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Zhu Z, Sun J, Xie Y, Lu X, Tang W, Zhao Y, Shen L, Liu H, Yu Y, Zhou S, Huo L, Jiao P, Jiang X. Immunogenicity and Safety of an Inactivated Quadrivalent Influenza Vaccine Administered Concomitantly with a 23-Valent Pneumococcal Polysaccharide Vaccine in Adults Aged 60 Years and Older. Vaccines (Basel) 2024; 12:935. [PMID: 39204058 PMCID: PMC11360506 DOI: 10.3390/vaccines12080935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/27/2024] [Accepted: 07/29/2024] [Indexed: 09/03/2024] Open
Abstract
The inactivated quadrivalent influenza vaccine (IIV4) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) have been administered for years and could be administered concomitantly if necessary. However, the immunogenicity and safety of the concomitant administration of these two vaccines have not been well documented, especially in the Chinese population. In this study, 480 participants aged 60 years and older were randomly assigned to the concomitant administration group (C group) or the separate administration group (S group) to receive IIV4 and PPSV23 either concomitantly or separately. Blood samples were collected before and 28 days after each vaccination. The antibodies against four influenza virus strains and twenty-three pneumococcus serotypes were tested. The results showed that the geometric mean titer (GMT) ratios (C group to S group) for the four influenza strains ranged from 0.72 to 0.95, with the lower limits of the 95% confidence intervals (CIs) ranging from 0.51 to 0.75, and the geometric mean concentration (GMC) ratios for the 23 pneumococcal serotypes ranged from 0.80 to 1.00, with the lower limits of 95% CIs ranging from 0.67 to 0.86. All values met the predefined criteria for non-inferiority. The incidence of adverse events was 0.63% in the C group and 1.56% in the S group. No serious adverse events were observed. In conclusion, the immunogenicity of the concomitant administration of IIV4 and PPSV23 was non-inferior to that of the separate administration, and the safety profile was favorable in adults aged 60 years and older in China.
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Affiliation(s)
- Zhongkui Zhu
- Department of Immunization Program, Taizhou City Center for Disease Control and Prevention, Taizhou 225300, China; (Z.Z.); (Y.X.); (W.T.); (L.S.); (H.L.); (Y.Y.)
| | - Jianwen Sun
- Department of Medical Affairs, Sinovac Biotech Co., Ltd., Beijing 100089, China; (J.S.); (X.L.); (Y.Z.); (S.Z.); (L.H.); (P.J.)
| | - Yan Xie
- Department of Immunization Program, Taizhou City Center for Disease Control and Prevention, Taizhou 225300, China; (Z.Z.); (Y.X.); (W.T.); (L.S.); (H.L.); (Y.Y.)
| | - Xi Lu
- Department of Medical Affairs, Sinovac Biotech Co., Ltd., Beijing 100089, China; (J.S.); (X.L.); (Y.Z.); (S.Z.); (L.H.); (P.J.)
| | - Wanqin Tang
- Department of Immunization Program, Taizhou City Center for Disease Control and Prevention, Taizhou 225300, China; (Z.Z.); (Y.X.); (W.T.); (L.S.); (H.L.); (Y.Y.)
| | - Yanwei Zhao
- Department of Medical Affairs, Sinovac Biotech Co., Ltd., Beijing 100089, China; (J.S.); (X.L.); (Y.Z.); (S.Z.); (L.H.); (P.J.)
| | - Lu Shen
- Department of Immunization Program, Taizhou City Center for Disease Control and Prevention, Taizhou 225300, China; (Z.Z.); (Y.X.); (W.T.); (L.S.); (H.L.); (Y.Y.)
| | - Huaxian Liu
- Department of Immunization Program, Taizhou City Center for Disease Control and Prevention, Taizhou 225300, China; (Z.Z.); (Y.X.); (W.T.); (L.S.); (H.L.); (Y.Y.)
| | - Yang Yu
- Department of Immunization Program, Taizhou City Center for Disease Control and Prevention, Taizhou 225300, China; (Z.Z.); (Y.X.); (W.T.); (L.S.); (H.L.); (Y.Y.)
| | - Siliang Zhou
- Department of Medical Affairs, Sinovac Biotech Co., Ltd., Beijing 100089, China; (J.S.); (X.L.); (Y.Z.); (S.Z.); (L.H.); (P.J.)
| | - Liqun Huo
- Department of Medical Affairs, Sinovac Biotech Co., Ltd., Beijing 100089, China; (J.S.); (X.L.); (Y.Z.); (S.Z.); (L.H.); (P.J.)
| | - Peng Jiao
- Department of Medical Affairs, Sinovac Biotech Co., Ltd., Beijing 100089, China; (J.S.); (X.L.); (Y.Z.); (S.Z.); (L.H.); (P.J.)
| | - Xiaoli Jiang
- Department of Immunization Program, Taizhou City Center for Disease Control and Prevention, Taizhou 225300, China; (Z.Z.); (Y.X.); (W.T.); (L.S.); (H.L.); (Y.Y.)
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Guo X, Li J, Qiu J, Zhang R, Ren J, Huang Z, Li Z, Liang X, Lan F, Chen J, Huang F, Sun X. Persistence of antibody to 23-valent pneumococcal polysaccharide vaccine: a 5-year prospective follow-up cohort study. Expert Rev Vaccines 2024; 23:237-245. [PMID: 38369970 DOI: 10.1080/14760584.2023.2296934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/15/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Pneumococcal vaccines are effective in preventing pneumococcal diseases in adults. The evaluation of the antibodies persistence to the 23-valent pneumococcal polysaccharide vaccine (PPV23) could provide evidence on PPV23 revaccination. RESEARCH DESIGN AND METHODS Adults aged ≥ 60 years were selected and vaccinated with PPV23 in Shanghai, and followed up for 5 years with blood samples collection of a 1-year interval. The geometric mean concentrations (GMC) of the IgG against 23 pneumococcal serotypes covered by PPV23 were detected using enzyme-linked immunosorbent assay. The antibodies to 23 pneumococcal serotypes among different groups was analyzed using statistical analysis. RESULTS Overall, 517 participants completed all six visits over a 5-year period (2013-2018). The GMC of 23 serotypes in adults aged ≥ 60 years decreased slowly after PPV23 vaccination compared to baseline pre-vaccination (P < 0.05), except serotype 3. Additionally, the multiplicative increase in the antibody concentration after PPV23 vaccination was greater, and the antibody levels of serotypes 1 and 6B were significantly higher at visit 5 than at visit 4 (P < 0.05). CONCLUSIONS The pneumococcal antibodies in elderly after PPV23 vaccination could sustain high levels over long-term follow-up, which suggested that the interval of revaccination with PPV23 in elderly should be at least 5 years after the first vaccination.
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Affiliation(s)
- Xiang Guo
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Juan Li
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jing Qiu
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Rui Zhang
- Vaccine Engineering Research Center of Sichuan Province, Chengdu Institute of Biological Products Co, Ltd, Chengdu, China
| | - Jia Ren
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Zhuoying Huang
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Zhi Li
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiufang Liang
- Institute of Immunization, Yangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Fang Lan
- Vaccine Engineering Research Center of Sichuan Province, Chengdu Institute of Biological Products Co, Ltd, Chengdu, China
| | - Juan Chen
- Vaccine Engineering Research Center of Sichuan Province, Chengdu Institute of Biological Products Co, Ltd, Chengdu, China
| | - Fang Huang
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiaodong Sun
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
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Woodward M, Ramasubramanian V, Kamarulzaman A, Tantawichien T, Wang M, Song JY, Choi WS, Djauzi S, Solante R, Lee WS, Tateda K, Pan H, Wang NC, Pang T. Addressing Unmet Needs in Vaccination for Older Adults in the Asia Pacific: Insights from the COVID-19 Pandemic. Clin Interv Aging 2023; 18:869-880. [PMID: 37284594 PMCID: PMC10239646 DOI: 10.2147/cia.s406601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/08/2023] [Indexed: 06/08/2023] Open
Abstract
The impact of vaccinating the older population against vaccine-preventable diseases in terms of health, social and economic benefits has been increasingly recognised. However, there is a gap in the utilisation of vaccines worldwide. The population is ageing at an unprecedented pace in the Asia-Pacific (APAC) region, with the number of persons older than 65 years set to double by 2050 to around 1.3 billion. More than 18% of the population in Japan, Hong Kong, and China is over the age of 65 years. This highlights the importance of prioritising resources to address societal obligations toward the needs of the ageing generation. This review provides an overview of the challenges to adult vaccination in APAC, drivers to increase vaccination coverage, vaccination insights gained through the COVID-19 pandemic, and potential measures to increase the uptake of adult vaccines in the region.
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Affiliation(s)
| | | | - Adeeba Kamarulzaman
- Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Terapong Tantawichien
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Minggui Wang
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, SH, People’s Republic of China
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korean University College of Medicine, Ansan, Korea
| | - Samsuridjal Djauzi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rontgene Solante
- Adult Infectious Diseases and Tropical Medicine, San Lazaro Hospital, Manila, NCR, Philippines
| | - Wen-Sen Lee
- Division of Infectious Diseases, Department of Internal Medicine, New Taipei City Hospital, New Taipei, Taiwan
| | - Kazuhiko Tateda
- Department of Microbiology and Infectious Diseases, Faculty of Medicine, Toho University, Tokyo, Japan
| | - HongXing Pan
- Institution of Vaccine Clinical Trials, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, JS, People’s Republic of China
| | - Ning-Chi Wang
- Department of Medicine, Tri-Service Hospital, Taipei, Taiwan
| | - Tikki Pang
- Centre for Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Pi Z, Aoyagi K, Arima K, Wu X, Ye Z, Jiang Y. Optimization of Elderly Influenza and Pneumococcal Immunization Programs in Beijing, China Using Health Economic Evaluations: A Modeling Study. Vaccines (Basel) 2023; 11:vaccines11010161. [PMID: 36680005 PMCID: PMC9863432 DOI: 10.3390/vaccines11010161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
(1) Background: Currently, residents ≥ 60 and ≥65 years old in Beijing, China, are eligible for free influenza and pneumococcal polysaccharide vaccines (PPSV23), respectively. The present study aimed to assess the cost-effectiveness of current and alternative strategies of dual influenza and PPSV23 vaccination among the elderly in Beijing. (2) Methods: We developed a Markov state-transition model to compare the costs and the quality-adjusted life years (QALYs) associated with four influenza and PPSV23 vaccination strategies among the elderly in Beijing. The strategies were as follows: (1) no vaccination; (2) only flu vaccine for people ≥ 60 years old; (3) flu vaccine for people ≥ 60 years old and PPSV23 for people ≥ 65 years old; and (4) dual influenza vaccines and PPSV23 for people ≥ 60 years old. Incremental costs and QALYs were quantified to determine the optimal option. If dominant strategies emerged, the Chinese gross domestic product per capita in 2021 (80,976 CNY) was used as the willingness-to-pay (WTP) threshold to covert QALYs into the monetary equivalent. (3) Results: The current program saved costs and increased QALYs compared to no vaccination or flu vaccine-only strategies. However, extending free PPSV23 to people ≥ 60 years old saved 0.35 CNY additionally while increasing QALYs marginally compared with the current policy. Results were robust in all sensitivity analyses. (4) Conclusion: Beijing's current dual influenza and pneumococcal vaccination program was cost-effective among the elderly compared with the preceding policies of no vaccination and flu-only immunization programs. However, the program can further save money while enhancing the population health by extending PPSV23 to all people ≥ 60 years old.
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Affiliation(s)
- Zhenfei Pi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Xiaoliang Wu
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Zhaojia Ye
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Yawen Jiang
- School of Public Health (Shenzhen), Sun Yat-sen University, Room 533, West Wing of Medical Complex #1, 66 Gongchang Road, Guangming District, Shenzhen 518107, China
- Correspondence: ; Tel.: +86-13632974660
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Tan MP, Sekawi Z, Abdul Manap R, Razali RM, Mahadzir H, Nordin N, Koh KC, Wong PL, Hasmuk K, Harrun NH, Mokhtar SA. A Malaysian consensus recommendation for the prevention of influenza in older persons. BMC Infect Dis 2022; 22:943. [PMID: 36522615 PMCID: PMC9756619 DOI: 10.1186/s12879-022-07920-3] [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: 07/19/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Older persons are at high-risk of developing severe complications from influenza. This consensus statement was developed to provide guidance on appropriate influenza prevention strategies relevant to the Malaysian healthcare setting. METHODS Under the initiative of the Malaysian Influenza Working Group (MIWG), a panel comprising 11 multi-speciality physicians was convened to develop a consensus statement. Using a modified Delphi process, the panellists reviewed published evidence on various influenza management interventions and synthesised 10 recommendations for the prevention of influenza among the aged population via group discussions and a blinded rating exercise. RESULTS Overall, annual influenza vaccination is recommended for individuals aged ≥ 60 years, particularly those with specific medical conditions or residing in aged care facilities (ACFs). There is no preference for a particular vaccine type in this target population. Antiviral agents can be given for post-exposure chemoprophylaxis or when vaccine contraindication exists. Infection control measures should serve as adjuncts to prevent the spread of influenza, especially during Hajj. CONCLUSION This consensus statement presents 10 evidence-based recommendations that can be adopted by healthcare providers to prevent influenza among the aged population in Malaysia. It could also serve as a basis for health policy planning in other lower- and middle-income countries.
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Affiliation(s)
- Maw-Pin Tan
- grid.10347.310000 0001 2308 5949Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, Universiti Malaya, Jalan Profesor DiRaja Ungku Aziz, 50603 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur Malaysia
| | - Zamberi Sekawi
- grid.11142.370000 0001 2231 800XUniversiti Putra Malaysia, Serdang, Selangor Malaysia
| | - Roslina Abdul Manap
- grid.412113.40000 0004 1937 1557National University of Malaysia, Cheras, Selangor Malaysia
| | - Rizah Mazzuin Razali
- grid.412516.50000 0004 0621 7139Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur Malaysia
| | - Hazlina Mahadzir
- Hospital Canselor Tuanku Muhriz, Cheras, Wilayah Persekutuan Kuala Lumpur Malaysia
| | - Nordiana Nordin
- KPJ Damansara Specialist Hospital, Petaling Jaya, Selangor Malaysia
| | - Kar-Chai Koh
- Poliklinik Kepong Baru, Kepong, Wilayah Persekutuan Kuala Lumpur Malaysia
| | - Pui-Li Wong
- grid.10347.310000 0001 2308 5949Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur Malaysia
| | - Kejal Hasmuk
- grid.413018.f0000 0000 8963 3111University Malaya Medical Centre, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur Malaysia
| | | | - Siti Aisah Mokhtar
- grid.11142.370000 0001 2231 800XUniversiti Putra Malaysia, Serdang, Selangor Malaysia
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Yunhua B, Peng B, Shuping L, Zheng Z. A narrative review on vaccination rate and factors associated with the willingness to receive pneumococcal vaccine in Chinese adult population. Hum Vaccin Immunother 2022; 18:2139123. [PMID: 36379017 DOI: 10.1080/21645515.2022.2139123] [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] [Indexed: 11/16/2022] Open
Abstract
The 23-valent pneumococcal polysaccharide vaccine (PPSV-23) is the only approved vaccine for pneumococcal diseases in elderly Chinese population. Though regional studies explored the PPSV-23 vaccination coverage rates and influencing factors in China, a large-scale, nation-wide epidemiological surveillance studies to understand the different factors impeding pneumococcal vaccination rate are required. Hence, this review summarized PPSV-23 coverage rate, analyzed and identified vaccination influencing factors among elderly population across China by exploring articles published in CNKI, Wanfang and PubMed databases. Pneumococcal vaccination coverage rate was found to be low at around 1.23%~42.10% in China. Co-morbidities, knowledge, attitude, perception toward pneumonia and PPSV-23, education level, socio-economic disparities, health education and local policies were some of the factors associated with vaccination willingness among elderly Chinese population. Interventions or policies like government funding, subsidies, inclusion of PPSV-23 in medical insurance, or systematic encouragement from HCPs as key strategies should be implemented to encourage vaccination.
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Affiliation(s)
- Bai Yunhua
- Center for Disease Control and Prevention of Chaoyang District, Beijing, China
| | - Bai Peng
- Global Medical Affairs, MRL, MSD China, Shanghai, China
| | - Li Shuping
- Center for Disease Control and Prevention of Chaoyang District, Beijing, China
| | - Zhang Zheng
- Center for Disease Control and Prevention of Chaoyang District, Beijing, China
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Li Y, Wu J, Hao J, Dou Q, Xiang H, Liu S. Short-term impact of ambient temperature on the incidence of influenza in Wuhan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:18116-18125. [PMID: 34677763 DOI: 10.1007/s11356-021-16948-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
Few studies have estimated the nonlinear association of ambient temperature with the risk of influenza. We therefore applied a time-series analysis to explore the short-term effect of ambient temperature on the incidence of influenza in Wuhan, China. Daily influenza cases were collected from Hubei Provincial Center for Disease Control and Prevention (Hubei CDC) from January 1, 2014, to December 31, 2017. The meteorological and daily pollutant data was obtained from the Hubei Meteorological Service Center and National Air Quality Monitoring Stations, respectively. We used a generalized additive model (GAM) coupled with the distributed lag nonlinear model (DLNM) to explore the exposure-lag-response relationship between the short-term risk of influenza and daily average ambient temperature. Analyses were also performed to assess the extreme cold and hot temperature effects. We observed that the ambient temperature was statistically significant, and the exposure-response curve is approximately S-shaped, with a peak observed at 23.57 ℃. The single-day lag curve showed that extreme hot and cold temperatures were both significantly associated with influenza. The extreme hot temperature has an acute effect on influenza, with the most significant effect observed at lag 0-1. The extreme cold temperature has a relatively smaller effect but lasts longer, with the effect exerted continuously during a lag of 2-4 days. Our study found significant nonlinear and delayed associations between ambient temperature and the incidence of influenza. Our finding contributes to the establishment of an early warning system for airborne infectious diseases.
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Affiliation(s)
- Yanbing Li
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan, 430071, China
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Jingtao Wu
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan, 430071, China
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Jiayuan Hao
- Department of Biostatistics, Harvard University, Cambridge, MA, 02138, USA
| | - Qiujun Dou
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan, 430071, China
| | - Hao Xiang
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan, 430071, China
| | - Suyang Liu
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan, 430071, China.
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Sun X, Guo X, Qiu J, Zhao G, Xu X, Wagner AL, Jiang H, Huang Z, Ren J, Ma X, Liang X, Yao Y, Wu J, Lu Y. Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against Pneumococcal Diseases Among the Elderly Aged 60 Years or Older: A Matched Test Negative Case-Control Study in Shanghai, China. Front Public Health 2021; 9:620531. [PMID: 34616702 PMCID: PMC8488431 DOI: 10.3389/fpubh.2021.620531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 08/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background:Streptococcus pneumoniae infection among adults, especially in adults over 60 years old in China results in a large number of hospitalizations and a substantial financial burden. This study assessed the vaccine effectiveness (VE) of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases among the elderly aged 60 years or older in Shanghai, China. Methods: We conducted a test-negative case–control study among the elderly aged 60 years or older who sought care at hospitals in 13 districts of Shanghai from September 14, 2013 to August 31, 2019. A case was defined as pneumococcal disease and testing positive for Streptococcus pneumoniae. Controls had symptoms congruent with pneumococcal disease but were negative for Streptococcus pneumoniae. We conducted 1:2 matching by gender, age, hospital and admission date. Vaccination status was verified from the immunization system database. VE was calculated with conditional logistic regression according to the formula (1–OR) ×100%. Results: Overall, 603 adults aged 60 years or older with pneumococcal disease and positive for Streptococcus pneumoniae were included as cases, and 19.6% (118 persons) had a recorded PPV23 vaccination. The controls included 1,206 adults, whose vaccination rate was 23.8% (287 persons). The VE against pneumococcal diseases among the whole population was 24% (95% CI: 2%, 40%) and among women 44% (95% CI: 6%, 67%). After adjusting for multiple variables, the effectiveness of PPV23 against pneumococcal diseases was still statistically significant with VE for all of 25% (95% CI: 3%, 42%) and VE for women of 49% (95% CI: 11%, 71%). Conclusion: PPV23 was effective against pneumococcal diseases in adults aged 60 years or older in Shanghai, China. Its relatively high effectiveness among women warrants this group to be particularly targeted for vaccination, with further research on why vaccination effectiveness is less among men.
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Affiliation(s)
- Xiaodong Sun
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiang Guo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jing Qiu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Xinxin Xu
- Shanghai Municipal Center for Health Promotion, Shanghai, China
| | - Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Hongli Jiang
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, China
| | - Zhuoying Huang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jia Ren
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiaoying Ma
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiufang Liang
- Yangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Yao Yao
- Chongming District Center for Disease Control and Prevention, Shanghai, China
| | - Jialing Wu
- Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
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Li Q, Zhang M, Chen H, Wu F, Xian J, Zheng L, Liang M, Cao H, Zhou X, Gu Z, Lin Q, Chen Q. Influenza Vaccination Coverage among Older Adults with Hypertension in Shenzhen, China: A Cross-Sectional Survey during the COVID-19 Pandemic. Vaccines (Basel) 2021; 9:vaccines9101105. [PMID: 34696213 PMCID: PMC8540932 DOI: 10.3390/vaccines9101105] [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: 08/28/2021] [Revised: 09/14/2021] [Accepted: 09/25/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Older individuals with hypertension are at a high risk of being infected with influenza. However, there have been few studies investigating the influenza vaccination status among older people with hypertension. The present work aimed to estimate the vaccination coverage and determine the predictors of seasonal influenza vaccinations among hypertensive patients aged over 60 years in Shenzhen, China. Method: The study used data from an online cross-sectional survey that was conducted in Shenzhen City, China, in October 2020. Frequencies and proportions of all the variables including sociodemographic characteristics and health-related information were described and tabulated based on the influenza vaccination status. Bivariate and multivariable logistic regression analyses were used to identify independent predictors associated with the influenza vaccination. Results: A total of 5216 older people with hypertension aged above 60 years were recruited. Overall, only 4.7% had received an influenza vaccine in the latest influenza season. Using the action toward being vaccinated as the primary outcome, the multivariable regression analysis showed that participants aged over 80 years (aOR 2.957, 95% CI: 1.784–4.900), obtaining higher education levels (aOR 1.424, 95% CI: 1.060–1.914 for high school, aOR 1.681, 95% CI: 1.066–2.650 for college or above), living with a partner (aOR 1.432, 95% CI: 1.068–1.920), using a family doctor (aOR 2.275, 95% CI: 1.744–2.968), and taking a physical examination 1–2 and ≥3 times each year (aOR 2.107, 95% CI: 1.601–2.772 and aOR 2.118, 95% CI: 1.083–4.143, respectively) were more likely to be vaccinated. In contrast, smokers had less likelihood of having the influenza vaccination than non-smokers (aOR 1.829, 95% CI: 1.208–2.767). Conclusions: The coverage rate of influenza vaccinations is far away from optimistic among older adults with hypertension. Additional works should be undertaken immediately to improve the influenza vaccination status.
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Affiliation(s)
- Qiushuang Li
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Q.L.); (M.Z.); (F.W.); (J.X.); (L.Z.); (M.L.)
| | - Minyi Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Q.L.); (M.Z.); (F.W.); (J.X.); (L.Z.); (M.L.)
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China; (H.C.); (H.C.); (X.Z.); (Z.G.)
| | - Fei Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Q.L.); (M.Z.); (F.W.); (J.X.); (L.Z.); (M.L.)
| | - Juxian Xian
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Q.L.); (M.Z.); (F.W.); (J.X.); (L.Z.); (M.L.)
| | - Liting Zheng
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Q.L.); (M.Z.); (F.W.); (J.X.); (L.Z.); (M.L.)
| | - Minyi Liang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Q.L.); (M.Z.); (F.W.); (J.X.); (L.Z.); (M.L.)
| | - He Cao
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China; (H.C.); (H.C.); (X.Z.); (Z.G.)
| | - Xiaofeng Zhou
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China; (H.C.); (H.C.); (X.Z.); (Z.G.)
| | - Zihao Gu
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China; (H.C.); (H.C.); (X.Z.); (Z.G.)
| | - Qihui Lin
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China; (H.C.); (H.C.); (X.Z.); (Z.G.)
- Correspondence: (Q.L.); (Q.C.); Tel.: +86-13808857517 (Q.L.); +86-020-6164-8312 (Q.C.)
| | - Qing Chen
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China; (Q.L.); (M.Z.); (F.W.); (J.X.); (L.Z.); (M.L.)
- Correspondence: (Q.L.); (Q.C.); Tel.: +86-13808857517 (Q.L.); +86-020-6164-8312 (Q.C.)
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10
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Jiang Y, Ye Z, Chen D, Shu Y. Dual influenza and pneumococcal vaccination was associated with lower short-term risks of all-cause and acute respiratory hospitalizations among the elderly in Shenzhen, China: a retrospective cohort study. Emerg Microbes Infect 2021; 9:2578-2587. [PMID: 33215981 PMCID: PMC7734018 DOI: 10.1080/22221751.2020.1854624] [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] [Indexed: 01/17/2023]
Abstract
The present study evaluated the real-world effectiveness of influenza and pneumococcal dual-vaccination among Chinese elderly, the evidence on which was absent. Outpatient and inpatient claims databases from Jan 1, 2015 to Apr 1, 2017 of persons at least 60 years old in Shenzhen, China were merged with electronic records of influenza vaccines and 23-valent pneumococcal polysaccharide vaccines (PPSV23) from Oct 1, 2016 - May 31, 2017. Individuals who were vaccinated with influenza between Nov 1 and Dec 31, 2016 and received PPSV23 30 days within the date of influenza vaccination were defined as the vaccinated group. A control group consisted of individuals that received neither of the vaccines was constructed by matching on year of birth, sex, and district. The two outcomes were all-cause and acute respiratory hospitalizations. Difference-in-difference (DiD) logistic regressions that were proceeded with an entropy balancing (EB) process were used to analyse the effectiveness of dual-vaccination. A total of 48,116 eligible individuals were identified in the vaccinated group, which were matched by 93,692 individuals in the control group. The EB-DiD analyses estimated that dual-vaccination was associated with lower short-term risks of all-cause (odds ratio: 0.59, CI: 0.55-0.63) and acute respiratory (odds ratio: 0.49, CI: 0.41-0.59) hospitalizations.
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Affiliation(s)
- Yawen Jiang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Zhaojia Ye
- Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Daqin Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Yuelong Shu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
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11
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Zhang M, Chen H, Wu F, Li Q, Lin Q, Cao H, Zhou X, Gu Z, Chen Q. Heightened Willingness toward Pneumococcal Vaccination in the Elderly Population in Shenzhen, China: A Cross-Sectional Study during the COVID-19 Pandemic. Vaccines (Basel) 2021; 9:vaccines9030212. [PMID: 33802327 PMCID: PMC8000999 DOI: 10.3390/vaccines9030212] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 01/28/2023] Open
Abstract
Background: Elderly population is considered at high risk for pneumococcal diseases. The pneumococcal vaccine coverage presents extremely low among elderly people in China. However, the serious event of COVID-19 drives interest in the pneumococcal vaccine, prompting us investigating the willingness to accept the 23-valent pneumococcal polysaccharide vaccine (PPSV23) and influencing factors among people aged over 60 years during the COVID-19 pandemic. Methods: A cross-sectional study was employed using a self-administered questionnaire in Shenzhen City of China, elaborating the willingness toward PPSV23 in the elderly persons. Binomial logistic analyses were performed to estimate the influencing factors using odds ratios (ORs) and 95% confidence interval (CI). Results: Among 15,066 respondents, 91.5% presented a positive attitude toward PPSV23. Logistic analyses suggested the influencing factors included knowledge about pneumonia (adjusted OR [aOR] 1.391, 95%CI 1.214–1.593), perception of the seriousness of pneumonia (aOR 1.437, 95%CI 1.230–1.680) and preventing way for pneumonia (aOR 1.639, 95%CI 1.440–1.865), worried about getting pneumonia (aOR 2.751, 95%CI 2.444–3.096), understanding vaccine policy (aOR 1.774, 95%CI 1.514–2.079), and influenza vaccine (aOR 3.516 and 95%CI 2.261–5.468) and PPSV23 histories (aOR 3.199, 95%CI 1.492–6.860). Conclusions: The interest surge in pneumococcal vaccine coincided with the COVID-19 outbreak, foreshadowing higher demand for pneumococcal vaccine in the near future.
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Affiliation(s)
- Minyi Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Control and Prevention of Infectious Diseases and Public Health, Shenzhen 518109, China
| | - Fei Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Qiushuang Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Qihui Lin
- Department of Epidemiology and Infectious Disease Control, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - He Cao
- Department of Epidemiology and Infectious Disease Control, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - Xiaofeng Zhou
- Department of Epidemiology and Infectious Disease Control, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - Zihao Gu
- Department of Epidemiology and Infectious Disease Control, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
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12
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Abstract
The Coronavirus Disease 2019 (COVID-19) outbreak, caused by the SARS-CoV-2 virus, surprised the whole world in an unprecedented and devastating way, resulting in almost 200,000 deaths and 2.3 million infections worldwide in less than 4 months. Moreover, the elevate capability of transmission threatens to collapse both the healthy and economic systems from most countries, stressing worse predictions for emerging countries. In such a turbulent scenario, fast diagnosis is essential for a successful treatment and isolation of patients, thus avoiding increasing the number of contaminations. However, traditional methods of detection using polymerase chain reaction are impractical in large scale due to elevate costs, material scarcity, and time demanded for processing. As an alternative, some researchers proposed a machine learning–based diagnosis considering chest X-ray analysis with promising results, thus opening room for possible improvements. This work introduces a different normalization approach that, together with an EfficientNet-B6-inspired neural network, can deal with COVID-19 diagnosis considering chest X-ray images. Experiments provided competitive results considering a lighter and faster architecture, thus fostering research toward COVID-19 detection.
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13
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Xie M, Chen Q. Insight into 2019 novel coronavirus - An updated interim review and lessons from SARS-CoV and MERS-CoV. Int J Infect Dis 2020; 94:119-124. [PMID: 32247050 PMCID: PMC7118633 DOI: 10.1016/j.ijid.2020.03.071] [Citation(s) in RCA: 238] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The rapid spread of the coronavirus disease 2019 (COVID-19), caused by a zoonotic beta-coronavirus entitled 2019 novel coronavirus (2019-nCoV), has become a global threat. Awareness of the biological features of 2019-nCoV should be updated in time and needs to be comprehensively summarized to help optimize control measures and make therapeutic decisions. METHODS Based on recently published literature, official documents and selected up-to-date preprint studies, we reviewed the virology and origin, epidemiology, clinical manifestations, pathology and treatment of 2019-nCoV infection, in comparison with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infection. RESULTS The genome of 2019-nCoV partially resembled SARS-CoV and MERS-CoV, and indicated a bat origin. The COVID-19 generally had a high reproductive number, a long incubation period, a short serial interval and a low case fatality rate (much higher in patients with comorbidities) than SARS and MERS. Clinical presentation and pathology of COVID-19 greatly resembled SARS and MERS, with less upper respiratory and gastrointestinal symptoms, and more exudative lesions in post-mortems. Potential treatments included remdesivir, chloroquine, tocilizumab, convalescent plasma and vaccine immunization (when possible). CONCLUSION The initial experience from the current pandemic and lessons from the previous two pandemics can help improve future preparedness plans and combat disease progression.
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Affiliation(s)
- Mingxuan Xie
- Department of Geriatrics / Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Qiong Chen
- Department of Geriatrics / Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.
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14
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Li X, Leng SX. Influenza immunization among Chinese seniors: Urgent calling for improving vaccination coverage, education, and research. Aging Med (Milton) 2020; 3:12-15. [PMID: 32232187 PMCID: PMC7099750 DOI: 10.1002/agm2.12103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Xin Li
- Department of Geriatrics The Second Hospital of Tianjin Medical University Tianjin China
| | - Sean X Leng
- Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Baltimore Maryland USA
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