influenza, despite relatively high annual vaccination coverage and substantial pre-existing immunity to influenza. To test the hypothesis that host factors, including age and sex, play a role in determining the effect of repeated vaccination and levels of pre-existing humoral immunity to influenza, we evaluated pre- and post-vaccination strain-specific hemagglutination inhibition (HAI) titers in adults over 75 years of age who received a high-dose influenza vaccine in at least four out of six influenza seasons. Pre-vaccination titers, rather than host factors and repeated vaccination were significantly associated with post-vaccination HAI titer outcomes, and displayed an age-by-sex interaction. Pre-vaccination titers to H1N1 remained constant with age. Titers to H3N2 and influenza B viruses decreased substantially with age in males, whereas titers in females remained constant with age. Our findings highlight the importance of pre-existing immunity in this highly vaccinated older adult population and suggest that older males are particularly vulnerable to reduced pre-existing humoral immunity to influenza.
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Affiliation(s)
- Janna R Shapiro
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Huifen Li
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yiyin Chen
- Guangdong Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Helen Kuo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiaoxuan Ning
- Department of Geriatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Patrick Shea
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cunjin Wu
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, Hebei, China
| | - Katherine Merport
- Zanvyl Krieger School of Arts and Science, Johns Hopkins University, Baltimore, MD, USA
| | - Rayna Saldanha
- Zanvyl Krieger School of Arts and Science, Johns Hopkins University, Baltimore, MD, USA
| | - Suifeng Liu
- Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China
| | - Engle Abrams
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yan Chen
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Sichuan, China
| | - Denise C Kelly
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eileen Sheridan-Malone
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lan Wang
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Scott L Zeger
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabra L Klein
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Sean X Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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115
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Pérez-Rubio A, Castrodeza JJ, Eiros JM. [Choice of influenza vaccine in people over 65 years old. Analysis of reports from international vaccination advisory committees]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2021; 34:631-638. [PMID: 34545737 PMCID: PMC8638763 DOI: 10.37201/req/076.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/19/2021] [Accepted: 08/04/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Annual recommendations on influenza vaccine use in different countries are developed by influenza-specific working groups within their Immunization Advisory Committees. Adults aged 65 years and over are included in the groups for which vaccination against influenza is particularly recommended due to the morbidity associated. A variety of influenza vaccines are available, some of which boosted immunity, are licensed for use only in this specific age group, where the immune response to traditional influenza vaccines may be suboptimal. We analyze the main annual recommendations on the use of the influenza vaccine issued by advisory committees on immunization for the population over 65 years of age. METHODS The latest influenza vaccination guidelines have been selected and the recommendations for people over 65 years of age published by the main vaccination advisory committees have been reviewed. RESULTS The UK Advisory Committee (JCVI) recommends the use of Quadruvalent Inactivated Influenza Vaccine with Adjuvant (aQIV) or High Dose Quadrivalent Inactivated Influenza Vaccine (QIV-HD). The US committee (ACIP) does not express a preference for any type of vaccine. The Australian committee (ATAGI) preferably recommends adjuvanted influenza vaccine. The advisory committees of Canada and Germany (NACI, STIKO) and the European Center for Disease Control (Ecdc) recommend using any of the age-appropriate flu vaccines available, although they bet on the The UK Advisory Committee (JCVI) recommends the use of Quadruvalent Inactivated Influenza Vaccine with Adjuvant (aQIV) or High Dose Quadrivalent Inactivated Influenza Vaccine (QIV-HD). The US committee (ACIP) does not express a preference for any type of vaccine. The Australian committee (ATAGI) preferably recommends adjuvanted influenza vaccine. The advisory committees of Canada and Germany (NACI, STIKO) and the European Center for Disease Control (Ecdc) recommend using any of the age-appropriate flu vaccines available, although they bet on the use of inactivated quadrivalent flu vaccine high dose at the individual level for those over 65 years.use of inactivated quadrivalent flu vaccine high dose at the individual level for those over 65 years. CONCLUSIONS It is necessary further studies and improvement in their quality that analyze the different vaccines available and their comparability, although the use of reinforced immunity vaccines is generally recommended in the population over 65 years of age.
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Affiliation(s)
- A Pérez-Rubio
- Alberto Pérez-Rubio, Complejo Asistencial de Ávila. Paseo Juan Carlos I. 05003. Avila. Spain.
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Jones WA, Castro RDC, Masters HL, Carrico R. Influenza Management During the COVID-19 Pandemic: A Review of Recent Innovations in Antiviral Therapy and Relevance to Primary Care Practice. Mayo Clin Proc Innov Qual Outcomes 2021; 5:974-991. [PMID: 34414356 PMCID: PMC8363430 DOI: 10.1016/j.mayocpiqo.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Seasonal influenza requires appropriate management to protect public health and resources. Decreasing the burden of influenza will depend primarily on increasing vaccination rates as well as prompt initiation of antiviral therapy within 48 hours of symptom onset, especially in the context of the current coronavirus disease 2019 pandemic. A careful approach is required to prevent health services from being overwhelmed by a surge in demand that could exceed capacity. This review highlights the societal burden of influenza and discusses the prevention, diagnosis, and treatment of influenza as a complicating addition to the challenges of the coronavirus disease 2019 pandemic. The importance of vaccination for seasonal influenza and the role of antiviral therapy in the treatment and prophylaxis of seasonal influenza, including the most up-to-date recommendations from the Centers for Disease Control and Prevention for influenza management, will also be reviewed.
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Affiliation(s)
- Warren A. Jones
- Department of Family Medicine, University of Mississippi Medical Center, Jackson
| | | | | | - Ruth Carrico
- Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, KY
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117
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Sanz-Rojo S, Jiménez-García R, López-de-Andrés A, de Miguel-Diez J, Perez-Farinos N, Zamorano-León JJ. Influenza vaccination uptake among high-risk target groups and health care workers in Spain and change from 2017 to 2020. Vaccine 2021; 39:7012-7020. [PMID: 34742593 DOI: 10.1016/j.vaccine.2021.10.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/10/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Using the 2020 European Health Survey for Spain (EHSS2020), which ran from July 2019 to July 2020, we aimed to describe influenza vaccination uptake among the following target groups; individuals aged ≥65 years, health care workers (HCWs), and persons with high-risk chronic medical conditions. We analyzed changes in uptake since the previous Spanish National Health Interview Survey conducted in 2017 and identified variables associated with vaccine uptake. METHODS We performed a cross-sectional study. The primary study variable was the self-reported uptake of influenza vaccine in the previous year. We analyzed sex, age, country of birth, and being an HCW. We identified participants with self-reported respiratory diseases, cardiovascular disease, diabetes, cancer, and cerebrovascular diseases. Multivariable logistic regression was applied to assess changes over time and to identify variables associated with vaccination in target groups. RESULTS Uptake was 19.2% in 22,072 participants aged ≥15 years. Uptake was 54.4% for those aged ≥65 years, 41.6% for those with a high-risk medical condition, and 26.53% among HCWs. Uptake by disease was 52.1% for cerebrovascular diseases, 51.3% for cardiovascular diseases, 48.3% for diabetes, 46.1% for cancer, and 36.2% for respiratory diseases. No significant improvement has been observed since 2017 in any target group, except for participants with cancer, whose uptake increased from 33.2% to 46.1%(p < 0.001). The variables that significantly increased the probability of reporting vaccine uptake were female sex, age ≥35 years, being born in Spain, self-reported respiratory or cardiovascular diseases, diabetes, cancer, and being a HCW. CONCLUSIONS Influenza vaccination uptake among target groups in Spain is below desirable levels and has not improved significantly since 2017. Older age, female sex, and being born in Spain are positive predictors of vaccine uptake. The COVID-19 pandemic highlights the urgent need to implement new strategies to increase influenza vaccine uptake.
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Affiliation(s)
- Sara Sanz-Rojo
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense, Madrid, Spain
| | - Rodrigo Jiménez-García
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense, Madrid, Spain.
| | - Ana López-de-Andrés
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier de Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
| | - Napoleón Perez-Farinos
- Public Health and Psychiatry Department, Faculty of Medicine, Universidad de Málaga, Málaga, Spain
| | - José J Zamorano-León
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense, Madrid, Spain
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118
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Simionescu AA, Streinu-Cercel A, Popescu FD, Stanescu AMA, Vieru M, Danciu BM, Miron VD, Săndulescu O. Comprehensive Overview of Vaccination during Pregnancy in Europe. J Pers Med 2021; 11:jpm11111196. [PMID: 34834548 PMCID: PMC8623700 DOI: 10.3390/jpm11111196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/02/2021] [Accepted: 11/11/2021] [Indexed: 12/18/2022] Open
Abstract
Vaccinations during pregnancy can protect the mother from several infections, thus blocking vertical transmission. Furthermore, through passive antibody transfer, the newborn can be protected against some infections in the first months of life until their own vaccination regimen is initiated and completed at the appropriate age. Pregnancy can be considered a high-risk condition that increases vulnerability to infectious diseases with potentially unfavorable evolution. We present the current knowledge on vaccination during pregnancy in Europe as a useful information source for different health workers involved in prenatal care. Many European countries implement vaccination policies specifically designed for pregnant women, but there is great heterogeneity among programs. Recommendations on vaccination during pregnancy must be based on current high-quality scientific data. The decisions must be made for each individual case, depending on the associated conditions or special circumstances, with a concomitant assessment of the potential benefits and risks to both the pregnant patient and the fetus. Many vaccines are well-tolerated in pregnant women, with no clinically meaningful injection site reactions, systemic symptoms, or vaccine-related serious adverse events.
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Affiliation(s)
- Anca Angela Simionescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.S.); (A.S.-C.); (A.M.A.S.); (M.V.); (V.D.M.); (O.S.)
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Anca Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.S.); (A.S.-C.); (A.M.A.S.); (M.V.); (V.D.M.); (O.S.)
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Florin-Dan Popescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.S.); (A.S.-C.); (A.M.A.S.); (M.V.); (V.D.M.); (O.S.)
- Department of Allergology and Clinical Immunology, Nicolae Malaxa Clinical Hospital, 022441 Bucharest, Romania
- Correspondence: or
| | - Ana Maria Alexandra Stanescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.S.); (A.S.-C.); (A.M.A.S.); (M.V.); (V.D.M.); (O.S.)
| | - Mariana Vieru
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.S.); (A.S.-C.); (A.M.A.S.); (M.V.); (V.D.M.); (O.S.)
- Department of Allergology and Clinical Immunology, Nicolae Malaxa Clinical Hospital, 022441 Bucharest, Romania
| | - Bianca Mihaela Danciu
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 127715 Bucharest, Romania;
| | - Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.S.); (A.S.-C.); (A.M.A.S.); (M.V.); (V.D.M.); (O.S.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 127715 Bucharest, Romania;
| | - Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.A.S.); (A.S.-C.); (A.M.A.S.); (M.V.); (V.D.M.); (O.S.)
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
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Chen CC, Lin CH, Hao WR, Yeh JS, Chiang KH, Fang YA, Chiu CC, Yang TY, Wu YW, Liu JC. Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study. Front Cardiovasc Med 2021; 8:731844. [PMID: 34722665 PMCID: PMC8551488 DOI: 10.3389/fcvm.2021.731844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/15/2021] [Indexed: 01/11/2023] Open
Abstract
Backgrounds: Influenza vaccination could decrease the risk of major cardiac events in patients with chronic obstructive pulmonary disease (COPD). However, the effects of the vaccine on decreasing the risk of ventricular arrhythmia (VA) development in such patients remain unclear. Methods: We retrospectively analyzed the data of 18,658 patients with COPD (≥55 years old) from the National Health Insurance Research Database from January 1, 2001, to December 31, 2012. After a 1:1 propensity score matching by the year of diagnosis, we divided the patients into vaccinated and unvaccinated groups. Time-varying Cox proportional hazards regression was applied to assess the time to event hazards of influenza vaccination exposure. Results: The risk of VA occurrence was significantly lower in the vaccinated group during influenza season and all seasons [adjusted hazard ratio (aHR): 0.62, 95% CI: 0.41-0.95; aHR: 0.69, 95% CI: 0.44-1.08; and aHR: 0.65, 95% CI: 0.48-0.89, in the influenza season, non-influenza season, and all seasons, respectively]. Among patients with CHA2DS2-VASc scores (conditions and characteristics included congestive heart failure, hypertension, diabetes, stroke, vascular disease, age, and sex) of 2-3, receiving one time and two to three times of influenza vaccination were associated with lower risk of VA occurrence in all seasons (aHR: 0.28, 95% CI: 0.10-0.80; aHR: 0.27, 95% CI: 0.10-0.68, respectively). Among patients without stroke, peripheral vascular disease, and diabetes, a lower risk of VA occurrence after receiving one and two to three times vaccination was observed in all seasons. Among patients with a history of asthma and patients without a history of heart failure, ischemic heart disease, angina hypertension, or renal failure, a significantly lower risk of VA occurrence was observed after the first time of vaccination in all seasons. Conclusions: Influenza vaccination may be associated with lower risks of VA among patients with COPD aged 55-74. Further investigation is still needed to resolve this clinical question.
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Affiliation(s)
- Chun-Chao Chen
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan.,Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Hsin Lin
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan.,Division of Cardiovascular Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Rui Hao
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan.,Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,College of Medicine, Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jong-Shiuan Yeh
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan.,Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Cardiovascular Medicine, Department of Internal Medicine, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan
| | - Kuang-Hsing Chiang
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan.,Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Yu-Ann Fang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chih Chiu
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
| | - Tsung Yeh Yang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
| | - Yu-Wei Wu
- College of Medical Science and Technology, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.,Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ju-Chi Liu
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan.,Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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120
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Michos ED, Udell JA. Am I Getting the Influenza Shot Too?: Influenza Vaccination as Post-Myocardial Infarction Care for the Prevention of Cardiovascular Events and Death. Circulation 2021; 144:1485-1488. [PMID: 34723637 DOI: 10.1161/circulationaha.121.057534] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Erin D Michos
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD (E.D.M.)
| | - Jacob A Udell
- Cardiovascular Division, Women's College Hospital and Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Ontario, Canada (J.A.U.)
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121
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Atyeo C, DeRiso EA, Davis C, Bordt EA, De Guzman RM, Shook LL, Yonker LM, Fasano A, Akinwunmi B, Lauffenburger DA, Elovitz MA, Gray KJ, Edlow AG, Alter G. COVID-19 mRNA vaccines drive differential antibody Fc-functional profiles in pregnant, lactating, and nonpregnant women. Sci Transl Med 2021; 13:eabi8631. [PMID: 34664972 PMCID: PMC9067624 DOI: 10.1126/scitranslmed.abi8631] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Substantial immunological changes occur throughout pregnancy to promote tolerization of the mother to the fetus and allow fetal growth. However, additional local and systemic immunological adaptations also occur, allowing the maternal immune system to continue to protect the dyad against pathogens both during pregnancy and after birth through lactation. This fine balance of tolerance and immunity, along with physiological and hormonal changes, contribute to increased susceptibility to particular infections in pregnancy, including more severe coronavirus disease 2019 (COVID-19). Whether these changes also make pregnant women less responsive to vaccination or induce altered immune responses to vaccination remains incompletely understood. To holistically define potential changes in vaccine response during pregnancy and lactation, we deeply profiled the humoral vaccine response in a group of pregnant and lactating women and non-pregnant age-matched controls. Vaccine-specific titers were comparable between pregnant women, lactating women, and non-pregnant controls. However, Fc receptor (FcR)-binding and antibody effector functions were induced with delayed kinetics in both pregnant and lactating women compared to non-pregnant women after the first vaccine dose, which normalized after the second dose. Antibody boosting resulted in high FcR-binding titers in breastmilk. These data suggest that pregnancy promotes resistance to generating highly inflammatory antibodies and indicates that there is a critical need to follow prime-boost timelines in this vulnerable population to ensure full immunity is attained. Pregnant and lactating women develop distinct antibody Fc profiles in response to the mRNA-1273 and BNT162b2 vaccines compared to non-pregnant women.
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Affiliation(s)
- Caroline Atyeo
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.,PhD Program in Virology, Division of Medical Sciences, Harvard University, Boston, MA 02115, USA
| | | | - Christine Davis
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Evan A Bordt
- Department of Pediatrics, Lurie Center for Autism, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Rose M De Guzman
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.,Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Lydia L Shook
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.,Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Lael M Yonker
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Massachusetts General Hospital, Boston, MA 02115, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Alessio Fasano
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Massachusetts General Hospital, Boston, MA 02115, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Babatunde Akinwunmi
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Douglas A Lauffenburger
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Michal A Elovitz
- Maternal and Child Health Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kathryn J Gray
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Andrea G Edlow
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.,Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
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122
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Behrouzi B, Udell JA. Moving the Needle on Atherosclerotic Cardiovascular Disease and Heart Failure with Influenza Vaccination. Curr Atheroscler Rep 2021; 23:78. [PMID: 34671861 PMCID: PMC8528654 DOI: 10.1007/s11883-021-00973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE OF REVIEW The interplay between viral respiratory infections and cardiovascular disease has been most comprehensively researched using seasonal and pandemic influenza viruses as case studies. Here, we summarize the latest international observational research and clinical trials that examined the association between influenza, influenza vaccines, and cardiovascular disease, while contextualizing their findings within those of landmark studies. RECENT FINDINGS Most recent observational literature found that one in eight adults hospitalized with laboratory-confirmed influenza infection experienced an acute cardiovascular event. The latest meta-analysis of the cardioprotective effects of influenza vaccine found a 25% reduced risk of all-cause death. There are four large cardiovascular outcome trials assessing the cardioprotective effects of different influenza vaccine strategies. Among these, the INVESTED study showed there is no significant difference between the high-dose trivalent and standard-dose quadrivalent influenza vaccines in reducing all-cause mortality or cardiopulmonary hospitalizations in a high-risk patient group with pre-existing cardiovascular disease. Persons with cardiovascular disease represent a high priority group for viral vaccines; hence, using robust evidence to increase vaccine confidence among patients and practitioners is integral as we prepare for a possible influenza resurgence in the coming years.
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Affiliation(s)
- Bahar Behrouzi
- ICES, Toronto, ON Canada
- Cardiovascular Division, Department of Medicine, Women’s College Hospital, 76 Grenville Street, Toronto, ON M5S 1B2 Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Jacob A. Udell
- ICES, Toronto, ON Canada
- Cardiovascular Division, Department of Medicine, Women’s College Hospital, 76 Grenville Street, Toronto, ON M5S 1B2 Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON Canada
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123
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Influenza Vaccination During COVID-19 in a Rural Community: A Cross-sectional Survey. J Community Health 2021; 47:226-231. [PMID: 34647201 PMCID: PMC8514004 DOI: 10.1007/s10900-021-01036-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 11/19/2022]
Abstract
Vaccination behavior is an informative metric for assessing flu seasons and is especially important to understand for the 2020–2021 flu season, which coincided with the COVID-19 pandemic. This study aimed to estimate flu vaccine behavior and assess vaccine perceptions during the pandemic season. Using a cross-sectional descriptive study design, we conducted an online survey to assess vaccination behavior and perceptions of both COVID-19 and the flu. Patients were identified as recently seen by providers in an academic internal medicine practice (n = 827) and surveys were distributed as messages in the Epic electronic medical record system. We found that 88.3% of respondents (188/206) had received their flu vaccination for the season at the time of their survey response in December 2020–February 2021. Of those that had not yet received the flu vaccine, only 13.6% indicated they planned on getting one. 12.5% of respondents said they had changed their flu vaccine plans due to the COVID-19 pandemic. Looking at differences from past season’s behavior, more individuals switched to getting the flu vaccine than those that switched to not getting the vaccine this season. The most frequently cited reasons for not receiving the flu vaccination were concerns about side effects and not being in a priority group. Changes in flu vaccination behavior from previous seasons represent a net positive in the direction of vaccine acceptance. Barriers to vaccination were identified and results from this study provide more information on vaccine perceptions, beliefs, and behavior, which can benefit future vaccination programs.
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124
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Peterson JT, Zareba AM, Fitz-Patrick D, Essink BJ, Scott DA, Swanson KA, Chelani D, Radley D, Cooper D, Jansen KU, Dormitzer PR, Gruber WC, Gurtman A. Safety and Immunogenicity of a Respiratory Syncytial Virus Prefusion F Vaccine When Co-Administered With a Tetanus, Diphtheria, and Acellular Pertussis Vaccine. J Infect Dis 2021; 225:2077-2086. [PMID: 34637519 PMCID: PMC9200146 DOI: 10.1093/infdis/jiab505] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/11/2021] [Indexed: 11/12/2022] Open
Abstract
Background Prevention of respiratory syncytial virus (RSV) disease in infants is an unmet vaccine need, and maternal immunization is a potential strategy to address this need. This study evaluated concomitant administration of RSV stabilized prefusion F subunit vaccine (RSVpreF) and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine adsorbed (Tdap) in healthy, nonpregnant women 18‒49 years of age. Methods In this phase 2b, multicenter, placebo-controlled, observer-blind, noninferiority study, participants were randomized to receive RSVpreF in a range of doses and formulations with Tdap or alone, or Tdap alone. Safety and immunogenicity were assessed. Results Local reactions and systemic events were generally similar across vaccine groups. Noninferiority of anti-RSV-A and anti-RSV-B immune responses induced by RSVpreF with Tdap was demonstrated compared to RSVpreF alone. Noninferiority of anti-diphtheria toxoid and anti-tetanus toxoid immune responses after administration of RSVpreF with Tdap was demonstrated compared to Tdap alone; noninferiority was not met for anti-pertussis component responses. Conclusions RSVpreF was safe and well tolerated when administered with Tdap or alone in nonpregnant women 18‒49 years of age. Immune responses induced by Tdap administered with RSVpreF were noninferior for the tetanus and diphtheria components of Tdap, but not for pertussis. Clinical Trials Registration NCT04071158.
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Affiliation(s)
- James T Peterson
- J. Lewis Research, Inc./Foothill Family Clinic, Salt Lake City, USA
| | | | | | | | - Daniel A Scott
- Pfizer Vaccine Research and Development, Collegeville, USA
| | - Kena A Swanson
- Pfizer Vaccine Research and Development, Pearl River, USA
| | - Dhawal Chelani
- Pfizer Vaccine Research and Development, Honey Lane, Hurley, UK
| | - David Radley
- Pfizer Vaccine Research and Development, Pearl River, USA
| | - David Cooper
- Pfizer Vaccine Research and Development, Pearl River, USA
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125
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Weinberger B. Vaccination of older adults: Influenza, pneumococcal disease, herpes zoster, COVID-19 and beyond. Immun Ageing 2021; 18:38. [PMID: 34627326 PMCID: PMC8501352 DOI: 10.1186/s12979-021-00249-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/21/2021] [Indexed: 12/11/2022]
Abstract
Preserving good health in old age is of utmost importance to alleviate societal, economic and health care-related challenges caused by an aging society. The prevalence and severity of many infectious diseases is higher in older adults, and in addition to the acute disease, long-term sequelae, such as exacerbation of underlying chronic disease, onset of frailty or increased long-term care dependency, are frequent. Prevention of infections e.g. by vaccination is therefore an important measure to ensure healthy aging and preserve quality of life. Several vaccines are specifically recommended for older adults in many countries, and in the current SARS-CoV-2 pandemic older adults were among the first target groups for vaccination due to their high risk for severe disease. This review highlights clinical data on the influenza, Streptococcus pneumoniae and herpes zoster vaccines, summarizes recent developments to improve vaccine efficacy, such as the use of adjuvants or higher antigen dose for influenza, and gives an overview of SARS-CoV-2 vaccine development for older adults. Substantial research is ongoing to further improve vaccines, e.g. by developing universal influenza and pneumococcal vaccines to overcome the limitations of the current strain-specific vaccines, and to develop novel vaccines against pathogens, which cause considerable morbidity and mortality in older adults, but for which no vaccines are currently available. In addition, we need to improve uptake of the existing vaccines and increase awareness for life-long vaccination in order to provide optimal protection for the vulnerable older age group.
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Affiliation(s)
- Birgit Weinberger
- Institute for Biomedical Aging Research, Universität Innsbruck, Rennweg 10, 6020, Innsbruck, Austria.
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126
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Olsen SJ, Winn AK, Budd AP, Prill MM, Steel J, Midgley CM, Kniss K, Burns E, Rowe T, Foust A, Jasso G, Merced-Morales A, Davis CT, Jang Y, Jones J, Daly P, Gubareva L, Barnes J, Kondor R, Sessions W, Smith C, Wentworth DE, Garg S, Havers FP, Fry AM, Hall AJ, Brammer L, Silk BJ. Changes in influenza and other respiratory virus activity during the COVID-19 pandemic-United States, 2020-2021. Am J Transplant 2021; 21:3481-3486. [PMID: 34624182 PMCID: PMC8653380 DOI: 10.1111/ajt.16049] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Sonja J. Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA,Correspondence Sonja J. Olsen, Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA.
| | - Amber K. Winn
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA,Amber K. Winn, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA.
| | - Alicia P. Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Mila M. Prill
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - John Steel
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Claire M. Midgley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Thomas Rowe
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Angela Foust
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Gabriela Jasso
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Angiezel Merced-Morales
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - C. Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Yunho Jang
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Joyce Jones
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Peter Daly
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Rebecca Kondor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Catherine Smith
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - David E. Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Fiona P. Havers
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Aron J. Hall
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Benjamin J. Silk
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
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127
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128
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Abstract
This technical report accompanies the recommendations of the American Academy of Pediatrics for the routine use of the influenza vaccine and antiviral medications in the prevention and treatment of influenza in children during the 2021-2022 season. Influenza vaccination is an important intervention to protect vulnerable populations and reduce the burden of respiratory illnesses during circulation of severe acute respiratory syndrome coronavirus 2, which is expected to continue during this influenza season. In this technical report, we summarize recent influenza seasons, morbidity and mortality in children, vaccine effectiveness, vaccination coverage, and detailed guidance on storage, administration, and implementation. We also provide background on inactivated and live attenuated influenza vaccine recommendations, vaccination during pregnancy and breastfeeding, diagnostic testing, and antiviral medications for treatment and chemoprophylaxis.
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MESH Headings
- Antiviral Agents/therapeutic use
- Breast Feeding
- Child
- Contraindications, Drug
- Drug Resistance, Viral
- Drug Storage
- Female
- Hospitalization
- Humans
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/adverse effects
- Influenza, Human/drug therapy
- Influenza, Human/epidemiology
- Influenza, Human/mortality
- Influenza, Human/prevention & control
- Mass Vaccination
- Risk Factors
- United States/epidemiology
- Vaccines, Attenuated/administration & dosage
- Vaccines, Attenuated/adverse effects
- Vaccines, Inactivated/administration & dosage
- Vaccines, Inactivated/adverse effects
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129
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Bartley JM, Cadar AN, Martin DE. Better, Faster, Stronger: mRNA Vaccines Show Promise for Influenza Vaccination in Older Adults. Immunol Invest 2021; 50:810-820. [PMID: 33830864 DOI: 10.1080/08820139.2021.1909617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Older adults have diminished immune responses that lead to increased susceptibility and severity of infectious diseases. Influenza is a leading killer of older adults despite the availability of seasonal influenza vaccination. Influenza vaccines are strain specific, and their efficacy varies greatly year to year based on how well the vaccine virus matches the circulating strains. Additionally, older adults have reduced vaccination responses. The COVID-19 pandemic highlighted the increased mortality rate in older adults for infectious disease, and brought vaccine development to the forefront. The speed of vaccine development was met with an equally impressive vaccine efficacy. Interestingly, both mRNA-based COVID-19 vaccines currently available have shown similar efficacy in both young and older adults. mRNA vaccine production has significantly reduced the production timeline compared to current influenza vaccines, making them particularly attractive for influenza vaccine development. Faster production coupled with improved efficacy would be a tremendous advancement in protecting older adults from influenza morbidity and mortality.
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Affiliation(s)
- Jenna M Bartley
- Center on Aging and Department of Immunology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Andreia N Cadar
- Center on Aging and Department of Immunology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Dominique E Martin
- Center on Aging and Department of Immunology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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130
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Nilsson NH, Bendix M, Öhlund L, Widerström M, Werneke U, Maripuu M. Increased Risks of Death and Hospitalization in Influenza/Pneumonia and Sepsis for Individuals Affected by Psychotic Disorders, Bipolar Disorders, and Single Manic Episodes: A Retrospective Cross-Sectional Study. J Clin Med 2021; 10:jcm10194411. [PMID: 34640430 PMCID: PMC8509221 DOI: 10.3390/jcm10194411] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/28/2021] [Accepted: 09/18/2021] [Indexed: 11/21/2022] Open
Abstract
Individuals with severe mental disorders (SMDs) such as psychotic disorders, bipolar disorders, and single manic episodes have increased mortality associated with COVID-19 infection. We set up a population-based study to examine whether individuals with SMD also had a higher risk of hospitalization and death from other infectious conditions. Anonymized and summarized data from multiple Swedish patient registers covering the entire Swedish population were supplied by the Swedish National Board of Health and Welfare. The frequencies of hospitalizations and deaths associated with influenza/pneumonia and sepsis in individuals with SMD were compared with the rest of the population during 2018–2019. Possible contributing comorbidities were also examined, of which diabetes, cardiovascular disease, chronic lung disease, and hypertension were chosen. A total of 7,780,727 individuals were included in the study; 97,034 (1.2%) cases with SMD and 7,683,693 (98.8%) controls. Individuals with SMD had increased risk of death associated with influenza/pneumonia (OR = 2.06, 95% CI [1.87–2.27]) and sepsis (OR = 1.61, 95% CI [1.38–1.89]). They also had an increased risk of hospitalization associated with influenza/pneumonia (OR = 2.12, 95% CI [2.03–2.20]) and sepsis (OR = 1.89, 95% CI [1.75–2.03]). Our results identify a need for further evaluation of whether these individuals should be included in prioritized risk groups for vaccination against infectious diseases other than COVID-19.
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Affiliation(s)
- Niklas Harry Nilsson
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (N.H.N.); (M.B.)
| | - Marie Bendix
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (N.H.N.); (M.B.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 11364 Stockholm, Sweden
| | - Louise Öhlund
- Division of Psychiatry, Sunderby Research Unit, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (L.Ö.); (U.W.)
| | - Micael Widerström
- Department of Clinical Microbiology, Umeå University, 90185 Umeå, Sweden;
| | - Ursula Werneke
- Division of Psychiatry, Sunderby Research Unit, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (L.Ö.); (U.W.)
| | - Martin Maripuu
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (N.H.N.); (M.B.)
- Correspondence:
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Girerd N, Chapet N, Roubille C, Roncalli J, Salvat M, Mouquet F, Lamblin N, Gueffet JP, Damy T, Galinier M, Tartiere JM, Janssen C, Berthelot E, Aguilhon S, Escamilla R, Roubille F. Vaccination for Respiratory Infections in Patients with Heart Failure. J Clin Med 2021; 10:jcm10194311. [PMID: 34640328 PMCID: PMC8509310 DOI: 10.3390/jcm10194311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 12/23/2022] Open
Abstract
Bronchopulmonary infections are a major trigger of cardiac decompensation and are frequently associated with hospitalizations in patients with heart failure (HF). Adverse cardiac effects associated with respiratory infections, more specifically Streptococcus pneumoniae and influenza infections, are the consequence of inflammatory processes and thrombotic events. For both influenza and pneumococcal vaccinations, large multicenter randomized clinical trials are needed to evaluate their efficacy in preventing cardiovascular events, especially in HF patients. No study to date has evaluated the protective effect of the COVID-19 vaccine in patients with HF. Different guidelines recommend annual influenza vaccination for patients with established cardiovascular disease and also recommend pneumococcal vaccination in patients with HF. The Heart Failure group of the French Society of Cardiology recently strongly recommended vaccination against COVID-19 in HF patients. Nevertheless, the implementation of vaccination recommendations against respiratory infections in HF patients remains suboptimal. This suggests that a national health policy is needed to improve vaccination coverage, involving not only the general practitioner, but also other health providers, such as cardiologists, nurses, and pharmacists. This review first summarizes the pathophysiology of the interrelationships between inflammation, infection, and HF. Then, we describe the current clinical knowledge concerning the protective effect of vaccines against respiratory diseases (influenza, pneumococcal infection, and COVID-19) in patients with HF and finally we propose how vaccination coverage could be improved in these patients.
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Affiliation(s)
- Nicolas Girerd
- Centre d’Investigations Cliniques—INSERM CHRU de Nancy, Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu, Université de Lorraine, 54500 Vandœuvre-lès-Nancy, France;
| | - Nicolas Chapet
- Department of Clinical Pharmacy, CHU de Montpellier, 34295 Montpellier, France;
| | - Camille Roubille
- Department of Internal Medicine, CHU Montpellier, Montpellier University, PhyMedExp, 34295 Montpellier, France;
| | - Jérôme Roncalli
- Service de Cardiologie, CHU de Toulouse-Rangueil, Université Paul Sabatier–Toulouse III, 31400 Toulouse, France;
| | | | - Frédéric Mouquet
- Department of Cardiology, Hôpital Privé Le Bois, 59000 Lille, France;
| | - Nicolas Lamblin
- Institut Pasteur, Université Lille, Inserm, CHU Lille, U1167 Lille, France;
| | | | - Thibaud Damy
- Referral Center for Cardiac Amyloidoisis, Department of Cardiology, GHU Henri Mondor-APHP, IMRB 955, 94000 Créteil, France;
| | - Michel Galinier
- Fédération des Services de Cardiologie, CHU Toulouse-Rangueil, Faculté de Médecine, Toulouse, Université Paul Sabatier-Toulouse III, 31400 Toulouse, France;
| | | | - Cécile Janssen
- Centre Hospitalier Annecy Genevois, Infectious Diseases Unit, 74370 Annecy, France;
| | - Emmanuelle Berthelot
- Service de Cardiologie, Hôpital Bicêtre, AP-HP, University of Paris Sud, 94270 Le Kremlin-Bicêtre, France;
| | - Sylvain Aguilhon
- Cardiology Department, CHU de Montpellier, 34295 Montpellier, France;
| | - Roger Escamilla
- Service de Pneumologie, Hôpital Larrey, 31400 Toulouse, France;
| | - François Roubille
- Cardiology Department, INI-CRT, CHU de Montpellier, PhyMedExp, Université de Montpellier, INSERM, CNRS, 34295 Montpellier, France
- Correspondence:
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Chantasrisawad N, Jantarabenjakul W, Anugulruengkitt S, Punrin S, Limsuwun K, Sawangsinth P, Phasomsap C, Sophonphan J, Pancharoen C, Puthanakit T. Immunogenicity of 2-dose pre-exposure rabies vaccine co-administered with quadrivalent influenza vaccine in children. Int J Infect Dis 2021; 112:89-95. [PMID: 34547486 DOI: 10.1016/j.ijid.2021.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/12/2021] [Accepted: 09/15/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The World Health Organization recommends a 2-dose rabies pre-exposure prophylaxis (PrEP) regimen. This study aimed to compare the immunogenicity of rabies PrEP regimens co-administered with inactivated quadrivalent influenza vaccine (IIV4). METHODS Children aged 3 to 9 years were randomly assigned (2:2:1) to receive 0.25 mL of chromatographically purified Vero cell rabies vaccine intramuscularly: Group A at day 0, 7 with IIV4; Group B at day 0, 28 with IIV4; Group C at day 0, 7. A booster-dose of CPRV was given on day 365. Primary outcome was the proportion of children with protective rabies virus neutralizing antibody (RVNA) ≥ 0.5 IU/mL, on day 42 and 7 days post-booster. RESULTS From November 2019 to January 2020; 100 children with a median age (IQR) of 5.4 years (4.8-7.3) were enrolled. All participants achieved protective RVNA titers on day 42 and 7-days post booster. Geometric mean titers (GMT) at day 42 were Group A, 8.98(95%CI 7.06-11.42); Group B, 23.89(95%CI 19.33-29.51); Group C, 9.94(95%CI 7.03-14.06). Likewise, RVNA GMT at 7 days post-booster were Group A, 42.53(95%CI 18.41-66.64); Group B, 23.19(95%CI 17.28-29.10); Group C, 57.75 (95%CI 35.86-79.67). CONCLUSIONS The 2-dose PrEP regimen of rabies vaccine produces adequate immune response either 0,7 or 0, 28 regimens.
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Affiliation(s)
- Napaporn Chantasrisawad
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Watsamon Jantarabenjakul
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Thai Red Cross Emerging Infectious Diseases Clinical Center (TRC-EID), King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
| | - Suvaporn Anugulruengkitt
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Suda Punrin
- Queen Saovabha Memorial Institute, The Thai Red Cross Society, Bangkok, Thailand
| | - Kornvika Limsuwun
- Queen Saovabha Memorial Institute, The Thai Red Cross Society, Bangkok, Thailand
| | - Panadda Sawangsinth
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chayapa Phasomsap
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jiratchaya Sophonphan
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chitsanu Pancharoen
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Kohl-Heckl WK, Schröter M, Dobos G, Cramer H. Complementary medicine use and flu vaccination - A nationally representative survey of US adults. Vaccine 2021; 39:5635-5640. [PMID: 34419302 DOI: 10.1016/j.vaccine.2021.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Prior research presented inconsistent results with less, equal or higher vaccination rates among patients using complementary medicine. Given that complementary medicine includes a wide range of therapies, variable vaccination patterns may occur within consultations with different professions. This analysis aims to to evaluate differences between categories of complementary medicine regarding vaccination behavior among US adults. METHODS AND RESULTS This analysis used data from the 2017 National Health Interview Survey (NHIS; n = 26,742; response rate 80.7%). Prevalences of flu vaccination, consultations with complementary medicine practitioners in the past 12 months and their potential interactions were examined. 42.7% of participants had received flu vaccination in the past 12 months, 32.4% had seen one or more complementary medicine practitioner. Users of any type of complementary medicine were as likely as non-users to have received a flu vaccination (44.8% users versus 41.7% non-users; p = 0,862; adjusted odds ratio [AOR] = 1.01, 95% confidence interval [CI] = 0.95-1.07). Regarding specific complementary medicine types, individuals consulting with naturopaths (p < 0.001; AOR = 0.67, 95 %CI = 0.54-0.82), homeopaths (p < 0.001; AOR = 0.55; 95 %CI = 0.44-0.69) and chiropractors (p = 0.016; AOR = 0.9, 95 %CI = 0.83-0.98) were less likely, while other complementary medicine approaches showed no significant association with flu vaccination behavior. Independent predictors for a flu shot were prior diabetes, cancer, current asthma, kidney disease, overweight and current pregnancy. As well, higher educational level, age, ethnicity, health insurance coverage and having seen a general physician or medical specialist in the past 12 months were also associated with a higher vaccination rate. CONCLUSIONS Complementary medicine users were equally likely to receive an influenza vaccination compared with non-users. Different complementary therapies showed varied associations with vaccination behavior. Further analyses may be needed to distinguish influencing factors among patients' vaccination behavior.
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Affiliation(s)
- Wiebke Kathrin Kohl-Heckl
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - Marleen Schröter
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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134
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Hauge SH, de Blasio BF, Håberg SE, Oakley L. Influenza hospitalizations during childhood in children born preterm. Influenza Other Respir Viruses 2021; 16:247-254. [PMID: 34519431 PMCID: PMC8818812 DOI: 10.1111/irv.12908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022] Open
Abstract
Objective The objective is to determine if children born preterm were at increased risk of influenza hospitalization up to age five. Methods National registry data on all children born in Norway between 2008 and 2011 were used in Cox regression models to estimate adjusted hazard ratios (aHRs) for influenza hospitalizations up to age five in children born preterm (<37 pregnancy weeks). HRs were also estimated separately for very preterm (<32 weeks), early term (37–38 weeks), and post‐term (≥42 weeks) children. Results Among 238,628 children born in Norway from January 2008 to December 2011, 15,086 (6.3%) were born preterm. There were 754 (0.3%) children hospitalized with influenza before age five. The rate of hospitalizations in children born preterm was 13.8 per 10,000 person‐years (95% confidence interval [CI] [11.3, 16.7]), and 5.9 per 10,000 person‐years (95% CI [5.5, 6.4]) in children born at term (≥37 weeks). Children born preterm had a higher risk of influenza hospitalization before age 5: aHR 2.33 (95% CI [1.85, 2.93]). The risk increased with decreasing gestational age and was highest among those born extremely/very preterm; aHR 4.07 (95% CI [2.63, 6.31]). Compared with children born at 40–41 weeks, children born early term also had an elevated risk of influenza hospitalization; aHR (37 weeks) 1.89 (95% CI [1.43, 2.50]), aHR (38 weeks) 1.43 (95% CI [1.15, 1.78]). Conclusion Children born preterm had a higher risk of influenza hospitalizations before age five. An elevated risk was also present among children born at an early term. Children born preterm could benefit from influenza vaccinations.
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Affiliation(s)
- Siri H Hauge
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.,Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Birgitte Freiesleben de Blasio
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.,Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Laura Oakley
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Has the Approach of Healthcare Workers to Influenza Vaccine Changed due to the Pandemic? What are their Perspectives on Covid-19 Vaccine? JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.929721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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136
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Stephenson PL, Taylor MV. Vaccination for Influenza - Consumer Health Information. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2021. [DOI: 10.1080/15398285.2021.1953340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Mary Virginia Taylor
- Retired, former Chief Librarian, Overton Brooks VA Medical Center, Shreveport, Louisiana, USA
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137
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Friedman MA, Curtis JR, Winthrop KL. Impact of disease-modifying antirheumatic drugs on vaccine immunogenicity in patients with inflammatory rheumatic and musculoskeletal diseases. Ann Rheum Dis 2021; 80:1255-1265. [PMID: 34493491 DOI: 10.1136/annrheumdis-2021-221244] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/25/2021] [Indexed: 12/14/2022]
Abstract
Patients with rheumatic diseases are at increased risk of infectious complications; vaccinations are a critical component of their care. Disease-modifying antirheumatic drugs may reduce the immunogenicity of common vaccines. We will review here available data regarding the effect of these medications on influenza, pneumococcal, herpes zoster, SARS-CoV-2, hepatitis B, human papilloma virus and yellow fever vaccines. Rituximab has the most substantial impact on vaccine immunogenicity, which is most profound when vaccinations are given at shorter intervals after rituximab dosing. Methotrexate has less substantial effect but appears to adversely impact most vaccine immunogenicity. Abatacept likely decrease vaccine immunogenicity, although these studies are limited by the lack of adequate control groups. Janus kinase and tumour necrosis factor inhibitors decrease absolute antibody titres for many vaccines, but do not seem to significantly impact the proportions of patients achieving seroprotection. Other biologics (interleukin-6R (IL-6R), IL-12/IL-23 and IL-17 inhibitors) have little observed impact on vaccine immunogenicity. Data regarding the effect of these medications on the SARS-CoV-2 vaccine immunogenicity are just now emerging, and early glimpses appear similar to our experience with other vaccines. In this review, we summarise the most recent data regarding vaccine response and efficacy in this setting, particularly in light of current vaccination recommendations for immunocompromised patients.
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Affiliation(s)
| | - Jeffrey R Curtis
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham Department of Medicine, Birmingham, Alabama, USA
| | - Kevin L Winthrop
- Medicine, Oregon Health & Science University, Portland, Oregon, USA.,School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
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Safety and Efficacy of Spray Intranasal Live Attenuated Influenza Vaccine: Systematic Review and Meta-Analysis. Vaccines (Basel) 2021; 9:vaccines9090998. [PMID: 34579235 PMCID: PMC8472940 DOI: 10.3390/vaccines9090998] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 01/15/2023] Open
Abstract
Although influenza is a major public health concern, little is known about the use of spray live attenuated influenza vaccine (LAIV) among adults. For this reason, we conducted a systematic review and meta-analysis to investigate the efficacy and safety of LAIV, especially in adults with/without clinical conditions and children <2 years, with the final aim of possibly extending the clinical indications. PubMed/MEDLINE and Scopus were the two databases consulted through February 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A critical appraisal was conducted. Analyses were performed by using ProMeta3 software. Twenty-two studies were included, showing that LAIV was associated with a higher probability of seroconversion when compared with a placebo and considering the A/H1N1 serotype (pooled OR = 2.26 (95% CI = 1.12–4.54), p-value = 0.022; based on 488 participants, without heterogeneity (I2 = 0.0%)). The meta-analysis also confirmed no significant association with systemic adverse events. Only rhinorrhea, nasal congestion, and sore throat were significantly associated with LAIV compared to the placebo. Despite limited available evidence, LAIV has proved to be a safe and effective flu vaccination, also due to its very low invasiveness, and our review’s results can be considered a starting point for guiding future research and shaping forthcoming vaccination campaigns.
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Yokomizo S, Katagiri W, Maki Y, Sano T, Inoue K, Fukushi M, Atochin DN, Kushibiki T, Kawana A, Kimizuka Y, Kashiwagi S. Brief exposure of skin to near-infrared laser augments early vaccine responses. NANOPHOTONICS 2021; 10:3187-3197. [PMID: 34868804 PMCID: PMC8635068 DOI: 10.1515/nanoph-2021-0133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Rapid establishment of herd immunity with vaccination is effective to combat emerging infectious diseases. Although the incorporation of adjuvant and intradermal (ID) injection could augment early responses to the vaccine, the current chemical or biological adjuvants are inappropriate for this purpose with their side effects and high reactogenicity in the skin. Recently, a near-infrared (NIR) laser has been shown to augment the immune response to ID vaccination and could be alternatively used for mass vaccination programs. Here, we determined the effect of NIR laser as well as licensed chemical adjuvants on the immunogenicity 1, 2, and 4 weeks after ID influenza vaccination in mice. The NIR laser adjuvant augmented early antibody responses, while the widely used alum adjuvant induced significantly delayed responses. In addition, the oil-in-water and alum adjuvants, but not the NIR laser, elicited escalated TH2 responses with allergenic immunoglobulin E (IgE) responses. The effect of the NIR laser was significantly suppressed in the basic leucine zipper transcription factor ATF-like 3 (Batf3) knockout mice, suggesting a critical role of the cluster of differentiation 103+ (CD103)+ dendritic cells. The current preliminary study suggests that NIR laser adjuvant is an alternative strategy to chemical and biological agents to timely combat emerging infectious diseases. Moreover, its immunomodulatory property could be used to enhance the efficacy of immunotherapy for allergy and cancer.
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Affiliation(s)
- Shinya Yokomizo
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, 149 13th Street, Charlestown 02129, MA, USA
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa 116-8551, Tokyo, Japan
| | - Wataru Katagiri
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, 149 13th Street, Charlestown 02129, MA, USA
- Graduate School of Science and Technology, Keio University, 3-14-1 Hiyoshi, Yokohama 223-8522, Kanagawa, Japan
| | - Yohei Maki
- Division of Infectious Diseases and Respiratory Medicine, Department of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Tomoya Sano
- Division of Infectious Diseases and Respiratory Medicine, Department of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Kazumasa Inoue
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa 116-8551, Tokyo, Japan
| | - Masahiro Fukushi
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa 116-8551, Tokyo, Japan
| | - Dmitriy N. Atochin
- Cardiovascular Research Center, Department of Medicine, Massachusetts General Hospital, 149 13th Street, Charlestown 02129, MA, USA
| | - Toshihiro Kushibiki
- Department of Medical Engineering, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Akihiko Kawana
- Division of Infectious Diseases and Respiratory Medicine, Department of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
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Frenkel LD. The global burden of vaccine-preventable infectious diseases in children less than 5 years of age: Implications for COVID-19 vaccination. How can we do better? Allergy Asthma Proc 2021; 42:378-385. [PMID: 34474707 DOI: 10.2500/aap.2021.42.210065] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Infectious diseases are a leading cause of morbidity and mortality worldwide. As of 2018, the total world population of children < 5 years of age was roughly estimated at 679 million. Of these children, an estimated 5.3 million died of all causes in 2018, with an estimated 700,000 who died of vaccine-preventable infectious diseases; 99% of the children who died had lived in low- and middle-income countries. The infectious diseases that remain major causes of mortality for which vaccines have been shown to provide proven preventive success include, in order of prevalence, are those caused by Streptococcus pneumoniae, Rotavirus, Bordetella pertussis, measles virus, Haemophilus influenzae type b and influenza virus. Objective: The purpose of the present report was to address the global burden of these six vaccine-preventable infectious diseases in children < 5 years of age, together with implications for the prevention of coronavirus disease 2019 (COVID-19) infection in children. Methods: The current immunization strategies for the prevention of the six vaccine-preventable infectious diseases in children are reviewed as a framework for new strategies of vaccine prevention of COVID-19 in children. Results: The burden of addressing vaccine prevention of future infectious disease in children can be effectively pursued through knowledge gained from past experiences with vaccine usage in these six vaccine-preventable childhood infectious diseases. Conclusion: Issues with regard to the burden of disease mortality, disease transmission, and available vaccines as well as vaccine successes and shortcomings for specific pathogens can serve as important landmarks for effective use of future vaccines. Although much success has been made globally in preventing these childhood deaths, much remains to be done.
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Hofstetter AM, Opel DJ, Stockwell MS, Hsu C, Zhou C, Mangione-Smith RM, Englund JA. Associations Between Health Care Professional Communication Practices and Influenza Vaccination of Hospitalized Children. Acad Pediatr 2021; 21:1142-1150. [PMID: 34217901 DOI: 10.1016/j.acap.2021.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/15/2021] [Accepted: 06/27/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Health care professionals (HCPs) (eg, nurses, doctors) play a key role in vaccine uptake. Few studies describe HCP influenza vaccine communication with parents of hospitalized children. METHODS This study included English- and Spanish-speaking parents of influenza vaccine-eligible children hospitalized at a tertiary care pediatric hospital between October 2018 and May 2019. A survey was completed online or via telephone 2 to 15 weeks (median 4 weeks) after discharge. It examined parental intent to vaccinate their child during hospitalization and parent-reported inpatient HCP communication practices (eg, vaccine recommendation strength, format for initiating the recommendation). Multivariable logistic regression examined the associations between HCP communication practices and influenza vaccination during hospitalization, adjusting for demographic, clinical, and visit characteristics. RESULTS Parents (n = 194; 63.0% response rate) were mostly white (66.8%) and English-speaking (97.4%). Their children were primarily 5 through 17 years (67.0%) with chronic disease (68.6%); 24.7% were vaccinated before discharge. Most parents initially had no plan (55.6%) or planned to decline (31.1%) influenza vaccine for their child during hospitalization. Of these parents, 22.2% decided to accept the vaccine, 66.7% citing a HCP conversation as the main reason for changing their mind. Overall, 75.3% recalled a HCP conversation about influenza vaccination. Of these parents, 61.0% reported a HCP recommendation (53.8% described it as "very strong"; 11.1% noted a presumptive initiation format). A parent-reported HCP conversation (adjusted odds ratio [AOR] 5.23, 95% confidence interval [CI] 1.64-16.68) and recommendation (AOR 5.59, 95% CI 2.01-15.51) were associated with influenza vaccination during hospitalization. CONCLUSION This study highlights the importance of discussing and recommending influenza vaccination with parents of hospitalized children.
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Affiliation(s)
- Annika M Hofstetter
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash.
| | - Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
| | - Melissa S Stockwell
- Department of Pediatrics, Columbia University (MS Stockwell), New York, NY; Department of Population and Family Health, Mailman School of Public Health, Columbia University (MS Stockwell), New York, NY
| | - Clarissa Hsu
- Kaiser Permanente Washington Health Research Institute (C Hsu and RM Mangione-Smith), Seattle, Wash
| | - Chuan Zhou
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
| | - Rita M Mangione-Smith
- Kaiser Permanente Washington Health Research Institute (C Hsu and RM Mangione-Smith), Seattle, Wash
| | - Janet A Englund
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
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Prevalence of antibodies against seasonal influenza A and B viruses among older adults in rural Thailand: A cross-sectional study. PLoS One 2021; 16:e0256475. [PMID: 34460848 PMCID: PMC8404998 DOI: 10.1371/journal.pone.0256475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/08/2021] [Indexed: 11/19/2022] Open
Abstract
Assessing the seroprevalence of the high-risk individuals against the influenza virus is essential to evaluate the progress of vaccine implementation programs and establish influenza virus interventions. Herein, we identified the pre-existing cross-protection of the circulating seasonal influenza viruses among the older-aged population. A cross-sectional study was performed base on the 176 residual sera samples collected from older adults aged 60 to 95 years without a history of vaccination in rural Thailand in 2015. Sera antibody titers against influenza A and B viruses circulating between 2016 and 2019 were determined by hemagglutination inhibition assay. These findings indicated the low titers of pre-existing antibodies to circulating influenza subtypes and showed age-independent antibody titers among the old adults. Moderate seropositive rates (HAI ≥ 1:40) were observed in influenza A viruses (65.9%A(H3N2), 50.0% for A(H1N1) pdm09), and found comparatively lower rates in influenza B viruses (14% B/Yam2, 21% B/Yam3 and 25% B/Vic). Only 5% of individuals possessed broadly protective antibodies against both seasonal influenza A and B virus in this region. Our findings highlighted the low pre-existing antibodies to circulating influenza strains in the following season observed in older adults. The serological study will help inform policy-makers for health care planning and guide control measures concerning vaccination programs.
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Grohskopf LA, Alyanak E, Ferdinands JM, Broder KR, Blanton LH, Talbot HK, Fry AM. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021-22 Influenza Season. MMWR Recomm Rep 2021; 70:1-28. [PMID: 34448800 PMCID: PMC8407757 DOI: 10.15585/mmwr.rr7005a1] [Citation(s) in RCA: 186] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
This report updates the 2020–21 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2020;69[No. RR-8]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. For each recipient, a licensed and age-appropriate vaccine should be used. ACIP makes no preferential recommendation for a specific vaccine when more than one licensed, recommended, and age-appropriate vaccine is available. During the 2021–22 influenza season, the following types of vaccines are expected to be available: inactivated influenza vaccines (IIV4s), recombinant influenza vaccine (RIV4), and live attenuated influenza vaccine (LAIV4). The 2021–22 influenza season is expected to coincide with continued circulation of SARS-CoV-2, the virus that causes COVID-19. Influenza vaccination of persons aged ≥6 months to reduce prevalence of illness caused by influenza will reduce symptoms that might be confused with those of COVID-19. Prevention of and reduction in the severity of influenza illness and reduction of outpatient visits, hospitalizations, and intensive care unit admissions through influenza vaccination also could alleviate stress on the U.S. health care system. Guidance for vaccine planning during the pandemic is available at https://www.cdc.gov/vaccines/pandemic-guidance/index.html. Recommendations for the use of COVID-19 vaccines are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19.html, and additional clinical guidance is available at https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html. Updates described in this report reflect discussions during public meetings of ACIP that were held on October 28, 2020; February 25, 2021; and June 24, 2021. Primary updates to this report include the following six items. First, all seasonal influenza vaccines available in the United States for the 2021–22 season are expected to be quadrivalent. Second, the composition of 2021–22 U.S. influenza vaccines includes updates to the influenza A(H1N1)pdm09 and influenza A(H3N2) components. U.S.-licensed influenza vaccines will contain hemagglutinin derived from an influenza A/Victoria/2570/2019 (H1N1)pdm09-like virus (for egg-based vaccines) or an influenza A/Wisconsin/588/2019 (H1N1)pdm09-like virus (for cell culture–based and recombinant vaccines), an influenza A/Cambodia/e0826360/2020 (H3N2)-like virus, an influenza B/Washington/02/2019 (Victoria lineage)-like virus, and an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus. Third, the approved age indication for the cell culture–based inactivated influenza vaccine, Flucelvax Quadrivalent (ccIIV4), has been expanded from ages ≥4 years to ages ≥2 years. Fourth, discussion of administration of influenza vaccines with other vaccines includes considerations for coadministration of influenza vaccines and COVID-19 vaccines. Providers should also consult current ACIP COVID-19 vaccine recommendations and CDC guidance concerning coadministration of these vaccines with influenza vaccines. Vaccines that are given at the same time should be administered in separate anatomic sites. Fifth, guidance concerning timing of influenza vaccination now states that vaccination soon after vaccine becomes available can be considered for pregnant women in the third trimester. As previously recommended, children who need 2 doses (children aged 6 months through 8 years who have never received influenza vaccine or who have not previously received a lifetime total of ≥2 doses) should receive their first dose as soon as possible after vaccine becomes available to allow the second dose (which must be administered ≥4 weeks later) to be received by the end of October. For nonpregnant adults, vaccination in July and August should be avoided unless there is concern that later vaccination might not be possible. Sixth, contraindications and precautions to the use of ccIIV4 and RIV4 have been modified, specifically with regard to persons with a history of severe allergic reaction (e.g., anaphylaxis) to an influenza vaccine. A history of a severe allergic reaction to a previous dose of any egg-based IIV, LAIV, or RIV of any valency is a precaution to use of ccIIV4. A history of a severe allergic reaction to a previous dose of any egg-based IIV, ccIIV, or LAIV of any valency is a precaution to use of RIV4. Use of ccIIV4 and RIV4 in such instances should occur in an inpatient or outpatient medical setting under supervision of a provider who can recognize and manage a severe allergic reaction; providers can also consider consulting with an allergist to help identify the vaccine component responsible for the reaction. For ccIIV4, history of a severe allergic reaction (e.g., anaphylaxis) to any ccIIV of any valency or any component of ccIIV4 is a contraindication to future use of ccIIV4. For RIV4, history of a severe allergic reaction (e.g., anaphylaxis) to any RIV of any valency or any component of RIV4 is a contraindication to future use of RIV4. This report focuses on recommendations for the use of vaccines for the prevention and control of seasonal influenza during the 2021–22 influenza season in the United States. A brief summary of the recommendations and a link to the most recent Background Document containing additional information are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html. These recommendations apply to U.S.-licensed influenza vaccines used according to Food and Drug Administration–licensed indications. Updates and other information are available from CDC’s influenza website (https://www.cdc.gov/flu); vaccination and health care providers should check this site periodically for additional information.
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144
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Lee YJ, Kim SE, Park YE, Chang JY, Song HJ, Kim DH, Yang YJ, Kim BC, Lee JG, Yang HC, Choi M, Myung SJ. [SARS-CoV-2 Vaccination for Adult Patients with Inflammatory Bowel Disease: Expert Consensus Statements by KASID]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021; 78:117-128. [PMID: 34446634 DOI: 10.4166/kjg.2021.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/01/2021] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases (KASID) developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.
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Affiliation(s)
- Yoo Jin Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Seong-Eun Kim
- Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Yong Eun Park
- Division of Gastroenterology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ji Young Chang
- Department of Health Promotion Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyun Joo Song
- Division of Gastroenterology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea
| | - Duk Hwan Kim
- Digestive Disease Center, CHA Bundang Hospital, CHA University, Seongnam, Korea
| | - Young Joo Yang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Byung Chang Kim
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Jae Gon Lee
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Hee Chan Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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145
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Relative effectiveness of influenza vaccines in elderly persons in the United States, 2012/2013-2017/2018 seasons. NPJ Vaccines 2021; 6:108. [PMID: 34429431 PMCID: PMC8385076 DOI: 10.1038/s41541-021-00373-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/12/2021] [Indexed: 12/02/2022] Open
Abstract
Influenza immunization protects seniors against influenza and its potentially serious complications. It is uncertain whether standard-dose (SD) quadrivalent vaccine offers better protection over other formulations in the elderly. In this study, we compared the effectiveness of SD-trivalent, high-dose (HD) trivalent, SD-quadrivalent, and adjuvanted trivalent vaccines in seniors (≥65 years) in a real-world setting. We selected over 200,000 individuals in each of 6 influenza seasons from 2012 to 2018 using MarketScan® databases. The two outcomes were hospitalization or emergency room (ER) visit due to (1) influenza or (2) pneumonia. Here, SD-quadrivalent was associated with higher risk of influenza-related hospitalization/ER visit (adjusted hazard ratio (aHR) 1.14 and 95% confidence interval (95% CI) 1.05–1.24) and of pneumonia-related hospitalization/ER visit (aHR 1.04 and 95% CI 1.01–1.07) vs. HD-trivalent. SD-trivalent followed similar trends compared to HD-trivalent (aHR 1.16 and 95% CI 1.06–1.27 for hospitalized/ER visit influenza; aHR 1.07 and 95% CI 1.05–1.10 for hospitalized/ER visit pneumonia). We could not demonstrate risk differences between SD vaccine formulations and between adjuvanted trivalent and one of the other three vaccines. Risk estimates slightly varied across seasons. These findings suggest that SD vaccine formulations vs. HD-trivalent were associated with higher risk of hospitalization/ER visit for influenza and pneumonia in seniors.
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146
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Kennedy RB, Ovsyannikova IG, Poland GA. Update on Influenza Vaccines: Needs and Progress. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3599-3603. [PMID: 34416408 DOI: 10.1016/j.jaip.2021.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
Influenza is an annual seasonal epidemic, and occasionally pandemic, respiratory disease that causes considerable morbidity and mortality worldwide. Despite the widespread availability of safe and effective vaccines since the 1950s, this virus continues to pose a significant public health threat. Variable and often weak vaccine effectiveness, antigenic drift and shift, and vaccine hesitancy are some of the obstacles that must be overcome to control this disease. In this article, we briefly review current influenza vaccines, address safety concerns and the need for newer influenza vaccines of higher efficacy, and discuss efforts to create broadly protective, universal influenza vaccines.
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Affiliation(s)
| | | | - Gregory A Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, Minn
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147
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Influenza Vaccination for the Prevention of Cardiovascular Disease in the Americas: Consensus document of the Inter-American Society of Cardiology and the Word Heart Federation. Glob Heart 2021; 16:55. [PMID: 34381676 PMCID: PMC8344961 DOI: 10.5334/gh.1069] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 02/01/2023] Open
Abstract
Background Cardiovascular mortality is decreasing but remains the leading cause of death world-wide. Respiratory infections such as influenza significantly contribute to morbidity and mortality in patients with cardiovascular disease. Despite of proven benefits, influenza vaccination is not fully implemented, especially in Latin America. Objective The aim was to develop a regional consensus with recommendations regarding influenza vaccination and cardiovascular disease. Methods A multidisciplinary team composed by experts in the management and prevention of cardiovascular disease from the Americas, convened by the Inter-American Society of Cardiology (IASC) and the World Heart Federation (WHF), participated in the process and the formulation of statements. The modified RAND/UCLA methodology was used. This document was supported by a grant from the WHF. Results An extensive literature search was divided into seven questions, and a total of 23 conclusions and 29 recommendations were achieved. There was no disagreement among experts in the conclusions or recommendations. Conclusions There is a strong correlation between influenza and cardiovascular events. Influenza vaccination is not only safe and a proven strategy to reduce cardiovascular events, but it is also cost saving. We found several barriers for its global implementation and potential strategies to overcome them.
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148
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Zhang D, Cui Q, Xu J, Cai J, Lu X, Yang Y. Factors related with COVID-19 vaccination willingness among outpatients in China. Hum Vaccin Immunother 2021; 17:3963-3968. [PMID: 34348592 DOI: 10.1080/21645515.2021.1954441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND COVID-19 vaccination has been accepted widely. However, there are only a few reports on patients' willingness to be vaccinated. This study investigated the willingness of Chinese outpatients to accept COVID-19 vaccination as well as influencing factors. METHODS A cross-sectional survey was conducted in Jiangsu province, China in December 2020. Self-administered questionnaires, which were distributed to 625 outpatients among secondary hospitals, addressed demographic characteristics, sociological characteristics, and subjective reasons. There were 522 (83.5%) participants who gave completely valid responses. Logistic regression analysis was performed to explore the risk factors for willingness of COVID-19 vaccination. RESULTS 71.5% of participants were willing to receive the COVID-19 vaccine. "worried about contracting COVID-19" (49.6%) and "vaccines have just been introduced and need time to consider" (38.9%) were the main reasons for being willing and unwilling to receive COVID-19 vaccine, respectively. The logistic regression analysis showed that "vaccines are an effective way to prevent diseases" (OR = 5.07, 95%CI: 3.32-7.75), "the price you are willing to pay for non-free vaccines (yuan) (101-500 vs ≤100)″ (OR = 1.87, 95%CI: 1.16-3.02), "per capital monthly income(yuan) (>6000 vs ≤3000)"(OR = 2.13, 95%CI: 1.03-4.41), and "self- assessed health status (Good vs Bad)″ (OR = 1.71, 95%CI: 1.01-2.90) were the main risk factors for outpatients to be willing to receive the COVID-19 vaccine. CONCLUSIONS The willingness of Chinese outpatients to receive COVID-19 vaccine was not high. The government should do more to increase publicity of knowledge about COVID-19 vaccine thus increasing willingness to vaccinate, and provide free vaccine to eliminate the cost impact.
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Affiliation(s)
- Di Zhang
- School of Medicine, Jiangsu University, Zhenjiang, P. R. China
| | - Qi Cui
- School of Public Health, China Medical University, Shenyang, P. R. China
| | - Junyi Xu
- Demonstration Ward of General Practitioners, Zhenjiang First People's Hospital, Zhenjiang, P. R. China
| | - Jian Cai
- Hospital Branch, Zhenjiang First People's Hospital, Zhenjiang, P. R. China
| | - Xiaoping Lu
- Community Health Service Center of Dagang Street, Zhenjiang, P. R. China
| | - Yinguang Yang
- Hospital Branch, Zhenjiang First People's Hospital, Zhenjiang, P. R. China.,Community Health Service Center of Dagang Street, Zhenjiang, P. R. China
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149
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O’Halloran AC, Holstein R, Cummings C, Daily Kirley P, Alden NB, Yousey-Hindes K, Anderson EJ, Ryan P, Kim S, Lynfield R, McMullen C, Bennett NM, Spina N, Billing LM, Sutton M, Schaffner W, Talbot HK, Price A, Fry AM, Reed C, Garg S. Rates of Influenza-Associated Hospitalization, Intensive Care Unit Admission, and In-Hospital Death by Race and Ethnicity in the United States From 2009 to 2019. JAMA Netw Open 2021; 4:e2121880. [PMID: 34427679 PMCID: PMC8385599 DOI: 10.1001/jamanetworkopen.2021.21880] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
IMPORTANCE Racial and ethnic minority groups, such as Black, Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons, often experience higher rates of severe influenza disease. OBJECTIVE To describe rates of influenza-associated hospitalization, intensive care unit (ICU) admission, and in-hospital death by race and ethnicity over 10 influenza seasons. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the Influenza-Associated Hospitalization Surveillance Network (FluSurv-NET), which conducts population-based surveillance for laboratory-confirmed influenza-associated hospitalizations in selected counties, representing approximately 9% of the US population. Influenza hospitalizations from the 2009 to 2010 season to the 2018 to 2019 season were analyzed. Data were analyzed from October 2020 to July 2021. MAIN OUTCOMES AND MEASURES The main outcomes were age-adjusted and age-stratified rates of influenza-associated hospitalization, ICU admission, and in-hospital death by race and ethnicity overall and by influenza season. RESULTS Among 113 352 persons with an influenza-associated hospitalization (34 436 persons [32.0%] aged ≥75 years; 61 009 [53.8%] women), 70 225 persons (62.3%) were non-Hispanic White (White), 24 850 persons (21.6%) were non-Hispanic Black (Black), 11 903 persons (10.3%) were Hispanic, 5517 persons (5.1%) were non-Hispanic Asian or Pacific Islander, and 857 persons (0.7%) were non-Hispanic American Indian or Alaska Native. Among persons aged younger than 75 years and compared with White persons of the same ages, Black persons were more likely to be hospitalized (eg, age 50-64 years: rate ratio [RR], 2.50 95% CI, 2.43-2.57) and to be admitted to an ICU (eg, age 50-64 years: RR, 2.09; 95% CI, 1.96-2.23). Among persons aged younger than 50 years and compared with White persons of the same ages, American Indian or Alaska Native persons were more likely to be hospitalized (eg, age 18-49 years: RR, 1.72; 95% CI, 1.51-1.96) and to be admitted to an ICU (eg, age 18-49 years: RR, 1.84; 95% CI, 1.40-2.42). Among children aged 4 years or younger and compared with White children, hospitalization rates were higher in Black children (RR, 2.21; 95% CI, 2.10-2.33), Hispanic children (RR, 1.87; 95% CI, 1.77-1.97), American Indian or Alaska Native children (RR, 3.00; 95% CI, 2.55-3.53), and Asian or Pacific Islander children (RR, 1.26; 95% CI, 1.16-1.38), as were rates of ICU admission (Black children: RR, 2.74; 95% CI, 2.43-3.09; Hispanic children: RR, 1.96; 95% CI, 1.73-2.23; American Indian and Alaska Native children: RR, 3.51; 95% CI, 2.45-5.05). In this age group and compared with White children, in-hospital death rates were higher among Hispanic children (RR, 2.98; 95% CI, 1.23-7.19), Black children (RR, 3.39; 95% CI, 1.40-8.18), and Asian or Pacific Islander children (RR, 4.35; 95% CI, 1.55-12.22). Few differences were observed in rates of severe influenza-associated outcomes by race and ethnicity among adults aged 75 years or older. For example, in this age group, compared with White adults, hospitalization rates were slightly higher only among Black adults (RR, 1.05; 95% CI 1.02-1.09). Overall, Black persons had the highest age-adjusted hospitalization rate (68.8 [95% CI, 68.0-69.7] hospitalizations per 100 000 population) and ICU admission rate (11.6 [95% CI, 11.2-11.9] admissions per 100 000 population). CONCLUSIONS AND RELEVANCE This cross-sectional study found racial and ethnic disparities in rates of severe influenza-associated disease. These data identified subgroups for whom improvements in influenza prevention efforts could be targeted.
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Affiliation(s)
- Alissa C. O’Halloran
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rachel Holstein
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Charisse Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- Abt Associates, Rockville, Maryland
| | | | - Nisha B. Alden
- Communicable Disease Branch, Colorado Department of Public Health and Environment, Denver
| | | | - Evan J. Anderson
- Departments of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Emerging Infections Program, Georgia Department of Health, Atlanta
- Veterans Affairs Medical Center, Atlanta, Georgia
| | | | - Sue Kim
- Communicable Disease Division, Michigan Department of Health and Human Services, Lansing
| | | | | | - Nancy M. Bennett
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | | | | | - Melissa Sutton
- Public Health Division, Oregon Health Authority, Portland
| | - William Schaffner
- Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - H. Keipp Talbot
- Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Andrea Price
- Salt Lake County Health Department, Salt Lake City, Utah
| | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carrie Reed
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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150
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Influenza Vaccination in Psoriatic Patients-Epidemiology and Patient Perceptions: A German Multicenter Study (Vac-Pso). Vaccines (Basel) 2021; 9:vaccines9080843. [PMID: 34451968 PMCID: PMC8402561 DOI: 10.3390/vaccines9080843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 01/10/2023] Open
Abstract
The risk of developing severe complications from an influenza virus infection is increased in patients with chronic inflammatory diseases such as psoriasis (PsO) and atopic dermatitis (AD). However, low influenza vaccination rates have been reported. The aim of this study was to determine vaccination rates in PsO compared to AD patients and explore patient perceptions of vaccination. A multicenter cross-sectional study was performed in 327 and 98 adult patients with PsO and AD, respectively. Data on vaccination, patient and disease characteristics, comorbidity, and patient perceptions was collected with a questionnaire. Medical records and vaccination certificates were reviewed. A total of 49.8% of PsO and 32.7% of AD patients were vaccinated at some point, while in season 2018/2019, 30.9% and 13.3% received an influenza vaccination, respectively. There were 96.6% and 77.6% of PsO and AD patients who had an indication for influenza vaccination due to age, immunosuppressive therapy, comorbidity, occupation, and/or pregnancy. Multivariate regression analysis revealed higher age (p < 0.001) and a history of bronchitis (p = 0.023) as significant predictors of influenza vaccination in PsO patients. Considering that most patients had an indication for influenza vaccination, the rate of vaccinated patients was inadequately low.
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