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Measles and Rubella Incidence and Molecular Epidemiology in Senegal: Temporal and Regional Trends during Twelve Years of National Surveillance, 2010-2021. Viruses 2022; 14:v14102273. [PMID: 36298828 PMCID: PMC9607477 DOI: 10.3390/v14102273] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 11/16/2022] Open
Abstract
We investigated the epidemiology of measles and rubella infections in Senegal based on data from twelve consecutive years of laboratory-based surveillance (2010−2021) and conducted phylogenetic analyses of circulating measles viruses. Sera from measles-suspected cases were collected and tested for measles and rubella-specific IgM antibodies using enzyme-linked immunosorbent assays (ELISA). Throat swabs were collected from patients with clinically diagnosed measles for confirmation by reverse-transcription polymerase chain reaction (RT-PCR) and viral genotyping. Among 8082 laboratory-tested specimens from measles-suspected cases, serological evidence of measles and rubella infection was confirmed in 1303/8082 (16.1%) and 465/6714 (6.9%), respectively. The incidence of rubella is now low—0.8 (95% CI 0.4−1.3) cases per million people in 2021—whereas progress towards measles pre-elimination targets (<1.0 case per million people per year) appears to have stalled; there were 10.8 (95% CI 9.3−12.5) cases per million people in 2021. Phylogenetic analyses revealed that all Senegalese measles strains belonged to genotype B3. The rubella virus sequence obtained in this study was consistent with genotype 1C. Our national surveillance data suggest that despite their low incidence both measles and rubella remain endemic in Senegal with a concerning stagnation in the decline of measles infections that represents a significant challenge to the goal of regional elimination.
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Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev 2021; 11:CD004407. [PMID: 34806766 PMCID: PMC8607336 DOI: 10.1002/14651858.cd004407.pub5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Measles, mumps, rubella, and varicella (chickenpox) are serious diseases that can lead to serious complications, disability, and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness. This is an update of a review published in 2005 and updated in 2012. OBJECTIVES To assess the effectiveness, safety, and long- and short-term adverse effects associated with the trivalent vaccine, containing measles, rubella, mumps strains (MMR), or concurrent administration of MMR vaccine and varicella vaccine (MMR+V), or tetravalent vaccine containing measles, rubella, mumps, and varicella strains (MMRV), given to children aged up to 15 years. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 5), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 2 May 2019), Embase (1974 to 2 May 2019), the WHO International Clinical Trials Registry Platform (2 May 2019), and ClinicalTrials.gov (2 May 2019). SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), prospective and retrospective cohort studies (PCS/RCS), case-control studies (CCS), interrupted time-series (ITS) studies, case cross-over (CCO) studies, case-only ecological method (COEM) studies, self-controlled case series (SCCS) studies, person-time cohort (PTC) studies, and case-coverage design/screening methods (CCD/SM) studies, assessing any combined MMR or MMRV / MMR+V vaccine given in any dose, preparation or time schedule compared with no intervention or placebo, on healthy children up to 15 years of age. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the methodological quality of the included studies. We grouped studies for quantitative analysis according to study design, vaccine type (MMR, MMRV, MMR+V), virus strain, and study settings. Outcomes of interest were cases of measles, mumps, rubella, and varicella, and harms. Certainty of evidence of was rated using GRADE. MAIN RESULTS We included 138 studies (23,480,668 participants). Fifty-one studies (10,248,159 children) assessed vaccine effectiveness and 87 studies (13,232,509 children) assessed the association between vaccines and a variety of harms. We included 74 new studies to this 2019 version of the review. Effectiveness Vaccine effectiveness in preventing measles was 95% after one dose (relative risk (RR) 0.05, 95% CI 0.02 to 0.13; 7 cohort studies; 12,039 children; moderate certainty evidence) and 96% after two doses (RR 0.04, 95% CI 0.01 to 0.28; 5 cohort studies; 21,604 children; moderate certainty evidence). The effectiveness in preventing cases among household contacts or preventing transmission to others the children were in contact with after one dose was 81% (RR 0.19, 95% CI 0.04 to 0.89; 3 cohort studies; 151 children; low certainty evidence), after two doses 85% (RR 0.15, 95% CI 0.03 to 0.75; 3 cohort studies; 378 children; low certainty evidence), and after three doses was 96% (RR 0.04, 95% CI 0.01 to 0.23; 2 cohort studies; 151 children; low certainty evidence). The effectiveness (at least one dose) in preventing measles after exposure (post-exposure prophylaxis) was 74% (RR 0.26, 95% CI 0.14 to 0.50; 2 cohort studies; 283 children; low certainty evidence). The effectiveness of Jeryl Lynn containing MMR vaccine in preventing mumps was 72% after one dose (RR 0.24, 95% CI 0.08 to 0.76; 6 cohort studies; 9915 children; moderate certainty evidence), 86% after two doses (RR 0.12, 95% CI 0.04 to 0.35; 5 cohort studies; 7792 children; moderate certainty evidence). Effectiveness in preventing cases among household contacts was 74% (RR 0.26, 95% CI 0.13 to 0.49; 3 cohort studies; 1036 children; moderate certainty evidence). Vaccine effectiveness against rubella, using a vaccine with the BRD2 strain which is only used in China, is 89% (RR 0.11, 95% CI 0.03 to 0.42; 1 cohort study; 1621 children; moderate certainty evidence). Vaccine effectiveness against varicella (any severity) after two doses in children aged 11 to 22 months is 95% in a 10 years follow-up (rate ratio (rr) 0.05, 95% CI 0.03 to 0.08; 1 RCT; 2279 children; high certainty evidence). Safety There is evidence supporting an association between aseptic meningitis and MMR vaccines containing Urabe and Leningrad-Zagreb mumps strains, but no evidence supporting this association for MMR vaccines containing Jeryl Lynn mumps strains (rr 1.30, 95% CI 0.66 to 2.56; low certainty evidence). The analyses provide evidence supporting an association between MMR/MMR+V/MMRV vaccines (Jeryl Lynn strain) and febrile seizures. Febrile seizures normally occur in 2% to 4% of healthy children at least once before the age of 5. The attributable risk febrile seizures vaccine-induced is estimated to be from 1 per 1700 to 1 per 1150 administered doses. The analyses provide evidence supporting an association between MMR vaccination and idiopathic thrombocytopaenic purpura (ITP). However, the risk of ITP after vaccination is smaller than after natural infection with these viruses. Natural infection of ITP occur in 5 cases per 100,000 (1 case per 20,000) per year. The attributable risk is estimated about 1 case of ITP per 40,000 administered MMR doses. There is no evidence of an association between MMR immunisation and encephalitis or encephalopathy (rate ratio 0.90, 95% CI 0.50 to 1.61; 2 observational studies; 1,071,088 children; low certainty evidence), and autistic spectrum disorders (rate ratio 0.93, 95% CI 0.85 to 1.01; 2 observational studies; 1,194,764 children; moderate certainty). There is insufficient evidence to determine the association between MMR immunisation and inflammatory bowel disease (odds ratio 1.42, 95% CI 0.93 to 2.16; 3 observational studies; 409 cases and 1416 controls; moderate certainty evidence). Additionally, there is no evidence supporting an association between MMR immunisation and cognitive delay, type 1 diabetes, asthma, dermatitis/eczema, hay fever, leukaemia, multiple sclerosis, gait disturbance, and bacterial or viral infections. AUTHORS' CONCLUSIONS: Existing evidence on the safety and effectiveness of MMR/MMRV vaccines support their use for mass immunisation. Campaigns aimed at global eradication should assess epidemiological and socioeconomic situations of the countries as well as the capacity to achieve high vaccination coverage. More evidence is needed to assess whether the protective effect of MMR/MMRV could wane with time since immunisation.
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Affiliation(s)
- Carlo Di Pietrantonj
- Servizio Regionale di Riferimento per l'Epidemiologia, SSEpi-SeREMI, Azienda Sanitaria Locale ASL AL, Alessandria, Italy
| | - Alessandro Rivetti
- Dipartimento di Prevenzione - S.Pre.S.A.L, ASL CN2 Alba Bra, Alba, Italy
| | - Pasquale Marchione
- Signal Management Unit, Post-Marketing Surveillance Department, Italian Medicine Agency - AIFA, Rome, Italy
| | | | - Vittorio Demicheli
- Servizio Regionale di Riferimento per l'Epidemiologia, SSEpi-SeREMI, Azienda Sanitaria Locale ASL AL, Alessandria, Italy
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Nyaku M, Richardson E, Martinon-Torres F, Kuter BJ. Evaluation of the Safety and Immunogenicity of M-M-RII (Combination Measles-mumps-rubella Vaccine): Clinical Trials of Healthy Children and Adults Published Between 2010 and 2019. Pediatr Infect Dis J 2021; 40:1046-1054. [PMID: 34310506 DOI: 10.1097/inf.0000000000003273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The safety and immunogenicity of M-M-RII (measles, mumps and rubella virus vaccine live, Merck & Co., Inc., West Point, PA)-the only combined measles, mumps and rubella vaccine licensed for use in the United States-were previously reported in pre- and postlicensure clinical trials conducted from 1988 to 2009. M-M-RII continues to be evaluated as a comparator in clinical trials of other vaccines. Here, we review safety and efficacy data from more recent clinical trials of M-M-RII. METHODS We performed a systematic literature review of trials using M-M-RII published from 2010 to 2019. RESULTS In the 15 studies that met the inclusion criteria, a total of 12,032 subjects were vaccinated: 7667 persons received a first dose only, 2137 participated in 2-dose studies (128 received 1 dose and 2009 received both) and 2063 received a single dose of M-M-RII as their second dose. Dose number was not specified for 165 participants, ≥6 years old, in 2 studies in which a single dose of M-M-RII was administered. Similar to previous reports, M-M-RII was well tolerated and immunogenic when administered alone or concomitantly with other routinely recommended vaccinations. The most common adverse events included transient injection site pain and fever. Serious adverse events were extremely rare, with only 4 probable or potential vaccine-related events reported among the 12,032 participating subjects. CONCLUSIONS In trials published from 2010 to 2019, M-M-RII continued to be safe and immunogenic in all age groups studied. These data, along with the results of earlier trials, indicate that the performance of the vaccine has been consistent across more than 30 years of postlicensure studies.
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Affiliation(s)
- Mawuli Nyaku
- From the Merck & Co., Inc., Kenilworth, New Jersey
| | | | - Federico Martinon-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario and Universidad de Santiago de Compostela (USC), Galicia, Spain
- Genetics, Vaccines, and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain
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High seroprevalence of rubella in Thai children with a 2-dose MMR national immunization policy. Vaccine 2021; 39:6206-6209. [PMID: 34556367 DOI: 10.1016/j.vaccine.2021.08.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/14/2021] [Accepted: 08/22/2021] [Indexed: 11/20/2022]
Abstract
Rubella is generally a mild disease, but infection during pregnancy can cause congenital rubella syndrome. Thailand has implemented a two-dose MMR vaccination policy since 2010. This study aimed to describe the seroprevalence rate of rubella among children and adolescents in Thailand. We conducted a cross-sectional study of 132 healthy children (aged 3-9 years) who had received 2 doses of rubella vaccine and 424 adolescents (aged 10-18 years) who were expected to receive at least 1 dose of rubella vaccine. Stored serum samples from healthy children and recently drawn serum samples from adolescents were tested for rubella IgG antibody using a commercial enzyme-linked immunosorbent assay (ELISA) kit (EUROIMMUN). Seroprotection was defined as a rubella IgG level ≥ 10 IU/mL. The rubella seroprevalence rate among children and adolescents who had 2 documented doses of MMR was 97.0% (95 %CI 92.5-99.2%) and 85.4% (95% CI 78.8-90.6%, p < 0.01) respectively. The geometric mean titer of rubella was higher in children, 38.3 (95% CI 33.5-43.9) compared to adolescents, 22.5 (19.4-25.9) IU/mL. We observed an inverse correlation between the rubella titer and time interval from the second rubella containing vaccine dose (R = -0.30, p < 0.01). A 2-dose MMR vaccination course produces a high seroprevalence of rubella immunity in children, which decreases with time, suggesting waning of immunity. Thai clinical trials registry number TCTR20191120001.
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Associations between Meteorological Factors and Reported Mumps Cases from 1999 to 2020 in Japan. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2021; 2:162-178. [PMID: 36417181 PMCID: PMC9620933 DOI: 10.3390/epidemiologia2020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/12/2021] [Accepted: 03/29/2021] [Indexed: 12/14/2022]
Abstract
The present study investigated associations between epidemiological mumps patterns and meteorological factors in Japan. We used mumps surveillance data and meteorological data from all 47 prefectures of Japan from 1999 to 2020. A time-series analysis incorporating spectral analysis and the least-squares method was adopted. In all power spectral densities for the 47 prefectures, spectral lines were observed at frequency positions corresponding to 1-year and 6-month cycles. Optimum least-squares fitting (LSF) curves calculated with the 1-year and 6-month cycles explained the underlying variation in the mumps data. The LSF curves reproduced bimodal and unimodal cycles that are clearly observed in northern and southern Japan, respectively. In investigating factors associated with the seasonality of mumps epidemics, we defined the contribution ratios of a 1-year cycle (Q1) and 6-month cycle (Q2) as the contributions of amplitudes of 1-year and 6-month cycles, respectively, to the entire amplitude of the time series data. Q1 and Q2 were significantly correlated with annual mean temperature. The vaccine coverage rate of a measles-mumps-rubella vaccine might not have affected the 1-year and 6-month modes of the time series data. The results of the study suggest an association between mean temperature and mumps epidemics in Japan.
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Kitano T. Close the gap for routine mumps vaccination in Japan. Hum Vaccin Immunother 2021; 17:205-210. [PMID: 32530735 PMCID: PMC7872047 DOI: 10.1080/21645515.2020.1765619] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/01/2020] [Indexed: 02/06/2023] Open
Abstract
Mumps is a vaccine-preventable disease. Because the mumps vaccine can cause aseptic meningitis in rare cases, this vaccine is not routine in Japan. This has led to low vaccine coverage and severe disease burden in Japan. The present review summarizes mumps epidemiology and vaccination and discusses effective future strategies to mitigate the current disease burden of mumps in Japan. Although a recent study reported that mumps vaccine coverage rates are improving in Japan, current coverage rates are far below the optimal rate to suppress the ongoing epidemic, which has caused an average annual financial loss of 85 billion JPY between 2000 and 2016. Recent reports have demonstrated a much lower incidence of vaccine-induced aseptic meningitis in newly developed vaccines, especially when administered at 1 year of age. Cost-effectiveness studies suggest that routinization of the currently distributed domestic vaccine would be highly cost-effective. In addition, questionnaire surveillance data suggest that the majority of the Japanese population accepts the nominal risk of the vaccine when the proper information is provided. Finally, there are some successful programs in Japan that have attained high vaccine coverage rates with financial support from local governments. Taken together, these data suggest that the mumps vaccine should be immediately included in routine vaccines in Japan.
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Affiliation(s)
- Taito Kitano
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada
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Connell AR, Connell J, Leahy TR, Hassan J. Mumps Outbreaks in Vaccinated Populations-Is It Time to Re-assess the Clinical Efficacy of Vaccines? Front Immunol 2020; 11:2089. [PMID: 33072071 PMCID: PMC7531022 DOI: 10.3389/fimmu.2020.02089] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/31/2020] [Indexed: 01/05/2023] Open
Abstract
History illustrates the remarkable public health impact of mass vaccination, by dramatically improving life expectancy and reducing the burden of infectious diseases and co-morbidities worldwide. It has been perceived that if an individual adhered to the MMR vaccine schedule that immunity to mumps virus (MuV) would be lifelong. Recent mumps outbreaks in individuals who had received two doses of the Measles Mumps Rubella (MMR) vaccine has challenged the efficacy of the MMR vaccine. However, clinical symptoms, complications, viral shedding and transmission associated with mumps infection has been shown to be reduced in vaccinated individuals, demonstrating a benefit of this vaccine. Therefore, the question of what constitutes a good mumps vaccine and how its impact is assessed in this modern era remains to be addressed. Epidemiology of the individuals most affected by the outbreaks (predominantly young adults) and variance in the circulating MuV genotype have been well-described alluding to a collection of influences such as vaccine hesitancy, heterogeneous vaccine uptake, primary, and/or secondary vaccine failures. This review aims to discuss in detail the interplay of factors thought to be contributing to the current mumps outbreaks seen in highly vaccinated populations. In addition, how mumps diagnoses has progressed and impacted the understanding of mumps infection since a mumps vaccine was first developed, the limitations of current laboratory tests in confirming protection in vaccinated individuals and how vaccine effectiveness is quantified are also considered. By highlighting knowledge gaps within this area, this state-of-the-art review proposes a change of perspective regarding the impact of a vaccine in a highly vaccinated population from a clinical, diagnostic and public perspective, highlighting a need for a paradigm shift on what is considered vaccine immunity.
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Affiliation(s)
- Anna R. Connell
- National Children's Research Centre, Children's Health Ireland, Dublin, Ireland
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - T. Ronan Leahy
- Children's Health Ireland, Dublin, Ireland
- Department of Pediatrics, University of Dublin, Trinity College, Dublin, Ireland
| | - Jaythoon Hassan
- National Children's Research Centre, Children's Health Ireland, Dublin, Ireland
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
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Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev 2020; 4:CD004407. [PMID: 32309885 PMCID: PMC7169657 DOI: 10.1002/14651858.cd004407.pub4] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Measles, mumps, rubella, and varicella (chickenpox) are serious diseases that can lead to serious complications, disability, and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness. This is an update of a review published in 2005 and updated in 2012. OBJECTIVES To assess the effectiveness, safety, and long- and short-term adverse effects associated with the trivalent vaccine, containing measles, rubella, mumps strains (MMR), or concurrent administration of MMR vaccine and varicella vaccine (MMR+V), or tetravalent vaccine containing measles, rubella, mumps, and varicella strains (MMRV), given to children aged up to 15 years. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 5), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 2 May 2019), Embase (1974 to 2 May 2019), the WHO International Clinical Trials Registry Platform (2 May 2019), and ClinicalTrials.gov (2 May 2019). SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), prospective and retrospective cohort studies (PCS/RCS), case-control studies (CCS), interrupted time-series (ITS) studies, case cross-over (CCO) studies, case-only ecological method (COEM) studies, self-controlled case series (SCCS) studies, person-time cohort (PTC) studies, and case-coverage design/screening methods (CCD/SM) studies, assessing any combined MMR or MMRV / MMR+V vaccine given in any dose, preparation or time schedule compared with no intervention or placebo, on healthy children up to 15 years of age. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the methodological quality of the included studies. We grouped studies for quantitative analysis according to study design, vaccine type (MMR, MMRV, MMR+V), virus strain, and study settings. Outcomes of interest were cases of measles, mumps, rubella, and varicella, and harms. Certainty of evidence of was rated using GRADE. MAIN RESULTS We included 138 studies (23,480,668 participants). Fifty-one studies (10,248,159 children) assessed vaccine effectiveness and 87 studies (13,232,509 children) assessed the association between vaccines and a variety of harms. We included 74 new studies to this 2019 version of the review. Effectiveness Vaccine effectiveness in preventing measles was 95% after one dose (relative risk (RR) 0.05, 95% CI 0.02 to 0.13; 7 cohort studies; 12,039 children; moderate certainty evidence) and 96% after two doses (RR 0.04, 95% CI 0.01 to 0.28; 5 cohort studies; 21,604 children; moderate certainty evidence). The effectiveness in preventing cases among household contacts or preventing transmission to others the children were in contact with after one dose was 81% (RR 0.19, 95% CI 0.04 to 0.89; 3 cohort studies; 151 children; low certainty evidence), after two doses 85% (RR 0.15, 95% CI 0.03 to 0.75; 3 cohort studies; 378 children; low certainty evidence), and after three doses was 96% (RR 0.04, 95% CI 0.01 to 0.23; 2 cohort studies; 151 children; low certainty evidence). The effectiveness (at least one dose) in preventing measles after exposure (post-exposure prophylaxis) was 74% (RR 0.26, 95% CI 0.14 to 0.50; 2 cohort studies; 283 children; low certainty evidence). The effectiveness of Jeryl Lynn containing MMR vaccine in preventing mumps was 72% after one dose (RR 0.24, 95% CI 0.08 to 0.76; 6 cohort studies; 9915 children; moderate certainty evidence), 86% after two doses (RR 0.12, 95% CI 0.04 to 0.35; 5 cohort studies; 7792 children; moderate certainty evidence). Effectiveness in preventing cases among household contacts was 74% (RR 0.26, 95% CI 0.13 to 0.49; 3 cohort studies; 1036 children; moderate certainty evidence). Vaccine effectiveness against rubella is 89% (RR 0.11, 95% CI 0.03 to 0.42; 1 cohort study; 1621 children; moderate certainty evidence). Vaccine effectiveness against varicella (any severity) after two doses in children aged 11 to 22 months is 95% in a 10 years follow-up (rate ratio (rr) 0.05, 95% CI 0.03 to 0.08; 1 RCT; 2279 children; high certainty evidence). Safety There is evidence supporting an association between aseptic meningitis and MMR vaccines containing Urabe and Leningrad-Zagreb mumps strains, but no evidence supporting this association for MMR vaccines containing Jeryl Lynn mumps strains (rr 1.30, 95% CI 0.66 to 2.56; low certainty evidence). The analyses provide evidence supporting an association between MMR/MMR+V/MMRV vaccines (Jeryl Lynn strain) and febrile seizures. Febrile seizures normally occur in 2% to 4% of healthy children at least once before the age of 5. The attributable risk febrile seizures vaccine-induced is estimated to be from 1 per 1700 to 1 per 1150 administered doses. The analyses provide evidence supporting an association between MMR vaccination and idiopathic thrombocytopaenic purpura (ITP). However, the risk of ITP after vaccination is smaller than after natural infection with these viruses. Natural infection of ITP occur in 5 cases per 100,000 (1 case per 20,000) per year. The attributable risk is estimated about 1 case of ITP per 40,000 administered MMR doses. There is no evidence of an association between MMR immunisation and encephalitis or encephalopathy (rate ratio 0.90, 95% CI 0.50 to 1.61; 2 observational studies; 1,071,088 children; low certainty evidence), and autistic spectrum disorders (rate ratio 0.93, 95% CI 0.85 to 1.01; 2 observational studies; 1,194,764 children; moderate certainty). There is insufficient evidence to determine the association between MMR immunisation and inflammatory bowel disease (odds ratio 1.42, 95% CI 0.93 to 2.16; 3 observational studies; 409 cases and 1416 controls; moderate certainty evidence). Additionally, there is no evidence supporting an association between MMR immunisation and cognitive delay, type 1 diabetes, asthma, dermatitis/eczema, hay fever, leukaemia, multiple sclerosis, gait disturbance, and bacterial or viral infections. AUTHORS' CONCLUSIONS Existing evidence on the safety and effectiveness of MMR/MMRV vaccines support their use for mass immunisation. Campaigns aimed at global eradication should assess epidemiological and socioeconomic situations of the countries as well as the capacity to achieve high vaccination coverage. More evidence is needed to assess whether the protective effect of MMR/MMRV could wane with time since immunisation.
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Affiliation(s)
- Carlo Di Pietrantonj
- Azienda Sanitaria Locale ASL AL, Servizio Regionale di Riferimento per l'Epidemiologia, SSEpi-SeREMI, Via Venezia 6, Alessandria, Italy, 15121
| | - Alessandro Rivetti
- ASL CN2 Alba Bra, Dipartimento di Prevenzione - S.Pre.S.A.L, Via Vida 10, Alba, Piemonte, Italy, 12051
| | - Pasquale Marchione
- Italian Medicine Agency - AIFA, Signal Management Unit, Post-Marketing Surveillance Department, Via del Tritone 181, Rome, Italy, 00187
| | | | - Vittorio Demicheli
- Azienda Sanitaria Locale ASL AL, Servizio Regionale di Riferimento per l'Epidemiologia, SSEpi-SeREMI, Via Venezia 6, Alessandria, Italy, 15121
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Abstract
As part of the evaluation of the French plan for the elimination of measles and rubella, we conducted a seroprevalence survey in 2013, aimed at updating seroprevalence data for people 18–32 years old. A secondary objective was to estimate measles incidence in this population during the 2009–2011 outbreak, and thus estimate the exhaustiveness of measles mandatory reporting. We used a cross-sectional survey design, targeting blood donors 18–32 years old, living in France since 2009, who came to give blood in a blood collecting site. We included 4647 people in metropolitan France, 806 people in Réunion Island and 496 in the French Caribbean. A further 3942 individuals were interviewed in the south-east region of metropolitan France to estimate the exhaustiveness of measles mandatory reporting. One of the main findings of this survey is that the proportion of people 18–32 years old susceptible to both measles and rubella infections remained high in France in 2013, 9.2% and 5.4%, respectively, in metropolitan France, even after the promotion campaigns about vaccination catch-up during and following the major measles epidemic in 2009–2011. Applying our results to French census data would suggest that around 1 million people aged 18–32 years old are currently susceptible to measles in France, despite this age group being one of the vaccination targets of the national measles elimination plan. Another important finding is that only an estimated 45% of the true number of cases in this age group was actually notified, despite notification being mandatory.
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Pöyhönen L, Bustamante J, Casanova JL, Jouanguy E, Zhang Q. Life-Threatening Infections Due to Live-Attenuated Vaccines: Early Manifestations of Inborn Errors of Immunity. J Clin Immunol 2019; 39:376-390. [PMID: 31123910 DOI: 10.1007/s10875-019-00642-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/02/2019] [Indexed: 02/07/2023]
Abstract
Live-attenuated vaccines (LAVs) can protect humans against 12 viral and three bacterial diseases. By definition, any clinical infection caused by a LAV that is sufficiently severe to require medical intervention attests to an inherited or acquired immunodeficiency that must be diagnosed or identified. Self-healing infections can also result from milder forms of immunodeficiency. We review here the inherited forms of immunodeficiency underlying severe infections of LAVs. Inborn errors of immunity (IEIs) underlying bacille Calmette-Guérin (BCG), oral poliovirus (OPV), vaccine measles virus (vMeV), and oral rotavirus vaccine (ORV) disease have been described from 1951, 1963, 1966, and 2009 onward, respectively. For each of these four LAVs, the underlying IEIs show immunological homogeneity despite genetic heterogeneity. Specifically, BCG disease is due to inborn errors of IFN-γ immunity, OPV disease to inborn errors of B cell immunity, vMeV disease to inborn errors of IFN-α/β and IFN-λ immunity, and ORV disease to adaptive immunity. Severe reactions to the other 11 LAVs have been described yet remain "idiopathic," in the absence of known underlying inherited or acquired immunodeficiencies, and are warranted to be the focus of research efforts. The study of IEIs underlying life-threatening LAV infections is clinically important for the affected patients and their families, as well as immunologically, for the study of the molecular and cellular basis of host defense against both attenuated and parental pathogens.
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Affiliation(s)
- Laura Pöyhönen
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Jacinta Bustamante
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France.,Center for the Study of Primary Immunodeficiencies, AP-HP, Necker Hospital for Sick Children, Paris, France
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France.,Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France.,Howard Hughes Medical Institute, New York, NY, USA
| | - Emmanuelle Jouanguy
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France
| | - Qian Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
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11
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Ong EZ, Gan ES, de Alwis R, Wijaya L, Ong XM, Zhang M, Wong AW, Cheung YB, Zellweger RM, Ooi EE, Low JG. Genomic signature of early T-cell response is associated with lower antibody titer threshold for sterilizing immunity. Antiviral Res 2019; 166:35-41. [PMID: 30940521 DOI: 10.1016/j.antiviral.2019.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/21/2019] [Accepted: 03/27/2019] [Indexed: 02/02/2023]
Abstract
Vaccination is an effective approach to reduce disease burden. High vaccination coverage blocks pathogen transmission to ensure herd immunity. However, the concept of herd immunity assumes that vaccinated individuals cannot be infected and mediate silent pathogen transmission. While the correlates of vaccine-mediated protection against disease have been examined, the correlates of sterilizing immunity that prevents infection have not been systematically defined. Here, we used full genome expression profiling to explore the molecular correlates of serological response and non-response to measles, mumps and rubella (MMR) vaccination as surrogates of infection and sterilizing immunity, respectively. We observed that the antibody titers needed to sterilize infection with the vaccine strains were higher than current WHO disease protection thresholds. In subjects with baseline antibodies below such sterilizing immunity thresholds, serological non-response to MMR vaccination was associated with gene expression profile indicative of early T-cell activation and signalling. Specifically, genes that regulate T-cell function and response were induced at day 1 post-vaccination in non-responders but not in responders. These findings suggest that rapid T-cell response prevented MMR vaccine infection to limit antigenic presentation and hence serological response. Collectively, our findings suggest an important role for T-cells in engendering sterilizing immunity.
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Affiliation(s)
- Eugenia Z Ong
- Viral Research and Experimental Medicine Centre @ SingHealth-Duke NUS, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Esther S Gan
- Viral Research and Experimental Medicine Centre @ SingHealth-Duke NUS, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Ruklanthi de Alwis
- Viral Research and Experimental Medicine Centre @ SingHealth-Duke NUS, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Limin Wijaya
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Xin Mei Ong
- Viral Research and Experimental Medicine Centre @ SingHealth-Duke NUS, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | | | - Abigail Wl Wong
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Yin Bun Cheung
- Center for Quantitative Medicine, Duke-NUS Medical School, Singapore; Department for International Health, University of Tampere, 33100, Finland
| | - Raphaël M Zellweger
- Viral Research and Experimental Medicine Centre @ SingHealth-Duke NUS, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Eng Eong Ooi
- Viral Research and Experimental Medicine Centre @ SingHealth-Duke NUS, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore; Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research & Technology (SMART), Singapore
| | - Jenny G Low
- Viral Research and Experimental Medicine Centre @ SingHealth-Duke NUS, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore.
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Magurano F, Baggieri M, Marchi A, Bucci P, Rezza G, Nicoletti L. Mumps clinical diagnostic uncertainty. Eur J Public Health 2019. [PMID: 28633302 DOI: 10.1093/eurpub/ckx067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background During recent years, various mumps outbreaks have occurred among populations vaccinated for mumps worldwide. In Italy, improving routine coverage with two doses of measles, mumps and rubella (MMR) vaccine is one of the key strategies to eliminate measles and rubella. To monitor the effect of the vaccination programme on the population, the surveillance of these vaccine-preventable diseases has been implemented. This provided the opportunity to evaluate the accuracy of the clinical diagnosis of those diseases, including mumps. In fact, vaccinated children may develop a variety of diseases caused by a series of different viruses [Epstein-Barr virus (EBV), parainfluenza virus types 1-3, adenoviruses, herpes virus and parvovirus B19] whose symptoms (i.e. swelling of parotid glands) may mimic mumps. For this reason, laboratory diagnosis is essential to confirm clinical suspicion. Methods The accuracy of clinical diagnosis of mumps was evaluated by differential diagnosis on EBV in Italy, a country at low incidence of mumps. This retrospective study investigated whether the etiology of 131 suspected mumps cases with a negative molecular/serological result for mumps virus, obtained from 2007 to 2016, were due to EBV, in order to establish a diagnosis. Results Differential diagnosis revealed a EBV positivity rate of 19.8% and all cases were caused by EBV type 1. Conclusions This study confirms the importance of a lab based differential diagnosis that can discriminate between different infectious diseases presenting with symptoms suggestive of mumps and, in particular, emphasize the importance to discriminate between mumps and EBV-related mononucleosis.
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Affiliation(s)
- Fabio Magurano
- National Reference Laboratory for Measles and Rubella, Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Melissa Baggieri
- National Reference Laboratory for Measles and Rubella, Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Antonella Marchi
- National Reference Laboratory for Measles and Rubella, Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Paola Bucci
- National Reference Laboratory for Measles and Rubella, Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Giovanni Rezza
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Loredana Nicoletti
- National Reference Laboratory for Measles and Rubella, Department of Infectious Diseases, National Institute of Health, Rome, Italy
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Matysiak-Klose D, Santibanez S, Schwerdtfeger C, Koch J, von Bernuth H, Hengel H, Littmann M, Terhardt M, Wicker S, Mankertz A, Heininger U. Post-exposure prophylaxis for measles with immunoglobulins revised recommendations of the standing committee on vaccination in Germany. Vaccine 2018; 36:7916-7922. [DOI: 10.1016/j.vaccine.2018.10.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/25/2022]
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14
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Ho YH, Tsai CC, Tsai YW, Wang YC, Lin TY, Lee DJ, Chen CJ. Humoral immunity to mumps in a highly vaccinated population in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2017; 52:379-385. [PMID: 29046249 DOI: 10.1016/j.jmii.2017.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/14/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND A resurgence of mumps was noted recently and outbreaks were increasingly reported in populations with high vaccine coverage. We aimed to evaluate the seroprevalence to mumps in Taiwan, where a two-dose childhood mumps-containing vaccine program, with a high coverage rate, had been implemented for >20 years. METHODS The anti-mumps IgG was determined in 3552 participants of all ages in Taiwan. The age-specific seropositivity rates were calculated and the sociodemographic variables associated with the seronegative sera were analyzed with a logistic regression method. RESULTS The overall seroprevalence to mumps was 71%, with a higher rate in adults ≥19 years old than in the pediatric population <19 years old (80.4% versus 62.0%, P < 0.0001). In participants aged 2-20 years, who had been given at least one mumps-containing vaccine, the seropositivity fluctuated across different age subgroups and the lowest rate (36.8%) occurred in the 17-18 years age group. The multivariate analysis identified age within 17-18 years (adjusted odds ratio [aOR] 8.598, 95% confidence interval [CI] 2.990-24.722, P < 0.0001), within 19-20 years (aOR 5.076, 95% CI 1.702-15.133, P = 0.0080), and being a resident of the suburban area of northern Taiwan (aOR 1.089, 95% CI 0.823-1.414, P = 0.0008) as independent factors associated with an increased risk of seronegative sera. CONCLUSION The seropositivity to mumps was unexpectedly low in highly vaccinated generations, and with a significant geographical discrepancy in Taiwan, which may have been responsible for the sustained reports of mumps cases in Taiwan.
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Affiliation(s)
- Yu-Huai Ho
- Section of Infectious Disease, Department of Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chen-Chi Tsai
- School of Medicine, Tzu Chi University, Hualien, Taiwan; Section of Infectious Disease, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Ya-Wen Tsai
- School of Medicine, College of Medicine, Chang Gung University, 333, Taoyuan, Taiwan
| | - Yu-Chiang Wang
- School of Medicine, College of Medicine, Chang Gung University, 333, Taoyuan, Taiwan
| | - Tzou-Yien Lin
- School of Medicine, College of Medicine, Chang Gung University, 333, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, 333, Taoyuan, Taiwan
| | - De-Jen Lee
- Physical Education Office, Chang Gung University, 333, Taoyuan, Taiwan.
| | - Chih-Jung Chen
- School of Medicine, College of Medicine, Chang Gung University, 333, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, 333, Taoyuan, Taiwan.
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15
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Prevention of treatable infectious diseases: A game-theoretic approach. Vaccine 2017; 35:5339-5345. [PMID: 28863868 DOI: 10.1016/j.vaccine.2017.08.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/16/2017] [Accepted: 08/17/2017] [Indexed: 11/20/2022]
Abstract
We model outcomes of voluntary prevention using an imperfect vaccine, which confers protection only to a fraction of vaccinees for a limited duration. Our mathematical model combines a single-player game for the individual-level decision to get vaccinated, and a compartmental model for the epidemic dynamics. Mathematical analysis yields a characterization for the effective vaccination coverage, as a function of the relative cost of prevention versus treatment; note that cost may involve monetary as well as non-monetary aspects. Three behaviors are possible. First, the relative cost may be too high, so individuals do not get vaccinated. Second, the relative cost may be moderate, such that some individuals get vaccinated and voluntary vaccination alleviates the epidemic. In this case, the vaccination coverage grows steadily with decreasing relative cost of vaccination versus treatment. Unlike previous studies, we find a third case where relative cost is sufficiently low so epidemics may be averted through the use of prevention, even for an imperfect vaccine. However, we also found that disease elimination is only temporary-as no equilibrium exists for the individual strategy in this third case-and, with increasing perceived cost of vaccination versus treatment, the situation may be reversed toward the epidemic edge, where the effective reproductive number is 1. Thus, maintaining relative cost sufficiently low will be the main challenge to maintain disease elimination. Furthermore, our model offers insight on vaccine parameters, which are otherwise difficult to estimate. We apply our findings to the epidemiology of measles.
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Kowalzik F, Faber J, Knuf M. MMR and MMRV vaccines. Vaccine 2017; 36:5402-5407. [PMID: 28757060 DOI: 10.1016/j.vaccine.2017.07.051] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/28/2017] [Accepted: 07/17/2017] [Indexed: 12/25/2022]
Abstract
Measles, mumps, rubella and varicella are viral infections which can implicate seriously long-term sequelae of infected individuals or even the unborn child. Vaccines against the individual diseases have long been available. Global measles vaccination is estimated to have prevented more than 20million deaths during 2000-2015. During the same time period, measles incidence decreased from 146 to 36 cases per million populations. Today vaccinations against measles, mumps, rubella and varicella are now carried out mainly with combination vaccines. These are today known as immunogenic and safe. MMRV had similar immunogenicity and overall safety profiles to MMR administered with or without varicella vaccine. This issue provides a review of the different vaccines, mode of administration, catch up immunization and postexposure prophylaxis as well as contraindications and adverse effects of the immunization against measles, mumps, rubella, and varicella. The article presents an overview of important information of preventing these diseases with a focus on the existing combination vaccines.
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Affiliation(s)
- Frank Kowalzik
- Center for Children and Adolescent Medicine of the Johannes Gutenberg-Universität, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Jörg Faber
- Center for Children and Adolescent Medicine of the Johannes Gutenberg-Universität, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Markus Knuf
- Children's Hospital, Dr. Horst Schmidt Klinik, Ludwig-Erhard-Strasse 100, 65199 Wiesbaden, Germany.
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Kitano T, Onaka M, Ishihara M, Nishiyama A, Hashimoto N, Yoshida S. Static model simulation for routine mumps vaccination in Japan: with a result of mumps-related complications in a Japanese community hospital. Clin Exp Vaccine Res 2017; 6:120-127. [PMID: 28775976 PMCID: PMC5540960 DOI: 10.7774/cevr.2017.6.2.120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/02/2017] [Accepted: 06/11/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose Mumps vaccine has not been included in the routine national immunization program in Japan, leading to low vaccine coverage rates and periodic epidemics approximately every 5 years. Our hospital (a secondary community hospital in Japan) experienced an increased number of mumps-related complications with a nationwide epidemic in 2016. Using previously reported data and mumps-related cases in our hospital, we estimated the cost-effectiveness of routine mumps vaccination in Japan with a static model using current epidemiologic data. Materials and Methods With a decision tree flowchart of mumps infection and adverse events, we estimated the burden of mumps-related complications in our hospital for 5 years, and calculated the current annual national burden. Finally, we compared the current burden and assumptive burden of the stable state after routine vaccination in Japan using a static model. Results The cost-benefit ratios with sensitivity analysis were 3.69 (1.08-9.52) and 6.84 (1.51-23.73) in independent inoculation and simultaneous inoculation, respectively, from a social perspective in addition to an annual gain of 9,487 (3,227-14,659) quality adjusted life years. Conclusion We contributed additional evidence in terms of cost-effectiveness that routine mumps vaccination should be introduced in Japan with simultaneous inoculation.
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Affiliation(s)
- Taito Kitano
- Department of Pediatrics, Nara Prefecture General Medical Center, Nara City, Japan
| | - Masayuki Onaka
- Department of Pediatrics, Nara Prefecture General Medical Center, Nara City, Japan
| | - Mariko Ishihara
- Department of Pediatrics, Nara Prefecture General Medical Center, Nara City, Japan
| | - Atsuko Nishiyama
- Department of Pediatrics, Nara Prefecture General Medical Center, Nara City, Japan
| | - Naoki Hashimoto
- Department of Pediatrics, Nara Prefecture General Medical Center, Nara City, Japan
| | - Sayaka Yoshida
- Department of Pediatrics, Nara Prefecture General Medical Center, Nara City, Japan
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Choe YJ, Eom HE, Cho SI. Trend of measles, mumps, and rubella incidence following the measles-rubella catch up vaccination in the Republic of Korea, 2001. J Med Virol 2017; 89:1528-1531. [PMID: 28303592 DOI: 10.1002/jmv.24808] [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: 10/13/2016] [Accepted: 03/01/2017] [Indexed: 11/09/2022]
Abstract
Following the introduction of measles-rubella (MR) catch-up vaccination in 2001 and two dose measles-mumps-rubella (MMR2) keep-up program in 2002, the incidence of measles, mumps, and rubella was not evaluated systematically. To describe the recent changes in epidemiology, a population-based incidence study from 2001 to 2015 using national notifiable disease surveillance data was conducted. Between 2001 and 2015, there was decrease in the incidence of measles and rubella, whereas a steady increase in mump incidence was noted. The age distribution of mumps cases has shifted to the older age group, whereas rubella became more frequent in younger age group. The incidence of mumps showed an increase in every birth cohorts, except for the decrease in incidence for catch-up vaccination cohort from 131 cases in 2007-2011 to 64 cases per 100 000 in 2012-2015. Continuing in monitoring of mumps and strengthening of the high two-dose MMR vaccination coverage should be taken place in Korea.
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Affiliation(s)
- Young June Choe
- Department of Epidemiology, Seoul National University School of Public Health, Seoul, Republic of Korea.,Division of National Immunization Program and Vaccine-Preventable Disease Control, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Hye-Eun Eom
- Division of National Immunization Program and Vaccine-Preventable Disease Control, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
| | - Sung-Il Cho
- Department of Epidemiology, Seoul National University School of Public Health, Seoul, Republic of Korea
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Choe YJ, Lee YH, Cho SI. Increasing mumps incidence rates among children and adolescents in the Republic of Korea: age-period-cohort analysis. Int J Infect Dis 2017; 57:92-97. [PMID: 28223174 DOI: 10.1016/j.ijid.2017.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/12/2017] [Accepted: 02/13/2017] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND To characterize the temporal dynamics of mumps epidemiology according to the different vaccine strains used, sex-specific trends were decomposed in an age-period-cohort (APC) analysis for mumps cases reported in South Korea. METHODS National surveillance data were used to describe the epidemiology of mumps cases from 2001 to 2015. An APC model was used to break down the reported mumps cases into the effects of age, period, and birth cohort. RESULTS From 2001 to 2015, the incidence started to increase from fewer than 10 cases to more than 100 cases per 100 000. The incidence rate was highest among males aged 15-17 years during 2013-2015, reaching 508.7 per 100 000 persons. There was an increased incidence during the late teenage years in the 1998-2000 cohort. An age shift towards the earlier teenage years was observed across the 2001-2003 and 2004-2006 cohorts. The risk of mumps increased according to the birth cohort; the net drift from 2001 to 2015 was 27.67 (95% confidence interval 27.5.47-29.90) for males and 27.25 (95% confidence interval 24.91-29.65) for females. CONCLUSIONS The increase in mumps seen in Korea may have been affected by the birth cohort exposed to the Rubini strain; however other factors may have contributed to the increase in non-exposed cohorts.
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Affiliation(s)
- Young-June Choe
- Medical Research Center, Seoul National University College of Medicine, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea; Department of Epidemiology, Seoul National University School of Public Health, Seoul, Republic of Korea
| | - Young Hwa Lee
- Medical Research Center, Seoul National University College of Medicine, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea; Department of Epidemiology, Seoul National University School of Public Health, Seoul, Republic of Korea
| | - Sung-Il Cho
- Medical Research Center, Seoul National University College of Medicine, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea; Department of Epidemiology, Seoul National University School of Public Health, Seoul, Republic of Korea.
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Safety and Immunogenicity of M-M-RII (Combination Measles-Mumps-Rubella Vaccine) in Clinical Trials of Healthy Children Conducted Between 1988 and 2009. Pediatr Infect Dis J 2016; 35:1011-20. [PMID: 27254037 DOI: 10.1097/inf.0000000000001241] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND M-M-RII, a combination measles, mumps and rubella vaccine, was licensed in the United States in 1978 based on data from several clinical trials that demonstrated that the safety and immunogenicity of the vaccine were comparable to the component monovalent vaccines and to the previous trivalent combination vaccine. METHODS Safety and immunogenicity data from 23 postlicensure clinical trials conducted with M-M-RII between 1988 and 2009 were summarized. A total of 12,901 children who received only a first dose, 920 children who received a first and second dose and 400 children who received only a second dose were evaluated. RESULTS The vaccine was generally well tolerated among children who received a first and/or second dose of M-M-RII. During the 28-42-day follow-up after dose 1 and dose 2, the median rate of temperatures ≥102°F (oral equivalent) was 24.8% and 13.0% and the median rate of measles/rubella-like rash was 3.2% and 0.5%, respectively. The median rate of injection-site reactions during the first 5 days postdose 1 and postdose 2 was 17.3% and 42.7%, respectively. The seroconversion rates (enzyme-linked immunosorbent assay) after dose 1 were remarkably consistent from study to study between 1988 and 2009 (92.8%-100% for measles, 97.7%-100% for mumps and 92.8%-100% for rubella). A trend test showed that there was no change in the immunogenicity of the vaccine over the 21-year period. CONCLUSIONS The results of this analysis demonstrate that M-M-RII is well tolerated and immunogenic. The vaccine performed consistently over 21 years of evaluation in clinical trials.
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Lin YC, Hsieh YC, Huang YL, Huang YC, Hung YT, Huang YC. Seroepidemiology for measles among elementary school children in Northern Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2016; 49:561-566. [PMID: 25442863 DOI: 10.1016/j.jmii.2014.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/21/2014] [Accepted: 08/23/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Despite the high vaccination coverage in Taiwan, sporadic cases or small cluster of measles still occur every year. Nevertheless, few studies provided information about the serostatus for measles in recent years. This cross-sectional survey aimed to establish the seroepidemiologic data of measles among elementary school children in New Taipei City, Taiwan during 2012-2013. METHODS A multistage stratified sampling design using 14 variables was employed to obtain samples. All selected schoolchildren were bled for the serologic tests of measles by both chemiluminescence immunoassay (CLIA) and enzyme immunoassay (EIA). RESULTS A total of 856 schoolchildren from 14 schools were recruited in this study. Among these individuals, the overall seropositive rates for measles were 82.24% and 92.17% by the Liaison and NovaLisa assays, respectively. For schoolchildren in each grade, the seropositive rates were > 90% for Grade 1, and then decreased gradually to 70-80% for Grade 6 (p < 0.001 for both methods). A decay of measles-specific immunoglobulin G titers was also observed with the maximum drop between Grade 1 and Grade 2 (declining trend of p < 0.001 for both). CONCLUSION Although the seropositive rate of measles was > 90% for Grade 1, the rate for Grade 6 was only in the range of 70-80%, which may be a challenge to prevent outbreaks of measles in the future and should be monitored meticulously.
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Affiliation(s)
- Yu-Chun Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chia Hsieh
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
| | - Ya-Ling Huang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chiau Huang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yung-Tai Hung
- Department of Political Science, National Taiwan University, Taipei, Taiwan
| | - Yhu-Chering Huang
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Decreased salivary matrix metalloproteinase-8 reflecting a defensive potential in juvenile parotitis. Int J Pediatr Otorhinolaryngol 2016; 80:74-7. [PMID: 26746616 DOI: 10.1016/j.ijporl.2015.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 11/12/2015] [Accepted: 11/13/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Matrix metalloproteinases MMP-2 and MMP-9 have been associated with juvenile parotitis. However, the role of MMP-8 has not been addressed previously. This work focuses on salivary MMP-8 and -9 levels in juvenile parotitis. METHODS During a five-year period at Helsinki University Hospital, a tertiary care hospital, 41 patients aged 17 or under, were identified as having parotitis; from 36 of these patients, saliva samples were collected for MMP-8 IFMA (time-resolved immunofluorometric assay) analyses. Control saliva samples were collected from 34 age- and gender-matched children admitted for an elective surgery who had no history of parotitis. For comparison, salivary levels of MMP-9, tissue inhibitor of matrix metalloproteinase (TIMP-1), MMP-8/TIMP-1 ratio, human neutrophil elastase (HNE), and myeloperoxidase (MPO) were analyzed by ELISA. Additionally, salivary MMP-8 levels were compared to historical saliva samples from 18 adult gingivitis patients as well as to 10 healthy adult controls. RESULTS The median (25%, 75% percentile) MMP-8 concentration in saliva of parotitis patients was significantly lower than MMP-8 concentration in saliva of their controls [50.4ng/ml (37.5, 72.9) vs. 148.5ng/ml (101.2, 178.5) p<0.0001] and lower than in patients with gingivitis [347.9ng/ml (242.6, 383.2) p<0.0001] or healthy adult controls [257.2ng/ml (164.9, 320.7) p<0.0001]. The MMP-8/TIMP-1 ratio was lower than in controls [0.13 (0.05-0.02) vs. 0.3 (0.17-0.46) p<0.0001]. The median MMP-9 concentration in saliva of parotitis patients was significantly higher than in controls [143.9ng/m (68.8-189.0) vs. 34.9ng/ml (16.3-87.6) p<0.0001]. Neither HNE, MPO, nor TIMP-1 alone separated the patients from the control groups. CONCLUSIONS MMP-9 was up-regulated in juvenile parotitis saliva, suggesting that MMP-9 may play a destructive role in juvenile parotitis, as others have suggested. The present novel findings reveal a decreased salivary MMP-8 concentration, suggesting that MMP-8 may reflect in juvenile parotitis down-regulated or anti-inflammatory immune characteristics.
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Deichmann KA, Ferrera G, Tran C, Thomas S, Eymin C, Baudin M. Immunogenicity and safety of a combined measles, mumps, rubella and varicella live vaccine (ProQuad®) administered concomitantly with a booster dose of a hexavalent vaccine in 12–23-month-old infants. Vaccine 2015; 33:2379-86. [DOI: 10.1016/j.vaccine.2015.02.070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/26/2015] [Accepted: 02/26/2015] [Indexed: 11/29/2022]
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Maltezou HC, Lionis C. The financial crisis and the expected effects on vaccinations in Europe: a literature review. Infect Dis (Lond) 2015; 47:437-46. [PMID: 25739315 DOI: 10.3109/23744235.2015.1018315] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Starting in 2008 several European countries experienced a financial crisis. Historically, diseases whose prevention and treatment depend highly on the continuity of healthcare re-emerge during political and financial crises. Evidence suggests that the current financial crisis has had an impact on the health and welfare of Europeans and that population health status and morbidity as well as mortality patterns may change in the coming years. At the same time decisions about expenditure for health services may impact the ability of public health providers to respond. It is expected that the current crisis will further exacerbate socioeconomic and health inequalities and novel vulnerable groups will emerge in addition to existing ones. We review the available evidence and discuss how the current crisis may have an impact on vaccine-preventable diseases and influence vaccination coverage rates in Europe.
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Affiliation(s)
- Helena C Maltezou
- From the 1 Department for Interventions in Health Care Facilities, Hellenic Center for Disease Control and Prevention , Athens
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Barrabeig I, Costa J, Rovira A, Marcos MA, Isanta R, López-Adalid R, Cervilla A, Torner N, Domínguez A. Viral etiology of mumps-like illnesses in suspected mumps cases reported in Catalonia, Spain. Hum Vaccin Immunother 2014; 11:282-7. [PMID: 25483547 PMCID: PMC4514168 DOI: 10.4161/hv.36165] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 07/12/2014] [Indexed: 11/19/2022] Open
Abstract
We investigated the etiology of reported sporadic suspected mumps cases with a negative RT-PCR result for the mumps virus in the Barcelona-South region in 2007-2011. Samples from mumps virus-negative patients presenting unilateral or bilateral parotitis or other salivary gland swelling were tested for Epstein-Barr virus (EBV) by real-time PCR and for respiratory viruses by two multiplex-PCR-based assays to detect parainfluenza virus (PIV) 1-4, influenza virus (InV) A, B and C, respiratory syncytial virus (RSV), enterovirus, coronavirus 229E, coronavirus OC43, and rhinovirus. 101 samples were analyzed in persons aged 8 months to 50 years. Oral samples were collected on the first day of glandular swelling in 53 patients (52.5%), and on the first two days in 74 patients (73.3%). Viruses were detected in 52 (51.5%) of samples: one virus (25 EBV, 8 PIV3, 4 adenovirus, 4 PIV2, 1 PIV1, 1 InVA, and 1 enterovirus) was detected in 44 patients (84.6%), two viruses in 7 patients, and three viruses in one patient. In 58 patients (57.5%) whose sample was collected in the first 2 days after onset of parotitis and had received two doses of MMR vaccine and in 15 patients (14.8%) whose sample was collected on the first day, it is very likely that the cause was not the mumps virus. This would mean that 72.3% (73/101) of the reported sporadic suspected mumps cases were not mumps cases. The timing of oral-sample collection is crucial to correctly interpret the negative results for mumps virus RNA, especially when suspected cases occur in vaccinated persons.
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Affiliation(s)
- Irene Barrabeig
- Epidemiological Surveillance Unit of Health Region, Barcelona-South; Public Health Agency of Catalonia; Hospitalet de LLobregat; Spain
| | - Josep Costa
- Microbiology Service (CDB) Hospital Clínic; Barcelona, Spain
- CIBERehd IDIBAPS; Barcelona, Spain
| | - Ariadna Rovira
- Epidemiological Surveillance Unit of Health Region, Barcelona-South; Public Health Agency of Catalonia; Hospitalet de LLobregat; Spain
| | - M Angeles Marcos
- Barcelona Center for International Health Research (CRESIB; Hospital Clínic; University of Barcelona; Barcelona); Barcelona, Spain
| | - Ricard Isanta
- Microbiology Service (CDB) Hospital Clínic; Barcelona, Spain
| | | | - Ana Cervilla
- Microbiology Service (CDB) Hospital Clínic; Barcelona, Spain
| | - Nuria Torner
- Epidemiological Surveillance Unit of Health Region, Barcelona-South; Public Health Agency of Catalonia; Hospitalet de LLobregat; Spain
- CIBER Epidemiologia y Salud Pública; Carlos III Institute of Health; Madrid, Spain
- Department of Public Health; University of Barcelona; Barcelona, Spain
| | - Angela Domínguez
- CIBER Epidemiologia y Salud Pública; Carlos III Institute of Health; Madrid, Spain
- Department of Public Health; University of Barcelona; Barcelona, Spain
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Epidemic of complicated mumps in previously vaccinated young adults in the South-West of France. Med Mal Infect 2014; 44:502-8. [PMID: 25391635 DOI: 10.1016/j.medmal.2014.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/24/2014] [Accepted: 09/10/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We report the features and diagnosis of complicated mumps in previously vaccinated young adults. PATIENTS AND METHODS We retrospectively studied 7 cases of complicated mumps managed during 1 year at the Bordeaux University Hospital. The diagnosis was suggested by the clinical presentation and confirmed using specific RT-PCR. RESULTS Five cases of meningitis, 1 of orchitis, and 1 of unilateral hearing impairment were identified. Each of the 7 patients had been previously vaccinated with MMR, 4 had received 2 doses of this vaccine. Blood tests revealed high rates of IgG antibodies, usually considered as sufficient for immunological protection, and every patient had at least 1 positive RT-PCR test for mumps. CONCLUSION Outbreaks of complicated mumps may still occur despite a broad coverage of MMR vaccination. The clinical presentation suggested mumps but the final diagnosis could only be confirmed by genomic detection of the virus. Unusual viral strains with increased neurovirulence, insufficient population coverage associated with immunity decrease over time may explain outbreaks of complicated mumps. A full vaccine scheme of contact people or a third injection of vaccine for previously vaccinated people who are at risk of developing mumps are required to prevent further spreading of the disease during the outbreak.
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Oraby T, Thampi V, Bauch CT. The influence of social norms on the dynamics of vaccinating behaviour for paediatric infectious diseases. Proc Biol Sci 2014; 281:20133172. [PMID: 24523276 DOI: 10.1098/rspb.2013.3172] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Mathematical models that couple disease dynamics and vaccinating behaviour often assume that the incentive to vaccinate disappears if disease prevalence is zero. Hence, they predict that vaccine refusal should be the rule, and elimination should be difficult or impossible. In reality, countries with non-mandatory vaccination policies have usually been able to maintain elimination or very low incidence of paediatric infectious diseases for long periods of time. Here, we show that including injunctive social norms can reconcile such behaviour-incidence models to observations. Adding social norms to a coupled behaviour-incidence model enables the model to better explain pertussis vaccine uptake and disease dynamics in the UK from 1967 to 2010, in both the vaccine-scare years and the years of high vaccine coverage. The model also illustrates how a vaccine scare can perpetuate suboptimal vaccine coverage long after perceived risk has returned to baseline, pre-vaccine-scare levels. However, at other model parameter values, social norms can perpetuate depressed vaccine coverage during a vaccine scare well beyond the time when the population's baseline vaccine risk perception returns to pre-scare levels. Social norms can strongly suppress vaccine uptake despite frequent outbreaks, as observed in some small communities. Significant portions of the parameter space also exhibit bistability, meaning long-term outcomes depend on the initial conditions. Depending on the context, social norms can either support or hinder immunization goals.
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Affiliation(s)
- Tamer Oraby
- Department of Mathematics and Statistics, University of Guelph, , Guelph, Ontario, Canada, Department of Applied Mathematics, University of Waterloo, , Waterloo, Ontario, Canada
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Cutts FT, Lessler J, Metcalf CJE. Measles elimination: progress, challenges and implications for rubella control. Expert Rev Vaccines 2014; 12:917-32. [DOI: 10.1586/14760584.2013.814847] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Post-Vaccination Immunity Against Measles in Under Twenty-Five-Year-Old Population of Ahvaz, Southwest of Iran. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.7707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pfaff G. [Elimination of measles and rubella in Germany: Progress and hindrances]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:1222-4. [PMID: 23990082 DOI: 10.1007/s00103-013-1803-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shirts BH, Welch RJ, Couturier MR. Seropositivity rates for measles, mumps, and rubella IgG and costs associated with testing and revaccination. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:443-5. [PMID: 23345583 PMCID: PMC3592343 DOI: 10.1128/cvi.00503-12] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 01/14/2013] [Indexed: 11/20/2022]
Abstract
Retrospective analysis of IgG test results and patterns for measles, mumps, and rubella revealed generally high seropositivity rates, with that of mumps being the lowest. A simplified cost analysis shows that when there is a suspicion of nonimmunity, serological testing may be cheaper than vaccination.
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Affiliation(s)
- Brian H. Shirts
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah, USA
| | - Ryan J. Welch
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah, USA
| | - Marc Roger Couturier
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah, USA
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Levine H, Ankol OE, Rozhavski V, Davidovitch N, Aboudy Y, Zarka S, Balicer RD. Rubella seroprevalence in the first birth cohort reaching fertility age after 20 years of two dose universal vaccination policy in Israel. Vaccine 2012; 30:7260-4. [DOI: 10.1016/j.vaccine.2012.09.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 09/21/2012] [Accepted: 09/29/2012] [Indexed: 10/27/2022]
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Waning population immunity to measles in Taiwan. Vaccine 2012; 30:6721-7. [DOI: 10.1016/j.vaccine.2012.05.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 04/30/2012] [Accepted: 05/02/2012] [Indexed: 11/20/2022]
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35
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Kontio M, Jokinen S, Paunio M, Peltola H, Davidkin I. Waning Antibody Levels and Avidity: Implications for MMR Vaccine-Induced Protection. J Infect Dis 2012; 206:1542-8. [DOI: 10.1093/infdis/jis568] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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36
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Lievano F, Galea SA, Thornton M, Wiedmann RT, Manoff SB, Tran TN, Amin MA, Seminack MM, Vagie KA, Dana A, Plotkin SA. Measles, mumps, and rubella virus vaccine (M-M-R™II): a review of 32 years of clinical and postmarketing experience. Vaccine 2012; 30:6918-26. [PMID: 22959986 DOI: 10.1016/j.vaccine.2012.08.057] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 08/20/2012] [Accepted: 08/23/2012] [Indexed: 10/27/2022]
Abstract
M-M-R™II (measles, mumps, and rubella virus vaccine live; Merck, Sharp, & Dohme Corp.) is indicated for simultaneous vaccination against measles, mumps, and rubella in individuals ≥ 12 months of age. Before the vaccine era, these viruses infected most exposed individuals, with subsequent morbidity and mortality. One of the greatest achievements of public health has been to eliminate these 3 diseases in large geographic areas. The safety profile of M-M-R™II is described using data from routine global postmarketing surveillance. Postmarketing surveillance has limitations (including incomplete reporting of case data), but allows collection of real-world information on large numbers of individuals, who may have concurrent medical problems excluding them from clinical trials. It can also identify rare adverse experiences (AEs). Over its 32-year history, ≈ 575 million doses of M-M-R™II have been distributed worldwide, with 17,536 AEs voluntarily reported for an overall rate of 30.5 AEs/1,000,000 doses distributed. This review provides evidence that the vaccine is safe and well-tolerated.
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Affiliation(s)
- Fabio Lievano
- Merck, Sharp, & Dohme Corp., Whitehouse Station, NJ, USA.
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Kim ES, Choe YJ, Cho H, Kim YJ, Yoon HS, Yang JS, Kim K, Bae GR, Lee DH. Seroprevalence of measles among children affected by national measles elimination program in Korea, 2010. Vaccine 2012; 30:3355-9. [PMID: 22484294 DOI: 10.1016/j.vaccine.2012.03.073] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 02/22/2012] [Accepted: 03/23/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Following the implementation of national measles elimination plan in Korea, the elimination was declared in 2006. In order to sustain the elimination, high population immunity should be continuously monitored. To evaluate the current age-related susceptibility within the Korean population, we conducted the seroprevalence in children and adolescents who were affected by the national measles elimination plan. METHODS We used residual serum specimens to measure measles specific IgG and geometric mean titer (GMT) in birth cohorts 2007-2008 and 1997-2003. Among birth cohorts, 2007-2008 cohorts were grouped to evaluate the timeliness of first dose of MMR, 1994-2003 cohorts were grouped to evaluate the effect of keep-up MMR2 campaign, and 1992-1993 cohorts were grouped to evaluate the effect of catch-up campaign in 2001. RESULTS Overall, measles seropositivity rate was 86%. The highest seroprevalence of measles IgG was in birth cohorts 2007-2008. Measles seropositivity declined continuously in age groups. The birth cohorts 1994-1996 showed significantly lower levels of seropositivity and GMT than did the other birth cohorts. CONCLUSION Despite efforts to eliminate measles for the past 10 years in Korea, our study revealed specific birth cohorts remaining at risk for transmission. The adolescents born during 1994-1996 had the lowest measles seropositivity levels, and might represent a 'pocket' that has potential at increased risk for measles transmission. Further discussion for follow-up immunization should be placed for consideration in the near future.
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Affiliation(s)
- Eun Seong Kim
- Division of Vaccine Preventable Disease Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea
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Levine H, Rishpon S, Huerta-Hartal M, Davidovitch N. Preventing mumps outbreaks in confined settings: comprehensive ring vaccination as a containment strategy. HUMAN VACCINES 2011; 7:1389-93. [PMID: 22108037 DOI: 10.4161/hv.7.12.18111] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Even among vaccinated cohorts, prevention and control of mumps outbreaks remain a challenge, owing to sub-optimal population immunity. This is especially true in confined settings, where a single case could be the index for an imminent outbreak. Efficacy of post-exposure prophylaxis has not been demonstrated, while early identification of mumps and comprehensive vaccination of populations in confined settings during outbreaks may enable containment of mumps and disrupt further spread. However, we are not aware of official international guidelines concerning vaccination of exposed individuals during an outbreak, especially in a confined setting. In this article we present our experience with mumps containment during outbreaks through vaccination campaigns in the Israeli civilian and military populations and discuss lessons for containment efforts in other settings. Our analysis shows that a comprehensive ring vaccination should be considered in any case of mumps in confined settings.
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Affiliation(s)
- Hagai Levine
- Braun Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel.
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Saffar MJ, Fathpour GR, Parsaei MR, Ajami A, Khalilian AR, Shojaei J, Saffar H. Measles-mumps-rubella revaccination; 18 months vs. 4-6 years of age: potential impacts of schedule changes. J Trop Pediatr 2011; 57:347-51. [PMID: 21078605 DOI: 10.1093/tropej/fmq102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The policy of administering the second dose of measles-mumps-rubella (MMR) vaccine (MMR(2)) has recently changed in Iran, at age 1.5 years instead of 4-6 years previously. The effects of such a change on the immune status of the individual are evaluated in this study. METHODS Totally 249 and 228 children aged 18 months and 4- to 6-year-olds, respectively, with a documented receipt of primary MMR vaccine at the age of ≥ 1 year were enrolled. Before, and 4-6 weeks after MMR(2) administration, anti-MMR IgG antibody levels were measured using ELISA method. IgM antibody levels were also assessed in measles-rubella seronegative children that responded to MMR(2). Collected data for each component from both age groups were compared by using Fischer's exact probability and chi-square tests. RESULTS Before revaccination, measles seroimmunity rate was similar between the two groups, but rates to mumps and rubella were significantly higher in younger children-measles: 74 vs. 78.3%; mumps: 82.3 vs. 68.4% and rubella: 75% vs. 67%, respectively. After administration of MMR(2), all seroimmune subjects were IgG boosted. Except for rubella, older seronegative children showed significantly higher seroconvertion rate to MMR(2) and seroprevalence rates increased in vaccinees--measles: 98.2 vs. 94%, mumps: 97 vs. 94.4% and rubella: 87 vs. 92.4%, respectively. Only few measles-rubella seronegative children showed IgM response to MMR(2). CONCLUSION This study showed that the majority of younger children were susceptible to MMR infection before revaccination. Earlier age policy provides more protection against MMR in preschool-aged children. Rubella strain seems to be less potent than reported.
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Affiliation(s)
- Mohammed Jafar Saffar
- Department of Pediatric Infectious Diseases, Bouali-Cina Hospital, Pasdaran Boulevard, Mazandaran University of Medical Sciences, Sari, Iran.
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Hickman CJ, Hyde TB, Sowers SB, Mercader S, McGrew M, Williams NJ, Beeler JA, Audet S, Kiehl B, Nandy R, Tamin A, Bellini WJ. Laboratory characterization of measles virus infection in previously vaccinated and unvaccinated individuals. J Infect Dis 2011; 204 Suppl 1:S549-58. [PMID: 21666212 DOI: 10.1093/infdis/jir106] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Waning immunity or secondary vaccine failure (SVF) has been anticipated by some as a challenge to global measles elimination efforts. Although such cases are infrequent, measles virus (MeV) infection can occur in vaccinated individuals following intense and/or prolonged exposure to an infected individual and may present as a modified illness that is unrecognizable as measles outside of the context of a measles outbreak. The immunoglobulin M response in previously vaccinated individuals may be nominal or fleeting, and viral replication may be limited. As global elimination proceeds, additional methods for confirming modified measles cases may be needed to understand whether SVF cases contribute to continued measles virus (MeV) transmission. In this report, we describe clinical symptoms and laboratory results for unvaccinated individuals with acute measles and individuals with SVF identified during MeV outbreaks. SVF cases were characterized by the serological parameters of high-avidity antibodies and distinctively high levels of neutralizing antibody. These parameters may represent useful biomarkers for classification of SVF cases that previously could not be confirmed as such using routine laboratory diagnostic techniques.
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Affiliation(s)
- Carole J Hickman
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Martin R, Wassilak S, Emiroglu N, Uzicanin A, Deshesvoi S, Jankovic D, Goel A, Khetsuriani N. What Will It Take to Achieve Measles Elimination in the World Health Organization European Region: Progress From 2003-2009 and Essential Accelerated Actions. J Infect Dis 2011; 204 Suppl 1:S325-34. [DOI: 10.1093/infdis/jir137] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rümke H, Loch H, Hoppenbrouwers K, Vandermeulen C, Malfroot A, Helm K, Douha M, Willems P. Immunogenicity and safety of a measles–mumps–rubella–varicella vaccine following a 4-week or a 12-month interval between two doses. Vaccine 2011; 29:3842-9. [DOI: 10.1016/j.vaccine.2011.02.067] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 01/17/2011] [Accepted: 02/13/2011] [Indexed: 10/18/2022]
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Muhsen K, Shohat T, Aboudy Y, Mendelson E, Algor N, Anis E, Cohen D. Sero-prevalence of mumps antibodies in subpopulations subsequently affected by a large scale mumps epidemic in Israel. Vaccine 2011; 29:3878-82. [PMID: 21453788 DOI: 10.1016/j.vaccine.2011.03.047] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 02/27/2011] [Accepted: 03/16/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Despite the high national vaccination coverage, a large outbreak of mumps occurred in Israel, in 2009-2010, with onset and heavy transmission in ultraorthodox Jewish communities and further country-wide spread. We examined the sero-prevalence of mumps antibodies in the subpopulations subsequently affected by this large mumps outbreak, compared with the general population. METHODS The study was conducted in ultraorthodox Jewish communities, in Jerusalem district (N=251), in Bnei Brak city in Tel Aviv district (N=453), and in the general population (N=1846), using residual sera of 1-20 year old subjects. Mumps IgG antibodies were measured using Enzygnost anti-parotitis virus IgG ELISA kit. RESULTS Mumps sero-positivity was significantly lower in Jerusalem: 51.8% (95% CI 51.9-61.0), and Bnei Brak: 56.5% (95% CI 45.6-57.9), than in the general population: 68.1% (95% CI 66.0-70.2). Sero-positivity increased with age, however in Jerusalem it was substantially low (46%) in the age group 10-20 years. This age group comprised a significant portion of mumps patients in the 2009-2010 outbreak. CONCLUSIONS Low immunity levels, combined with overcrowding and social mixing, were the main predisposing factors of the enhanced epidemic transmission of mumps in the ultraorthodox Jewish communities and further country-wide spread.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel
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Levine H, Ankol OE, Rozhavski V, Davidovitch N, Aboudy Y, Zarka S, Balicer RD. Sub-optimal prevalence of mumps antibodies in a population based study of young adults in Israel after 20 years of two dose universal vaccination policy. Vaccine 2011; 29:2785-90. [DOI: 10.1016/j.vaccine.2011.01.103] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Revised: 01/24/2011] [Accepted: 01/30/2011] [Indexed: 10/18/2022]
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Davidkin I, Kontio M, Paunio M, Peltola H. MMR vaccination and disease elimination: the Finnish experience. Expert Rev Vaccines 2010; 9:1045-53. [PMID: 20822347 DOI: 10.1586/erv.10.99] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Measles, mumps and rubella (MMR) vaccinations have been included in Finland's national vaccination program as a two-dose schedule since 1982. Owing to the high (>95%) coverage of vaccinations, indigenous MMR diseases were eliminated from Finland by the mid-1990s. In 1982, the incidence of measles, mumps and rubella was 105, 43 and 64 per 100,000 population, respectively, but declined to 0.1 per 100,000 population for all MMR diseases in 1995. Since then, the few cases of measles, mumps and rubella imported annually have not caused any outbreaks. Several research projects that started along with the vaccination campaign have provided important support throughout the program. The vaccine was proven to be safe, immunogenic and effective. Antibody follow-up has revealed that MMR vaccine-induced antibodies wane over time, and concerns have arisen about the continuation of this good situation. High vaccination coverage, enhanced surveillance and preparedness to administer additional doses when needed are key factors for future success. Here we present an overview of MMR vaccinations and the Finnish experience of the MMR disease elimination process, and we describe surveillance activities in the era following elimination in Finland.
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Affiliation(s)
- Irja Davidkin
- National Institute for Health and Welfare, Department of Vaccination and Immune Protection, Helsinki, Finland.
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Levine MM. Immunogenicity and efficacy of oral vaccines in developing countries: lessons from a live cholera vaccine. BMC Biol 2010; 8:129. [PMID: 20920375 PMCID: PMC2958895 DOI: 10.1186/1741-7007-8-129] [Citation(s) in RCA: 177] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 10/01/2010] [Indexed: 01/22/2023] Open
Abstract
Oral vaccines, whether living or non-living, viral or bacterial, elicit diminished immune responses or have lower efficacy in developing countries than in developed countries. Here I describe studies with a live oral cholera vaccine that include older children no longer deriving immune support from breast milk or maternal antibodies and that identify some of the factors accounting for the lower immunogenicity, as well as suggesting counter-measures that may enhance the effectiveness of oral immunization in developing countries. The fundamental breakthrough is likely to require reversing effects of the 'environmental enteropathy' that is often present in children living in fecally contaminated, impoverished environments.
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Affiliation(s)
- Myron M Levine
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Heininger U. A risk-benefit analysis of vaccination. Vaccine 2010; 27 Suppl 6:G9-G12. [PMID: 20006145 DOI: 10.1016/j.vaccine.2009.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 10/05/2009] [Indexed: 11/24/2022]
Abstract
Impressive success has been achieved worldwide with population based immunisation programmes against several serious infectious diseases. This success is being threatened: the incidence of previously frequent, potentially devastating diseases decreases as a consequence of successful immunisation programmes and attention of the public shifts towards true and alleged "side effects" of vaccines. This can lead to the dilemma of waning public confidence in the necessity, tolerability and safety of vaccinations. Therefore, continuous evaluation of risks and benefits of vaccines is required and results of these need to be communicated broadly to strengthen the confidence in immunisation programmes.
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Affiliation(s)
- Ulrich Heininger
- Division of Pediatric Infectious Diseases, University Children's Hospital Basel, P.O. Box, CH-4005, Basel, Switzerland.
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Lehtinen M, Paavonen J. Impact of human papillomavirus vaccination depends on effective vaccination strategy. Int J Cancer 2009; 125:1490-1. [PMID: 19507251 DOI: 10.1002/ijc.24476] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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