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Montero DA, Vidal RM, Velasco J, Carreño LJ, Torres JP, Benachi O. MA, Tovar-Rosero YY, Oñate AA, O'Ryan M. Two centuries of vaccination: historical and conceptual approach and future perspectives. Front Public Health 2024; 11:1326154. [PMID: 38264254 PMCID: PMC10803505 DOI: 10.3389/fpubh.2023.1326154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Over the past two centuries, vaccines have been critical for the prevention of infectious diseases and are considered milestones in the medical and public health history. The World Health Organization estimates that vaccination currently prevents approximately 3.5-5 million deaths annually, attributed to diseases such as diphtheria, tetanus, pertussis, influenza, and measles. Vaccination has been instrumental in eradicating important pathogens, including the smallpox virus and wild poliovirus types 2 and 3. This narrative review offers a detailed journey through the history and advancements in vaccinology, tailored for healthcare workers. It traces pivotal milestones, beginning with the variolation practices in the early 17th century, the development of the first smallpox vaccine, and the continuous evolution and innovation in vaccine development up to the present day. We also briefly review immunological principles underlying vaccination, as well as the main vaccine types, with a special mention of the recently introduced mRNA vaccine technology. Additionally, we discuss the broad benefits of vaccines, including their role in reducing morbidity and mortality, and in fostering socioeconomic development in communities. Finally, we address the issue of vaccine hesitancy and discuss effective strategies to promote vaccine acceptance. Research, collaboration, and the widespread acceptance and use of vaccines are imperative for the continued success of vaccination programs in controlling and ultimately eradicating infectious diseases.
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Affiliation(s)
- David A. Montero
- Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Centro Integrativo de Biología y Química Aplicada, Universidad Bernardo O'Higgins, Santiago, Chile
| | - Roberto M. Vidal
- Programa de Microbiología y Micología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Instituto Milenio de Inmunología e Inmunoterapia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juliana Velasco
- Unidad de Paciente Crítico, Clínica Hospital del Profesor, Santiago, Chile
- Programa de Formación de Especialista en Medicina de Urgencia, Universidad Andrés Bello, Santiago, Chile
| | - Leandro J. Carreño
- Instituto Milenio de Inmunología e Inmunoterapia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juan P. Torres
- Departamento de Pediatría y Cirugía Pediátrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Manuel A. Benachi O.
- Área de Biotecnología, Tecnoacademia Neiva, Servicio Nacional de Aprendizaje, Regional Huila, Neiva, Colombia
| | - Yenifer-Yadira Tovar-Rosero
- Departamento de Biología, Facultad de Ciencias Naturales, Exactas y de la Educación, Universidad del Cauca, Popayán, Colombia
| | - Angel A. Oñate
- Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Miguel O'Ryan
- Programa de Microbiología y Micología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Azevedo LF, Karpova N, Rocha BA, Barbosa Junior F, Gobe GC, Hornos Carneiro MF. Evidence on Neurotoxicity after Intrauterine and Childhood Exposure to Organomercurials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1070. [PMID: 36673825 PMCID: PMC9858833 DOI: 10.3390/ijerph20021070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Although the molecular mechanisms underlying methylmercury toxicity are not entirely understood, the observed neurotoxicity in early-life is attributed to the covalent binding of methylmercury to sulfhydryl (thiol) groups of proteins and other molecules being able to affect protein post-translational modifications from numerous molecular pathways, such as glutamate signaling, heat-shock chaperones and the antioxidant glutaredoxin/glutathione system. However, for other organomercurials such as ethylmercury or thimerosal, there is not much information available. Therefore, this review critically discusses current knowledge about organomercurials neurotoxicity-both methylmercury and ethylmercury-following intrauterine and childhood exposure, as well as the prospects and future needs for research in this area. Contrasting with the amount of epidemiological evidence available for methylmercury, there are only a few in vivo studies reporting neurotoxic outcomes and mechanisms of toxicity for ethylmercury or thimerosal. There is also a lack of studies on mechanistic approaches to better investigate the pathways involved in the potential neurotoxicity caused by both organomercurials. More impactful follow-up studies, especially following intrauterine and childhood exposure to ethylmercury, are necessary. Childhood vaccination is critically important for controlling infectious diseases; however, the safety of mercury-containing thimerosal and, notably, its effectiveness as preservative in vaccines are still under debate regarding its potential dose-response effects to the central nervous system.
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Affiliation(s)
- Lara Ferreira Azevedo
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil
| | - Nina Karpova
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil
| | - Bruno Alves Rocha
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil
| | - Fernando Barbosa Junior
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil
| | - Glenda Carolyn Gobe
- Kidney Disease Research Group, School of Medicine, Translational Research Institute, University of Queensland, 37 Kent Street, Woolloongabba, QLD 4102, Australia
| | - Maria Fernanda Hornos Carneiro
- Department of Pharmacy, Faculty of Chemistry and Pharmacy, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
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Effect of Patient Use of Physical Therapy After Referral for Musculoskeletal Conditions on Future Medical Utilization: A Retrospective Cohort Analysis. J Manipulative Physiol Ther 2022; 44:621-636. [DOI: 10.1016/j.jmpt.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 11/18/2022]
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4
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Vaccines are not always perfect: adverse effects and their clinical impact. A NEW HISTORY OF VACCINES FOR INFECTIOUS DISEASES 2022. [PMCID: PMC8989430 DOI: 10.1016/b978-0-12-812754-4.00016-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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5
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Guzoglu N, Daneshvar Z, Hamrang E, Kayisbudak ID, Khasawneh H, Mahmoud OY, Sani AM, Sokmen G. General attitudes toward and awareness of vaccines among students at a university in Northern Cyprus. Hum Vaccin Immunother 2021; 17:2647-2651. [PMID: 33720809 DOI: 10.1080/21645515.2021.1891815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Misinformation and movements against vaccines put public health at risk. This study investigated vaccine awareness and opinions on the anti-vaccination movement among students at three faculties of Eastern Mediterranean University. Data were collected by questionnaire. Exposure to anti-vaccination propaganda increased proportionally with the size of the cities where participants were born. In total, 88.6% of the participants declared that they planned to vaccinate their children, while those who did not cited various reasons including the belief that vaccines do not work, that vaccines are harmful, and that it is better to be infected naturally. 60.6% of participants reported that they would get vaccinated against SARS-CoV-2 if there was an effective vaccine. Meanwhile, 24.5% of participants were not sure whether would get vaccinated even if it were possible, 11.4% of participants stated that they would not vaccinate their children for a variety of reasons. These results are important, especially in the context of a pandemic, because students will become leaders in education, business, and media, and thus shape the thoughts and opinions of future generations. The anti-vaccination movement is building momentum, and is especially influential in big cities; therefore, it is vital to change our approach to informing students about vaccination.
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Affiliation(s)
- Nilufer Guzoglu
- Department of Pediatrics, Faculty of Medicine, Eastern Mediterranean University, Famagusta, Northern Cyprus
| | - Zahra Daneshvar
- Eastern Mediterranean University- Marmara University Faculty of Medicine Joint Program, Famagusta, Northern Cyprus
| | - Elmira Hamrang
- Eastern Mediterranean University- Marmara University Faculty of Medicine Joint Program, Famagusta, Northern Cyprus
| | - Ilayda Deniz Kayisbudak
- Eastern Mediterranean University- Marmara University Faculty of Medicine Joint Program, Famagusta, Northern Cyprus
| | - Hayel Khasawneh
- Eastern Mediterranean University- Marmara University Faculty of Medicine Joint Program, Famagusta, Northern Cyprus
| | - Omar Yasser Mahmoud
- Eastern Mediterranean University- Marmara University Faculty of Medicine Joint Program, Famagusta, Northern Cyprus
| | - Abeer Mohammad Sani
- Eastern Mediterranean University- Marmara University Faculty of Medicine Joint Program, Famagusta, Northern Cyprus
| | - Gorkem Sokmen
- Eastern Mediterranean University- Marmara University Faculty of Medicine Joint Program, Famagusta, Northern Cyprus
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Conklin L, Hviid A, Orenstein WA, Pollard AJ, Wharton M, Zuber P. Vaccine safety issues at the turn of the 21st century. BMJ Glob Health 2021; 6:bmjgh-2020-004898. [PMID: 34011504 PMCID: PMC8137241 DOI: 10.1136/bmjgh-2020-004898] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/16/2022] Open
Abstract
Global gains in vaccination coverage during the early 21st century have been threatened by the emergence of antivaccination groups that have questioned the effectiveness of vaccines to generate public distrust of vaccines and immunisation programmes. This manuscript summarises six key topics that have been at the centre of global discussions on vaccine safety during the early 21st century: thiomersal in multi-dose non-live vaccines, aluminium adjuvants used with several non-live vaccines, autism and auto-immune conditions as possible consequences of vaccination, a risk of immune overload with increasing numbers of vaccinations, and detrimental non-specific effects (NSEs) of vaccination. For each topic, we describe the hypothesis behind the public concern, the evidence reviewed by the WHO’s Global Advisory Committee for Vaccine Safety (GACVS) during 1999–2019, and any significant new data that has emerged since GACVS conclusions were made. Although the scientific evidence on these issues overwhelmingly supports the safety of vaccines, communication messages to caregivers and providers need to condense and convey scientific information in an appropriate way to address concerns contributing to vaccine distrust. In addition, there is need for further studies specifically designed to address both positive and negative NSE of vaccination. The role of GACVS will be increasingly important in evaluating the evidence and engaging the global community in promoting and assuring the safety of vaccines in the decades to come as we move into an era in which we use new vaccination platforms, antigens and formulations.
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Affiliation(s)
- Laura Conklin
- Global Immunizations Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anders Hviid
- Department of Epidemiology Research, Statens Serum Institut, Kobenhavn, Denmark
| | | | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Melinda Wharton
- Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Patrick Zuber
- Essential Medicines and Health Products, Organisation mondiale de la Sante, Geneve, Switzerland
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Sharpe JA, Martin BI, Fritz JM, Newman MG, Magel J, Vanneman ME, Thackeray A. Identifying patients who access musculoskeletal physical therapy: a retrospective cohort analysis. Fam Pract 2021; 38:203-209. [PMID: 33043360 PMCID: PMC8679185 DOI: 10.1093/fampra/cmaa104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Musculoskeletal conditions are common and cause high levels of disability and costs. Physical therapy is recommended for many musculoskeletal conditions. Past research suggests that referral rates appear to have increased over time, but the rate of accessing a physical therapist appears unchanged. OBJECTIVE Our retrospective cohort study describes the rate of physical therapy use after referral for a variety of musculoskeletal diagnoses while comparing users and non-users of physical therapy services after referral. METHODS The study sample included patients in the University of Utah Health system who received care from a medical provider for a musculoskeletal condition. We included a comprehensive set of variables available in the electronic data warehouse possibly associated with attending physical therapy. Our primary analysis compared differences in patient factors between physical therapy users and non-users using Poisson regression. RESULTS 15 877 (16%) patients had a referral to physical therapy, and 3812 (24%) of these patients accessed physical therapy after referral. Most of the factors included in the model were associated with physical therapy use except for sex and number of comorbidities. The receiver operating characteristic curve was 0.63 suggesting poor predictability of the model but it is likely related to the heterogeneity of the sample. CONCLUSIONS We found that obesity, ethnicity, public insurance and urgent care referrals were associated with poor adherence to physical therapy referral. However, the limited predictive power of our model suggests a need for a deeper examination into factors that influence patients access to a physical therapist.
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Affiliation(s)
- Jason A Sharpe
- University of Utah, Department of Physical Therapy and Athletic Training
| | - Brook I Martin
- University of Utah School of Medicine, Department of Orthopaedics.,University of Utah, Department of Population Health Sciences, Division of Health System Innovation and Research
| | - Julie M Fritz
- University of Utah, Department of Physical Therapy and Athletic Training
| | - Michael G Newman
- Data Science Services, University of Utah, Data Science Services
| | - John Magel
- University of Utah, Department of Physical Therapy and Athletic Training
| | - Megan E Vanneman
- University of Utah, Department of Population Health Sciences, Division of Health System Innovation and Research.,University of Utah School of Medicine, Department of Internal Medicine, Division of Epidemiology.,Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), Veterans Affairs Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), Salt Lake City, UT, USA
| | - Anne Thackeray
- University of Utah, Department of Physical Therapy and Athletic Training.,University of Utah, Department of Population Health Sciences, Division of Health System Innovation and Research
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Saposnik FE, Huber JF. Trends in Web Searches About the Causes and Treatments of Autism Over the Past 15 Years: Exploratory Infodemiology Study. JMIR Pediatr Parent 2020; 3:e20913. [PMID: 33284128 PMCID: PMC7752533 DOI: 10.2196/20913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/29/2020] [Accepted: 09/07/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Ninety percent of adults in the United States use the internet, and the majority of internet users report looking on the web for health information using search engines. The rising prevalence of autism spectrum disorder (ASD), uncertainty surrounding its etiology, and variety of intervention approaches contribute to questions about its causes and treatments. It is not known which terms people search most frequently about ASD and whether web search queries have changed over time. Infodemiology is an area of health informatics research using big data analytics to understand web search behavior. OBJECTIVE The objectives were to (1) use infodemiological data to analyze trends in web-based searches about the causes and treatments of ASD over time and (2) inform clinicians and ASD organizations about web queries regarding ASD. METHODS Google Trends was used to analyze web searches about the causes and treatments of ASD in the United States from 2004 to 2019. The search terms analyzed for queries about causes of ASD included vaccines, genetics, environmental factors, and microbiome and those for therapies included applied behavior analysis (ABA), gluten-free diet, chelation therapy, marijuana, probiotics, and stem cell therapy. RESULTS Google Trends results are normalized on a scale ranging from 0 to 100 to represent the frequency and relative interest of search topics. For searches about ASD causes, vaccines had the greatest frequency compared to other terms, with an initial search peak observed in 2008 (scaled score of 81), reaching the highest frequency in 2015 (scaled score of 100), and a current upward trend. In comparison, searches about genetics, environmental factors, and microbiome occurred less frequently. For web searches about ASD therapies, ABA consistently had a high frequency of search interest since 2004, reaching a maximum scaled score of 100 in 2019. The analyses of chelation therapy and gluten-free diet showed trending interest in 2005 (scaled score of 68) and 2007 (scaled score of 100), respectively, followed by a steady decline since (scaled scores of only 10 and 16, respectively, in 2019). Searches related to ASD and marijuana showed a rise in 2009 (scaled score of 35), and they continue to trend upward. Searches about probiotics and stem cell therapy have been relatively low (scaled scores of 22 and 18, respectively), but are gradually gaining interest. Web search volumes for stem cell therapy in 2019 surpassed both gluten-free diet and chelation therapy as web-searched interventions for ASD. CONCLUSIONS Google Trends is an effective infodemiology tool to analyze large-scale web search trends about ASD. The results showed informative variation in search trends over 15 years. These data are useful to inform clinicians and organizations about web queries on topics related to ASD, identify knowledge gaps, and target web-based education and knowledge translation strategies.
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Affiliation(s)
| | - Joelene F Huber
- Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Division of Developmental Paediatrics, Department of Paediatrics, University of Toronto, Toronto, ON, Canada.,Surrey Place, Toronto, ON, Canada
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9
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Dórea JG. Neurotoxic effects of combined exposures to aluminum and mercury in early life (infancy). ENVIRONMENTAL RESEARCH 2020; 188:109734. [PMID: 32544722 DOI: 10.1016/j.envres.2020.109734] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 06/11/2023]
Abstract
Aluminum and mercury are environmentally ubiquitous. Individually they are both neurotoxic elements with shared neuro-pathogenic pathways: oxidative stress, altered neurotransmission, and disruption of the neuroendocrine and immune systems. In the infant, Al and Hg differ in type of exposure, absorption, distribution (brain access), and metabolism. In environmentally associated exposure (breast milk and infant formulas) their co-occurrences fluctuate randomly, but in Thimerosal-containing vaccines (TCVs) they occur combined in a proprietary ratio; in these cases, low-doses of Thimerosal-ethylmercury (EtHg) and adjuvant-Al present the most widespread binary mixture in less developed countries. Although experimental studies at low doses of the binary Hg and Al mixture are rare, when studied individually they have been shown to affect neurological outcomes negatively. In invitro systems, comparative neurotoxicity between Al and Hg varies in relation to the measured parameters but seems less for Al than for Hg. While neurotoxicity of environmental Hg (mainly fish methyl-Hg, MeHg) is associated with neurobehavioral outcomes in children, environmental Al is not associated, except in certain clinical conditions. Therefore, the issues of their neurotoxic effects (singly or combined) are discussed. In the infant (up to six months) the organic-Hg and Al body burdens from a full TCV schedule are estimated to reach levels higher than that originating from breastfeeding or from high aluminum soy-based formulas. Despite worldwide exposure to both Al and Hg (inorganic Hg, MeHg, and Thimerosal/EtHg), our knowledge on this combined exposure is insufficient to predict their combined neurotoxic effects (and with other co-occurring neurotoxicants).
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Affiliation(s)
- José G Dórea
- Universidade de Brasília, Brasília, 70919-970, DF, Brazil.
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10
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Nilsen FM, Ruiz JD, Tulve NS. A Meta-Analysis of Stressors from the Total Environment Associated with Children's General Cognitive Ability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155451. [PMID: 32751096 PMCID: PMC7432904 DOI: 10.3390/ijerph17155451] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 12/31/2022]
Abstract
General cognitive ability, often referred to as ‘general intelligence’, comprises a variety of correlated abilities. Childhood general cognitive ability is a well-studied area of research and can be used to predict social outcomes and perceived success. Early life stage (e.g., prenatal, postnatal, toddler) exposures to stressors (i.e., chemical and non-chemical stressors from the total (built, natural, social) environment) can impact the development of childhood cognitive ability. Building from our systematic scoping review (Ruiz et al., 2016), we conducted a meta-analysis to evaluate more than 100 stressors related to cognitive development. Our meta-analysis identified 23 stressors with a significant increase in their likelihood to influence childhood cognitive ability by 10% or more, and 80 stressors were observed to have a statistically significant effect on cognitive ability. Stressors most impactful to cognition during the prenatal period were related to maternal health and the mother’s ability to access information relevant to a healthy pregnancy (e.g., diet, lifestyle). Stressors most impactful to cognition during the early childhood period were dietary nutrients (infancy), quality of social interaction (toddler), and exposure to toxic substances (throughout early childhood). In conducting this analysis, we examined the relative impact of real-world exposures on cognitive development to attempt to understand the inter-relationships between exposures to both chemical and non-chemical stressors and early developmental life stages. Our findings suggest that the stressors observed to be the most influential to childhood cognitive ability are not permanent and can be broadly categorized as activities/behaviors which can be modified to improve childhood cognition. This meta-analysis supports the idea that there are complex relationships between a child’s total environment and early cognitive development.
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Affiliation(s)
- Frances M. Nilsen
- Office of Research and Development, U.S. Environmental Protection Agency Research Triangle Park, Durham, NC 27709, USA; (J.D.C.R.); (N.S.T.)
- Correspondence: ; Tel.: +1-919-541-2574
| | - Jazmin D.C. Ruiz
- Office of Research and Development, U.S. Environmental Protection Agency Research Triangle Park, Durham, NC 27709, USA; (J.D.C.R.); (N.S.T.)
- Honeywell International, Buffalo, NY 14210, USA
| | - Nicolle S. Tulve
- Office of Research and Development, U.S. Environmental Protection Agency Research Triangle Park, Durham, NC 27709, USA; (J.D.C.R.); (N.S.T.)
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Principi N, Esposito S. Do Vaccines Have a Role as a Cause of Autoimmune Neurological Syndromes? Front Public Health 2020; 8:361. [PMID: 32850592 PMCID: PMC7399175 DOI: 10.3389/fpubh.2020.00361] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/24/2020] [Indexed: 01/05/2023] Open
Abstract
Vaccines are the most important preventive measure against infectious diseases presently available. Although they have led to the eradication or the elimination of some infectious diseases, concerns about safety are among the main reasons for vaccine hesitancy. In some cases, the biological plausibility of a given damage in association with the temporal association between vaccine administration and disease development makes it difficult to define causality and can justify hesitancy. Only well-conducted epidemiological studies with adequate evaluation of results can clarify whether a true association between vaccines and adverse event development truly exists. Autoimmune neurological syndromes that follow vaccine use are among these. In this narrative review, the potential association between vaccines and the development of these syndromes are discussed. Literature analysis showed that most of the associations between vaccines and nervous system autoimmune syndromes that have been reported as severe adverse events following immunization are no longer evidenced when well-conducted epidemiological studies are carried out. Although the rarity of autoimmune diseases makes it difficult to strictly exclude that, albeit exceptionally, some vaccines may induce an autoimmune neurological disease, no definitive demonstration of a potential role of vaccines in causing autoimmune neurological syndromes is presently available. Consequently, the fear of neurological autoimmune disease cannot limit the use of the most important preventive measure presently available against infectious diseases.
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Affiliation(s)
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
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12
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DeStefano F, Bodenstab HM, Offit PA. Principal Controversies in Vaccine Safety in the United States. Clin Infect Dis 2020; 69:726-731. [PMID: 30753348 DOI: 10.1093/cid/ciz135] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/07/2019] [Indexed: 12/27/2022] Open
Abstract
Concerns about vaccine safety can lead to decreased acceptance of vaccines and resurgence of vaccine-preventable diseases. We summarize the key evidence on some of the main current vaccine safety controversies in the United States, including (1) measles, mumps, and rubella vaccine and autism; (2) thimerosal, a mercury-based vaccine preservative and the risk of neurodevelopmental disorders; (3) vaccine-induced Guillain-Barré syndrome (GBS); (4) vaccine-induced autoimmune diseases; (5) safety of human papillomavirus vaccine; (6) aluminum adjuvant-induced autoimmune diseases and other disorders; and (7) too many vaccines given early in life predisposing children to health and developmental problems. A possible small increased risk of GBS following influenza vaccination has been identified, but the magnitude of the increase is less than the risk of GBS following influenza infection. Otherwise, the biological and epidemiologic evidence does not support any of the reviewed vaccine safety concerns.
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Affiliation(s)
- Frank DeStefano
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Greorgia
| | | | - Paul A Offit
- Division of Infectious Diseases, The Children's Hospital of Philadelphia, Pennsylvania
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13
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Ojeda J, Arredondo JL, Salcedo P, Paredes-Paredes M, Dupuy M, Petit C, Chabanon AL, Rivas E, Gurunathan S, De Bruijn I, Pepin S. Immunogenicity and safety of a multi-dose quadrivalent inactivated influenza vaccine in individuals aged 6 months to 17 years: a randomized phase III trial. Hum Vaccin Immunother 2020; 16:1380-1384. [PMID: 31810418 PMCID: PMC7482911 DOI: 10.1080/21645515.2019.1697595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Annual vaccination is the most effective way to prevent seasonal influenza. Influenza vaccines in multi-dose vial (MDV) formats can facilitate timely vaccination of large populations by reducing per-dose costs and cold storage requirements compared to single-dose pre-filled syringe (PFS) formats. MDV vaccines require thiomersal or another preservative to prevent microbial contamination. We conducted a randomized, open-label trial in 302 healthy subjects aged 6 months to 17 years to evaluate the immunogenicity and safety of a quadrivalent influenza vaccine (QIV) in a thiomersal-containing MDV format compared to the licensed thiomersal-free PFS format. Subjects were randomly assigned in a 1:1 ratio to receive the MDV (n = 153) or PFS (n = 149) format. Post-vaccination hemagglutination inhibition titers for all four vaccine strains were ≥4.9-fold higher than baseline titers with no difference in magnitude between the MDV and PFS groups. Seroconversion rates per strain were also comparable between the two groups. There were no differences in reactogenicity or safety between the two vaccine formats. These results showed that the MDV format of QIV was as safe and immunogenic as the PFS format in infants, children, and adolescents. These findings support the use of MDV QIV as a resource-saving alternative for seasonal influenza vaccination.
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Affiliation(s)
- Joyce Ojeda
- Global Clinical Science, Sanofi Pasteur , Mexico City, Mexico
| | - José Luis Arredondo
- Instituto Nacional de Pediatría, Unidad de Investigación Clínica , Mexico City, Mexico
| | - Perla Salcedo
- Hospital General de Ecatepec "Las Américas", Fraccionamiento las Américas , Ecatepec de Morelos, Mexico
| | | | - Martin Dupuy
- Global Biostatistical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
| | - Celine Petit
- Global Clinical Immunology, Sanofi Pasteur , Marcy l'Étoile, France
| | | | - Enrique Rivas
- Global Clinical Sciences, Sanofi Pasteur , Mexico City, Mexico
| | | | - Iris De Bruijn
- Global Clinical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
| | - Stephanie Pepin
- Global Clinical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
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14
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Kern JK, Geier DA, Homme KG, Geier MR. Examining the evidence that ethylmercury crosses the blood-brain barrier. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2020; 74:103312. [PMID: 31841767 DOI: 10.1016/j.etap.2019.103312] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/06/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Scientific research can provide us with factual, repeatable, measurable, and determinable results. As such, scientific research can provide information that can be used in the decision-making process in the care of patients and in public policy. Although it has been suggested that ethylmercury (C2H5Hg+)-containing compounds do not cross the blood-brain barrier (BBB), this review examines the literature that addresses the question as to whether ethylmercury-containing compounds cross the BBB. The review will begin with cellular studies that provide evidence for the passive and active transport of mercury species across the BBB. Then, animal and clinical studies will be presented that specifically examine whether mercury accumulates in the brain after exposure to ethylmercury-containing compounds or Thimerosal (an ethylmercury-containing compound used as a preservative in vaccines and other drugs that metabolizes or degrades to ethylmercury-containing compounds and thiosalicylate). The results indicate that ethylmercury-containing compounds are actively transported across membranes by the L (leucine-preferring)-amino acid transport (LAT) system, the same as methylmercury-containing compounds. Further, 22 studies from 1971 to 2019 show that exposure to ethylmercury-containing compounds (intravenously, intraperitoneally, topically, subcutaneously, intramuscularly, or intranasally administered) results in accumulation of mercury in the brain. In total, these studies indicate that ethylmercury-containing compounds and Thimerosal readily cross the BBB, convert, for the most part, to highly toxic inorganic mercury-containing compounds, which significantly and persistently bind to tissues in the brain, even in the absence of concurrent detectable blood mercury levels.
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Affiliation(s)
- Janet K Kern
- Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA; CoMeD, Inc, Silver Spring, MD, USA; CONEM US Autism Research Group, Allen, TX, USA.
| | - David A Geier
- Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA; CoMeD, Inc, Silver Spring, MD, USA
| | - Kristin G Homme
- International Academy of Oral Medicine and Toxicology, ChampionsGate, FL, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA; CoMeD, Inc, Silver Spring, MD, USA
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15
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The science of vaccine safety: Summary of meeting at Wellcome Trust. Vaccine 2020; 38:1869-1880. [PMID: 31987690 DOI: 10.1016/j.vaccine.2020.01.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/18/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022]
Abstract
Vaccines are everywhere hugely successful but are also under attack. The reason for the latter is the perception by some people that vaccines are unsafe. However that may be, vaccine safety, life any other scientific subject, must be constantly studied. It was from this point of view that a meeting was organized at the Wellcome Trust in London in May 2019 to assess some aspects of vaccine safety as subjects for scientific study. The objective of the meeting was to assess what is known beyond reasonable doubt and conversely what areas need additional studies. Although the meeting could not cover all aspects of vaccine safety science, many of the most important issues were addressed by a group of about 30 experts to determine what is already known and what additional studies are merited to assess the safety of the vaccines currently in use. The meeting began with reviews of the current situation in different parts of the world, followed by reviews of specific controversial areas, including the incidence of certain conditions after vaccination and the safety of certain vaccine components. Lastly, information about the human papillomavirus vaccine was considered because its safety has been particularly challenged by vaccine opponents. The following is a summary of the meeting findings. In addition to this summary, the meeting organizers will explore opportunities to perform studies that would enlarge knowledge of vaccine safety.
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16
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McCaulley ME. Autism spectrum disorder and mercury toxicity: use of genomic and epigenetic methods to solve the etiologic puzzle. Acta Neurobiol Exp (Wars) 2019. [DOI: 10.21307/ane-2019-010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Domínguez A, Astray J, Castilla J, Godoy P, Tuells J, Barrabeig I. [False beliefs about vaccines]. Aten Primaria 2019; 51:40-46. [PMID: 30262223 PMCID: PMC6836946 DOI: 10.1016/j.aprim.2018.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 05/14/2018] [Indexed: 02/08/2023] Open
Abstract
Vaccines are an essential tool for the prevention of infectious diseases. However, false ideas and rumours with no scientific foundation about their possible negative effects may dissuade people from being vaccinated, with the consequent risks for the health of the population. The objective of this article is to evaluate the origin and the arguments of some of the most frequent mistaken ideas and rumours about the possible adverse effects of vaccines. Some clearly established adverse effects are presented, as well as false beliefs about various vaccines and potential harm to health. Vaccines, like any drug, can cause adverse effects, but the possible adverse effects of vaccination programs are clearly lower than their individual (vaccinated) and collective benefits (those vaccinated and those who cannot be vaccinated for medical reasons). The possible adverse effects attributable to vaccines should be detected by powerful and well-structured pharmacovigilance systems.
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Affiliation(s)
- Angela Domínguez
- Departamento de Medicina, Universidad de Barcelona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España
| | - Jenaro Astray
- Dirección General de Salud Pública, Comunidad de Madrid, Madrid, España
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Pamplona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España
| | - Pere Godoy
- Agencia de Salud Pública de Cataluña, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España
| | - José Tuells
- Cátedra Balmis de Vacunología, Universidad de Alicante, Alicante, España.
| | - Irene Barrabeig
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España; Agencia de Salud Pública de Cataluña, Barcelona, España
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18
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Dórea JG. Multiple low-level exposures: Hg interactions with co-occurring neurotoxic substances in early life. Biochim Biophys Acta Gen Subj 2018; 1863:129243. [PMID: 30385391 DOI: 10.1016/j.bbagen.2018.10.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/01/2018] [Accepted: 10/19/2018] [Indexed: 12/11/2022]
Abstract
All chemical forms of Hg can affect neurodevelopment; however, low levels of organic Hg (methylmercury-MeHg and ethylmercury-EtHg in Thimerosal-containing vaccines, hereafter 'TCV') exposures during early life (pregnancy and lactation) co-occur with other environmental neurotoxic substances. These neurotoxicants may act in parallel, synergistically, or antagonistically to Hg. Nevertheless, the risks of neurotoxicity associated with multiple neuro-toxicants depend on type, time, combinations of exposure, and environmental and/or genetic-associated factors. Neurological developmental disorders, delays in cognition and behavioral outcomes associated with multiple exposures (which include Hg) may show transient or lasting outcomes depending on constitutional and/or environmental factors that can interact to neutralize, aggravate or attenuate these effects; often these studies are challenging to interpret. During pregnancy and lactation, fish-MeHg exposure is frequently confounded with the opposing effects of neuroactive nutrients (in fish) that lead to positive, negative, or no effects on neurobehavioral tests. In infancy, exposures to acute binary mixtures (TCV- EtHg and Al-adjuvants in infant immunizations) are associated with increased risks of tics and other developmental disorders. Despite the certitude that promulgates single environmental neurotoxicants, empirical comparisons of combined exposures indicate that Hg-related outcome is uneven. Hg in combination with other neurotoxic mixtures may elevate risks of neurotoxicity, but these risks arise in circumstances that are not yet predictable. Therefore, to achieve the goals of the Minamata treaty and to safeguard the health of children, low levels of mercury exposure (in any chemical form) needs to be further reduced whether the source is environmental (air- and food-borne) or iatrogenic (pediatric TCVs).
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Affiliation(s)
- José G Dórea
- Universidade de Brasília, Brasília 70919-970, DF, Brazil..
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19
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Hasegawa Y, Curtis B, Yutuc V, Rulien M, Morrisroe K, Watkins K, Ferrier C, English C, Hewitson L, Slupsky CM. Microbial structure and function in infant and juvenile rhesus macaques are primarily affected by age, not vaccination status. Sci Rep 2018; 8:15867. [PMID: 30367140 PMCID: PMC6203732 DOI: 10.1038/s41598-018-34019-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 10/06/2018] [Indexed: 01/12/2023] Open
Abstract
Although thimerosal, an ethylmercury-based preservative, has been removed from most pediatric vaccines in the United States, some multidose vaccines, such as influenza vaccines, still contain thimerosal. Considering that a growing number of studies indicate involvement of the gut microbiome in infant immune development and vaccine responses, it is important to elucidate the impact of pediatric vaccines, including thimerosal-containing vaccines, on gut microbial structure and function. Here, a non-human primate model was utilized to assess how two vaccine schedules affect the gut microbiome in infants (5-9 days old) and juveniles (77-88 weeks old) through 16S ribosomal RNA sequencing and metabolomics analyses of the fecal samples. Two treatment groups (n = 12/group) followed either the vaccine schedule that was in place during the 1990s (intensive exposure to thimerosal) or an expanded schedule administered in 2008 (prenatal and postnatal exposure to thimerosal mainly via influenza vaccines), and were compared with a control group (n = 16) that received saline injections. The primary impact on gut microbial structure and function was age. Although a few statistically significant impacts of the two common pediatric vaccine schedules were observed when confounding factors were considered, the magnitude of the differences was small, and appeared to be positive with vaccination.
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Affiliation(s)
- Yu Hasegawa
- Department of Food Science and Technology, University of California Davis, Davis, California, USA
| | - Britni Curtis
- Infant Primate Research Laboratory (IPRL), Washington National Primate Research Center, and Center on Human Development and Disability (CHDD), Seattle, Washington, USA
| | - Vernon Yutuc
- Infant Primate Research Laboratory (IPRL), Washington National Primate Research Center, and Center on Human Development and Disability (CHDD), Seattle, Washington, USA
| | - Megan Rulien
- Infant Primate Research Laboratory (IPRL), Washington National Primate Research Center, and Center on Human Development and Disability (CHDD), Seattle, Washington, USA
| | - Kelly Morrisroe
- Infant Primate Research Laboratory (IPRL), Washington National Primate Research Center, and Center on Human Development and Disability (CHDD), Seattle, Washington, USA
| | - Kristin Watkins
- Infant Primate Research Laboratory (IPRL), Washington National Primate Research Center, and Center on Human Development and Disability (CHDD), Seattle, Washington, USA
| | - Clayton Ferrier
- Infant Primate Research Laboratory (IPRL), Washington National Primate Research Center, and Center on Human Development and Disability (CHDD), Seattle, Washington, USA
| | - Chris English
- Infant Primate Research Laboratory (IPRL), Washington National Primate Research Center, and Center on Human Development and Disability (CHDD), Seattle, Washington, USA
| | - Laura Hewitson
- The Johnson Center for Child Health and Development, Austin, Texas, USA.
| | - Carolyn M Slupsky
- Department of Food Science and Technology, University of California Davis, Davis, California, USA.
- Department of Nutrition, University of California Davis, Davis, California, USA.
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20
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The risk of neurodevelopmental disorders following Thimerosal-containing Hib vaccine in comparison to Thimerosal-free Hib vaccine administered from 1995 to 1999 in the United States. Int J Hyg Environ Health 2018; 221:677-683. [DOI: 10.1016/j.ijheh.2018.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 12/27/2017] [Accepted: 03/13/2018] [Indexed: 01/24/2023]
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21
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Namvarpour Z, Nasehi M, Amini A, Zarrindast MR. Protective role of alpha-lipoic acid in impairments of social and stereotyped behaviors induced by early postnatal administration of thimerosal in male rat. Neurotoxicol Teratol 2018; 67:1-9. [PMID: 29481853 DOI: 10.1016/j.ntt.2018.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 12/20/2022]
Abstract
Aim Thimerosal, a mercury-containing preservative has been widely used in a number of biological and drug products, including many vaccines, and has been studied as a possible etiological factor for some neurodevelopmental disabilities. Here, the protective effects of Alpha Lipoic Acid (ALA), an organosulfur compound derived from Octanoic Acid, on Thimerosal-induced behavioral abnormalities in rat were examined. METHODS 108 male Wistar rats were divided into three cohorts and treated as follows: 1) Thimerosal at different doses (30, 300, or 3000 μg Hg/kg) in four i.m. injections on 7, 9, 11, 15postnatal days. 2) ALA (at doses of 5, 10 and 20 mg/kg), following the same order; 3) single dose of Thimerosal (3000 μg Hg/kg) plus ALA at different doses (5, 10 or 20 mg/kg), by the previously described method. A saline treated control group and a ALA vehicle control (0.1% NaOH) were also included. At 5 and 8 weeks after birth, rats were evaluated with behavioral tests, to assess locomotor activity, social interactions and stereotyped behaviors, respectively. RESULTS The data showed that Thimerosal at all doses (30, 300 and 3000 μg Hg/kg) significantly impacted locomotor activity. Thimerosal at doses of 300 and 3000 but not 30 μg Hg/kg impaired social and stereotyped behaviors. In contrast, ALA (at doses of 5, 10 and 20 mg/kg) did not alter behaviors by itself, at doses of 20 mg/kg, it reduced social interaction deficits induced by the highest dose of Thimerosal (3000 μg Hg/kg). Moreover, ALA, at all doses prevented the adverse effects of Thimerosal on stereotyped behaviors. CONCLUSIONS the results of this preclinical study, consistent with previous studies on mice and rats, reveals that neonatal dose-dependent exposure to Thimerosal mimicking the childhood vaccine schedule can induce abnormal social interactions and stereotyped behaviors similar to those observed in neurodevelopmental disorders such as autism, and, for the first time, revealed that these abnormalities may be ameliorated by ALA. This indicates that ALA may protect against mercurial-induced abnormal behaviors.
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Affiliation(s)
| | - Mohammad Nasehi
- Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
| | - Abdollah Amini
- Department of Biology and Anatomy, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Zarrindast
- Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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22
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23
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Committee Opinion No. 718: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination. Obstet Gynecol 2017; 130:e153-e157. [PMID: 28832489 DOI: 10.1097/aog.0000000000002301] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The overwhelming majority of morbidity and mortality attributable to pertussis infection occurs in infants who are 3 months and younger. Infants do not begin their own vaccine series against pertussis until approximately 2 months of age. This leaves a window of significant vulnerability for newborns, many of whom contract serious pertussis infections from family members and caregivers, especially their mothers, or older siblings, or both. In 2013, the Advisory Committee on Immunization Practices published its updated recommendation that a dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) should be administered during each pregnancy, irrespective of the prior history of receiving Tdap. The recommended timing for maternal Tdap vaccination is between 27 weeks and 36 weeks of gestation. To maximize the maternal antibody response and passive antibody transfer and levels in the newborn, vaccination as early as possible in the 27-36-weeks-ofgestation window is recommended. However, the Tdap vaccine may be safely given at any time during pregnancy if needed for wound management, pertussis outbreaks, or other extenuating circumstances. There is no evidence of adverse fetal effects from vaccinating pregnant women with an inactivated virus or bacterial vaccine or toxoid, and a growing body of robust data demonstrate safety of such use. Adolescent and adult family members and caregivers who previously have not received the Tdap vaccine and who have or anticipate having close contact with an infant younger than 12 months should receive a single dose of Tdap to protect against pertussis. Given the rapid evolution of data surrounding this topic, immunization guidelines are likely to change over time, and the American College of Obstetricians and Gynecologists will continue to issue updates accordingly.
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24
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Novack GD. Anti-science in the 21st century. Ocul Surf 2017; 15:813-819. [PMID: 28807792 DOI: 10.1016/j.jtos.2017.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gary D Novack
- PharmaLogic Development Inc., San Rafael CA, USA; Departments of Pharmacology and Ophthalmology, University of California, Davis, USA.
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25
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Measles in the United States since the Millennium: Perils and Progress in the Postelimination Era. Microbiol Spectr 2017; 4. [PMID: 27227293 DOI: 10.1128/microbiolspec.ei10-0006-2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This article describes measles and measles vaccination, along with the challenges, successes, and progress in the postelimination era.
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26
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Park HJ, Min JJ, Bom HS, Kim J, Song HC, Kwon SY. Early stimulated thyroglobulin for response prediction after recombinant human thyrotropin-aided radioiodine therapy. Ann Nucl Med 2017; 31:616-622. [PMID: 28688088 PMCID: PMC5622909 DOI: 10.1007/s12149-017-1190-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/02/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Measurement of recombinant human thyrotropin (rhTSH)-stimulated thyroglobulin (Tg) is generally recommended 72 h after the second rhTSH injection. However, due to the acute effect of I-131 on thyrocytes, Tg measured after radioiodine therapy (RIT) would not accurately reflect the thyroid tissue burden. We aimed to determine predictive values of serum Tg level measured just before rhTSH-aided RIT and to compare the results obtained just after RIT in patients with differentiated thyroid carcinoma (DTC). METHODS We evaluated 150 patients with DTC who underwent rhTSH-aided RIT (2.96-6.66 GBq) after total thyroidectomy between 2009 and 2014. Serum Tg level was measured 24 h (early Tg) and 72 (or 96) h (delayed Tg) after the second rhTSH injection. An excellent response was defined based on the latest American Thyroid Association Guidelines. Univariate and multivariate analyses were performed for early Tg, delayed Tg, and other clinical variables. RESULTS In the multivariate analysis, tumor size [odds ratio (OR) 1.716; 95% confidence interval (CI) 1.019-2.882; p = 0.042] and early Tg level (OR 2.012; 95% CI 1.384-2.925, p < 0.001) independently predicted excellent responses. The cutoff for the best early Tg level to predict a non-excellent response was 2.0 ng/mL. Delayed Tg was not a significant predictor (OR 0.992; 95% CI 0.969-1.015; p = 0.492). CONCLUSIONS Early stimulated Tg significantly predicted therapeutic response after rhTSH-aided RIT in patients with DTC. Therefore, serum Tg should be measured before RIT to predict therapeutic responses.
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Affiliation(s)
- Hee Jeong Park
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-Gun, Jeonnam, 58128, South Korea
| | - Jung-Joon Min
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-Gun, Jeonnam, 58128, South Korea
| | - Hee-Seung Bom
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-Gun, Jeonnam, 58128, South Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, 61469, South Korea
| | - Ho-Chun Song
- Department of Nuclear Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju, 61469, South Korea
| | - Seong Young Kwon
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-Gun, Jeonnam, 58128, South Korea.
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Dórea JG. Abating Mercury Exposure in Young Children Should Include Thimerosal-Free Vaccines. Neurochem Res 2017; 42:2673-2685. [PMID: 28439753 DOI: 10.1007/s11064-017-2277-x] [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: 01/30/2017] [Revised: 04/11/2017] [Accepted: 04/19/2017] [Indexed: 12/27/2022]
Abstract
Pediatric immunization is essential to prevent, control and eradicate children`s infectious diseases. Newborns and infants in less developed countries have a concentrated schedule of Thimerosal-containing vaccines (TCVs); pregnant mothers are also immunized with TCVs. Metabolic changes during early development are demonstrably an important risk factor for ethylmercury (EtHg) effects on neurodevelopment, while exposure to Thimerosal sensitizes susceptible individuals to life-long contact dermatitis. Concerns regarding toxicity of Hg have moved rich nations to withdraw it from medicines and, in particular, Thimerosal from pediatric vaccines; it has been more than 20 years since rich countries started using Thimerosal-free vaccines. TCVs and Thimerosal-free vaccines show dissimilar profiles of adverse effects. Thimerosal-free vaccines have shown a decrease in contact dermatitis, while TCVs showed a significant association with increased risk of tic disorders; in some circumstances, EtHg in combination with other neurotoxic substances negatively impacted neurobehavioral tests. In studies that explored vaccines and risk of tics, Thimerosal was a necessary factor. However, when the binary exposure to organic Hg forms (TCV-EtHg and fish-MeHg) was considered, effects on neurobehavioral tests were inconsistent. CONCLUSIONS (a) The indiscriminate use of pediatric-TCVs in less developed countries carries an unjustifiable and excessive EtHg exposure with an unnecessary risk of neurotoxicity to the developing brain; (b) measurable benefits (of Thimerosal-free) and measurable risks of tic disorders have been associated with the (Thimerosal-containing) type of vaccine;
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Affiliation(s)
- José G Dórea
- Professor Emeritus, Faculty of Health Sciences, Universidade de Brasília, 70919-970, Brasília, DF, Brazil.
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28
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Dórea JG. Low-dose Thimerosal in pediatric vaccines: Adverse effects in perspective. ENVIRONMENTAL RESEARCH 2017; 152:280-293. [PMID: 27816865 DOI: 10.1016/j.envres.2016.10.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 10/26/2016] [Accepted: 10/27/2016] [Indexed: 06/06/2023]
Abstract
Vaccines are prophylactics used as the first line of intervention to prevent, control and eradicate infectious diseases. Young children (before the age of six months) are the demographic group most exposed to recommended/mandatory vaccines preserved with Thimerosal and its metabolite ethylmercury (EtHg). Particularly in the less-developed countries, newborns, neonates, and young children are exposed to EtHg because it is still in several of their pediatric vaccines and mothers are often immunized with Thimerosal-containing vaccines (TCVs) during pregnancy. While the immunogenic component of the product has undergone more rigorous testing, Thimerosal, known to have neurotoxic effects even at low doses, has not been scrutinized for the limit of tolerance alone or in combination with adjuvant-Al during immaturity or developmental periods (pregnant women, newborns, infants, and young children). Scientific evidence has shown the potential hazards of Thimerosal in experiments that modeled vaccine-EtHg concentrations. Observational population studies have revealed uncertainties related to neurological effects. However, consistently, they showed a link of EtHg with risk of certain neurodevelopment disorders, such as tic disorder, while clearly revealing the benefits of removing Thimerosal from children's vaccines (associated with immunological reactions) in developed countries. So far, only rich countries have benefited from withdrawing the risk of exposing young children to EtHg. Regarding Thimerosal administered to the very young, we have sufficient studies that characterize a state of uncertainty: the collective evidence strongly suggests that Thimerosal exposure is associated with adverse neurodevelopmental outcomes. It is claimed that the continued use of Thimerosal in the less-developed countries is due to the cost to change to another preservative, such as 2-phenoxyethanol. However, the estimated cost increase per child in the first year of life is lower than estimated lifetime cost of caring for a child with a neurodevelopmental disorder, such tic disorder. The evidence indicates that Thimerosal-free vaccine options should be made available in developing countries.
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Affiliation(s)
- José G Dórea
- Professor Emeritus, Faculty of Health Sciences, Universidade de Brasilia, 70919-970 Brasilia, DF, Brazil.
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29
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Kern JK, Geier DA, Homme KG, King PG, Bjørklund G, Chirumbolo S, Geier MR. Developmental neurotoxicants and the vulnerable male brain: a systematic review of suspected neurotoxicants that disproportionally affect males. Acta Neurobiol Exp (Wars) 2017. [DOI: 10.21307/ane-2017-061] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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30
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Grohskopf LA, Sokolow LZ, Broder KR, Olsen SJ, Karron RA, Jernigan DB, Bresee JS. Prevention and Control of Seasonal Influenza with Vaccines. MMWR Recomm Rep 2016; 65:1-54. [PMID: 27560619 DOI: 10.15585/mmwr.rr6505a1] [Citation(s) in RCA: 295] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This report updates the 2015-16 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines (Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Karron RA. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices, United States, 2015-16 influenza season. MMWR Morb Mortal Wkly Rep 2015;64:818-25). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. For the 2016-17 influenza season, inactivated influenza vaccines (IIVs) will be available in both trivalent (IIV3) and quadrivalent (IIV4) formulations. Recombinant influenza vaccine (RIV) will be available in a trivalent formulation (RIV3). In light of concerns regarding low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013-14 and 2015-16 seasons, for the 2016-17 season, ACIP makes the interim recommendation that live attenuated influenza vaccine (LAIV4) should not be used. Vaccine virus strains included in the 2016-17 U.S. trivalent influenza vaccines will be an A/California/7/2009 (H1N1)-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (Victoria lineage). Quadrivalent vaccines will include an additional influenza B virus strain, a B/Phuket/3073/2013-like virus (Yamagata lineage).Recommendations for use of different vaccine types and specific populations are discussed. A licensed, age-appropriate vaccine should be used. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended product is otherwise appropriate. This information is intended for vaccination providers, immunization program personnel, and public health personnel. Information in this report reflects discussions during public meetings of ACIP held on October 21, 2015; February 24, 2016; and June 22, 2016. These recommendations apply to all licensed influenza vaccines used within Food and Drug Administration-licensed indications, including those licensed after the publication date of this report. Updates and other information are available at CDC's influenza website (http://www.cdc.gov/flu). Vaccination and health care providers should check CDC's influenza website periodically for additional information.
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Affiliation(s)
- Lisa A Grohskopf
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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Geier DA, Kern JK, Hooker BS, King PG, Sykes LK, Homme KG, Geier MR. Thimerosal exposure and increased risk for diagnosed tic disorder in the United States: a case-control study. Interdiscip Toxicol 2016; 8:68-76. [PMID: 27486363 PMCID: PMC4961900 DOI: 10.1515/intox-2015-0011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/10/2015] [Accepted: 04/23/2015] [Indexed: 01/08/2023] Open
Abstract
A hypothesis testing, case-control study evaluated automated medical records for exposure to organic-Hg from Thimerosal-containing hepatitis B vaccines (TM-HepB) administered at specific intervals in the first six-months-of-life among cases diagnosed with a tic disorder (TD) or cerebral degeneration (CD) (an outcome not biologically plausibly linked to TM exposure) in comparison to controls; both cases and controls were continuously enrolled from birth (born from 1991-2000) within the Vaccine Safety Datalink (VSD) database. TD cases were significantly more likely than controls to have received increased organic-Hg from TM-HepB administered within the first month-of-life (odds ratio (OR)=1.59, p<0.00001), first two-months-of-life (OR=1.59, p<0.00001), and first six-months-of-life (OR=2.97, p<0.00001). Male TD cases were significantly more likely than male controls to have received increased organic-Hg from TM-HepB administered within the first month-of-life (OR =1.65, p<0.0001), first two-months-of-life (OR=1.64, p<0.0001), and first six months-of-life (OR=2.47, p<0.05), where as female TD were significantly more likely than female controls to have received increased organic-Hg from TM-HepB administered within the first six-months-of-life (OR=4.97, p<0.05). By contrast, CD cases were no more likely than controls to have received increased organic-Hg exposure from TM-HepB administered at any period studied within the first six-months-of-life. Although routine childhood vaccination is considered an important public health tool to combat infectious diseases, the present study associates increasing organic-Hg exposure from TM-HepB and the subsequent risk of a TD diagnosis.
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Affiliation(s)
- David A Geier
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Janet K Kern
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Brian S Hooker
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Paul G King
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Lisa K Sykes
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Kristin G Homme
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD, USA
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Abstract
INTRODUCTION To assure the highest safety of immunization programs, detect adverse events following immunization (AEFIs), eliminate concerns, and reduce the risk of low vaccination coverage, authorities in industrialized countries have collected years of reports of suspected AEFIs and have systematically assessed their clinical importance. AREAS COVERED In this paper, the methods used to assess vaccine safety and the results obtained by the analysis of reports, studies, and meta-analyses are discussed. EXPERT OPINION Severe AEFIs are rare, and all evaluations of safety of vaccines recommended for both children and adults have demonstrated that the advantages of vaccines are always significantly higher than the problems that they cause, and there is no need to modify recommendations. However, the definition of AEFI is dependent on the vaccines themselves, complicating the definition of an AEFI and explaining why doubts and concerns have been raised. Presently, disease epidemiology data collected in healthy people and in subjects with underlying disease, general vaccine coverage, and the vaccination status of subjects with AEFIs are managed by many independent institutions. Only strict co-operation between these institutions will lead to the successful identification of AEFIs and to a reduction of the weight of anti-vaccine arguments.
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Affiliation(s)
- Nicola Principi
- a Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation , Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - Susanna Esposito
- a Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation , Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
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Colaianna M, Ilmjärv S, Peterson H, Kern I, Julien S, Baquié M, Pallocca G, Bosgra S, Sachinidis A, Hengstler JG, Leist M, Krause KH. Fingerprinting of neurotoxic compounds using a mouse embryonic stem cell dual luminescence reporter assay. Arch Toxicol 2016; 91:365-391. [PMID: 27015953 PMCID: PMC5225183 DOI: 10.1007/s00204-016-1690-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 03/10/2016] [Indexed: 02/05/2023]
Abstract
Identification of neurotoxic drugs and environmental chemicals is an important challenge. However, only few tools to address this topic are available. The aim of this study was to develop a neurotoxicity/developmental neurotoxicity (DNT) test system, using the pluripotent mouse embryonic stem cell line CGR8 (ESCs). The test system uses ESCs at two differentiation stages: undifferentiated ESCs and ESC-derived neurons. Under each condition, concentration–response curves were obtained for three parameters: activity of the tubulin alpha 1 promoter (typically activated in early neurons), activity of the elongation factor 1 alpha promoter (active in all cells), and total DNA content (proportional to the number of surviving cells). We tested 37 compounds from the ESNATS test battery, which includes polypeptide hormones, environmental pollutants (including methylmercury), and clinically used drugs (including valproic acid and tyrosine kinase inhibitors). Different classes of compounds showed distinct concentration–response profiles. Plotting of the lowest observed adverse effect concentrations (LOAEL) of the neuronal promoter activity against the general promoter activity or against cytotoxicity, allowed the differentiation between neurotoxic/DNT substances and non-neurotoxic controls. Reporter activity responses in neurons were more susceptible to neurotoxic compounds than the reporter activities in ESCs from which they were derived. To relate the effective/toxic concentrations found in our study to relevant in vivo concentrations, we used a reverse pharmacokinetic modeling approach for three exemplary compounds (teriflunomide, geldanamycin, abiraterone). The dual luminescence reporter assay described in this study allows high-throughput, and should be particularly useful for the prioritization of the neurotoxic potential of a large number of compounds.
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Affiliation(s)
- Marilena Colaianna
- Department of Pathology and Immunology, Medical School, University of Geneva, Geneva, Switzerland
| | - Sten Ilmjärv
- Department of Pathology and Immunology, Medical School, University of Geneva, Geneva, Switzerland
| | | | - Ilse Kern
- Department of Pediatrics, Geneva University Hospital, Geneva, Switzerland.,Department of Genetic and Laboratory Medicine, Geneva University Hospital, Centre Medical Universitaire, Rue Michel-Servet, 1211, Geneva 4, Switzerland
| | - Stephanie Julien
- Department of Pathology and Immunology, Medical School, University of Geneva, Geneva, Switzerland
| | | | - Giorgia Pallocca
- Doerenkamp-Zbinden Chair for In Vitro Toxicology and Biomedicine, University of Konstanz, Constance, Germany
| | - Sieto Bosgra
- TNO, Zeist, The Netherlands.,BioMarin Pharmaceutical Inc., Leiden, The Netherlands
| | - Agapios Sachinidis
- Institute of Neurophysiology and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Jan G Hengstler
- Leibniz Research Centre for Working Environment and Human Factors (IfADo), Technical University of Dortmund, Dortmund, Germany
| | - Marcel Leist
- Doerenkamp-Zbinden Chair for In Vitro Toxicology and Biomedicine, University of Konstanz, Constance, Germany
| | - Karl-Heinz Krause
- Department of Pathology and Immunology, Medical School, University of Geneva, Geneva, Switzerland. .,Department of Genetic and Laboratory Medicine, Geneva University Hospital, Centre Medical Universitaire, Rue Michel-Servet, 1211, Geneva 4, Switzerland.
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Sealey LA, Hughes BW, Sriskanda AN, Guest JR, Gibson AD, Johnson-Williams L, Pace DG, Bagasra O. Environmental factors in the development of autism spectrum disorders. ENVIRONMENT INTERNATIONAL 2016; 88:288-298. [PMID: 26826339 DOI: 10.1016/j.envint.2015.12.021] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 05/22/2023]
Abstract
Autism spectrum disorders (ASD) are highly heterogeneous developmental conditions characterized by deficits in social interaction, verbal and nonverbal communication, and obsessive/stereotyped patterns of behavior and repetitive movements. Social interaction impairments are the most characteristic deficits in ASD. There is also evidence of impoverished language and empathy, a profound inability to use standard nonverbal behaviors (eye contact, affective expression) to regulate social interactions with others, difficulties in showing empathy, failure to share enjoyment, interests and achievements with others, and a lack of social and emotional reciprocity. In developed countries, it is now reported that 1%-1.5% of children have ASD, and in the US 2015 CDC reports that approximately one in 45 children suffer from ASD. Despite the intense research focus on ASD in the last decade, the underlying etiology remains unknown. Genetic research involving twins and family studies strongly supports a significant contribution of environmental factors in addition to genetic factors in ASD etiology. A comprehensive literature search has implicated several environmental factors associated with the development of ASD. These include pesticides, phthalates, polychlorinated biphenyls, solvents, air pollutants, fragrances, glyphosate and heavy metals, especially aluminum used in vaccines as adjuvant. Importantly, the majority of these toxicants are some of the most common ingredients in cosmetics and herbicides to which almost all of us are regularly exposed to in the form of fragrances, face makeup, cologne, air fresheners, food flavors, detergents, insecticides and herbicides. In this review we describe various scientific data to show the role of environmental factors in ASD.
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Affiliation(s)
- L A Sealey
- South Carolina Center for Biotechnology, Claflin University, 400 Magnolia Street, Orangeburg, SC, 29115, United States
| | - B W Hughes
- South Carolina Center for Biotechnology, Claflin University, 400 Magnolia Street, Orangeburg, SC, 29115, United States
| | - A N Sriskanda
- South Carolina Center for Biotechnology, Claflin University, 400 Magnolia Street, Orangeburg, SC, 29115, United States
| | - J R Guest
- South Carolina Center for Biotechnology, Claflin University, 400 Magnolia Street, Orangeburg, SC, 29115, United States
| | - A D Gibson
- South Carolina Center for Biotechnology, Claflin University, 400 Magnolia Street, Orangeburg, SC, 29115, United States
| | - L Johnson-Williams
- South Carolina Center for Biotechnology, Claflin University, 400 Magnolia Street, Orangeburg, SC, 29115, United States
| | - D G Pace
- School of Humanities and Social Science, Claflin University, 400 Magnolia Street, Orangeburg, SC, 29115, United States
| | - O Bagasra
- South Carolina Center for Biotechnology, Claflin University, 400 Magnolia Street, Orangeburg, SC, 29115, United States.
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Ruiz JDC, Quackenboss JJ, Tulve NS. Contributions of a Child's Built, Natural, and Social Environments to Their General Cognitive Ability: A Systematic Scoping Review. PLoS One 2016; 11:e0147741. [PMID: 26840411 PMCID: PMC4739499 DOI: 10.1371/journal.pone.0147741] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/09/2015] [Indexed: 12/24/2022] Open
Abstract
The etiology of a child’s cognitive ability is complex, with research suggesting that it is not attributed to a single determinant or even a defined period of exposure. Rather, cognitive development is the product of cumulative interactions with the environment, both negative and positive, over the life course. The aim of this systematic scoping review was to collate evidence associated with children’s cognitive health, including inherent factors as well as chemical and non-chemical stressors from the built, natural, and social environments. Three databases were used to identify recent epidemiological studies (2003–2013) that examined exposure factors associated with general cognitive ability in children. Over 100 factors were evaluated from 258 eligible studies. We found that recent literature mainly assessed the hypothesized negative effects of either inherent factors or chemical exposures present in the physical environment. Prenatal growth, sleep health, lead and water pollutants showed consistent negative effects. Of the few studies that examined social stressors, results consistently showed cognitive development to be influenced by both positive and negative social interactions at home, in school or the community. Among behavioral factors related to diet and lifestyle choices of the mother, breastfeeding was the most studied, showing consistent positive associations with cognitive ability. There were mostly inconsistent results for both chemical and non-chemical stressors. The majority of studies utilized traditional exposure assessments, evaluating chemical and non-chemical stressors separately. Collective evidence from a limited number of studies revealed that cumulative exposure assessment that incorporates multiple chemical and non-chemical stressors over the life course may unravel the variability in effect on cognitive development and help explain the inconsistencies across studies. Future research examining the interactions of multiple stressors within a child’s total environment, depicting a more real-world exposure, will aid in understanding the cumulative effects associated with a child’s ability to learn.
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Affiliation(s)
- Jazmin Del Carmen Ruiz
- Oak Ridge Institute for Science and Education, Research Participation Program, Oak Ridge, TN, United States of America
- Human Exposure and Atmospheric Sciences Division, National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, Durham, NC, United States of America
- * E-mail: ;
| | - James J. Quackenboss
- Human Exposure and Atmospheric Sciences Division, National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Las Vegas, NV, United States of America
| | - Nicolle S. Tulve
- Human Exposure and Atmospheric Sciences Division, National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, Durham, NC, United States of America
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Zeneli L, Sekovanić A, Ajvazi M, Kurti L, Daci N. Alterations in antioxidant defense system of workers chronically exposed to arsenic, cadmium and mercury from coal flying ash. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2016; 38:65-72. [PMID: 25663364 DOI: 10.1007/s10653-015-9683-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Humans are exposed to different stress factors that are responsible for over-production of reactive oxygen species. Exposure to heavy metals is one of these factors. The aim of the study was to analyze the effect of chronic exposure to heavy metals through coal flying ash on the efficiency of antioxidative defensive mechanisms, represented by the activity of superoxide dismutase, glutathione peroxidase and ascorbic acid. Nonessential elements such as arsenic and mercury levels showed a significant increase (p > 0.001) in the power plant workers rather than in the control subjects. There were no significant differences of blood cadmium between power plant workers and control subjects. We found a significant positive correlation (p < 0.05) between BAs/SZn (r = 0.211), BAs/BSe (r = 0.287), BCd/SCu (r = 0.32) and BHg/BSe (r = 0.263) in the plant workers. Red blood cell antioxidant enzymes and plasma ascorbic acid were significantly lower in power plants workers than in the control group (p < 0.002). We can conclude that levels of mercury, arsenic and cadmium in blood, despite their concentration within the reference values, significantly affect plasma ascorbic acid concentration, superoxide dismutase and glutathione peroxidase activity, which are able to increase the risk of oxidative stress.
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Affiliation(s)
- Lulzim Zeneli
- Faculty of Medicine, Institute of Biochemistry, University of Prishtina, 10000, Prishina, Republic of Kosovo.
| | - Ankica Sekovanić
- Institute of Medical Research and Occupational Health, Zagreb, Croatia
| | - Majlinda Ajvazi
- Department of Chemistry, University of Prishtina, Prishina, Republic of Kosovo
| | - Leonard Kurti
- Faculty of Medicine, Institute of Biochemistry, University of Prishtina, 10000, Prishina, Republic of Kosovo
| | - Nexhat Daci
- Department of Chemistry, University of Prishtina, Prishina, Republic of Kosovo
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Glanz JM, Newcomer SR, Jackson ML, Omer SB, Bednarczyk RA, Shoup JA, DeStefano F, Daley MF, Goddard K, Panneton M, Groom H, Plotkin SA, Orenstein WA, Marcuse EK, Brookhart MA, Kulldorff M, Shimabukuro T, McNeil M, Gee J, Weintraub E, Sukumaran L. White Paper on studying the safety of the childhood immunization schedule in the Vaccine Safety Datalink. Vaccine 2016; 34 Suppl 1:A1-A29. [DOI: 10.1016/j.vaccine.2015.10.082] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
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Fahey KR. The Pioneering Role of the Vaccine Safety Datalink Project (VSD) to Advance Collaborative Research and Distributed Data Networks. EGEMS 2015; 3:1195. [PMID: 26793736 PMCID: PMC4708093 DOI: 10.13063/2327-9214.1195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Large-scale distributed data networks consisting of diverse stakeholders including providers, patients, and payers are changing health research in terms of methods, speed and efficiency. The Vaccine Safety Datalink (VSD) set the stage for expanded involvement of health plans in collaborative research. Expanding Surveillance Capacity and Progress Toward a Learning Health System: From an initial collaboration of four integrated health systems with fewer than 10 million covered lives to 16 diverse health plans with nearly 100 million lives now in the FDA Sentinel, the expanded engagement of health plan researchers has been essential to increase the value and impact of these efforts. The collaborative structure of the VSD established a pathway toward research efforts that successfully engage all stakeholders in a cohesive rather than competitive manner. The scientific expertise and methodology developed through the VSD such as rapid cycle analysis (RCA) to conduct near real-time safety surveillance allowed for the development of the expanded surveillance systems that now exist. Building on Success and Lessons Learned: These networks have learned from and built on the knowledge base and infrastructure created by the VSD investigators. This shared technical knowledge and experience expedited the development of systems like the FDA’s Mini-Sentinel and the Patient Centered Outcomes Research Institute (PCORI)’s PCORnet Conclusion: This narrative reviews the evolution of the VSD, its contribution to other collaborative research networks, longer-term sustainability of this type of distributed research, and how knowledge gained from the earlier efforts can contribute to a continually learning health system.
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Glanz JM, Newcomer SR, Daley MF, McClure DL, Baxter RP, Jackson ML, Naleway AL, Lugg MM, DeStefano F. Cumulative and episodic vaccine aluminum exposure in a population-based cohort of young children. Vaccine 2015; 33:6736-44. [DOI: 10.1016/j.vaccine.2015.10.076] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/09/2015] [Accepted: 10/14/2015] [Indexed: 10/22/2022]
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Gadad BS, Li W, Yazdani U, Grady S, Johnson T, Hammond J, Gunn H, Curtis B, English C, Yutuc V, Ferrier C, Sackett GP, Marti CN, Young K, Hewitson L, German DC. Administration of thimerosal-containing vaccines to infant rhesus macaques does not result in autism-like behavior or neuropathology. Proc Natl Acad Sci U S A 2015; 112:12498-503. [PMID: 26417083 PMCID: PMC4603476 DOI: 10.1073/pnas.1500968112] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder. Some anecdotal reports suggest that ASD is related to exposure to ethyl mercury, in the form of the vaccine preservative, thimerosal, and/or receiving the measles, mumps, rubella (MMR) vaccine. Using infant rhesus macaques receiving thimerosal-containing vaccines (TCVs) following the recommended pediatric vaccine schedules from the 1990s and 2008, we examined behavior, and neuropathology in three brain regions found to exhibit neuropathology in postmortem ASD brains. No neuronal cellular or protein changes in the cerebellum, hippocampus, or amygdala were observed in animals following the 1990s or 2008 vaccine schedules. Analysis of social behavior in juvenile animals indicated that there were no significant differences in negative behaviors between animals in the control and experimental groups. These data indicate that administration of TCVs and/or the MMR vaccine to rhesus macaques does not result in neuropathological abnormalities, or aberrant behaviors, like those observed in ASD.
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Affiliation(s)
- Bharathi S Gadad
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Wenhao Li
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Umar Yazdani
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Stephen Grady
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Trevor Johnson
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Jacob Hammond
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Howard Gunn
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Britni Curtis
- Infant Primate Research Laboratory, Washington National Primate Research Center, Seattle, WA 98195
| | - Chris English
- Infant Primate Research Laboratory, Washington National Primate Research Center, Seattle, WA 98195
| | - Vernon Yutuc
- Infant Primate Research Laboratory, Washington National Primate Research Center, Seattle, WA 98195
| | - Clayton Ferrier
- Infant Primate Research Laboratory, Washington National Primate Research Center, Seattle, WA 98195
| | - Gene P Sackett
- Infant Primate Research Laboratory, Washington National Primate Research Center, Seattle, WA 98195; Department of Psychology, University of Washington, Seattle, WA 98195
| | | | - Keith Young
- Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center & Central Texas Veterans Health Care System, Temple, TX 76504
| | - Laura Hewitson
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390; Johnson Center for Child Health & Development, Austin, TX 78701
| | - Dwight C German
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390;
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Sukumaran L, McCarthy NL, Li R, Weintraub ES, Jacobsen SJ, Hambidge SJ, Jackson LA, Naleway AL, Chan B, Tao B, Gee J. Demographic characteristics of members of the Vaccine Safety Datalink (VSD): A comparison with the United States population. Vaccine 2015; 33:4446-50. [PMID: 26209836 PMCID: PMC4547875 DOI: 10.1016/j.vaccine.2015.07.037] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/08/2015] [Accepted: 07/11/2015] [Indexed: 01/20/2023]
Abstract
BACKGROUND The Vaccine Safety Datalink (VSD) is a collaboration between CDC and nine integrated health care systems that serves as a cornerstone of US post-licensure vaccine safety monitoring. Given concerns that potential differences between the insured VSD population and the US population could limit the generalizability of VSD study findings, we performed a comparison of the demographic characteristics between the two populations. METHODS We collected data from medical records and administrative files at VSD sites in 2010 to compare sex, age, race, ethnicity, income, and educational attainment to the 2010 US Census population. We also compared data on the 2012 VSD Medicaid population to 2012 US Medicaid data. RESULTS The VSD population included over eight million individuals in 2010, which represented 2.6% of the total US population. All major demographic groups were represented in the VSD. We found no major differences in comparing sex, race, ethnicity, and educational attainment between the VSD and the US population. Middle income populations were comparable between the VSD and the US. While the percentage of lower income populations was less in the VSD compared to the US, the VSD had over two million individuals in this group. Additionally, there were over 600,000 Medicaid members in the VSD in 2012, which represented 1.1% of the US Medicaid population. CONCLUSIONS We found that the VSD population is representative of the general US population on several key demographic and socioeconomic variables. Despite a few specific groups being underrepresented in the VSD compared to the US, the absolute number of VSD members is large enough to ensure significant representation of these groups in vaccine safety studies that use VSD data.
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Affiliation(s)
- Lakshmi Sukumaran
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
| | - Natalie L McCarthy
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rongxia Li
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric S Weintraub
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, California, USA
| | - Simon J Hambidge
- Department of Ambulatory Care Services, Denver Health, Institute for Health Research, Kaiser Permanente Colorado, Department of Pediatrics, University of Colorado, Denver, Colorado, USA
| | - Lisa A Jackson
- Group Health Research Institute, Seattle, Washington, USA
| | - Allison L Naleway
- The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Berwick Chan
- Kaiser Permanente Vaccine Study Center, Oakland, California, USA
| | - Biwen Tao
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Julianne Gee
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
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Macias AE, Precioso AR, Falsey AR. The Global Influenza Initiative recommendations for the vaccination of pregnant women against seasonal influenza. Influenza Other Respir Viruses 2015; 9 Suppl 1:31-7. [PMID: 26256293 PMCID: PMC4549100 DOI: 10.1111/irv.12320] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2015] [Indexed: 02/03/2023] Open
Abstract
There is a heavy disease burden due to seasonal influenza in pregnant women, their fetuses, and their newborns. The main aim of this study was to review and analyze current evidence on safety, immunogenicity, and clinical benefits of the inactivated influenza vaccine (IIV) in pregnant women. Current evidence shows that in pregnant women, the seasonal and pandemic IIVs are safe and well tolerated. After vaccination, pregnant women have protective concentrations of anti-influenza antibodies, conferring immunogenicity in newborns. The best evidence, to date, suggests that influenza vaccination confers clinical benefits in both pregnant women and their newborns. Vaccination with either the seasonal or pandemic vaccine has been shown to be cost-effective in pregnancy. There are scarce data from randomized clinical trials; fortunately, new phase 3 clinical trials are under way. In the Northern and Southern Hemispheres, data suggest that the greatest clinical benefit for infants occurs if the IIV is administered within the first weeks of availability of the vaccine, at the beginning of the influenza season, regardless of the pregnancy trimester. The optimal timing to vaccinate pregnant women who live in tropical regions is unclear. Based on evaluation of the evidence, the Global Influenza Initiative (GII) recommends that to prevent seasonal influenza morbidity and mortality in infants and their mothers, all pregnant women, regardless of trimester, should be vaccinated with the IIV. For countries where vaccination against influenza is starting or expanding, the GII recommends that pregnant women have the highest priority.
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Affiliation(s)
| | - Alexander R Precioso
- Division of Clinical Trials and Pharmacovigilance, Instituto ButantanSão Paulo, Brazil
- Pediatric Department, Medical School of University of Sao PauloSao Paulo, Brazil
| | - Ann R Falsey
- Department of Medicine, Rochester General Hospital and University of Rochester School of Medicine and DentistryRochester, NY, USA
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Curtis B, Liberato N, Rulien M, Morrisroe K, Kenney C, Yutuc V, Ferrier C, Marti CN, Mandell D, Burbacher TM, Sackett GP, Hewitson L. Examination of the safety of pediatric vaccine schedules in a non-human primate model: assessments of neurodevelopment, learning, and social behavior. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:579-589. [PMID: 25690930 PMCID: PMC4455585 DOI: 10.1289/ehp.1408257] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 02/12/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND In the 1990s, the mercury-based preservative thimerosal was used in most pediatric vaccines. Although there are currently only two thimerosal-containing vaccines (TCVs) recommended for pediatric use, parental perceptions that vaccines pose safety concerns are affecting vaccination rates, particularly in light of the much expanded and more complex schedule in place today. OBJECTIVES The objective of this study was to examine the safety of pediatric vaccine schedules in a non-human primate model. METHODS We administered vaccines to six groups of infant male rhesus macaques (n = 12-16/group) using a standardized thimerosal dose where appropriate. Study groups included the recommended 1990s Pediatric vaccine schedule, an accelerated 1990s Primate schedule with or without the measles-mumps-rubella (MMR) vaccine, the MMR vaccine only, and the expanded 2008 schedule. We administered saline injections to age-matched control animals (n = 16). Infant development was assessed from birth to 12 months of age by examining the acquisition of neonatal reflexes, the development of object concept permanence (OCP), computerized tests of discrimination learning, and infant social behavior. Data were analyzed using analysis of variance, multilevel modeling, and survival analyses, where appropriate. RESULTS We observed no group differences in the acquisition of OCP. During discrimination learning, animals receiving TCVs had improved performance on reversal testing, although some of these same animals showed poorer performance in subsequent learning-set testing. Analysis of social and nonsocial behaviors identified few instances of negative behaviors across the entire infancy period. Although some group differences in specific behaviors were reported at 2 months of age, by 12 months all infants, irrespective of vaccination status, had developed the typical repertoire of macaque behaviors. CONCLUSIONS This comprehensive 5-year case-control study, which closely examined the effects of pediatric vaccines on early primate development, provided no consistent evidence of neurodevelopmental deficits or aberrant behavior in vaccinated animals.
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Affiliation(s)
- Britni Curtis
- Infant Primate Research Laboratory, Washington National Primate Research Center, Seattle, Washington, USA
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Geier DA, King PG, Hooker BS, Dórea JG, Kern JK, Sykes LK, Geier MR. Thimerosal: Clinical, epidemiologic and biochemical studies. Clin Chim Acta 2015; 444:212-20. [DOI: 10.1016/j.cca.2015.02.030] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 02/06/2015] [Accepted: 02/14/2015] [Indexed: 10/24/2022]
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Early exposure to thimerosal-containing vaccines and children's cognitive development. A 9-year prospective birth cohort study in Poland. Eur J Pediatr 2015; 174:383-91. [PMID: 25185528 PMCID: PMC4334107 DOI: 10.1007/s00431-014-2412-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 08/18/2014] [Accepted: 08/25/2014] [Indexed: 11/12/2022]
Abstract
UNLABELLED The controversial topic of the early exposure to mercury is regarding ethylmercury, which is present in the thimerosal-containing vaccines (TCVs). The objective of this study was to determine the relationship between the early exposure to TCVs and cognitive development in children during the first 9 years of life. The cohort included 318 children vaccinated in an early period (neonatal and up to 6 months) against hepatitis B and diphtheria-tetanus-pertussis (DTP) using formulation with or without thimerosal. The children's development was assessed using the Fagan test (6th month of life), the Bayley Scales of Infant Development (BSID)-II (12th-36th month), the Raven test (5th, 8th year), and the Wechsler Intelligence Scale for Children (WISC-R) (6th, 7th, 9th year). Results were determined by multivariable linear and logistic regression, adjusted to potential confounders. Children exposed and not exposed to TCVs in the neonatal period had similar outcomes of cognitive-developmental tests; only the results of BSID-II at the 36th month and WISC-R at the 9th year were significantly higher for those exposed to TCVs. Developmental test results in children exposed to TCVs up to the 6th month of life also did not depend on thimerosal dose. CONCLUSION TCV administration in early infancy did not affect children's cognitive development.
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Feng L, Yang P, Zhang T, Yang J, Fu C, Qin Y, Zhang Y, Ma C, Liu Z, Wang Q, Zhao G, Yu H. Technical guidelines for the application of seasonal influenza vaccine in China (2014-2015). Hum Vaccin Immunother 2015; 11:2077-101. [PMID: 26042462 PMCID: PMC4635867 DOI: 10.1080/21645515.2015.1027470] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022] Open
Abstract
Influenza, caused by the influenza virus, is a respiratory infectious disease that can severely affect human health. Influenza viruses undergo frequent antigenic changes, thus could spread quickly. Influenza causes seasonal epidemics and outbreaks in public gatherings such as schools, kindergartens, and nursing homes. Certain populations are at risk for severe illness from influenza, including pregnant women, young children, the elderly, and people in any ages with certain chronic diseases.
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Affiliation(s)
- Luzhao Feng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease; Division of Infectious Disease; Chinese Center for Disease Control and Prevention; Beijing, China
| | - Peng Yang
- Beijing Center for Disease Control and Prevention; Beijing, China
| | - Tao Zhang
- School of Public Health; Fudan University; Shanghai, China
| | - Juan Yang
- Key Laboratory of Surveillance and Early-warning on Infectious Disease; Division of Infectious Disease; Chinese Center for Disease Control and Prevention; Beijing, China
| | - Chuanxi Fu
- Guangzhou Center for Disease Control and Prevention; Guangzhou, China
| | - Ying Qin
- Key Laboratory of Surveillance and Early-warning on Infectious Disease; Division of Infectious Disease; Chinese Center for Disease Control and Prevention; Beijing, China
| | - Yi Zhang
- Beijing Center for Disease Control and Prevention; Beijing, China
| | - Chunna Ma
- Beijing Center for Disease Control and Prevention; Beijing, China
| | - Zhaoqiu Liu
- Hua Xin Hospital; First Hospital of Tsinghua University; Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Control and Prevention; Beijing, China
| | - Genming Zhao
- School of Public Health; Fudan University; Shanghai, China
| | - Hongjie Yu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease; Division of Infectious Disease; Chinese Center for Disease Control and Prevention; Beijing, China
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47
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Levy SE, Hyman SL. Complementary and alternative medicine treatments for children with autism spectrum disorders. Child Adolesc Psychiatr Clin N Am 2015; 24:117-43. [PMID: 25455579 DOI: 10.1016/j.chc.2014.09.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There are many treatments in current use for core and associated symptoms of autism spectrum disorders (ASD). This review discusses the complementary and alternative medical (CAM) treatments commonly added to conventional interventions for children with ASD, including natural products, mind and body practices, and other biomedical treatments. The article focuses on factors associated with use of CAM, the empirical evidence for the most frequently used treatments, and how clinicians work with families who choose CAM treatments. Some treatments have been ineffective, some have unacceptable potential side effects, and others require more study in depth.
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Affiliation(s)
- Susan E Levy
- Division of Developmental & Behavioral Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3550 Market Street, 3rd Floor, Philadelphia, PA 19104, USA.
| | - Susan L Hyman
- Neurodevelopmental and Behavioral Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
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48
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Contribution of Oxidative Stress to the Pathophysiology of Autism Spectrum Disorders: Impact of Genetic and Environmental Factors. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/978-1-4939-0440-2_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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49
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Golding J, Emmett P, Iles-Caven Y, Steer C, Lingam R. A review of environmental contributions to childhood motor skills. J Child Neurol 2014; 29:1531-47. [PMID: 24170258 PMCID: PMC4004720 DOI: 10.1177/0883073813507483] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although much of children's motor skills have a heredity component, at least half of the variance is likely to be influenced by the environment. It is important to ascertain features of the environment that are responsible so that toxins can be avoided, children at risk can be identified, and beneficial interventions initiated. This review outlines the results of published studies and recommends the areas where further research is required. We found much confusion with little comparability concerning the ages or measures used. Few studies had sufficient power and few allowed for confounders. We found that research to date implicates associations with prenatal drinking ≥4 drinks of alcohol per day; diabetes; taking antidepressant drugs; being deficient in iodine or iron; dietary fish; and postnatal depression. The child appearing to be most at risk was born of low birth weight (but not due to preterm delivery) or with neonatal problems.
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Affiliation(s)
- Jean Golding
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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50
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McNeil MM, Gee J, Weintraub ES, Belongia EA, Lee GM, Glanz JM, Nordin JD, Klein NP, Baxter R, Naleway AL, Jackson LA, Omer SB, Jacobsen SJ, DeStefano F. The Vaccine Safety Datalink: successes and challenges monitoring vaccine safety. Vaccine 2014; 32:5390-8. [PMID: 25108215 PMCID: PMC6727851 DOI: 10.1016/j.vaccine.2014.07.073] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/08/2014] [Accepted: 07/21/2014] [Indexed: 11/27/2022]
Abstract
The Vaccine Safety Datalink (VSD) is a collaborative project between the Centers for Disease Control and Prevention (CDC) and 9 health care organizations. Established in 1990, VSD is a vital resource informing policy makers and the public about the safety of vaccines used in the United States. Large linked databases are used to identify and evaluate adverse events in over 9 million individuals annually. VSD generates rapid, important safety assessments for both routine vaccinations and emergency vaccination campaigns. VSD monitors safety of seasonal influenza vaccines in near-real time, and provided essential information on the safety of influenza A (H1N1) 2009 monovalent vaccine during the recent pandemic. VSD investigators have published important studies demonstrating that childhood vaccines are not associated with autism or other developmental disabilities. VSD prioritizes evaluation of new vaccines; searches for possible unusual health events after vaccination; monitors vaccine safety in pregnant women; and has pioneered development of biostatistical research methods.
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Affiliation(s)
- Michael M McNeil
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Julianne Gee
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Eric S Weintraub
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Edward A Belongia
- Marshfield Clinic Research Foundation, Marshfield, WI, United States
| | - Grace M Lee
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Jason M Glanz
- Institute for Health Research, Kaiser Permanente, Denver, CO, United States
| | - James D Nordin
- HealthPartners Institute for Education and Research, Minneapolis, MN, United States
| | - Nicola P Klein
- Vaccine Study Center, Kaiser Permanente of Northern California, Oakland, CA, United States
| | - Roger Baxter
- Vaccine Study Center, Kaiser Permanente of Northern California, Oakland, CA, United States
| | - Allison L Naleway
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States
| | | | - Saad B Omer
- Kaiser Permanente Center for Health Research, Atlanta, GA, United States
| | - Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, United States
| | - Frank DeStefano
- Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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