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Sievers BL, Sievers RE, Sievers EL. Incentivized self-vaccination for global measles eradication. J Virus Erad 2022; 8:100310. [PMID: 36578361 PMCID: PMC9791812 DOI: 10.1016/j.jve.2022.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Measles-we've become inured to its cruel, insidious impact as it kills over 100,000 children yearly because of suboptimal vaccination coverage. It does not have to be this way. A familiar, safe, exceptionally effective measles vaccine saves lives and permanent, global measles eradication is within reach. But now we need to be clever and courageously explore new strategies to save lives. Firstly, let us enable people to vaccinate themselves, not with a needle and syringe, but with a quick inhaled puff of dry powder vaccine. Secondly, let us provide micro-payments using digital currency to incentivize those who vaccinate themselves. Thirdly, let us leverage learnings from how our social networks guide our behaviors to further encourage self-vaccination. Fourthly, let us inspire friendly regional competition among communities vying for the highest proportion of citizens who show measles neutralizing antibodies in spot saliva samples. With global cooperation and relentless determination, we eradicated smallpox. Next up? Measles.
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Affiliation(s)
| | - Robert E. Sievers
- Department of Chemistry and Biochemistry, University of Colorado Boulder, Boulder, CO, 80309, USA
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Eid D, Osborne J, Borowicz B. Moving the Needle: A 50-State and District of Columbia Landscape Review of Laws Regarding Pharmacy Technician Vaccine Administration. PHARMACY 2019; 7:E168. [PMID: 31835561 PMCID: PMC6958442 DOI: 10.3390/pharmacy7040168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 12/04/2022] Open
Abstract
Pharmacy technicians are essential for inner workings of pharmacy teams and their depth of involvement in roles continues to evolve. An innovative role for pharmacy technicians, administration of vaccines, has emerged. With Idaho, Rhode Island, and Utah recently implementing changes that allow pharmacy technicians to safely perform this role, the need arose for a detailed examination of the law climate in all 50 states and the District of Columbia. A nine-question survey was sent out to all 51 state boards of pharmacy inquiring to legislative and regulatory environment of pharmacy technician vaccine administration. Additionally, a protocol driven, peer-reviewed process of state-specific regulations and statutes revealed categorized trends pertaining to this topic. Each state was classified per protocol into four different categories. The categorization resulted in identification of nine states in which pharmacy technician administered vaccination may be considered "Not Expressly Prohibited". A majority of states were categorized as prohibited (either directly or indirectly). Board of pharmacy respondents (43%) reported varying viewpoints on technician administered vaccines. While three states (Idaho, Rhode Island, Utah) have already made changes to allow for pharmacy technician administered vaccinations, opportunities exist for other states to consider changes to statutes or rules.
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Affiliation(s)
- Deeb Eid
- Department of Pharmacy Practice, Ferris State University, Grand Rapids, MI 49503, USA; (J.O.); (B.B.)
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Bragazzi NL, Orsi A, Ansaldi F, Gasparini R, Icardi G. Fluzone® intra-dermal (Intanza®/Istivac® Intra-dermal): An updated overview. Hum Vaccin Immunother 2016; 12:2616-2627. [PMID: 27246556 DOI: 10.1080/21645515.2016.1187343] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Influenza is a highly contagious respiratory acute viral disease which imposes a very heavy burden both in terms of epidemiology and costs, in the developed countries as well as in the developing ones. It represents a serious public health concern and vaccination constitutes an important tool to reduce or at least mitigate its burden. Despite the existence of a broad armamentarium against influenza and despite all the efforts and recommendations of international organisms to broaden immunization, influenza vaccination coverage is still far from being optimal. This, taken together with logistic and technical difficulties that can result into vaccine shortage, makes intra-dermal (ID) vaccines, such as Fluzone® ID and Intanza®, particularly attractive. ID vaccines are comparable and, in some cases, superior to intra-muscular/sub-cutaneous vaccines in terms of immunogenicity, safety, reactogenicity, tolerability and cross-protection profiles, as well as in terms of patient preference, acceptance and vaccine selection. Further advances, such as Fluzone® ID with alternative B strains and Quadrivalent Fluzone® ID or the possibility of self-administering the vaccines, make influenza ID vaccines even more valuable.
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Affiliation(s)
| | - Andrea Orsi
- a Department of Health Sciences (DISSAL) , University of Genoa , Genoa , Italy.,b Hygiene Unit, IRCCS AOU San Martino - IST of Genoa , Genoa , Italy
| | - Filippo Ansaldi
- a Department of Health Sciences (DISSAL) , University of Genoa , Genoa , Italy.,b Hygiene Unit, IRCCS AOU San Martino - IST of Genoa , Genoa , Italy
| | - Roberto Gasparini
- a Department of Health Sciences (DISSAL) , University of Genoa , Genoa , Italy
| | - Giancarlo Icardi
- a Department of Health Sciences (DISSAL) , University of Genoa , Genoa , Italy.,b Hygiene Unit, IRCCS AOU San Martino - IST of Genoa , Genoa , Italy
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Coleman BL, McNeil SA, Langley JM, Halperin SA, McGeer AJ. Differences in efficiency, satisfaction and adverse events between self-administered intradermal and nurse-administered intramuscular influenza vaccines in hospital workers. Vaccine 2015; 33:6635-40. [PMID: 26529074 DOI: 10.1016/j.vaccine.2015.10.095] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 10/17/2015] [Accepted: 10/23/2015] [Indexed: 11/19/2022]
Abstract
UNLABELLED Vaccinating healthcare workers against influenza takes tens of thousands of hours of work annually. This study was undertaken to determine the acceptability, success rate, and time to vaccinate healthcare workers in nurse-led groups that self-vaccinated with intradermal influenza vaccine compared with nurse-administered intramuscular vaccine. METHODS Volunteer hospital workers were randomly assigned to groups that either self-administered intradermal influenza vaccine (Intanza(®)) in a nurse-led group or received nurse-administered intramuscular vaccine (Vaxigrip(®)). Research assistants timed vaccination procedures; pre- and post-injection questionnaires assessed acceptability and reactogenicity. RESULTS 810 adults, 21-69 years of age, from two study sites were vaccinated: 401 self-administered the intradermal vaccine while 409 received their intramuscular vaccine from a nurse. Of those who self-administered for the first time, 98.5% were successful on their first attempt with an additional 1.5% on their second attempt. Acceptability was high: 96% were very or somewhat certain that they administered the vaccine correctly, 83% would choose intradermal influenza vaccine again and of those, 75% would choose self-administration again, if given the choice. It took 51.3-72.6s per person for the nurses to guide the groups through the self-administration process, which was significantly less time than it took to individually administer the intramuscular vaccines (93.6s). CONCLUSION Self-administration of intradermal influenza vaccine by people working in healthcare settings is a possible alternative to nurse administered vaccinations, with nurse-led group sessions a good way of teaching the technique while being available to respond to unanticipated problems (NCT01665807).
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Affiliation(s)
- Brenda L Coleman
- Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada; University of Toronto, 155 College Street, Toronto, ON, Canada.
| | - Shelly A McNeil
- Canadian Center for Vaccinology, Dalhousie University, 6299 South Street, Halifax, NS, Canada; QE II Health Sciences Centre, Nova Scotia Health Authority, 1276 South Park Street, Halifax, NS, Canada.
| | - Joanne M Langley
- Canadian Center for Vaccinology, Dalhousie University, 6299 South Street, Halifax, NS, Canada; IWK Health Centre, Nova Scotia Health Authority, 5980 University Avenue, Halifax, NS, Canada.
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University, 6299 South Street, Halifax, NS, Canada; QE II Health Sciences Centre, Nova Scotia Health Authority, 1276 South Park Street, Halifax, NS, Canada.
| | - Allison J McGeer
- Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada; University of Toronto, 155 College Street, Toronto, ON, Canada.
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Burgess TH, Murray CK, Bavaro MF, Landrum ML, O'Bryan TA, Rosas JG, Cammarata SM, Martin NJ, Ewing D, Raviprakash K, Mor D, Zell ER, Wilkins KJ, Millar EV. Self-administration of intranasal influenza vaccine: Immunogenicity and volunteer acceptance. Vaccine 2015; 33:3894-9. [PMID: 26117150 DOI: 10.1016/j.vaccine.2015.06.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 06/09/2015] [Accepted: 06/12/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND In outbreak settings, mass vaccination strategies could maximize health protection of military personnel. Self-administration of live attenuated influenza vaccine (LAIV) may be a means to vaccinate large numbers of people and achieve deployment readiness while sparing the use of human resources. METHODS A phase IV, open-label, randomized controlled trial evaluating the immunogenicity and acceptance of self-administered (SA) LAIV was conducted from 2012 to 2014. SA subjects were randomized to either individual self-administration or self-administration in a group setting. Control randomized subjects received healthcare worker-administered (HCWA) LAIV. Anti-hemagglutinin (HAI) antibody concentrations were measured pre- and post-vaccination. The primary endpoint was immunogenicity non-inferiority between SA and HCWA groups. Subjects were surveyed on preferred administration method. RESULTS A total of 1077 subjects consented and were randomized (529 SA, 548 HCWA). Subject characteristics were very similar between groups, though SA subjects were younger, more likely to be white and on active duty. The per-protocol analysis included 1024 subjects (501 SA, 523 HCWA). Post-vaccination geometric mean titers by vaccine strain and by study group (HCWA vs. SA) were: A/H1N1 (45.8 vs. 48.7, respectively; p=0.43), A/H3N2 (45.5 vs. 46.4; p=0.80), B/Yamagata (17.2 vs. 17.8; p=0.55). Seroresponses to A components were high (∼67%), while seroresponses to B components were lower (∼25%). Seroresponse did not differ by administration method. Baseline preference for administration method was similar between groups, with the majority in each group expressing no preference. At follow-up, the majority (64%) of SA subjects preferred SA vaccine. CONCLUSIONS LAIV immunogenicity was similar for HCWA and SA vaccines. SA was well-tolerated and preferred to HCWA among those who performed SA.
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Affiliation(s)
- Timothy H Burgess
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA.
| | - Clinton K Murray
- San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA.
| | - Mary F Bavaro
- Naval Medical Center, 34800 Bob Wilson Drive, San Diego, CA 92134, USA.
| | - Michael L Landrum
- San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA; Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, 11300 Rockville Pike, Suite 1211, Rockville, MD 20852, USA.
| | - Thomas A O'Bryan
- San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA; Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, 11300 Rockville Pike, Suite 1211, Rockville, MD 20852, USA.
| | - Jessica G Rosas
- San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX, 78234, USA; Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, 11300 Rockville Pike, Suite 1211, Rockville, MD 20852, USA.
| | - Stephanie M Cammarata
- Naval Medical Center, 34800 Bob Wilson Drive, San Diego, CA 92134, USA; Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, 11300 Rockville Pike, Suite 1211, Rockville, MD 20852, USA.
| | - Nicholas J Martin
- Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.
| | - Daniel Ewing
- Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.
| | - Kanakatte Raviprakash
- Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.
| | - Deepika Mor
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, 11300 Rockville Pike, Suite 1211, Rockville, MD 20852, USA.
| | - Elizabeth R Zell
- Stat-Epi Associates Inc., 13 Sea Winds Lane South, Ponte Vedra Beach, FL 32082, USA.
| | - Kenneth J Wilkins
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
| | - Eugene V Millar
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, 11300 Rockville Pike, Suite 1211, Rockville, MD 20852, USA.
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