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Cohen R, Mahlab-Guri K, Atali M, Elbirt D. Viruses and celiac disease: what do we know ? Clin Exp Med 2023; 23:2931-2939. [PMID: 37103650 PMCID: PMC10134706 DOI: 10.1007/s10238-023-01070-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
The aim of this review is to provide a comprehensive overview about the link between viruses and celiac disease. A systematic search on PubMed, Embase, and Scopus was conducted on March 07, 2023. The reviewers independently selected the articles and chose which articles to include. The review is a textual systemic review, and all relevant articles were included based on title and abstract. If there was a disagreement between the reviewers, they came to a consensus during deliberation sessions. A total of 178 articles were selected for the review and read in full; only part of them was retained. We found studies between celiac disease and 12 different viruses. Some of the studies were done only on small groups. Most studies were on pediatric population. Evidence for an association was found with several viruses (trigger or protective). It seems that only a part of the viruses could induce the disease. Several points are important to keep in mind: firstly, simple mimicry or that the virus induces a high level of TGA is not sufficient to promote the disease. Secondly, inflammatory background is necessary to induce CD with virus. Thirdly, IFN type 1 seems to have an important role. Some of the viruses are potential or known triggers like enteroviruses, rotaviruses, reoviruses, and influenza. Further studies are needed to better understand the role of viruses in celiac disease to better treat and prevent the disease.
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Affiliation(s)
- Ramon Cohen
- Internal Department B, Kaplan Medical Center, Rehovot, Israel.
- Department of Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel.
| | - Keren Mahlab-Guri
- Department of Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel
| | - Malka Atali
- Internal Department B, Kaplan Medical Center, Rehovot, Israel
| | - Daniel Elbirt
- Department of Clinical Immunology Allergy and AIDS, Kaplan Medical Center, Rehovot, Israel
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2
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Isonne C, Petrone D, Del Manso M, Iera J, Caramia A, Bandini L, Fadda G, Grossi A, Baccolini V, Costantino C, Pezzotti P, Siddu A, D'Ancona F. The Impact of Rotavirus Vaccination on Discharges for Pediatric Gastroenteritis in Italy: An Eleven Year (2009-2019) Nationwide Analysis. Vaccines (Basel) 2023; 11:1037. [PMID: 37376427 DOI: 10.3390/vaccines11061037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/11/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
In Italy, despite the documented positive effects of rotavirus (RV) vaccination on reducing the burden of RV disease, an updated national assessment of its impact on clinical outcomes is still lacking. This study aims to analyze the implementation of RV vaccination in Italy, evaluating its impact on discharges for acute pediatric gastroenteritis (AGE). A retrospective analysis, including hospital discharge records and data on vaccination coverage for children aged 0-71 months from 2009 to 2019, was conducted. We examined trends in hospital discharge standardized incidence before and after vaccine introduction using a negative binomial mixture model with fixed effects to evaluate the impact of universal vaccination. The percentage of vaccination coverage increased over the years, from <5% between 2009 and 2013 to 26% in 2017, reaching 70% in 2019. The standardized incidence of discharges decreased over the period from 16.6/100,000 inhabitants in 2009-2013 to 9.9/100,000 inhabitants in 2018-2019. In this phase, about 15% of the estimated hospital discharges were avoided compared with those estimated in the first phase. The implementation of RV vaccination reduced AGE incidence discharges in children aged 0-71 months. Further efforts are needed to continue monitoring the vaccination effect over time and to increase vaccination coverage.
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Affiliation(s)
- Claudia Isonne
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Department of Statistics, Sapienza University of Rome, 00185 Rome, Italy
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Jessica Iera
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Management and Health Laboratory, Institute of Management-Department EMbeDS, Sant'Anna School of Advanced Studies, 56127 Pisa, Italy
| | - Alessandra Caramia
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
- Policlinico Riuniti Foggia Hospital, Hygiene Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Lorenzo Bandini
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Giulia Fadda
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Adriano Grossi
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
| | - Andrea Siddu
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 00144 Rome, Italy
| | - Fortunato D'Ancona
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
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3
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Costantino C, Conforto A, Bonaccorso N, Cimino L, Sciortino M, Palermo M, Maiolo K, Tina LG, Betta PM, Caracciolo M, Loretta CM, Arco A, Gitto E, Vitaliti SM, Mancuso D, Vitaliti G, Rosella V, Pinello G, Corsello G, Serra G, Gabriele B, Tramuto F, Restivo V, Amodio E, Vitale F. Safety of Rotavirus Vaccination in Preterm Infants Admitted in Neonatal Intensive Care Units in Sicily, Italy: A Multicenter Observational Study. Vaccines (Basel) 2023; 11:vaccines11040718. [PMID: 37112630 PMCID: PMC10145326 DOI: 10.3390/vaccines11040718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Rotavirus (RV) is among the most common vaccine-preventable diseases in children under five years of age. Despite the severity of rotavirus pathology in early childhood, rotavirus vaccination for children admitted to the neonatal intensive care unit (NICU), who are often born preterm and with various previous illnesses, is not performed. This multicenter, 3-year project aims to evaluate the safety of RV vaccine administration within the six main neonatal intensive care units of the Sicilian Region to preterm infants. Methods: Monovalent live attenuated anti-RV vaccination (RV1) was administered from April 2018 to December 2019 to preterm infants with gestational age ≥ 28 weeks. Vaccine administrations were performed in both inpatient and outpatient hospital settings as a post-discharge follow-up (NICU setting) starting at 6 weeks of age according to the official immunization schedule. Any adverse events (expected, unexpected, and serious) were monitored from vaccine administration up to 14 days (first assessment) and 28 days (second assessment) after each of the two scheduled vaccine doses. Results: At the end of December 2019, 449 preterm infants were vaccinated with both doses of rotavirus vaccine within the six participating Sicilian NICUs. Mean gestational age in weeks was 33.1 (±3.8 SD) and the first dose of RV vaccine was administered at 55 days (±12.9 SD) on average. The mean weight at the first dose was 3388 (SD ± 903) grams. Only 0.6% and 0.2% of infants reported abdominal colic and fever above 38.5 °C in the 14 days after the first dose, respectively. Overall, 1.9% EAEs were observed at 14 days and 0.4% at 28 days after the first/second dose administration. Conclusions: Data obtained from this study confirm the safety of the monovalent rotavirus vaccine even in preterm infants with gestational age ≥ 28 weeks, presenting an opportunity to improve the vaccination offer both in Sicily and in Italy by protecting the most fragile infants who are more at risk of contracting severe rotavirus gastroenteritis and nosocomial RV infection.
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Arianna Conforto
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Nicole Bonaccorso
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Livia Cimino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Martina Sciortino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Mario Palermo
- Regional Health Authority of Sicily, Via Vaccaro 5, 90145 Palermo, Italy
| | - Kim Maiolo
- Neonatal Intensive Care Unit, Garibaldi Hospital, 95124 Catania, Italy
| | | | - Pasqua Maria Betta
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Mariacarmela Caracciolo
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Carmine Mattia Loretta
- Neonatal Intensive Care Unit, University Hospital of Catania (G. Rodolico), 90123 Catania, Italy
| | - Alessandro Arco
- Neonatal Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy
| | - Eloisa Gitto
- Neonatal Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy
| | | | - Domenica Mancuso
- Neonatology Unit, NICU and Creche, ARNAS Civico, 90127 Palermo, Italy
| | - Giuliana Vitaliti
- Neonatology Unit, NICU and Creche, ARNAS Civico, 90127 Palermo, Italy
| | - Vincenzo Rosella
- Neonatal Intensive Care Unit, Maternal and Child Department, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy
| | - Giuseppa Pinello
- Neonatal Intensive Care Unit, Maternal and Child Department, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy
| | - Giovanni Corsello
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Gregorio Serra
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Bruna Gabriele
- Neonatology and Neonatal Intensive Care Unit, University Hospital of Palermo (P. Giaccone), 90127 Palermo, Italy
| | - Fabio Tramuto
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Emanuele Amodio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
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4
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Arístegui J, Alfayate-Miguelez S, Carazo-Gallego B, Garrote E, Díaz-Munilla L, Mendizabal M, Méndez-Hernández M, Doménech E, Ferrer-Lorente B, Unsaín-Mancisidor M, Ramos-Amador JT, Illán-Ramos M, Croche-Santander B, Centeno Malfaz F, Rodríguez-Suárez J, Cotarelo Suárez M, San-Martín M, Ruiz-Contreras J. Clinical characteristics, health care resource utilization and direct medical costs of Rotavirus hospitalizations in Spain (2013-2018). Hum Vaccin Immunother 2022; 18:2046961. [PMID: 35435807 PMCID: PMC9196715 DOI: 10.1080/21645515.2022.2046961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rotavirus (RV) is the most common cause of severe gastroenteritis (GE) in infants and young children worldwide and is associated with a significant clinical and economic burden. The objective of this study was to analyze the characteristics, healthcare resource utilization and the direct medical costs related to RVGE hospitalizations in Spain. An observational, multicenter, cross-sectional study was conducted from June 2013 to May 2018 at the pediatric departments of 12 hospitals from different Spanish regions. Children under 5 years of age admitted to the hospital with a confirmed diagnosis of RVGE were selected. Data on clinical characteristics, healthcare resource use and costs were collected from patient records and hospital databases. Most children hospitalized for RVGE did not have any previous medical condition or chronic disease. Forty-seven percent had previously visited the Emergency Room (ER), 27% had visited a primary care pediatrician, and 15% had received pharmacological treatment prior to hospital admission due to an RVGE episode. The average length of a hospital stay for RVGE was 5.6 days, and the mean medical costs of RVGE hospitalizations per episode ranged from 3,940€ to 4,100€. The highest direct medical cost was due to the hospital stay. This study showed a high burden of health resource utilization and costs related to the management of cases of RVGE requiring hospitalization. RV vaccination with high coverage rates should be considered to minimize the clinical and economic impacts of this disease on the health-care system.
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Affiliation(s)
| | | | | | - Elisa Garrote
- Pediatrics, Hospital Universitario de Basurto, Bilbao, Spain
| | | | | | | | - Elia Doménech
- Paediatrics, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Belén Ferrer-Lorente
- Paediatrics, Hospital Germans Trias i Pujol, Badalona, Spain.,Paediatrics, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - María Unsaín-Mancisidor
- Paediatrics, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,Paediatrics, Hospital Universitario de Donostia, San Sebastián, Spain
| | - José Tomás Ramos-Amador
- Paediatrics, Hospital Universitario de Donostia, San Sebastián, Spain.,Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Marta Illán-Ramos
- Paediatrics, Hospital Universitario de Donostia, San Sebastián, Spain.,Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Borja Croche-Santander
- Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain.,Paediatrics, Hospital Juan Ramón Jiménez, Huelva, Spain
| | - Fernando Centeno Malfaz
- Paediatrics, Hospital Juan Ramón Jiménez, Huelva, Spain.,Paediatrics, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Julián Rodríguez-Suárez
- Paediatrics, Hospital Universitario Río Hortega, Valladolid, Spain.,Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Manuel Cotarelo Suárez
- Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain.,Medical Affairs Department, MSD, Madrid, Spain
| | - María San-Martín
- Paediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain.,Medical Affairs Department, MSD, Madrid, Spain
| | - Jesús Ruiz-Contreras
- Medical Affairs Department, MSD, Madrid, Spain.,Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
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5
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Kempe A, O'Leary ST, Cortese MM, Crane LA, Cataldi JR, Brtnikova M, Beaty BL, Hurley LP, Gorman C, Tate JE, St Pierre JL, Lindley MC. Why Aren't We Achieving High Vaccination Rates for Rotavirus Vaccine in the United States? Acad Pediatr 2022; 22:542-550. [PMID: 34252608 PMCID: PMC9987347 DOI: 10.1016/j.acap.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rotavirus vaccine (RV) coverage levels for US infants are <80%. METHODS We surveyed nationally representative networks of pediatricians by internet/mail from April to June, 2019. Multivariable regression assessed factors associated with difficulty administering the first RV dose (RV#1) by the maximum age. RESULTS Response rate was 68% (303/448). Ninety-nine percent of providers reported strongly recommending RV. The most common barriers to RV delivery overall (definite/somewhat of a barrier) were: parental concerns about vaccine safety overall (27%), parents wanting to defer (25%), parents not thinking RV was necessary (12%), and parent concerns about RV safety (6%). The most commonly reported reasons for nonreceipt of RV#1 by 4 to 5 months (often/always) were parental vaccine refusal (9%), hospitals not giving RV at discharge from nursery (7%), infants past the maximum age when discharged from neonatal intensive care unit/nursery (6%), and infant not seen before maximum age for well care visit (3%) or seen but no vaccine given (4%). Among respondents 4% strongly agreed and 25% somewhat agreed that they sometimes have difficulty giving RV#1 before the maximum age. Higher percentage of State Child Health Insurance Program/Medicaid-insured children in the practice and reporting that recommendations for timing of RV doses are too complicated were associated with reporting difficulty delivering the RV#1 by the maximum age. CONCLUSIONS US pediatricians identified multiple, actionable issues that may contribute to suboptimal RV immunization rates including lack of vaccination prior to leaving nurseries after prolonged stays, infants not being seen for well care visits by the maximum age, missed opportunities at visits and parents refusing/deferring.
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Affiliation(s)
- Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus (A Kempe, ST O'Leary, JR Cataldi, and M Brtnikova), Aurora, Colo.
| | - Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus (A Kempe, ST O'Leary, JR Cataldi, and M Brtnikova), Aurora, Colo
| | - Margaret M Cortese
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (MM Cortese, JE Tate, JL St. Pierre, and MC Lindley), Atlanta, Ga
| | - Lori A Crane
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Community and Behavioral Health, Colorado School of Public Health (LA Crane), Denver, Colo
| | - Jessica R Cataldi
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus (A Kempe, ST O'Leary, JR Cataldi, and M Brtnikova), Aurora, Colo
| | - Michaela Brtnikova
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus (A Kempe, ST O'Leary, JR Cataldi, and M Brtnikova), Aurora, Colo
| | - Brenda L Beaty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo
| | - Laura P Hurley
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo; Division of General Internal Medicine, Denver Health (LP Hurley), Denver, Colo
| | - Carol Gorman
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe, ST O'Leary, LA Crane, JR Cataldi, M Brtnikova, BL Beaty, LP Hurley, and C Gorman), Aurora, Colo
| | - Jacqueline E Tate
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (MM Cortese, JE Tate, JL St. Pierre, and MC Lindley), Atlanta, Ga
| | - Jeanette L St Pierre
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (MM Cortese, JE Tate, JL St. Pierre, and MC Lindley), Atlanta, Ga
| | - Megan C Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (MM Cortese, JE Tate, JL St. Pierre, and MC Lindley), Atlanta, Ga
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6
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Miron VD, Toma AR, Filimon C, Bar G, Craiu M. Optional Vaccines in Children—Knowledge, Attitudes, and Practices in Romanian Parents. Vaccines (Basel) 2022; 10:vaccines10030404. [PMID: 35335036 PMCID: PMC8955643 DOI: 10.3390/vaccines10030404] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022] Open
Abstract
Vaccination is one of the most useful medical interventions for controlling certain infectious diseases. The aim of current research is to identify some of the drivers of vaccine hesitancy or acceptance in a rather skeptical European population by addressing parental perception on optional vaccination (OV) perception. Novel tools, delivered by social media, were used in our research attempt. A validated questionnaire was distributed online among parents. Parental knowledge, attitudes and perceptions of OV were analyzed. The majority of parent respondents (55.1%) showed very good knowledge about vaccination and vaccine-preventable diseases, and 76.0% stated that they had given at least one optional vaccine to at least one of their children. The most common optional vaccine administered was the rotavirus vaccine. The level of knowledge appeared to be related to compliance with OV. Concurrently, the rate of vaccine acceptance in the NIP (National Immunization Program) was not correlated with the level of parental knowledge. In total, a high percentage of parents (77.6%) believed that OV can bring an additional health safety benefit to their children. This study shows the need to involve the medical community in a steady dialogue with parents about OV. Raising awareness by presenting clear and understandable information could be a game-changing intervention in mitigating the public health impact of OV-preventable diseases.
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Affiliation(s)
- Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
- Correspondence:
| | - Andrei Răzvan Toma
- Central Military Emergency Hospital Dr. Carol Davila, 010825 Bucharest, Romania;
| | - Claudiu Filimon
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
| | - Gabriela Bar
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
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7
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Ruiz-Contreras J, Alfayate-Miguelez S, Carazo-Gallego B, Onís E, Díaz-Munilla L, Mendizabal M, Méndez Hernández M, Ferrer-Lorente B, Unsaín-Mancisidor M, Ramos-Amador JT, Croche-Santander B, Centeno Malfaz F, Rodríguez-Suárez J, Cotarelo M, San-Martín M, Arístegui J. Rotavirus gastroenteritis hospitalizations in provinces with different vaccination coverage rates in Spain, 2013-2018. BMC Infect Dis 2021; 21:1138. [PMID: 34742235 PMCID: PMC8572461 DOI: 10.1186/s12879-021-06841-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/29/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Rotavirus (RV) vaccines are available in Spain since 2006 but are not included in the National Immunization Program. RV vaccination has reached an intermediate vaccination coverage rate (VCR) but with substantial differences between provinces. The aim of this study was to assess the ratio of RV gastroenteritis (RVGE) admissions to all-cause hospitalizations in children under 5 years of age in areas with different VCR. METHODS Observational, multicenter, cross-sectional, medical record-based study. All children admitted to the study hospitals with a RVGE confirmed diagnosis during a 5-year period were selected. The annual ratio of RVGE to the total number of all-cause hospitalizations in children < 5 years of age were calculated. The proportion of RVGE hospitalizations were compared in areas with low (< 30%), intermediate (31-59%) and high (> 60%) VCR. RESULTS From June 2013 to May 2018, data from 1731 RVGE hospitalizations (16.47% of which were nosocomial) were collected from the 12 study hospitals. RVGE hospital admissions accounted for 2.82% (95 CI 2.72-3.00) and 43.84% (95% CI 40.53-47.21) of all-cause and Acute Gastroenteritis (AGE) hospitalizations in children under 5 years of age, respectively. The likelihood of hospitalization due to RVGE was 56% (IC95%, 51-61%) and 27% (IC95%, 18-35%) lower in areas with high and intermediate VCR, respectively, compared to the low VCR areas. CONCLUSIONS RVGE hospitalization ratios are highly dependent on the RV VCR. Increasing VCR in areas with intermediate and low coverage rates would significantly reduce the severe burden of RVGE that requires hospital management in Spain. Clinical trial registration Not applicable.
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Affiliation(s)
| | - S Alfayate-Miguelez
- Pediatrics, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - B Carazo-Gallego
- Pediatrics, Hospital Regional Universitario de Málaga, Malaga, Spain
| | - E Onís
- Pediatrics, Hospital Universitario de Basurto, Bilbao, Spain
| | - L Díaz-Munilla
- Pediatrics, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Mendizabal
- Pediatrics, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - B Ferrer-Lorente
- Pediatrics, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - J T Ramos-Amador
- Pediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | - F Centeno Malfaz
- Pediatrics, Hospital Universitario Río Hortega, Valladolid, Spain
| | | | - M Cotarelo
- Medical Affairs Department, MSD Spain, C/Josefa Valcárcel, 38, 28027, Madrid, Spain
| | - M San-Martín
- Medical Affairs Department, MSD Spain, C/Josefa Valcárcel, 38, 28027, Madrid, Spain.
| | - J Arístegui
- Pediatrics, Hospital Universitario de Basurto, Bilbao, Spain
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8
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Mao K. WITHDRAWN: Health risk assessment and health management of urban residents facing epidemic pneumonia. Work 2021:WOR205367. [PMID: 34308884 DOI: 10.3233/wor-205367] [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: 11/15/2022] Open
Abstract
Ahead of Print article withdrawn by publisher.
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Affiliation(s)
- Kedun Mao
- School of Law, Institute of Rule of Law of Market Economy, Sichuan University, Chengdu, China E-mail:
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9
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Rotavirus Strain Surveillance in Estonia After Introduction of Rotavirus Universal Mass Vaccination. Pediatr Infect Dis J 2021; 40:489-494. [PMID: 33847298 DOI: 10.1097/inf.0000000000003039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Estonia implemented the rotavirus (RV) vaccine into its national immunization program in July 2014. We aimed to determine circulating RV genotypes and the clinical profile by genotypes from February 1, 2015, to August 30, 2016, among children 0-18 years hospitalized due to rotavirus gastroenteritis (RVGE). METHODS During an observational study in 7 Estonian hospitals, we determined the RV genotypes in stool samples of RVGE patients who met predetermined criteria. Shannon's diversity index (H´) and Simpson's index (D) was used to evaluate genotype diversity by season and age and to compare prevaccine period data (2007-2008) for children 0-4 years of age (n = 77) to corresponding data from the postvaccine period (2015-2016, n = 346). The Vesikari Clinical Severity Scoring System was used for clinical profile evaluation. RESULTS Stool samples of 479 RVGE patients were genotyped. Seventy-seven percent of RVGE infections were caused by G4P[8] (n = 150, 31%), G1P[8] (n = 100, 21%), G9P[8] (n = 79, 16%), G2P[4] (n = 23, 5%), G4P[4] (n = 17, 4%). The prevailing genotypes varied seasonally. Diversity increased during the postvaccine period among age groups 0-4: H´1.42 (95% CI: 1.2-1.7) in the prevaccine era versus 1.8 (95% CI: 1.7-2) in the postvaccine era (P = 0.008), and D 0.6 (95% CI: 0.5-0.7) versus 0.78 (0.75-0.80) (P = 0.01), respectively. The off-season period presented higher diversity compared with in-seasons. G2P[8], G1P[8], G4P[4], G9P[8], and G8P[8] presented with a different clinical profile compared with others. CONCLUSION Since the introduction of universal mass vaccination in Estonia, the circulating RV genotypes have changed compared with those reported in the prevaccine era. Our study adds to knowledge about RV genotype distribution in Europe and expected dynamics after RV universal mass vaccination and provides insight on the clinical profile of prevailing genotypes.
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Ghaswalla PK, D’Angelo J, Abu-Elyazeed R. Rotavirus vaccination in the US: a systematic review of vaccination coverage and completion. Hum Vaccin Immunother 2021; 17:872-879. [PMID: 32845792 PMCID: PMC7993132 DOI: 10.1080/21645515.2020.1794440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/06/2020] [Indexed: 11/05/2022] Open
Abstract
A systematic literature review of Medline and Embase databases was conducted to describe rotavirus (RV) vaccine coverage for a complete series, timing of receipt of all doses in the series, and predictors of RV vaccination coverage in the US for two licensed RV vaccines (RV1, RV5). Nine publications were included in the review. RV vaccination coverage rates of under 80% suggest RV vaccines are underutilized relative to the Healthy People 2020 target and other childhood vaccines. About 50-90% of children initiating RV vaccination complete the series and coverage for a complete series is lower for black and Hispanic children (vs. whites), uninsured or Medicaid insured (vs. privately insured), and for foreign-born (vs. US-born) children. Series completion is significantly greater in children receiving DTaP, RV1 (vs. RV5), and for those receiving routine care from a pediatrician. There is a need to design and implement better RV immunization strategies for US children.
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Zeevat F, Dvortsin E, Wondimu A, Wilschut JC, Boersma C, Postma MJ. Rotavirus Vaccination of Infants Delayed and Limited within the National Immunization Programme in the Netherlands: An Opportunity Lost. Vaccines (Basel) 2021; 9:vaccines9020144. [PMID: 33579025 PMCID: PMC7916749 DOI: 10.3390/vaccines9020144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/24/2022] Open
Abstract
In this study, we estimated the benefits of rotavirus vaccination for infants had the rotavirus vaccine been introduced in the Netherlands as of its market authorization in 2006. An age-structured, deterministic cohort model was developed to simulate different birth cohorts over a period of 15 years from 2006 until 2021, comparing both universal and targeted high-risk group vaccination to no vaccination. Different scenarios for the duration of protection (5 or 7 years) and herd immunity (only for universal vaccination) were analyzed. All birth cohorts together included 2.6 million infants, of which 7.9% were high-risk individuals, and an additional 13.2 million children between 1-15 years born prior to the first cohort in 2006. The costs and health outcomes associated with rotavirus vaccination were calculated per model scenario and discounted at 4% and 1.5%, respectively. Our analysis reveals that, had rotavirus vaccination been implemented in 2006, it would have prevented 356,800 (51% decrease) and 32,200 (5% decrease) cases of rotavirus gastroenteritis after universal and targeted vaccination, respectively. Over the last 15 years, this would have led to significant avoided costs and quality-adjusted life year losses for either vaccination strategy with the most favorable outcomes for universal vaccination. Clearly, an opportunity has been lost.
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Affiliation(s)
- Florian Zeevat
- Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands; (A.W.); (C.B.); (M.J.P.)
- Correspondence:
| | | | - Abrham Wondimu
- Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands; (A.W.); (C.B.); (M.J.P.)
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Jan C. Wilschut
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands;
| | - Cornelis Boersma
- Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands; (A.W.); (C.B.); (M.J.P.)
- Faculty of Management Sciences, Open University, 6419 AT Heerlen, The Netherlands
| | - Maarten J. Postma
- Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands; (A.W.); (C.B.); (M.J.P.)
- Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, 9700 AV Groningen, The Netherlands
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López-Lacort M, Orrico-Sánchez A, Martínez-Beneito MÁ, Muñoz-Quiles C, Díez-Domingo J. Spatio-temporal impact of self-financed rotavirus vaccination on rotavirus and acute gastroenteritis hospitalisations in the Valencia region, Spain. BMC Infect Dis 2020; 20:656. [PMID: 32894071 PMCID: PMC7487659 DOI: 10.1186/s12879-020-05373-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Several studies have shown a substantial impact of Rotavirus (RV) vaccination on the burden of RV and all-cause acute gastroenteritis (AGE). However, the results of most impact studies could be confused by a dynamic and complex space-time process. Therefore, there is a need to analyse the impact of RV vaccination on RV and AGE hospitalisations in a space-time framework to detect geographical-time patterns while avoiding the potential confusion caused by population inequalities in the impact estimations. METHODS A retrospective population-based study using real-world data from the Valencia Region was performed among children aged less than 3 years old in the period 2005-2016. A Bayesian spatio-temporal model was constructed to analyse RV and AGE hospitalisations and to estimate the vaccination impact measured in averted hospitalisations. RESULTS We found important spatio-temporal patterns in RV and AGE hospitalisations, RV vaccination coverage and in their associated adverted hospitalisations. Overall, ~ 1866 hospital admissions for RV were averted by RV vaccination during 2007-2016. Despite the low-medium vaccine coverage (~ 50%) in 2015-2016, relevant 36 and 20% reductions were estimated in RV and AGE hospitalisations respectively. CONCLUSIONS The introduction of the RV vaccines has substantially reduced the number of RV hospitalisations, averting ~ 1866 admissions during 2007-2016 which were space and time dependent. This study improves the methodologies commonly used to estimate the RV vaccine impact and their interpretation.
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Affiliation(s)
- Mónica López-Lacort
- Vaccine Research Department FISABIO-Public Health, Avenida Cataluña, 21, 46020, Valencia, Spain.
| | | | - Miguel Ángel Martínez-Beneito
- Departament d'Estadística i Investigació Operativa. Universitat de Valencia, Valencia, Spain
- Unitat Mixta de Recerca en Mètodes Estadístics per a Dades Biomédiques i Sanitàries, Valencia, Spain
| | - Cintia Muñoz-Quiles
- Vaccine Research Department FISABIO-Public Health, Avenida Cataluña, 21, 46020, Valencia, Spain
| | - Javier Díez-Domingo
- Vaccine Research Department FISABIO-Public Health, Avenida Cataluña, 21, 46020, Valencia, Spain
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Phylodynamics of G4P[8] and G2P[4] strains of rotavirus A isolated in Russia in 2017 based on full-genome analyses. Virus Genes 2020; 56:537-545. [PMID: 32472472 DOI: 10.1007/s11262-020-01771-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023]
Abstract
Rotavirus A is a dynamically evolving pathogen causing acute gastroenteritis in children during the first years of life. In the present study, we conducted a phylodynamic analysis based on the complete sequences of 11 segments of rotaviruses with the G4P[8] and G2P[4] genotypes isolated in Russia in 2017. Since rotavirus has a segmented genome, our analysis was performed using the Bayesian approach based on separate samples of nucleotide sequences for each gene of the strains studied. For the strain with the genotype G4P[8], the most likely geographical locations of the nearest common ancestor were Russia (VP7, VP4, VP6), China (VP1), Thailand (VP3), Belgium (NSP1), Hungary (VP2, NSP2, NSP3), Italy (NSP4) and Japan (NSP5). For the strain with the G2P[4] genotype, India (VP7, VP4, VP6, NSP1, NSP4), Malawi (VP2, NSP2, NSP3), Australia (VP1), Italy (NSP5) and Bangladesh (VP3). The closest common ancestor of the strain with the genotype G4P[8] circulated in 2001-2012, depending on the gene being analyzed. For the strain with the G2P[4] genotype, the closest common ancestor dates from 2006 to 2013.
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Quee FA, de Hoog MLA, Schuurman R, Bruijning-Verhagen P. Community burden and transmission of acute gastroenteritis caused by norovirus and rotavirus in the Netherlands (RotaFam): a prospective household-based cohort study. THE LANCET. INFECTIOUS DISEASES 2020; 20:598-606. [DOI: 10.1016/s1473-3099(20)30058-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/02/2019] [Accepted: 11/06/2019] [Indexed: 11/30/2022]
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Acute gastroenteritis hospitalizations after implementation of universal mass vaccination against rotavirus. Vaccine 2020; 38:2879-2886. [DOI: 10.1016/j.vaccine.2020.01.098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/10/2020] [Accepted: 01/20/2020] [Indexed: 12/18/2022]
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IMMUNISATION SCHEDULE OF THE SPANISH ASSOCIATION OF PAEDIATRICS: 2020 RECOMMENDATIONS. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.anpede.2019.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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17
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Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Merino Moína M, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J, Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Merino Moína M, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J. Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2020. An Pediatr (Barc) 2020; 92:52.e1-52.e10. [DOI: 10.1016/j.anpedi.2019.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 12/19/2022] Open
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[Immunisation schedule of the Spanish Association of Paediatrics: 2019 recommendations]. An Pediatr (Barc) 2019; 90:56.e1-56.e9. [PMID: 30609975 DOI: 10.1016/j.anpedi.2018.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 11/21/2022] Open
Abstract
The Advisory Committee on Vaccines of the Spanish Association of Paediatrics annually publishes the immunisation schedule considered optimal for children resident in Spain, according to available evidence on current vaccines. As regards funded immunisations, the 2+1 strategy (2, 4, 11 months) with hexavalent (DTPa-IPV-Hib-HB) and 13-valent pneumococcal vaccines are recommended. Administration of the 6-year booster dose with DTPa is recommended, with a poliomyelitis dose for children who had received the 2+1 scheme, as well as Tdap vaccine for adolescents and pregnant women in every pregnancy between 27 and 32 weeks gestation. The 2-dose scheme should be used for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years). MMRV vaccine could be applied as the second dose. Vaccination against HPV is recommended in both genders, preferably at 12 years of age. A stronger effort should be made to improve vaccination coverage. The new 9-valent vaccine is now available, expanding the coverage for both genders. Tetravalent meningococcal vaccine (MenACWY) is recommended at 12 months and 12-14 years, with a catch-up up at 19 years of age. It is also recommended in infants older than 6 weeks of age with risk factors, or travellers to countries with high incidence of ACWY meningococcal serogroups. As regards non-funded immunisations, it is recommended meningococcal B vaccination, with a 2+1 schedule, and requests that it be included in the National Immunisation Program. Vaccination against rotavirus is recommended in all infants.
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Benninghoff B, Pereira P, Vetter V. Role of healthcare practitioners in rotavirus disease awareness and vaccination - insights from a survey among caregivers. Hum Vaccin Immunother 2019; 16:138-147. [PMID: 31210567 PMCID: PMC7012184 DOI: 10.1080/21645515.2019.1632685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
An online survey was designed to assess awareness and understanding of Rotavirus (RV) gastroenteritis (RVGE), and knowledge and attitudes towards RV vaccination in Germany, Poland, Turkey, Indonesia, the Philippines and Thailand. Survey participants (n = 1500) comprised parents, expectant parents and guardians of children ≤5 years of age who have sole or joint responsibility for health and well-being decisions relating to their child, who were recruited from an online panel and provided their consent for study participation. Participants from most countries had a high level of awareness of RV infections (mean: 82%) and of those aware of RV, a mean of 61% participants were aware that RV was the most common cause of GE, however the majority (mean: 59%) were unaware that nearly every child would be infected with RVGE by the age of 5 years. Healthcare professional (HCP) recommendation was identified as the key driver for participants seeking vaccination (48%–75% of participants stated this reason, with results differing by country) followed by availability of RV vaccine in the national immunization program. Despite a high level of awareness of RVGE among participants, fostering knowledge regarding the difficulty of RVGE prevention, the risk of RV contraction and the associated serious consequences like dehydration is imperative to improve RV vaccination uptake. HCPs, being the primary influence on participants’ decision on vaccination, are best suited to bridge existing knowledge gaps and recommend parents to vaccinate their children against RVGE.
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Pöyhönen L, Bustamante J, Casanova JL, Jouanguy E, Zhang Q. Life-Threatening Infections Due to Live-Attenuated Vaccines: Early Manifestations of Inborn Errors of Immunity. J Clin Immunol 2019; 39:376-390. [PMID: 31123910 DOI: 10.1007/s10875-019-00642-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/02/2019] [Indexed: 02/07/2023]
Abstract
Live-attenuated vaccines (LAVs) can protect humans against 12 viral and three bacterial diseases. By definition, any clinical infection caused by a LAV that is sufficiently severe to require medical intervention attests to an inherited or acquired immunodeficiency that must be diagnosed or identified. Self-healing infections can also result from milder forms of immunodeficiency. We review here the inherited forms of immunodeficiency underlying severe infections of LAVs. Inborn errors of immunity (IEIs) underlying bacille Calmette-Guérin (BCG), oral poliovirus (OPV), vaccine measles virus (vMeV), and oral rotavirus vaccine (ORV) disease have been described from 1951, 1963, 1966, and 2009 onward, respectively. For each of these four LAVs, the underlying IEIs show immunological homogeneity despite genetic heterogeneity. Specifically, BCG disease is due to inborn errors of IFN-γ immunity, OPV disease to inborn errors of B cell immunity, vMeV disease to inborn errors of IFN-α/β and IFN-λ immunity, and ORV disease to adaptive immunity. Severe reactions to the other 11 LAVs have been described yet remain "idiopathic," in the absence of known underlying inherited or acquired immunodeficiencies, and are warranted to be the focus of research efforts. The study of IEIs underlying life-threatening LAV infections is clinically important for the affected patients and their families, as well as immunologically, for the study of the molecular and cellular basis of host defense against both attenuated and parental pathogens.
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Affiliation(s)
- Laura Pöyhönen
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Jacinta Bustamante
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France.,Center for the Study of Primary Immunodeficiencies, AP-HP, Necker Hospital for Sick Children, Paris, France
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France.,Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France.,Howard Hughes Medical Institute, New York, NY, USA
| | - Emmanuelle Jouanguy
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France
| | - Qian Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
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Moreno-Pérez D, Álvarez García FJ, Álvarez Aldeán J, Cilleruelo Ortega MJ, Garcés Sánchez M, García Sánchez N, Hernández Merino Á, Méndez Hernández M, Merino Moína M, Montesdeoca Melián A, Ruiz-Contreras J. Immunisation schedule of the Spanish Association of Paediatrics: 2019 recommendations. An Pediatr (Barc) 2019. [DOI: 10.1016/j.anpede.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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22
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Tafalla M, Gardovska D, Gopala K, Kozlovska L. Primary care-based surveillance to estimate the proportion of rotavirus gastroenteritis among Latvian children below 5 years of age with acute gastroenteritis. Hum Vaccin Immunother 2018; 15:1272-1278. [PMID: 30335570 PMCID: PMC6663140 DOI: 10.1080/21645515.2018.1534515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Rotavirus (RV) is worldwide an important cause of acute gastroenteritis (AGE) in infants and young children. There is no specific treatment for AGE caused by RV (RVGE) but since 2006 two safe and effective vaccines have been available. RV vaccination was included in the national immunization program (NIP) of Latvia in 2015 with full reimbursement, and within the first year a coverage of 87% was achieved. This surveillance study was carried out to investigate the proportion of RVGE among AGE episodes in Latvia up to the inclusion of RV vaccination in the NIP to provide a basis for future assessments of the impact of RV vaccination. Methods: Prospective, one-year observational study of children younger than 5 years presenting with AGE in the primary care setting. At first primary care contact, a stool sample was collected and tested for RV using a rapid, visual immunochromatographic kit. The parents monitored their child’s symptoms over 2 weeks after the first contact and the investigator recorded these observations during a follow-up phone call. The proportion of RVGE among the AGE cases was estimated and the severity of each AGE case was assessed based on the recorded symptoms using the 20-point Vesikari scale. The seasonality of RVGE was also investigated. Results: Fifty-two primary care investigators collected data on 606 evaluable children with AGE. The proportion of RVGE was 38.1%. Severe AGE was experienced by 40.7% of the RV-positive and 19.5% of the RV-negative patients. The rate of hospitalization was 9.1% for the RV-positive and 4.8% for the RV-negative with no difference in the mean duration of hospital stays. AGE and RVGE both occurred all year round but with a clearly marked peak only for RVGE, from March to May. Conclusion: This study underlines that RV is an important cause of AGE in children under 5 years old in Latvia and that the burden of disease of RVGE in primary care was substantial before inclusion of RV vaccination in the NIP. Trial registration: NCT01733849
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Affiliation(s)
- Monica Tafalla
- a Epidemiology & Health Outcomes , GSK , Wavre , Belgium
| | - Dace Gardovska
- b Paediatric Department , Riga Stradiņš University, Children's University Hospital , Riga , Latvia
| | | | - Liga Kozlovska
- d Biostatistics EPI , Riga Stradiņš University , Riga , Latvia
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Restivo V, Caracci F, Sannasardo CE, Scarpitta F, Vella C, Ventura G, Tramuto F, Costantino C. Rotavirus gastroenteritis hospitalization rates and correlation with rotavirus vaccination coverage in Sicily. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:437-442. [PMID: 30333453 PMCID: PMC6502119 DOI: 10.23750/abm.v89i3.7578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/03/2018] [Indexed: 01/25/2023]
Abstract
Background and aim of the works:Rotavirus (RV) is considered the main cause of gastroenteritis in children from 0 to 59 months and vaccination represents the only strategy to prevent hospitalizations due to RV. In 2013 Sicilian Region introduced universal RV vaccination for all newborns. The present study aims to estimate the reduction rotavirus gastroenteritis (RVGE) hospitalization rates among Sicilian children and their relations with vaccination coverages of the nine Sicilian Local Health Units (LHUs). Methods: Were analyzed hospital discharge records including a diagnosis of RVGE occurred from January 2009 to December 2017 in hospitalized children aged 0 to 59 months, residents in Sicily. Were reported data on complete RV vaccination cycles among Sicilian children under 12 months of age (vaccination coverage). Results: A 49.2% overall reduction of RVGE hospitalization rates was reported after RV vaccination introduction. A more considerable reduction of hospitalization rates was observed among children aged 0 to 11 months (-61.4%), followed by children aged 12-23 months (-51.2%) and 24-35 months (-48.8%). In all the nine Sicilian Local Health Units (LHUs), a reduction of RVGE hospitalization rates was observed after RV vaccine implementation. Conclusions: This study demonstrated the significant impact of RV vaccination on RVGE hospitalization rates in Sicily, especially among children aged 0 to 23 months. The reduction in RVGE hospitalization rates observed in the Sicilian LHUs after universal vaccination program implementation, were generally higher or consistent with average vaccination coverage reported from 2013 to 2017. (www.actabiomedica.it)
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Affiliation(s)
- Vincenzo Restivo
- University of Palermo - Department of Science for Health Promotion and Mother to Child Care.
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Bruijning-Verhagen P, van Dongen JAP, Verberk JDM, Pijnacker R, van Gaalen RD, Klinkenberg D, de Melker HE, Mangen MJJ. Updated cost-effectiveness and risk-benefit analysis of two infant rotavirus vaccination strategies in a high-income, low-endemic setting. BMC Med 2018; 16:168. [PMID: 30196794 PMCID: PMC6130096 DOI: 10.1186/s12916-018-1134-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 07/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Since 2013, a biennial rotavirus pattern has emerged in the Netherlands with alternating high and low endemic years and a nearly 50% reduction in rotavirus hospitalization rates overall, while infant rotavirus vaccination has remained below 1% throughout. As the rotavirus vaccination cost-effectiveness and risk-benefit ratio in high-income settings is highly influenced by the total rotavirus disease burden, we re-evaluated two infant vaccination strategies, taking into account this recent change in rotavirus epidemiology. METHODS We used updated rotavirus disease burden estimates derived from (active) surveillance to evaluate (1) a targeted strategy with selective vaccination of infants with medical risk conditions (prematurity, low birth weight, or congenital conditions) and (2) universal vaccination including all infants. In addition, we added herd protection as well as vaccine-induced intussusception risk to our previous cost-effectiveness model. An age- and risk-group structured, discrete-time event, stochastic multi-cohort model of the Dutch pediatric population was used to estimate the costs and effects of each vaccination strategy. RESULTS The targeted vaccination was cost-saving under all scenarios tested from both the healthcare payer and societal perspective at rotavirus vaccine market prices (€135/child). The cost-effectiveness ratio for universal vaccination was €51,277 at the assumed vaccine price of €75/child, using a societal perspective and 3% discount rates. Universal vaccination became cost-neutral at €32/child. At an assumed vaccine-induced intussusception rate of 1/50,000, an estimated 1707 hospitalizations and 21 fatal rotavirus cases were averted by targeted vaccination per vaccine-induced intussusception case. Applying universal vaccination, an additional 571 hospitalizations and < 1 additional rotavirus death were averted in healthy children per vaccine-induced intussusception case. CONCLUSION While universal infant rotavirus vaccination results in the highest reductions in the population burden of rotavirus, targeted vaccination should be considered as a cost-saving alternative with a favorable risk-benefit ratio for high-income settings where universal implementation is unfeasible because of budget restrictions, low rotavirus endemicity, and/or public acceptance.
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Affiliation(s)
- P Bruijning-Verhagen
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. .,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | - J A P van Dongen
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - J D M Verberk
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - R Pijnacker
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - R D van Gaalen
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - D Klinkenberg
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - H E de Melker
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - M-J J Mangen
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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