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Hirsiger JR, Tamborrini G, Harder D, Bantug GR, Hoenger G, Recher M, Marx C, Li QZ, Martin I, Hess C, Scherberich A, Daikeler T, Berger CT. Chronic inflammation and extracellular matrix-specific autoimmunity following inadvertent periarticular influenza vaccination. J Autoimmun 2021; 124:102714. [PMID: 34403915 DOI: 10.1016/j.jaut.2021.102714] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Viral infections may trigger autoimmunity in genetically predisposed individuals. Immunizations mimic viral infections immunologically, but only in rare instances vaccinations coincide with the onset of autoimmunity. Inadvertent vaccine injection into periarticular shoulder tissue can cause inflammatory tissue damage ('shoulder injury related to vaccine administration, SIRVA). Thus, this accident provides a model to study if vaccine-induced pathogen-specific immunity accompanied by a robust inflammatory insult may trigger autoimmunity in specific genetic backgrounds. METHODS We studied 16 otherwise healthy adults with suspected SIRVA occurring following a single work-related influenza immunization campaign in 2017. We performed ultrasound, immunophenotypic analyses, HLA typing, and influenza- and self-reactivity functional immunoassays. Vaccine-related bone toxicity and T cell/osteoclast interactions were assessed in vitro. FINDINGS Twelve of the 16 subjects had evidence of inflammatory tissue damage on imaging, including bone erosions in six. Tissue damage was associated with a robust peripheral blood T and B cell activation signature and extracellular matrix-reactive autoantibodies. All subjects with erosions were HLA-DRB1*04 positive and showed extracellular matrix-reactive HLA-DRB1*04 restricted T cell responses targeting heparan sulfate proteoglycan (HSPG). Antigen-specific T cells potently activated osteoclasts via RANK/RANK-L, and the osteoclast activation marker Trap5b was high in sera of patients with an erosive shoulder injury. In vitro, the vaccine component alpha-tocopheryl succinate recapitulated bone toxicity and stimulated osteoclasts. Auto-reactivity was transient, with no evidence of progression to rheumatoid arthritis or overt autoimmune disease. CONCLUSION Vaccine misapplication, potentially a genetic predisposition, and vaccine components contribute to SIRVA. The association with autoimmunity risk allele HLA-DRB1*04 needs to be further investigated. Despite transient autoimmunity, SIRVA was not associated with progression to autoimmune disease during two years of follow-up.
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Affiliation(s)
- Julia R Hirsiger
- Translational Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Giorgio Tamborrini
- Ultrasound Center for Rheumatology (UZR), Basel, Switzerland; Rheumatology Clinic, University Hospital Basel, Basel, Switzerland
| | - Dorothee Harder
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Glenn R Bantug
- Immunobiology Lab, Department Biomedicine, University of Basel, Basel, Switzerland
| | - Gideon Hoenger
- HLA-Diagnostics and Immunogenetics, Department of Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Mike Recher
- Immunodeficiency Lab, Department Biomedicine, University of Basel, Basel, Switzerland
| | | | - Quan-Zhen Li
- Department of Immunology & Internal Medicine, IIMT Microarray Core Facility, University of Texas Southwestern Medical Center, USA
| | - Ivan Martin
- Laboratory of Tissue Engineering, Departments of Surgery and Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Christoph Hess
- Immunobiology Lab, Department Biomedicine, University of Basel, Basel, Switzerland
| | - Arnaud Scherberich
- Laboratory of Tissue Engineering, Departments of Surgery and Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Thomas Daikeler
- Rheumatology Clinic, University Hospital Basel, Basel, Switzerland
| | - Christoph T Berger
- Translational Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland; Interdisciplinary Center for Immunology, Departments of Dermatology, Internal Medicine, and Rheumatology, University Hospital Basel, Basel, Switzerland.
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Lama Y, Hancock GR, Freimuth VS, Jamison AM, Quinn SC. Using classification and regression tree analysis to explore parental influenza vaccine decisions. Vaccine 2019; 38:1032-1039. [PMID: 31806534 DOI: 10.1016/j.vaccine.2019.11.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Influenza poses a public health threat for children and adults. The CDC recommends annual influenza vaccination for children <18 years, yet vaccine uptake remains low for children (57.9%) and adults (37.1%). Given that parental decision-making is key in childhood vaccine uptake, there is a critical need to understand vaccine hesitancy among parents who decide not to vaccinate their children. This study aims to explore predictors of children's influenza vaccine status given parental vaccination status and examine the factors that contribute to concordance or discordance between parental and children's vaccine uptake. METHODS Classification and regression tree (CART) analyses were used to identify drivers of parental decisions to vaccinate their children against influenza. Hierarchy and interactions of these variables in predicting children's vaccination status were explored. RESULTS From a nationally representative sample of non-Hispanic Black and White parents who completed an online survey (n = 328), the main factors influencing parents' decisions to vaccinate their children were vaccine behavior following physician recommendation, knowledge of influenza recommendations for children, influenza vaccine confidence and disease risk. Among unvaccinated parents, the greatest concordance was observed among parents who usually do not get vaccinated following physician recommendation and had lower knowledge of recommendations for influenza vaccination for children. The greatest discordance was observed among unvaccinated parents who had lower hesitancy about recommended vaccines. CONCLUSIONS Understanding drivers of parental decisions to vaccinate themselves and their children can provide insights on health communication and provider approaches to increase influenza vaccine coverage and prevent influenza related mortality.
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Affiliation(s)
- Yuki Lama
- Department of Family Science, University of Maryland, College Park, MD, United States.
| | - Gregory R Hancock
- Department of Human Development and Quantitative Methods, University of Maryland, College Park, MD, United States
| | - Vicki S Freimuth
- Center for Health and Risk Communication (Emeritus), University of Georgia, Athens, GA, United States
| | - Amelia M Jamison
- Center for Health Equity, University of Maryland, College Park, MD, United States
| | - Sandra Crouse Quinn
- Department of Family Science, University of Maryland, College Park, MD, United States; Center for Health Equity, University of Maryland, College Park, MD, United States
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Abstract
Vaccines have saved millions of lives and reduced the severity of many infections. A reduction in vaccination coverage is now reflected in the re-emergence of epidemics of mumps, pertussis, measles and chickenpox. Many people do not recognize the effectiveness of vaccination and fear the side effects. The main concern is the safety of vaccines. Lack of information weighs less than lack of trust in health authorities. The greater responsibility of the individual and the respect for his free will, may lead the authorities to a less vigourous promotion of the "vaccination duty" which is also a social duty. The attitude of individuals is guided by their health beliefs which are often supported by an erroneous perception of risk. In addition, insidious anti-vaccine lobbying plays on fears and uses biased reasoning that the media help to amplify. Thus the analysis of the brakes to vaccination both in the general population and among health professionals, the dismantling of the arguments developed by the anti-vaccine leagues and vigilance with regard to "fake news" should allow a concerted communication, transparent, clear and effective, in order to limit the occurrence of preventable deaths.
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Affiliation(s)
- B Housset
- Pneumologie, CHI de Créteil, 40, avenue de Verdun, 94000 Créteil, France.
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Abstract
Although measles was eradicated in the United States in 2000, there has been an increasing number of cases. As of April 4, 2019, the Centers for Disease Control and Prevention (CDC) reported 465 cases of measles as compared to 372 in 2018. Pockets of unvaccinated communities and travelers bringing measles from countries with large outbreaks are attributed to the rise in cases in the United States. With the increasing anti-vaccine sentiment, it’s imperative to take preventative measures to avoid the proliferation of deadly diseases. The objective of this study was to determine effective techniques to decrease vaccine refusal and increase the childhood vaccination rate. To this effect, a systematic review of English peer-reviewed articles published in the years 2000 to 2019 using Arizona State University’s online database was conducted. The titles, abstracts, and discussions for each journal article were screened for methods that promote vaccination. Any articles that included vaccine development, promoting vaccination coverage rate in developing countries, pregnant women, healthcare workers, and animals, and promoting the uptake of vaccines that aren’t part of CDC’s seven-vaccine series were excluded. A total of nine journal articles were identified, including five systematic reviews, one case study, a randomized controlled trial, a literature review, and a quasi-experimental study. The methods discovered pertained to three themes: technological, mass marketing or campaigning, and direct communication. The Guide to Tailored Immunization Programme (TIP) in conjunction with visually enhanced educational materials and storytelling articles were found to be effective tools in encouraging vaccination coverage. The basis of any strategy is determining the perspective and needs of the target population and tailoring the approaches to match them to alleviate barriers that hinder vaccination uptake. The use of technology perpetuates the efficacy of social marketing strategies, further promoting vaccines and their benefits.
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Affiliation(s)
- Rawan Nour
- Miscellaneous, College of Health Solutions, Arizona State University, Phoenix, USA
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5
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Janković S. Childhood vaccination in the twenty-first century: Parental concerns and challenges for physicians. ARHIV ZA FARMACIJU 2019. [DOI: 10.5937/arhfarm1906452j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Loeb M, Russell ML, Neupane B, Thanabalan V, Singh P, Newton J, Pullenayegum E. A randomized, blinded, placebo-controlled trial comparing antibody responses to homeopathic and conventional vaccines in university students. Vaccine 2018; 36:7423-7429. [PMID: 30352746 DOI: 10.1016/j.vaccine.2018.08.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Homeopathic vaccines are licensed in many countries but scientific data to support their use are sparse. The goal of this study was to compare the antibody response of homeopathic and conventional vaccines and placebo in young adults. We hypothesized that there would be no significant difference between homeopathic vaccines and placebo, while there would be a significant increase in antibodies in those received conventional vaccines. METHODS A randomized blinded placebo-controlled trial was conducted where 150 university students who had received childhood vaccinations were assigned to diphtheria, pertussis, tetanus, mumps, measles homeopathic vaccine, placebo, or conventional diphtheria, pertussis, tetanus (Tdap) and mumps, measles, rubella (MMR) vaccines. The primary outcome was a ≥ two-fold increase in antibodies from baseline following vaccination as measured by ELISA. Participants, investigators, study coordinator, data blood drawers, laboratory technician, and data analyst were blinded. RESULTS None of the participants in either the homeopathic vaccine or the placebo group showed a ≥ two-fold response to any of the antigens. In contrast, of those vaccinated with Tdap, 68% (33/48) had a ≥ two-fold response to diphtheria, 83% (40/48) to pertussis toxoid, 88% (42/48) to tetanus, and 35% (17/48) of those vaccinated with MMR had a response to measles or mumps antigens (p < 0.001 for each comparison of conventional vaccine to homeopathic vaccine or to placebo). There was a significant increase in geometric mean titres of antibody from baseline for conventional vaccine antigens (p < 0.001 for each), but none for the response to homeopathic antigens or placebo. CONCLUSIONS Homeopathic vaccines do not evoke antibody responses and produce a response that is similar to placebo. In contrast, conventional vaccines provide a robust antibody response in the majority of those vaccinated. TRIAL REGISTRY NCT 02825368.
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Affiliation(s)
- Mark Loeb
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada; Health Research Methodology, Evidence, and Impact, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada; Institute for Infectious Diseases Research, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada.
| | - Margaret L Russell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive W Calgary, Alberta T2N4Z6, Canada
| | - Binod Neupane
- Health Research Methodology, Evidence, and Impact, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada
| | - Vitheya Thanabalan
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada
| | - Pardeep Singh
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada
| | - Jennifer Newton
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada
| | - Eleanor Pullenayegum
- Hospital for Sick Childrene, 555 University Avenue Toronto, Ontario M5G 1X8, Canada
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Sun X, Huang Z, Wagner AL, Prosser LA, Xu E, Ren J, Wang B, Yan W, Zikmund-Fisher BJ. The role of severity perceptions and beliefs in natural infections in Shanghai parents' vaccine decision-making: a qualitative study. BMC Public Health 2018; 18:813. [PMID: 29954371 PMCID: PMC6025737 DOI: 10.1186/s12889-018-5734-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 06/21/2018] [Indexed: 12/03/2022] Open
Abstract
Background China has reduced incidence of vaccine-preventable diseases through its Expanded Program on Immunization (EPI). Vaccines outside of the EPI are not provided for free by the government, however. This study explored how the stated importance of different disease and vaccine-related attributes interacted with beliefs about the immune system of a child to affect Chinese parents’ decision to obtain a non-EPI vaccine. Methods Mothers and fathers of young children at immunization clinics in Shanghai, China, were interviewed about vaccine decision-making and what attributes of a disease were important when making this decision. An inductive thematic analysis explored their beliefs about disease attributes and how these related to vaccination decisions. Results Among the 34 interviews, severity of the disease—particularly in causing long-term disability—was the most commonly cited factor influencing a parent’s decision to get a vaccine for their child. Many parents believed that natural infection was preferable to vaccination, as long as disease was not severe, and many were concerned that imported vaccines were inadequate for Chinese children’s physical constitutions. All these beliefs could influence the decision to vaccinate. Conclusions Many parents do not appear to understand how and why vaccines can support development of a healthy immune system. Because severity emerged as parents’ overriding concern when making decisions about vaccines, marketing for a childhood vaccine could focus on the severe condition that a vaccine can protect against.
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Affiliation(s)
- Xiaodong Sun
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, 1380, West Zhongshan Road, Shanghai, 200336, NO, China
| | - Zhuoying Huang
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, 1380, West Zhongshan Road, Shanghai, 200336, NO, China
| | - Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Lisa A Prosser
- Child Health Evaluation and Research Unit, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Erzhan Xu
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Jia Ren
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, 1380, West Zhongshan Road, Shanghai, 200336, NO, China
| | - Bei Wang
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Wenlu Yan
- School of Information, University of Michigan, 4322 North Quad, 105 S. State St, Ann Arbor, MI, 48109, USA
| | - Brian J Zikmund-Fisher
- Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.,Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
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Shapiro GK, Tatar O, Dube E, Amsel R, Knauper B, Naz A, Perez S, Rosberger Z. The vaccine hesitancy scale: Psychometric properties and validation. Vaccine 2017; 36:660-667. [PMID: 29289384 DOI: 10.1016/j.vaccine.2017.12.043] [Citation(s) in RCA: 245] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/05/2017] [Accepted: 12/14/2017] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The SAGE Working Group on Vaccine Hesitancy developed a vaccine hesitancy measure, the Vaccine Hesitancy Scale (VHS). This scale has the potential to aid in the advancement of research and immunization policy but has not yet been psychometrically evaluated. METHODS Using a cross-sectional design, we collected self-reported survey data from a large national sample of Canadian parents from August to September 2016. An online questionnaire was completed in English or French. We used exploratory and confirmatory factor analysis to identify latent constructs underlying parents' responses to 10 VHS items (response scale 1-5, with higher scores indicating greater hesitancy). In addition to the VHS, measures included socio-demographics items, vaccine attitudes, parents' human papillomavirus (HPV) vaccine decision-making stage, and vaccine refusal. RESULTS A total of 3779 Canadian parents completed the survey in English (74.1%) or French (25.9%). Exploratory and confirmatory factor analysis revealed a two-factor structure best explained the data, consisting of 'lack of confidence' (M = 1.98, SD = 0.72) and 'risks' (M = 3.07, SD = 0.95). Significant Pearson correlations were found between the scales and related vaccine attitudes. ANOVA analyses found significant differences in the VHS sub-scales by parents' vaccine decision-making stages (p < .001). Independent samples t-tests found that the VHS sub-scales were associated with HPV vaccine refusal and refusing another vaccine (p < .001). Socio-demographic differences in the VHS were found; however, effect sizes were small (η2 < 0.02). CONCLUSIONS The VHS was found to have two factors that have construct and criterion validity in identifying vaccine hesitant parents. A limitation of the VHS was few items that loaded on the 'risks' component and a lack of positively and negatively worded items for both components. Based on these results, we suggest modifying the wording of some items and adding items on risk perceptions.
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Affiliation(s)
- Gilla K Shapiro
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Québec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Québec, Canada.
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Québec, Canada
| | - Eve Dube
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Rhonda Amsel
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Québec, Canada
| | - Barbel Knauper
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Québec, Canada
| | - Anila Naz
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Québec, Canada
| | - Samara Perez
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Québec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Québec, Canada
| | - Zeev Rosberger
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Québec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Québec, Canada; Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Québec, Canada; Departments of Psychiatry and Oncology, McGill University, 1205 Dr. Penfield Avenue, Montreal, Québec, Canada
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10
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Amith M, Cunningham R, Savas LS, Boom J, Schvaneveldt R, Tao C, Cohen T. Using Pathfinder networks to discover alignment between expert and consumer conceptual knowledge from online vaccine content. J Biomed Inform 2017; 74:33-45. [PMID: 28823922 DOI: 10.1016/j.jbi.2017.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/28/2017] [Accepted: 08/14/2017] [Indexed: 10/19/2022]
Abstract
This study demonstrates the use of distributed vector representations and Pathfinder Network Scaling (PFNETS) to represent online vaccine content created by health experts and by laypeople. By analyzing a target audience's conceptualization of a topic, domain experts can develop targeted interventions to improve the basic health knowledge of consumers. The underlying assumption is that the content created by different groups reflects the mental organization of their knowledge. Applying automated text analysis to this content may elucidate differences between the knowledge structures of laypeople (heath consumers) and professionals (health experts). This paper utilizes vaccine information generated by laypeople and health experts to investigate the utility of this approach. We used an established technique from cognitive psychology, Pathfinder Network Scaling to infer the structure of the associational networks between concepts learned from online content using methods of distributional semantics. In doing so, we extend the original application of PFNETS to infer knowledge structures from individual participants, to infer the prevailing knowledge structures within communities of content authors. The resulting graphs reveal opportunities for public health and vaccination education experts to improve communication and intervention efforts directed towards health consumers. Our efforts demonstrate the feasibility of using an automated procedure to examine the manifestation of conceptual models within large bodies of free text, revealing evidence of conflicting understanding of vaccine concepts among health consumers as compared with health experts. Additionally, this study provides insight into the differences between consumer and expert abstraction of domain knowledge, revealing vaccine-related knowledge gaps that suggest opportunities to improve provider-patient communication.
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Affiliation(s)
- Muhammad Amith
- The University of Texas School of Biomedical Informatics at Houston. 7000 Fannin St, #600, Houston, TX, United States(1)
| | - Rachel Cunningham
- Texas Children's Hospital, 6621 Fannin St, Houston, TX, United States(3)
| | - Lara S Savas
- The University of Texas School of Public Health at Houston, 1200 Pressler Street Houston, TX 77030, United States(2)
| | - Julie Boom
- Texas Children's Hospital, 6621 Fannin St, Houston, TX, United States(3)
| | - Roger Schvaneveldt
- Arizona State University, Tempe, AZ, United States(4); New Mexico State University, Las Cruces, NM, United States(5)
| | - Cui Tao
- The University of Texas School of Biomedical Informatics at Houston. 7000 Fannin St, #600, Houston, TX, United States(1)
| | - Trevor Cohen
- The University of Texas School of Biomedical Informatics at Houston. 7000 Fannin St, #600, Houston, TX, United States(1).
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Poland GA, Ovsyannikova IG, Kennedy RB. Personalized vaccinology: A review. Vaccine 2017; 36:5350-5357. [PMID: 28774561 PMCID: PMC5792371 DOI: 10.1016/j.vaccine.2017.07.062] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/19/2017] [Accepted: 07/12/2017] [Indexed: 12/18/2022]
Abstract
At the current time, the field of vaccinology remains empirical in many respects. Vaccine development, vaccine immunogenicity, and vaccine efficacy have, for the most part, historically been driven by an empiric “isolate-inactivate-inject” paradigm. In turn, a population-level public health paradigm of “the same dose for everyone for every disease” model has been the normative thinking in regard to prevention of vaccine-preventable infectious diseases. In addition, up until recently, no vaccines had been designed specifically to overcome the immunosenescence of aging, consistent with a post-WWII mentality of developing vaccines and vaccine programs for children. It is now recognized that the current lack of knowledge concerning how immune responses to vaccines are generated is a critical barrier to understanding poor vaccine responses in the elderly and in immunoimmaturity, discovery of new correlates of vaccine immunogenicity (vaccine response biomarkers), and a directed approach to new vaccine development. The new fields of vaccinomics and adversomics provide models that permit global profiling of the innate, humoral, and cellular immune responses integrated at a systems biology level. This has advanced the science beyond that of reductionist scientific approaches by revealing novel interactions between and within the immune system and other biological systems (beyond transcriptional level), which are critical to developing “downstream” adaptive humoral and cellular responses to infectious pathogens and vaccines. Others have applied systems level approaches to the study of antibody responses (a.k.a. “systems serology”), [1] high-dimensional cell subset immunophenotyping through CyTOF, [2,3] and vaccine induced metabolic changes [4]. In turn, this knowledge is being utilized to better understand the following: identifying who is at risk for which infections; the level of risk that exists regarding poor immunogenicity and/or serious adverse events; and the type or dose of vaccine needed to fully protect an individual. In toto, such approaches allow for a personalized approach to the practice of vaccinology, analogous to the substantial inroads that individualized medicine is playing in other fields of human health and medicine. Herein we briefly review the field of vaccinomics, adversomics, and personalized vaccinology.
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Affiliation(s)
- G A Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA.
| | - I G Ovsyannikova
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
| | - R B Kennedy
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
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Maltezou HC, Doudounakis S, Lekaditi M, Tanou K, Katerelos P, Theodoridou M. Study of Greek children and youths with cystic fibrosis identifies immunisation gaps and delays. Acta Paediatr 2017; 106:288-291. [PMID: 27862309 DOI: 10.1111/apa.13663] [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] [Received: 07/05/2016] [Revised: 10/18/2016] [Accepted: 11/07/2016] [Indexed: 11/29/2022]
Abstract
AIM Data about immunisation rates in cystic fibrosis (CF) patients are scarce. We estimated the rates and timeliness of immunisations in CF patients aged 0.55-22 years. METHODS We studied 122 subjects at a hospital in Greece in 2014. A standard questionnaire was used to collect data and parents' opinions about immunisations. RESULTS The complete immunisation rates were 92.6% for diphtheria-tetanus-acellular pertussis-inactivated poliomyelitis-Haemophilus influenzae (DTaP-IPV-Hib), 96.7% for hepatitis A, 97.4% for hepatitis B, 97.4% for measles-mumps-rubella, 85.1% for the varicella zoster virus, 85.1% for the meningococcus C conjugate, 84.3% for the pneumococcus conjugate and 58.9% for the bacillus Calmette-Guérin vaccine. Immunisation rates in youths were 64.4% for DTaP-IPV, 26.8% for the tetravalent meningococcus conjugate vaccine and 54.1% for the human papilloma virus vaccine. In addition, 30.1% received the 23-valent pneumococcal polysaccharide vaccine and 45.6% received annual influenza vaccines. Complete, up-to-date immunisation rates fell from 61.4% at 12 months of age to 14.5% at six and 12 years. All vaccines experienced delays. Most parents believed vaccines were necessary to protect their child's health. CONCLUSION Our study of children with CF found immunisation gaps with no catch-up immunisations and these need to be administered at follow-up visits.
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Affiliation(s)
- Helena C. Maltezou
- Department for Interventions in Health‐Care Facilities Hellenic Center for Disease Control and Prevention Athens Greece
| | - Stavros Doudounakis
- Cystic Fibrosis Department University of Athens, Aghia Sophia Children's Hospital Athens Greece
| | - Maria Lekaditi
- Cystic Fibrosis Department University of Athens, Aghia Sophia Children's Hospital Athens Greece
| | - Kalliopi Tanou
- Cystic Fibrosis Department University of Athens, Aghia Sophia Children's Hospital Athens Greece
| | - Panos Katerelos
- Department for Interventions in Health‐Care Facilities Hellenic Center for Disease Control and Prevention Athens Greece
| | - Maria Theodoridou
- First Department of Pediatrics University of Athens, Aghia Sophia Children's Hospital Athens Greece
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Corben P, Leask J. To close the childhood immunization gap, we need a richer understanding of parents' decision-making. Hum Vaccin Immunother 2016; 12:3168-3176. [PMID: 27564975 PMCID: PMC5215493 DOI: 10.1080/21645515.2016.1221553] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/22/2016] [Accepted: 08/03/2016] [Indexed: 12/22/2022] Open
Abstract
Vaccination is widely acknowledged as one of the most successful public health interventions globally and in most high-income countries childhood vaccination coverage rates are moderately high. Yet in many instances, immunisation rates remain below aspirational targets and have shown only modest progress toward those targets in recent years, despite concerted efforts to improve uptake. In part, coverage rates reflect individual parents' vaccination attitudes and decisions and, because vaccination decision-making is complex and context-specific, it remains challenging at individual and community levels to assist parents to make positive decisions. Consequently, in the search for opportunities to improve immunisation coverage, there has been a renewed research focus on parents' decision-making. This review provides an overview of the literature surrounding parents' vaccination decision-making, offering suggestions for where efforts to increase vaccination coverage should be targeted and identifying areas for further research.
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Affiliation(s)
- Paul Corben
- North Coast Public Health, Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia
| | - Julie Leask
- School of Public Health, University of Sydney, University of Sydney, NSW, Australia
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14
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Abstract
The human papillomavirus (HPV) infects approximately 550,000 Canadians annually. Cancers of the cervix, mouth, anus, throat and neck are caused by various strains of the virus. The virus also causes genital warts. The disease and economic burden of HPV is high. Primary prevention through vaccine administration prior to onset of sexual activity is evidenced as best practice. Two vaccines are available, Gardasil and Cervarix. Consistent with global practices in developed countries, these vaccines are currently publicly funded for females and provided in school-based clinics in all provinces and territories in Canada. Despite well-documented efficacy with minimal adverse effects, the uptake of these vaccines remains low in all countries, including Canada. Although HPV immunization rates have increased, they remain significantly below the rates of other vaccine-preventable diseases. This is puzzling since school-based clinics and public funding presumably increase vaccine access. Barriers explicated include family lack of knowledge about the vaccine, and attitudes that are not informed by science and epidemiology. There is evidence that a health provider's recommendation is the single biggest influence on uptake. However, not all providers are cognizant about emerging issues in this area, including controversies about universal coverage for boys as well as girls, new vaccines and more. Nurse practitioners are in a position to collaborate with public health agencies to expand knowledge and coverage across Canada.
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15
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Should we lower the age for routine HPV vaccination in the United States? Prev Med 2016; 89:334-336. [PMID: 27240451 DOI: 10.1016/j.ypmed.2016.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 05/26/2016] [Indexed: 11/20/2022]
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16
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Masaryk R, Hatoková M. Qualitative inquiry into reasons why vaccination messages fail. J Health Psychol 2016; 22:1880-1888. [PMID: 27387511 DOI: 10.1177/1359105316656770] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A growing tendency to refuse child vaccination is commonly regarded as a reason for concern. Attempts to promote vaccination by authorities often prove to be unsuccessful or even counter-productive. The aim of this study was to explore how parents perceived four messages used to promote vaccination. In eight focus groups ( N = 73), we presented participants with messages and asked them to assess them. Using thematic analysis, we identified themes that our participants considered the most important. Messages that promote vaccination should be unambiguous, more balanced, not focus on repeating the negative effects of vaccine-preventable diseases and provide links to the evidence.
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17
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Rodriguez NJ. Vaccine-Hesitant Justifications: "Too Many, Too Soon," Narrative Persuasion, and the Conflation of Expertise. Glob Qual Nurs Res 2016; 3:2333393616663304. [PMID: 28508015 PMCID: PMC5415268 DOI: 10.1177/2333393616663304] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 06/28/2016] [Accepted: 07/08/2016] [Indexed: 11/28/2022] Open
Abstract
Vaccine-preventable diseases have re-emerged as more individuals have strayed from the recommended inoculation schedule. Previous work on vaccine hesitancy is generally limited to content analyses. Using grounded theory, this project examines vaccine debates on a prominent discussion board over a period of five years. Individuals generally justified opposition or hesitancy toward vaccines through personal experience and/or research, and the concepts of narrative persuasion and the conflation of expertise help describe the most prominent characteristics of such discourse. A consideration of online comments regarding vaccinations allows practitioners to not only become better prepared for patient concerns they might encounter, and but also become more familiar with the types of anecdotes and narratives that may be influential but left unspoken in face-to-face conversations.
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18
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Whitaker JA, Ovsyannikova IG, Poland GA. Adversomics: a new paradigm for vaccine safety and design. Expert Rev Vaccines 2015; 14:935-47. [PMID: 25937189 DOI: 10.1586/14760584.2015.1038249] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Despite the enormous population benefits of routine vaccination, vaccine adverse events (AEs) and reactions, whether real or perceived, have posed one of the greatest barriers to vaccine acceptance--and thus to infectious disease prevention--worldwide. A truly integrated clinical, translational, and basic science approach is required to understand the mechanisms behind vaccine AEs, predict them, and then apply this knowledge to new vaccine design approaches that decrease, or avoid, these events. The term 'adversomics' was first introduced in 2009 and refers to the study of vaccine adverse reactions using immunogenomics and systems biology approaches. In this review, we present the current state of adversomics research, review known associations and mechanisms of vaccine AEs/reactions, and outline a plan for the further development of this emerging research field.
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19
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Betsch C. Overcoming healthcare workers’ vaccine refusal – competition between egoism and altruism. Euro Surveill 2014; 19:20979. [DOI: 10.2807/1560-7917.es2014.19.48.20979] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- C Betsch
- University of Erfurt, Erfurt, Germany
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20
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Dubé E, Vivion M, MacDonald NE. Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications. Expert Rev Vaccines 2014; 14:99-117. [PMID: 25373435 DOI: 10.1586/14760584.2015.964212] [Citation(s) in RCA: 478] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of parents. Anti-vaccination movements have been implicated in lowered vaccine acceptance rates and in the increase in vaccine-preventable disease outbreaks and epidemics. In this review, we will look at determinants of parental decision-making about vaccination and provide an overview of the history of anti-vaccination movements and its clinical impact.
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Affiliation(s)
- Eve Dubé
- Institut national de santé publique du Québec, Québec, QC, Canada
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21
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Abstract
BACKGROUND Neonatal Vitamin K prophylaxis is an effective intervention for reducing vitamin K deficiency bleeding. A recently published report of parental refusal of vitamin K prompted an investigation of the prevalence and characteristics of this group, and exploration of whether these same parents were likely to subsequently refuse immunization for their children. METHODS We conducted a retrospective population-based cohort study of all infants born in Alberta between 2006 and 2012 by using linkage of administrative health data. Risk factors for vitamin K refusal were determined by using Poisson regression. The association between vitamin K refusal and nonimmunization was assessed using relative risk. RESULTS Among the 282378 children in the cohort, 99.7% received vitamin K and 0.3% declined. Midwife-assisted deliveries were more likely to be associated with vitamin K refusal compared with physician-attended delivery (risk ratio 8.4, 95% confidence interval [CI] 6.5-11.0). Planned home delivery (risk ratio 4.9, CI 3.8-6.4) or delivery in a birth center (risk ratio 3.6, CI 2.3-5.6) were more likely to result in decline of vitamin K compared with hospital delivery. Vitamin K refusal was associated with a 14.6 (CI 13.9-15.3) higher relative risk of having no recommended childhood vaccines at 15 months. CONCLUSIONS This is the first population-based study to characterize parents who are likely to decline vitamin K for their infants and whose children are likely to be unimmunized. These findings enable earlier identification of high-risk parents and provide an opportunity to enact strategies to increase uptake of vitamin K and childhood immunizations.
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Affiliation(s)
- Vanita Sahni
- Alberta Health Surveillance and Assessment, Edmonton, Alberta, Canada
| | - Florence Y Lai
- Alberta Health Surveillance and Assessment, Edmonton, Alberta, Canada
| | - Shannon E MacDonald
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; and Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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22
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Theodoridou M. Professional and ethical responsibilities of health-care workers in regard to vaccinations. Vaccine 2014; 32:4866-8. [PMID: 24951862 DOI: 10.1016/j.vaccine.2014.05.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 05/13/2014] [Accepted: 05/20/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Maria Theodoridou
- First University Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens School of Medicine, Greece.
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23
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Tota J, Ramana–Kumar A, El-Khatib Z, Franco E. The road ahead for cervical cancer prevention and control. Curr Oncol 2014; 21:e255-64. [PMID: 24764711 PMCID: PMC3997459 DOI: 10.3747/co.21.1720] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Since the early 1950s, Papanicolaou ("Pap") cytology screening has dramatically reduced cervical cancer mortality in most high-income settings. Currently, human papillomavirus (hpv) vaccination has the greatest potential to reduce the global burden of cervical cancer and precancerous lesions. However, as the prevalence of precancerous lesions declines, maintaining cytology as the primary screening test in settings with established programs might become less efficient. A reduction in test performance (sensitivity, specificity, and positive predictive value) would lead to an increase in unnecessary colposcopy referrals. Fortunately, hpv dna testing has emerged as a suitable candidate to replace cytology. Compared with the Pap test, hpv testing is less specific but much more sensitive in detecting high-grade precancerous lesions, less prone to human error, and more reproducible across settings. Linkage of hpv vaccination and screening registries could serve the added role of monitoring vaccine efficacy. As a triage test, cytology is expected to perform with sufficient accuracy because most hpv-positive smears would contain relevant abnormalities. This approach and others-for example, hpv testing followed by genotyping-are being evaluated in large population studies and have already been recommended in some settings. Other specific biomarkers that might perform well for screening and triage include hpv E6/E7 messenger rna testing, methylation of host or viral genes, and p16(INK4a) staining. Considering the rapid pace of major discoveries and the anticipated arrival of a nonavalent hpv vaccine (currently in phase iii trials), the evidence base in this field has become an elusive target and will continue to be an obstacle for policymakers.
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Affiliation(s)
- J.E. Tota
- Department of Oncology, McGill University, Montreal, QC
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC
| | | | - Z. El-Khatib
- Department of Oncology, McGill University, Montreal, QC
| | - E.L. Franco
- Department of Oncology, McGill University, Montreal, QC
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC
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24
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Van Rostenberghe H. Pediatric infectious diseases: getting research evidence into practice and generation of new evidence. Front Pediatr 2014; 2:138. [PMID: 25538932 PMCID: PMC4259003 DOI: 10.3389/fped.2014.00138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 11/24/2014] [Indexed: 11/21/2022] Open
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25
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Rhee JH. Towards Vaccine 3.0: new era opened in vaccine research and industry. Clin Exp Vaccine Res 2013; 3:1-4. [PMID: 24427757 PMCID: PMC3890443 DOI: 10.7774/cevr.2014.3.1.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 11/20/2013] [Accepted: 11/25/2013] [Indexed: 11/15/2022] Open
Affiliation(s)
- Joon Haeng Rhee
- Department of Microbiology and Clinical Vaccine R&D Center, Chonnam National University Medical School, Gwangju, Korea
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26
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Abstract
Vaccines have eradicated or controlled many infectious diseases, saving each year millions of lives and quality of life of many other millions of people. In spite of the success of vaccines over the last two centuries, parents (and also some health care workers) gloss over the devastating consequences of diseases, which are now avoided thanks to vaccines, and direct their attention to possible negative effects of immunization. Three immunological objections are raised: vaccines cause antigenic overload, natural immunity is safer and better than vaccine-induced immunity, and vaccines induce autoimmunity. The last point is examined in this review. Theoretically, vaccines could trigger autoimmunity by means of cytokine production, anti-idiotypic network, expression of human histocompatibility leukocyte antigens, modification of surface antigens and induction of novel antigens, molecular mimicry, bystander activation, epitope spreading, and polyclonal activation of B cells. There is strong evidence that none of these mechanisms is really effective in causing autoimmune diseases. Vaccines are not a source of autoimmune diseases. By contrast, absolute evidence exists that infectious agents can trigger autoimmune mechanisms and that they do cause autoimmune diseases.
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Affiliation(s)
- M De Martino
- Department of Health Sciences, University of Florence, Anna Meyer Childrens University Hospital, Florence, Italy
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27
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Ojha RP, Jackson BE, Tota JE, Offutt-Powell TN, Singh KP, Bae S. Guillain-Barre syndrome following quadrivalent human papillomavirus vaccination among vaccine-eligible individuals in the United States. Hum Vaccin Immunother 2013; 10:232-7. [PMID: 24013368 DOI: 10.4161/hv.26292] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Post-marketing surveillance studies provide conflicting evidence about whether Guillain-Barre syndrome occurs more frequently following quadrivalent human papillomavirus (HPV4) vaccination. We aimed to assess whether Guillain-Barre syndrome is reported more frequently following HPV4 vaccination than other vaccinations among females and males aged 9 to 26 y in the United States. We used adverse event reports received by the United States Vaccine Adverse Event Reporting System (VAERS) between January 1, 2010 and December 31, 2012 to estimate overall, age-, and sex-specific proportional reporting ratios (PRRs) and corresponding Χ2 values for reports of Guillain-Barre syndrome between 5 and 42 d following HPV vaccination. Minimum criteria for a signal using this approach are 3 or more cases, PRR≥2, and Χ2≥4. Guillain-Barre syndrome was listed as an adverse event in 45 of 14,822 reports, of which 9 reports followed HPV4 vaccination and 36 reports followed all other vaccines. The overall, age-, and sex-specific PRR estimates were uniformly below 1. In addition, the overall, age-, and sex-specific Χ2 values were uniformly below 3. Our analysis of post-marketing surveillance data does not suggest that Guillain-Barre syndrome is reported more frequently following HPV4 vaccination than other vaccinations among vaccine-eligible females or males in the United States. Our findings may be useful when discussing the risks and benefits of HPV4 vaccination.
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Affiliation(s)
- Rohit P Ojha
- Department of Epidemiology and Cancer Control; St. Jude Children's Research Hospital; Memphis, TN USA
| | - Bradford E Jackson
- Division of Preventive Medicine; Department of Medicine; University of Alabama at Birmingham; Birmingham, AL USA
| | - Joseph E Tota
- Division of Cancer Epidemiology; Department of Epidemiology; Biostatistics, and Occupational Health; McGill University; Montreal, QC Canada
| | - Tabatha N Offutt-Powell
- Office of Infectious Disease Epidemiology; Delaware Health and Social Services; Dover, DE USA
| | - Karan P Singh
- Division of Preventive Medicine; Department of Medicine; University of Alabama at Birmingham; Birmingham, AL USA
| | - Sejong Bae
- Division of Preventive Medicine; Department of Medicine; University of Alabama at Birmingham; Birmingham, AL USA
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28
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Hardt K, Schmidt-Ott R, Glismann S, Adegbola RA, Meurice FP. Sustaining Vaccine Confidence in the 21st Century. Vaccines (Basel) 2013; 1:204-24. [PMID: 26344109 PMCID: PMC4494231 DOI: 10.3390/vaccines1030204] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/17/2013] [Accepted: 05/27/2013] [Indexed: 11/18/2022] Open
Abstract
Vaccination provides many health and economic benefits to individuals and society, and public support for immunization programs is generally high. However, the benefits of vaccines are often not fully valued when public discussions on vaccine safety, quality or efficacy arise, and the spread of misinformation via the internet and other media has the potential to undermine immunization programs. Factors associated with improved public confidence in vaccines include evidence-based decision-making procedures and recommendations, controlled processes for licensing and monitoring vaccine safety and effectiveness and disease surveillance. Community engagement with appropriate communication approaches for each audience is a key factor in building trust in vaccines. Vaccine safety/quality issues should be handled rapidly and transparently by informing and involving those most affected and those concerned with public health in effective ways. Openness and transparency in the exchange of information between industry and other stakeholders is also important. To maximize the safety of vaccines, and thus sustain trust in vaccines, partnerships are needed between public health sector stakeholders. Vaccine confidence can be improved through collaborations that ensure high vaccine uptake rates and that inform the public and other stakeholders of the benefits of vaccines and how vaccine safety is constantly assessed, assured and communicated.
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Affiliation(s)
- Karin Hardt
- GlaxoSmithKline Vaccines, Global Scientific Affairs & Medical Education, 20 Avenue Fleming, 1300 Wavre, Belgium.
| | - Ruprecht Schmidt-Ott
- GlaxoSmithKline Vaccines, Global Scientific Affairs & Medical Education, Prinzregentenplatz 9, 81675 Munich, Germany.
| | - Steffen Glismann
- GlaxoSmithKline Vaccines, Global Scientific Affairs & Medical Education, 68 Nykaer, DK-2605 Broendby, Denmark.
| | - Richard A Adegbola
- GlaxoSmithKline Vaccines, Global Scientific Affairs & Medical Education, 20 Avenue Fleming, 1300 Wavre, Belgium.
| | - François P Meurice
- GlaxoSmithKline Vaccines, Global Scientific Affairs & Medical Education, 20 Avenue Fleming, 1300 Wavre, Belgium.
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29
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Poland GA, Kennedy RB, McKinney BA, Ovsyannikova IG, Lambert ND, Jacobson RM, Oberg AL. Vaccinomics, adversomics, and the immune response network theory: individualized vaccinology in the 21st century. Semin Immunol 2013; 25:89-103. [PMID: 23755893 DOI: 10.1016/j.smim.2013.04.007] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 03/23/2013] [Accepted: 04/18/2013] [Indexed: 02/08/2023]
Abstract
Vaccines, like drugs and medical procedures, are increasingly amenable to individualization or personalization, often based on novel data resulting from high throughput "omics" technologies. As a result of these technologies, 21st century vaccinology will increasingly see the abandonment of a "one size fits all" approach to vaccine dosing and delivery, as well as the abandonment of the empiric "isolate-inactivate-inject" paradigm for vaccine development. In this review, we discuss the immune response network theory and its application to the new field of vaccinomics and adversomics, and illustrate how vaccinomics can lead to new vaccine candidates, new understandings of how vaccines stimulate immune responses, new biomarkers for vaccine response, and facilitate the understanding of what genetic and other factors might be responsible for rare side effects due to vaccines. Perhaps most exciting will be the ability, at a systems biology level, to integrate increasingly complex high throughput data into descriptive and predictive equations for immune responses to vaccines. Herein, we discuss the above with a view toward the future of vaccinology.
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30
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Franco EL, de Sanjosé S, Broker TR, Stanley MA, Chevarie-Davis M, Isidean SD, Schiffman M. Human papillomavirus and cancer prevention: gaps in knowledge and prospects for research, policy, and advocacy. Vaccine 2013. [PMID: 23199961 DOI: 10.1016/j.vaccine.2012.06.092] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The recognition that human papillomavirus (HPV) infection is the central, necessary cause of cervical cancer paved the way to new fronts of prevention via improved screening methods and HPV vaccination. Much has been learned in all fronts, from the molecular basis of our understanding of how HPV causes disease to the health economics of preventive strategies at the individual and population levels. Progress in other areas of cancer control has yet to show the same multi- and trans-disciplinary gains seen in research on HPV-associated malignancies, which is one of the unequivocal success stories in disease prevention. Yet, as an embarrassment of riches, much more research is needed to fill the gaps in knowledge that remain before we are able to reap the benefits from the knowledge translation from all fronts. Public health research on setting-specific implementation of HPV-based preventive strategies and more concerted advocacy to counter barriers facing the adoption of these strategies are likely to yield major dividends in reducing the burden of HPV-associated diseases. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.
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Affiliation(s)
- Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Canada.
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31
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Abstract
Health care reform calls for the nursing profession, with a focus on disease prevention and health restoration, to innovate and create new models of care that are client-centric, evidence-based, and cost-effective. To do so, nurses must develop a fundamentally different paradigm and epistemology. New care models are required that focus on issues such as evidence-based prevention. Among the prevention foci for hospitals are hospital-acquired infections, including influenza, which kills 36,000 Americans annually. One crucial step in eliminating hospital-acquired influenza is to require influenza vaccination of all health care workers. This article challenges nursing leadership to seize opportunities to lead health care initiatives and encourage courageous innovative actions that depart from old paradigms; these actions must be based on scientific evidence, reduce costs, and promote patient safety and quality care and outcomes.
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Affiliation(s)
- Sharon Tucker
- University of Iowa Hospitals & Clinics, Iowa City, IA, USA
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32
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Tucker S, Poland GA. Health Care Reform and Influenza Immunization. Workplace Health Saf 2013. [DOI: 10.3928/21650799-20130426-75] [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]
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33
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Poland GA. Pertussis outbreaks and pertussis vaccines: new insights, new concerns, new recommendations? Vaccine 2013; 30:6957-9. [PMID: 23141958 DOI: 10.1016/j.vaccine.2012.09.084] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 09/19/2012] [Indexed: 11/17/2022]
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34
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Caoili SEC. Antidotes, antibody-mediated immunity and the future of pharmaceutical product development. Hum Vaccin Immunother 2013; 9:294-9. [PMID: 23291934 PMCID: PMC3859750 DOI: 10.4161/hv.22858] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
If new scientific knowledge is to be more efficiently generated and applied toward the advancement of health, human safety must be more effectively addressed in the conduct of research. Given the present difficulties of accurately predicting biological outcomes of novel interventions in vivo, the imperative of human safety suggests the development of novel pharmaceutical products in tandem with their prospective antidotes in anticipation of possible adverse events, to render the risks of initial clinical trials more acceptable from a regulatory standpoint. Antibody-mediated immunity provides a generally applicable mechanistic basis for developing antidotes to both biologicals and small-molecule drugs (such that antibodies may serve as antidotes to pharmaceutical agents as a class including other antibodies) and also for the control and prevention of both infectious and noninfectious diseases via passive or active immunization. Accordingly, the development of prophylactic or therapeutic passive-immunization strategies using antipeptide antibodies is a plausible prelude to the development of corresponding active-immunization strategies using peptide-based vaccines. In line with this scheme, global proliferation of antibody- and vaccine-production technologies, especially those that obviate dependence on the cold chain for storage and transport of finished products, could provide geographically distributed breakout capability against emerging and future health challenges.
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Affiliation(s)
- Salvador Eugenio C Caoili
- Department of Biochemistry and Molecular Biology; College of Medicine; University of the Philippines Manila; Manila, Philippines
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35
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Baron-Epel O, Madjar B, Grefat R, Rishpon S. Trust and the demand for autonomy may explain the low rates of immunizations among nurses. Hum Vaccin Immunother 2012; 9:100-7. [PMID: 23108353 DOI: 10.4161/hv.22503] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Rates of vaccinations of healthcare workers with recommended vaccines are generally low in the developed countries. Our goals were to identify attitudes associated with self-reported vaccinations against pertussis and seasonal influenza among Israeli nurses in Mother and Child Healthcare Centers (MCHC) in the Haifa District. Over 100 nurses answered a self-administered questionnaire. Forty two percent of the nurses reported receiving the pertussis vaccine in the last five years and 44% reported receiving the influenza vaccine during the previous year. Attitudes toward the importance of vaccinating nurses, trust in the public health authorities and demand for autonomy were associated with receiving the pertussis vaccine. Attitudes toward the importance of vaccinating nurses and trust were associated with receiving the influenza vaccine in a bivariant analysis. However, in the logistic regression models only attitudes toward the importance of vaccinating nurses were associated with vaccinations [odds ratio (OR)- 3.66, 95% confidence interval (CI)- 1.4-9.6 for pertussis and OR- 4.53, CI-1.6-13.0 for influenza]. Jewish nurses reported more often receiving the influenza vaccine compared with the Arab nurses, whereas there was no difference between them in receiving the pertussis vaccine. Low levels of positive attitudes toward the importance of vaccinating nurses may inhibit nurses in MCHC from receiving vaccines. The demand for autonomy and low levels of trust may, in part, form these low levels of positive attitudes toward the importance of vaccinating nurses.
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Affiliation(s)
- Orna Baron-Epel
- School of Public Health; Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
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