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Kibler A, Seifert M, Budeus B. Age-related changes of the human splenic marginal zone B cell compartment. Immunol Lett 2023; 256-257:59-65. [PMID: 37044264 DOI: 10.1016/j.imlet.2023.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/24/2023] [Accepted: 04/07/2023] [Indexed: 04/14/2023]
Abstract
In this review, we will summarize the growing body of knowledge on the age-related changes of human splenic B cell composition and molecular evidence of immune maturation and discuss the contribution of these changes on splenic protective function. From birth on, the splenic marginal zone (sMZ) contains a specialized B cell subpopulation, which recruits and archives memory B cells from immune responses throughout the organism. The quality of sMZ B cell responses is augmented by germinal center (GC)-dependent maturation of memory B cells during childhood, however, in old age, these mechanisms likely contribute to waning of splenic protective function.
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Affiliation(s)
- Artur Kibler
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
| | - Marc Seifert
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany; Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University, Düsseldorf, Germany.
| | - Bettina Budeus
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Essen, Germany
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Goshu Muluneh A, Woldemariam Merid M, Tigabu B, Getie Ferede M, Molla Kassa G, Animut Y. Less than one-fifth of Ethiopian children were vaccinated for measles second dose; evidence from the Ethiopian mini demographic and health survey 2019. Vaccine X 2022; 12:100217. [PMID: 36148266 PMCID: PMC9486014 DOI: 10.1016/j.jvacx.2022.100217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022] Open
Abstract
Ethiopia introduced the measles second dose vaccine from the routine expanded immunization program in 2018. Shreds of evidence are scarce on the measles second dose vaccination coverage and its associated factors in Ethiopia. We aimed to assess the measles second dose vaccination coverage and associated factors in Ethiopia using the recent Ethiopian Mini Demographic and Health Survey (EMDHS) 2019 data. An in-depth secondary data analysis was conducted based on the Ethiopian mini demographic and health survey 2019 data; which was a cross-sectional survey targeted on key indicators of maternal and child health. A weighted sample of 965 children was included in the analysis. A multi-level mixed effect logistics regression model was fitted. Adjusted Odds Ratio (AOR) with 95 %CI was reported for statistically significant variables. The measles second dose coverage was 12.36 % (95 %CI = 10.89, 15.44). Not vaccinated for the third dose of pentavalent vaccine (Penta 3) (AOR = 0.60, 95 %CI: 0.37, 0.95), age of the child [13 to 23 months (AOR = 2.14, 95 %CI: 1.05, 4.36), 24 to 36 months (AOR = 2.58, 95 %CI: 1.32, 5.05)], household head educational status [no education (AOR = 0.51,95 %CI: 0.26, 0.99), primary (AOR = 0.44, 95 %CI: 0.23, 0.85)], and living in south nation, nationalities and peoples region (SNNPR) (AOR = 2.83,95 %CI: 1.12, 7.11) were significantly associated with measles second dose vaccination coverage. Measles second dose vaccination coverage was low in Ethiopia. Age of the child, being vaccinated for the Penta 3, educational status of the household head, and region of residence were significant determinants of measles second dose vaccination coverage.
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Balogun FM, Bamgboye EA, Akindolire AE. Improving timeliness and completion of infant vaccination among infants in Nigerian urban slums through older women's participation. Front Public Health 2022; 10:898636. [PMID: 36159258 PMCID: PMC9494024 DOI: 10.3389/fpubh.2022.898636] [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] [Received: 03/17/2022] [Accepted: 08/03/2022] [Indexed: 01/22/2023] Open
Abstract
Nigerian urban slums have a high population of infants with suboptimal vaccination despite previous interventions. Older women traditionally play supervisory roles in infant care in Nigeria but their influence is untapped in infant vaccination. This study sought to determine if training of older women (≥35 years) in urban slum communities in Ibadan, South west Nigeria, and involving them in infant vaccination will improve infant vaccination timeliness and completion. This was a randomized experimental community study and pregnant women in their third trimester, residing in seven urban slum communities were randomized using their antenatal clinics (ANCs) into intervention (six ANCs) and control groups (six ANCs). The older women who will supervise the care of the infants of pregnant women in the intervention group had seven sessions of training on the importance of infant vaccination timeliness and completion. The vaccinations of the infants from both groups were compared from birth till 9 months. Data were analyzed using descriptive statistics and Chi square test at α = 0.05. There were 96 older women, 198 pregnant women (105 in intervention group and 93 controls) and 202 infants (109 in intervention group and 93 controls). Infants in the intervention group (67.9%) significantly had both timely and complete vaccinations compared with those in the control group (36.6%). Vaccines given at birth were the least timely in both groups. More infants whose older women caregiver were married had timely and complete vaccinations. Also, a higher proportion of male infants, low birth weight babies and infants with older women caregiver with at most two children had timely and completed vaccinations but these were not statistically significant. Training of older women caregivers improved infant vaccination timeliness and completion in these urban slum communities. This model may improve infant vaccination in other similar urban slum settings.
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Affiliation(s)
- Folusho Mubowale Balogun
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria,Institute of Child Health, University College Hospital, Ibadan, Nigeria,*Correspondence: Folusho Mubowale Balogun
| | - Eniola Adetola Bamgboye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Abimbola Ellen Akindolire
- Institute of Child Health, University College Hospital, Ibadan, Nigeria,Department of Pediatrics, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Characterization of Vaccine Breakthrough Cases during Measles Outbreaks in Milan and Surrounding Areas, Italy, 2017–2021. Viruses 2022; 14:v14051068. [PMID: 35632809 PMCID: PMC9147195 DOI: 10.3390/v14051068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/13/2022] [Accepted: 05/13/2022] [Indexed: 02/04/2023] Open
Abstract
Despite the existence of an effective live-attenuated vaccine, measles can appear in vaccinated individuals. We investigated breakthrough measles cases identified during our surveillance activities within the measles/rubella surveillance network (MoRoNet) in Milan and surrounding areas (Northern Italy). Between 2017 and 2021, we confirmed measles virus (genotypes B3 or D8) infections in 653 patients and 51 of these (7.8%) were vaccinees. Among vaccinated individuals whose serum was available, a secondary failure was evidenced in 69.4% (25/36) of cases while 11 patients (30.6%) were non-responders. Non-responders were more frequently hospitalized and had significantly lower Ct values in both respiratory and urine samples. Median age and time since the last immunization were similar in the two groups. Importantly, we identified onward transmissions from vaccine failure cases. Vaccinees were involved in 20 outbreaks, in 10 of them they were able to transmit the virus, and in 8 of them, they were the index case. Comparing viral hemagglutinin sequences from vaccinated and non-vaccinated subjects did not show a specific mutation pattern. These results suggest that vaccination failure was likely due to the poor immune response of single individuals and highlights the importance of identifying breakthrough cases and characterizing their clinical and virologic profiles.
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Saffar H, Mousavi SJ, Saffar H, Parsaei MR, Ghorbani GR, Saffar MJ. Seroconversion rates following 2 doses of measles- mumps- rubella vaccination given at the ages 12 and 18 months: data for possible additional dose at older age. BMC Immunol 2022; 23:2. [PMID: 35034609 PMCID: PMC8762940 DOI: 10.1186/s12865-021-00465-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022] Open
Abstract
Background Despite high rate of vaccination coverage with 2-doses of measles containing vaccine among Iranian children, outbreaks of measles occurred among different age groups and fully vaccinated subjects. Although the main reason for these outbreaks is unknown, however, vaccine failure was supposed to be an important cause. This study was designed to determine the seroconversion rates to measles- mumps- rubella (MMR) vaccine currently in use among Iranian children. Methods This prospective study was conducted among healthy children older than 12 months who were candidates of scheduled MMR vaccination. Blood samples were obtained from each mother- infant pair just before vaccination, and from infants 4–6 weeks after MMR1 and MMR2 immunization. Collected sera were tested for specific lgG antibodies against MMR agents using ELISA method. The proportion of seroprotected subjects among mother- infant pairs before vaccination as well as the prevalence rates of seroconversion after MMR1 and MMR2 vaccination were calculated. Collected data were analyzed using descriptive statistical methods. Results During 22-months study period, 92 mother- infant pairs were participated. Seroimmunity rates against MMR viruses were 85.8%, 84.7% and 86.9% for mothers, and 3.2%, 2.1% and 1.0% for children, respectively. After MMR1 vaccination from 52 seronegative children, 80.7%, 78.8% and 75% were seroconverted. These rates increased to 94.8%, 89.7% and 94.8% after the MMR2 vaccination. Also, the specific immunity was enhanced among seropositive children. Conclusion Majority of the mothers and few infants were immune to MMR viruses prior to MMR1 vaccination. Immune responses detected after MMR1 injection, and overall seroconversion rates achieved after 2-doses of MMR vaccination were less than expected and inadequate to preserve long-term protection against MMR agents.
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Affiliation(s)
- Hana Saffar
- Department of Anatomical and Clinical Pathology, IKHC, Teheran University of Medical Sciences, Tehran, Iran
| | - Sayed Jaber Mousavi
- Department of Community Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hiva Saffar
- Department of Pathology, Shariati Hospital, Teheran University of Medical Sciences, Tehran, Iran
| | | | | | - Mohammad Jafar Saffar
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute and Department of Pediatric Infectious Diseases, Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Pasdaran Bolv, Sari, Iran.
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Khampanisong P, Pauly M, Nouanthong P, Vickers MA, Virachith S, Xaydalasouk K, Black AP, Muller CP, Hübschen JM. Waning of Maternal Antibodies against Measles Suggests a Large Window of Susceptibility in Infants in Lao People's Democratic Republic. Pathogens 2021; 10:1316. [PMID: 34684265 PMCID: PMC8538652 DOI: 10.3390/pathogens10101316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Measles is an endemic but largely neglected disease in Lao People's Democratic Republic. New-borns are protected by maternal antibodies, but antibody waning before measles vaccination at 9 months of age leaves infants susceptible to infection. In this study, the susceptibility window of infants was determined to generate scientific evidence to assess the national measles immunization strategy. METHODS Between 2015 and 2016, demographic data, medical history, and blood samples were collected from 508 mother-child pairs at the provincial hospital in Vientiane. The samples were screened with a commercial kit detecting anti-measles IgG antibodies. RESULTS The large majority (95.7%) of the mothers were seropositive for anti-measles IgG and antibody titers of the mothers and infants were highly correlated (p < 0.01). While at birth 97.7% of the infants were seropositive, seropositivity rates decreased to 74.2% two months later to reach only 28.2% four months after birth (p < 0.01). Just before the first dose of the measles-rubella vaccine, scheduled at 9 months of age, was actually given, less than 14% of the infants were seropositive. CONCLUSION This alarmingly wide susceptibility gap due to rapid maternal antibody decay leaves infants at risk of measles infection and serious disease complications. A high herd immunity is crucial to protect young infants and can be achieved through improved routine vaccination coverage and (expanded age group) supplementary immunization activities.
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Affiliation(s)
- Phonepaseuth Khampanisong
- Institut Pasteur du Laos, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, Vientiane P.O. Box 3560, Laos; (P.K.); (P.N.); (S.V.); (K.X.); (A.P.B.)
| | - Maude Pauly
- Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, 4354 Esch-sur-Alzette, Luxembourg; (M.P.); (M.A.V.); (C.P.M.)
| | - Phonethipsavanh Nouanthong
- Institut Pasteur du Laos, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, Vientiane P.O. Box 3560, Laos; (P.K.); (P.N.); (S.V.); (K.X.); (A.P.B.)
| | - Molly A. Vickers
- Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, 4354 Esch-sur-Alzette, Luxembourg; (M.P.); (M.A.V.); (C.P.M.)
| | - Siriphone Virachith
- Institut Pasteur du Laos, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, Vientiane P.O. Box 3560, Laos; (P.K.); (P.N.); (S.V.); (K.X.); (A.P.B.)
| | - Kinnaly Xaydalasouk
- Institut Pasteur du Laos, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, Vientiane P.O. Box 3560, Laos; (P.K.); (P.N.); (S.V.); (K.X.); (A.P.B.)
| | - Antony P. Black
- Institut Pasteur du Laos, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, Vientiane P.O. Box 3560, Laos; (P.K.); (P.N.); (S.V.); (K.X.); (A.P.B.)
| | - Claude P. Muller
- Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, 4354 Esch-sur-Alzette, Luxembourg; (M.P.); (M.A.V.); (C.P.M.)
| | - Judith M. Hübschen
- Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, 4354 Esch-sur-Alzette, Luxembourg; (M.P.); (M.A.V.); (C.P.M.)
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Exploration and Ethical Analysis of Open-Label Pediatric Vaccine Trials in a Pandemic. Clin Ther 2021; 43:e163-e172. [PMID: 34039479 PMCID: PMC8141907 DOI: 10.1016/j.clinthera.2021.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/16/2022]
Abstract
Young children will ultimately need to be vaccinated to stop the spread of coronavirus disease 2019 (COVID-19). Initial studies of vaccine were performed in adults. Randomized controlled trials are the gold standard. In the COVID-19 pandemic, many questions need to be answered about the ethics and feasibility of these trials. Given the harms of the COVID-19 pandemic and the now-known efficacy of the vaccines in adults and teens, the question of whether clinical equipoise exists for a placebo-controlled trial of vaccines in younger children remains. Parents may be reluctant to enroll children in these trials because they want their child to receive the vaccine or because they are worried about vaccines or clinical trials in general. One option for gathering data on tolerability and efficacy in children would be to use a nonrandomized trial to enroll parents willing to vaccinate their children and those who are hesitant. We discuss the advantages and disadvantages of such an open-label trial that could provide guidance for future pandemics. (Clin Ther. 2021;XX:XXX-XXX) © 2021 Elsevier HS Journals, Inc.
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Xu J, Doyon-Plourde P, Tunis M, Quach C. Effect of early measles vaccination on long-term protection: A systematic review. Vaccine 2021; 39:2929-2937. [PMID: 33926750 DOI: 10.1016/j.vaccine.2021.04.012] [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: 12/14/2020] [Revised: 03/24/2021] [Accepted: 04/06/2021] [Indexed: 09/30/2022]
Abstract
BACKGROUND In North America, the first dose of a measles-containing vaccine (MCV1) is administered at ≥12 months of age. However, MCV1 may be given to infants <12 months living in highly endemic areas or traveling to these areas. Although an early dose of MCV1 leads to immediate protection, it remains unclear how this impacts long-term immunity. METHODS This systematic review and meta-analysis evaluates the impact of MCV1 given at <12 months vs. ≥12 months of age on long-term immunogenicity and vaccine effectiveness, with long-term defined as at least one-year post-vaccination. PubMed, EMBASE, Global Health, Web of Science and Scopus were searched on October 31st, 2019. Studies were included if they included a cohort of infants vaccinated <12 months of age and evaluated long-term immunogenicity, vaccine efficacy, or effectiveness. RESULTS A total of 51 texts were identified: 23 reported outcomes related to vaccine effectiveness and 30 to immunogenicity. Infants vaccinated with MCV1 < 12 months of age showed an overall higher risk of measles compared to ≥12 months of age (RR = 3.16, 95% CI: 2.00, 5.01; OR = 2.46, 95% CI: 1.40, 4.32). Risk of measles decreased with increasing age at first vaccination, with those vaccinated with one dose ≥15 months at a lesser risk compared to 12-14 months or <12 months. Measles seroconversion and seropositivity was not affected by age at first vaccination, but antibody levels were significantly lower in the MCV1 < 12-month group (MD = -0.40, 95% CI: -0.71, -0.09). CONCLUSION Long-term measles seroconversion and seropositivity did not appear to be affected by age at MCV1, while vaccine effectiveness decreased with younger age. There was not enough evidence to look at the effect of age at MCV1 on immune blunting.
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Affiliation(s)
- Janine Xu
- Department of Microbiology and Immunology, Faculty of Science, McGill University, Montreal, Canada
| | - Paméla Doyon-Plourde
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Matthew Tunis
- Centre for Immunization and Respiratory Infectious Disease, Public Health Agency of Canada, Ottawa, Canada
| | - Caroline Quach
- Department of Microbiology, Infectious Diseases, and Immunology, Faculty of Medicine, University of Montreal, Canada.
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Saffar H, Khalifeloo M, Saffar MJ, Abdollahi A, Parsaei MR, Ghorbani GR, Salarvand S, Aarabi M. Measles and rubella serosusceptibity among population vaccinated with different schedules: the potential impact on measles-rubella elimination in Iran. BMC Infect Dis 2021; 21:305. [PMID: 33765968 PMCID: PMC7995582 DOI: 10.1186/s12879-021-05970-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 03/08/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Iranian children were vaccinated with the scheduled two doses of monovalent measles vaccine (mMV) from 1984. In December 2003, a nationwide campaign of measles-rubella (MR) immunization was established to vaccinate 5-25 year- old individuals. In 2004, the mMV was replaced with measles- mumps- rubella (MMR) vaccine. Despite the high vaccination coverage, the outbreaks of measles still occur in the country. In this Study, the MR immunity status of various age groups, vaccinated with different schedules was investigated, and the immunologic response of seronegative subjects to revaccination was examined. METHODS This cross-sectional study was conducted among 7-33-year-old healthy individuals with a documented history of measles vaccination from November 2017 to June 2018. The subjects were categorized as follows: group A, including 20-33 year-old individuals; vaccinated with 1-2 doses of mMV at ages 9 and 15 months, and revaccinated with MR, group B, including 15-19-year-old individuals, vaccinated with two doses of mMV at 9 and 15 months of age, and received additional dose of MMR upon school entrance, group C, including 11-14 year-old individuals, vaccinated with two-doses of MMR at the ages of 15 months and 6 years, and group D, including 7-10 year-old individuals vaccinated with two-doses of MMR vaccine at the ages 12 and 18 months, respectively. Levels of antimeasles- antirubella IgG antibodies in the collected sera were measured. Also antimeasles- antirubella IgM and IgG of seronegative individuals were reexamined at 4-6 weeks after MMR revaccination. The collected data were analyzed using descriptive statistical methods. RESULTS A total of 635 individuals were investigated in this study. Group A, 98; group B, 295; group C, 139; and group D, 103 persons. Overall, 12.3 and 18.4% of the population were seronegative for measles and rubella antibodies. This rate varied greatly between the 4 groups: group A, 0/0-2%; group B,15.2-25.0%; group C,11.5-17.2%; and groupD,14.6-18.4%. After revaccination, 92 and 94.9% of seronegative individuals showed IgG response to measles and rubella vaccines, respectively. CONCLUSION Despite the high coverage rate of M-R containing vaccines, a significant number of vaccinated subjects were seronegative for measles and rubella, possibly because of secondary vaccine failure; this may negatively affect measles-rubella elimination targets in the country. If these findings are confirmed in similar future studies, a more robust regional/national supplementary immunization activity will be considered.
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Affiliation(s)
- Hana Saffar
- Department of Pathology, School of medicine, IKHC, Teheran University of Medical Sciences, Tehran, Iran
| | - Maryam Khalifeloo
- Department of Pathology, School of medicine, IKHC, Teheran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Jafar Saffar
- Pediatric Infectious Diseases Research Center, communicable Diseases Institute, and Department of Pediatric Infectious Diseases, Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Pasdaran Bolv, Sari, Iran
| | - Alireza Abdollahi
- Department of Pathology, School of medicine, IKHC, Teheran University of Medical Sciences, Tehran, Iran
| | | | | | - Samaneh Salarvand
- Department of Pathology, School of medicine, IKHC, Teheran University of Medical Sciences, Tehran, Iran
| | - Mohsen Aarabi
- Deputy of Health, Mazandaran University of Medical Sciences, Sari, Iran
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Lirussi D, Weissmann SF, Ebensen T, Nitsche-Gloy U, Franz HBG, Guzmán CA. Cyclic Di-Adenosine Monophosphate: A Promising Adjuvant Candidate for the Development of Neonatal Vaccines. Pharmaceutics 2021; 13:pharmaceutics13020188. [PMID: 33535570 PMCID: PMC7912751 DOI: 10.3390/pharmaceutics13020188] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/18/2022] Open
Abstract
Underdeveloped immunity during the neonatal age makes this period one of the most dangerous during the human lifespan, with infection-related mortality being one of the highest of all age groups. It is also discussed that vaccination during this time window may result in tolerance rather than in productive immunity, thus raising concerns about the overall vaccine-mediated protective efficacy. Cyclic di-nucleotides (CDN) are bacterial second messengers that are rapidly sensed by the immune system as a danger signal, allowing the utilization of these molecules as potent activators of the immune response. We have previously shown that cyclic di-adenosine monophosphate (CDA) is a potent and versatile adjuvant capable of promoting humoral and cellular immunity. We characterize here the cytokine profiles elicited by CDA in neonatal cord blood in comparison with other promising neonatal adjuvants, such as the imidazoquinoline resiquimod (R848), which is a synthetic dual TLR7 and TLR8 agonist. We observed superior activity of CDA in eliciting T helper 1 (Th1) and T follicular helper (TfH) cytokines in cells from human cord blood when compared to R848. Additional in vivo studies in mice showed that neonatal priming in a three-dose vaccination schedule is beneficial when CDA is used as a vaccine adjuvant. Humoral antibody titers were significantly higher in mice that received a neonatal prime as compared to those that did not. This effect was absent when using other adjuvants that were reported as suitable for neonatal vaccination. The biological significance of this immune response was assessed by a challenge with a genetically modified influenza H1N1 PR8 virus. The obtained results confirmed that CDA performed better than any other adjuvant tested. Altogether, our results suggest that CDA is a potent adjuvant in vitro on human cord blood, and in vivo in newborn mice, and thus a suitable candidate for the development of neonatal vaccines.
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Affiliation(s)
- Darío Lirussi
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124 Braunschweig, Germany; (S.F.W.); (C.A.G.)
- Correspondence: (D.L.); (T.E.); Tel.: +49-531-61814607 (T.E.); Fax: +49-531-618414699 (T.E.)
| | - Sebastian Felix Weissmann
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124 Braunschweig, Germany; (S.F.W.); (C.A.G.)
| | - Thomas Ebensen
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124 Braunschweig, Germany; (S.F.W.); (C.A.G.)
- Correspondence: (D.L.); (T.E.); Tel.: +49-531-61814607 (T.E.); Fax: +49-531-618414699 (T.E.)
| | - Ursula Nitsche-Gloy
- Women’s Clinic, Hospital Marienstift GmbH, Helmstedter Strasse 35, 38102 Braunschweig, Germany;
| | - Heiko B. G. Franz
- Department of Obstetrics and Gynecology, Women’s Clinic, Braunschweig Central Hospital, Celler Strasse 38, 38114 Braunschweig, Germany;
| | - Carlos A. Guzmán
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124 Braunschweig, Germany; (S.F.W.); (C.A.G.)
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Bassal R, Indenbaum V, Pando R, Levin T, Shinar E, Amichay D, Barak M, Ben-Dor A, Haim AB, Mendelson E, Cohen D, Shohat T. Seropositivity of measles antibodies in the Israeli population prior to the nationwide 2018 - 2019 outbreak. Hum Vaccin Immunother 2020; 17:1353-1357. [PMID: 33121333 DOI: 10.1080/21645515.2020.1824968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Measles vaccine is administered in Israel as part of the routine childhood immunization program, at ages 1 and 6 years. In this study, we assessed seropositivity of the Israeli population against measles before the onset and propagation of the 2018-2019 measles outbreak. From the Israel Center for Disease Control National Serum Bank, 3,164 samples collected during 2015 were tested for measles antibodies. All the tests were performed using Enzyme-Linked Immunosorbent Assay (ELISA) commercial kit (Enzygnost, Anti-Measles Virus/IgG: Behring, Marburg, Germany). The overall seropositivity rate for measles was 90.7%. The seropositivity rate at 6 months and younger was 48.9%, and decreased to 3.8% among infants aged 6-11 months. Seropositivity increased to 90.7% in the 1-4-year age group, and reached 96.1% for 5-9 year-old children. Our results suggest high immunity in the Israeli population against measles virus, but not high enough to prevent outbreaks because of pockets of specific population groups with low immunization coverage. Infants between ages 6 and 11 months and children younger than 2 years had the lowest seropositivity rates being the age groups with the highest attack rates of measles during the epidemic of 2018. Efforts should be aimed at avoiding any delay in vaccination once a child reaches the age of 1 year and improving immunity levels in children aged 1-4 years.
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Affiliation(s)
- Ravit Bassal
- Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Victoria Indenbaum
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Rakefet Pando
- Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Ramat-Gan, Israel.,Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Tal Levin
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Eilat Shinar
- Blood Services, Magen David Adom, Ramat-Gan, Israel
| | - Doron Amichay
- Soroka University Medical Center, Clalit Health Services, Beer Sheva, Israel
| | - Mira Barak
- Haifa and Western Galilee Laboratories, Clalit Health Services, Nesher, Israel
| | - Anat Ben-Dor
- Schneider Children Medical Center, Clalit Health Services, Petah-Tiqwa, Israel
| | - Adina Bar Haim
- Blood Services, Mayanei Hayeshua Medical Center, Bnei-Brak, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamy Shohat
- Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Ramat-Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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12
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Sun X, Tang F, Hu Y, Deng X, Wang Z, Zhou M, Liu Y. High risk of mumps infection in children who received one dose of mumps-containing vaccine: waning immunity to mumps in children aged 2-5 years from kindergartens in Jiangsu Province, China. Hum Vaccin Immunother 2020; 16:1738-1742. [PMID: 31977281 DOI: 10.1080/21645515.2019.1708162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND During the period of immunization with a single-dose measles-mumps-rubella (MMR) vaccine, which has been available since 2008in China, the incidence of mumps in children aged 2-5 years has been high. The aim of this study was to determine the immunity profile of mumps in children aged 2-5 years as part of the assessment of the MMR vaccination strategy. METHODS A cross-sectional survey of IgG antibodies against mumps virus in children aged 2-5 years was performed. Analysis by enzyme-linked immune sorbent assay(ELISA)was performed to measure IgG antibodies against mumps virus in the sera of 2-to5-year-old children who had been vaccinated with at least one dose of MMR vaccine. RESULTS Mumps outbreaks mainly occurred in kindergarten and primary schools and primarily involved children in kindergarten from 2015-2016 in Jiangsu Province. In total, 4,033 children were surveyed. The overall seroprevalence of mumps antibodies was 79.0% (95% CI:78.4-79.6), and the geometric mean concentration (GMC) was 323.6 mIU/ml (309.0-338.8). Both univariate and multivariate survival analysis of seroprevalence showed that several factors contributed to having significant seroprevalence among the 2-to-5-year-old group (P < .05). The seroprevalence of children with a single-dose MMR vaccine regimen (78.4%, 95% CI: 77.8-80.4) was significantly lower than that of children with a two-dose MMR vaccine regimen (96.5%, 95% CI: 88.6%-96.1%). The seroprevalence rate was negatively correlated with time since inoculation (P < .01). CONCLUSION Children who received a single dose of MMR vaccine in kindergarten, particularly the 2-year-old group in the northern region of Jiangsu Province, China, are at high risk of mumps infection. Our study demonstrates thata single-dose MMR vaccine regimen has a limited effect on controlling mumps, which highlights the benefit of introducing a two-dose MMR vaccine schedule.
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Affiliation(s)
- Xiang Sun
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Fenyang Tang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Ying Hu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Xiuying Deng
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Zhiguo Wang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Minghao Zhou
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
| | - Yuanbao Liu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention , Nanjing, Jiangsu Province, China
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13
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Carazo S, Billard MN, Boutin A, De Serres G. Effect of age at vaccination on the measles vaccine effectiveness and immunogenicity: systematic review and meta-analysis. BMC Infect Dis 2020; 20:251. [PMID: 32223757 PMCID: PMC7104533 DOI: 10.1186/s12879-020-4870-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 02/11/2020] [Indexed: 12/15/2022] Open
Abstract
Background The objectives of this review were to evaluate the effect of age at administration of the first dose of a measles-containing vaccine (MCV1) on protection against measles and on antibody response after one- and two-dose measles vaccinations. Methods We conducted a systematic review of the PubMed/MEDLINE, Embase, Web of Science and Cochrane databases (1964–2017) to identify observational studies estimating vaccine effectiveness and/or measles attack rates by age at first vaccination as well as experimental studies comparing seroconversion by age at first vaccination. Random effect models were used to pool measles risk ratios (RR), measles odds ratios (OR) and seroconversion RR of MCV1 administered at < 9, 9–11 or ≥ 15 months compared with 12 or 12–14 months of age. Results We included 41 and 67 studies in the measles protection and immunogenicity analyses. Older age at MCV1, from 6 to ≥15 months, improved antibody response and measles protection among one-dose recipients. Pooled measles RR ranged from 3.56 (95%CI: 1.28, 9.88) for MCV1 at < 9 months to 0.48 (95%CI: 0.36, 0.63) for MCV1 at ≥15 months, both compared to 12–14 months. Pooled seroconversion RR ranged from 0.93 (95%CI: 0.90, 0.96) for MCV1 at 9–11 months to 1.03 (95%CI: 1.00, 1.06) for MCV1 at ≥15 months, both compared to 12 months. After a second dose, serological studies reported high seropositivity regardless of age at administration of MCV1 while epidemiological data based on few studies suggested lower protection with earlier age at MCV1. Conclusions Earlier age at MCV1 decreases measles protection and immunogenicity after one dose and might still have an impact on vaccine failures after two doses of measles vaccine. While two-dose vaccination coverage is most critical to interrupt measles transmission, older age at first vaccination may be necessary to keep the high level of population immunity needed to maintain it.
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Affiliation(s)
- Sara Carazo
- Department of Social and Preventive Medicine, Laval University, 1050, Avenue de la Médecine, Quebec, QC, G1V 0A6, Canada
| | - Marie-Noëlle Billard
- CHU de Québec - Université Laval Research Center, 2400, Avenue d'Estimauville, Quebec, QC, G1E 7G9, Canada
| | - Amélie Boutin
- CHU de Québec - Université Laval Research Center, 2400, Avenue d'Estimauville, Quebec, QC, G1E 7G9, Canada
| | - Gaston De Serres
- Department of Social and Preventive Medicine, Laval University, 1050, Avenue de la Médecine, Quebec, QC, G1V 0A6, Canada. .,CHU de Québec - Université Laval Research Center, 2400, Avenue d'Estimauville, Quebec, QC, G1E 7G9, Canada. .,Institut National de Santé Publique du Québec, 2400, Avenue d'Estimauville, Quebec, QC, G1E 7G9, Canada.
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14
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Seeking the optimal schedule for chickenpox vaccination in Canada: Using an agent-based model to explore the impact of dose timing, coverage and waning of immunity on disease outcomes. Vaccine 2020; 38:521-529. [DOI: 10.1016/j.vaccine.2019.10.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/06/2019] [Accepted: 10/23/2019] [Indexed: 11/23/2022]
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15
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Gastañaduy PA, Funk S, Lopman BA, Rota PA, Gambhir M, Grenfell B, Paul P. Factors Associated With Measles Transmission in the United States During the Postelimination Era. JAMA Pediatr 2020; 174:56-62. [PMID: 31738391 PMCID: PMC6865326 DOI: 10.1001/jamapediatrics.2019.4357] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Measles cases and outbreaks continue to occur in the United States after the introduction of measles from endemic settings. OBJECTIVE To discern the factors associated with measles transmission in the United States after measles had been eliminated. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted from January 1, 2001, to December 31, 2017, in the United States among US residents and international visitors with confirmed measles. A maximum likelihood algorithm that uses the observed dates of rash onset and the known distribution of the serial interval (time between symptom onset in related consecutive cases) was applied to outbreak notification data to estimate the effective reproduction number (R), or the mean number of new infections generated per case. Transmissibility was assessed by comparing R based on the characteristics of primary and secondary cases of measles. EXPOSURES Measles virus. MAIN OUTCOMES AND MEASURES Effective reproduction number (R), or the mean number of successful transmission events per case of measles (ie, the mean number of persons to whom each patient with measles spreads measles). RESULTS A total of 2218 individuals with confirmed measles cases (1025 female, 1176 male, and 17 sex not reported; median age, 15 years [range, 0-89 years]) reported from 2001 to 2017 were evaluated. Among patients who received no doses of measles vaccine, R was 0.76 (95% CI, 0.71-0.81); among patients who received 1 dose of measles vaccine, R was 0.17 (95% CI, 0.11-0.26); among patients who received 2 doses or more of measles vaccine, R was 0.27 (95% CI, 0.17-0.39); and among patients with unknown vaccination status, R was 0.52 (95% CI, 0.44-0.60). Among patients born before 1957, R was 0.35 (95% CI, 0.20-0.58), and among those born on or after 1957, R was 0.64 (95% CI, 0.61-0.68). R was higher when primary and secondary cases of measles were patients aged 5 to 17 years (0.36 [95% CI, 0.31-0.42]) compared with assortative transmission in other age groups (<1 year, 0.14 [95% CI, 0.10-0.20]; 1-4 years, 0.25 [95% CI, 0.20-0.30]; 18-29 years, 0.19 [95% CI, 0.15-0.24]; 30-49 years, 0.15 [95% CI, 0.11-0.20]; ≥50 years, 0.04 [95% CI, 0.01-0.10]). CONCLUSIONS AND RELEVANCE The findings of this study support having high targets for 2-dose measles vaccine coverage, particularly among school-aged children in the United States.
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Affiliation(s)
- Paul A. Gastañaduy
- Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sebastian Funk
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Paul A. Rota
- Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manoj Gambhir
- Epidemiological Modelling Unit, Monash University, Melbourne, Victoria, Australia,Health Modelling and Analytics Team, IBM Research Australia, Melbourne, Victoria, Australia
| | - Bryan Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey
| | - Prabasaj Paul
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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16
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Zahraei SM, Mokhtari-Azad T, Izadi S, Mohammadi M, Sabouri A. Seroprevalence of anti-rubella and anti-measles antibodies in women at the verge of marriage in Iran. Vaccine 2019; 38:235-241. [PMID: 31668816 DOI: 10.1016/j.vaccine.2019.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 10/09/2019] [Accepted: 10/09/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Measles and rubella as two highly contagious eruptive diseases are on the agenda to be eliminated in Iran by 2020. To evaluate the seroimmunity of the future mothers against rubella and measles, a nationwide serosurvey was implemented in 10 provinces, selected at random from 31 provinces in the country. METHODS using a multistage sampling method, 1600 participants were interviewed and blood sampled in 40 'Pre-marriage Consultation Centers' across 40 districts. Using ELISA method, the sera were tested for anti-rubella and anti-measles IgG antibodies in the National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. RESULTS Of the 1600 initial participants, the sera of 1573 participants were tested for rubella and 1569 for measles. The total seroprevalence of anti-rubella and anti-measles antibodies were 90.6% (95%CI: 89.1 to 92.0%) and 80.7% (95%CI: 78.7 to 82.6%) respectively. After 14 years, the effect of the immunization campaign of 2003 against rubella and measles on the age group of 5 to 25 years, was still apparent, i.e., there was a sharp difference between the seroprevalence of antibody (against both measles and rubella) of those who at the time of the present study were above 18 years with the younger age cohorts. For both diseases, higher seroprevalence of antibodies was detected in women above 18 years old. CONCLUSION Implementation of a Supplemental Immunization activity or revision of the national immunization schedule to add a third dose of measles and rubella containing vaccine during adolescence are/might be considered as possible options for bridging the gap in the seroimmunity of the younger age groups.
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Affiliation(s)
- Seyed Mohsen Zahraei
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Talat Mokhtari-Azad
- National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrokh Izadi
- Health Promotion Research Centre, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mahdi Mohammadi
- Health Promotion Research Centre, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Azam Sabouri
- Focal Point for Measles and Rubella Surveillance, Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
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17
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Javelle E, Colson P, Parola P, Raoult D. Measles, the need for a paradigm shift. Eur J Epidemiol 2019; 34:897-915. [DOI: 10.1007/s10654-019-00569-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/03/2019] [Indexed: 01/24/2023]
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18
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Effect of measles vaccination in infants younger than 9 months on the immune response to subsequent measles vaccine doses: a systematic review and meta-analysis. THE LANCET. INFECTIOUS DISEASES 2019; 19:1246-1254. [PMID: 31548081 PMCID: PMC6838663 DOI: 10.1016/s1473-3099(19)30396-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 04/20/2019] [Accepted: 06/13/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Vaccinating infants with a first dose of measles-containing vaccine (MCV1) before 9 months of age in high-risk settings has the potential to reduce measles-related morbidity and mortality. However, there is concern that early vaccination might blunt the immune response to subsequent measles vaccine doses. We systematically reviewed the available evidence on the effect of MCV1 administration to infants younger than 9 months on their immune responses to subsequent MCV doses. METHODS For this systematic review and meta-analysis, we searched for randomised and quasi-randomised controlled trials, outbreak investigations, and cohort and case-control studies without restriction on publication dates, in which MCV1 was administered to infants younger than 9 months. We did the literature search on June 2, 2015, and updated it on Jan 14, 2019. We included studies reporting data on strength or duration of humoral and cellular immune responses, and on vaccine efficacy or vaccine effectiveness after two-dose or three-dose MCV schedules. Our outcome measures were proportion of seropositive infants, geometric mean titre, vaccine efficacy, vaccine effectiveness, antibody avidity index, and T-cell stimulation index. We used random-effects meta-analysis to derive pooled estimates of the outcomes, where appropriate. We assessed the methodological quality of included studies using Grading of Recommendation Assessment, Development and Evaluation (GRADE) guidelines. FINDINGS Our search retrieved 1156 records and 85 were excluded due to duplication. 1071 records were screened for eligibility, of which 351 were eligible for full-text screening and 21 were eligible for inclusion in the review. From 13 studies, the pooled proportion of infants seropositive after two MCV doses, with MCV1 administered before 9 months of age, was 98% (95% CI 96-99; I2=79·8%, p<0·0001), which was not significantly different from seropositivity after a two-dose MCV schedule starting later (p=0·087). Only one of four studies found geometric mean titres after MCV2 administration to be significantly lower when MCV1 was administered before 9 months of age than at 9 months of age or later. There was insufficient evidence to determine an effect of age at MCV1 administration on antibody avidity. The pooled vaccine effectiveness estimate derived from two studies of a two-dose MCV schedule with MCV1 vaccination before 9 months of age was 95% (95% CI 89-100; I2=12·6%, p=0·29). Seven studies reporting on measles virus-specific cellular immune responses found that T-cell responses and T-cell memory were sustained, irrespective of the age of MCV1 administration. Overall, the quality of evidence was moderate to very low. INTERPRETATION Our findings suggest that administering MCV1 to infants younger than 9 months followed by additional MCV doses results in high seropositivity, vaccine effectiveness, and T-cell responses, which are independent of the age at MCV1, supporting the vaccination of very young infants in high-risk settings. However, we also found some evidence that MCV1 administered to infants younger than 9 months resulted in lower antibody titres after one or two subsequent doses of MCV than when measles vaccination is started at age 9 months or older. The clinical and public-health relevance of this immunity blunting effect are uncertain. FUNDING WHO.
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19
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Brinkman ID, de Wit J, Smits GP, ten Hulscher HI, Jongerius MC, Abreu TC, van der Klis FRM, Hahné SJM, Koopmans MPG, Rots NY, van Baarle D, van Binnendijk RS. Early Measles Vaccination During an Outbreak in the Netherlands: Short-Term and Long-Term Decreases in Antibody Responses Among Children Vaccinated Before 12 Months of Age. J Infect Dis 2019; 220:594-602. [PMID: 30972418 PMCID: PMC6639599 DOI: 10.1093/infdis/jiz159] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/03/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The majority of infants will not be protected by maternal antibodies until their first measles vaccination, between 12 and 15 months of age. This provides incentive to reduce the age at measles vaccination, but immunological consequences are insufficiently understood, and long-term effects are largely unknown. METHODS A total of 79 infants who received early measles vaccination between 6 and 12 months age and a second dose at 14 months of age were compared to 44 children in a control group who received 1 dose at 14 months of age. Measles virus-specific neutralizing antibody concentrations and avidity were determined up to 4 years of age. RESULTS Infants who first received measles vaccination before 12 months of age had a long-term decrease in the concentration and avidity of measles virus-specific neutralizing antibodies, compared with infants in the control group. For 11.1% of children with a first dose before 9 months of age, antibody levels at 4 years of age had dropped below the cutoff for clinical protection. CONCLUSIONS Early measles vaccination provides immediate protection in the majority of infants but yields a long-term decrease in neutralizing antibody responses, compared to vaccination at a later age. Additional vaccination at 14 months of age does not improve this. Over the long term, this may result in an increasing number of children susceptible to measles.
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Affiliation(s)
- Iris D Brinkman
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
- Department of Viroscience, Erasmus Medical Center, Rotterdam
| | - Jelle de Wit
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Gaby P Smits
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Hinke I ten Hulscher
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Maria C Jongerius
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Taymara C Abreu
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Fiona R M van der Klis
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Susan J M Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | | | - Nynke Y Rots
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Debbie van Baarle
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
- Laboratory of Translational Immunology, Department of Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Robert S van Binnendijk
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
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20
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Abstract
There is substantial variation between individuals in the immune response to vaccination. In this review, we provide an overview of the plethora of studies that have investigated factors that influence humoral and cellular vaccine responses in humans. These include intrinsic host factors (such as age, sex, genetics, and comorbidities), perinatal factors (such as gestational age, birth weight, feeding method, and maternal factors), and extrinsic factors (such as preexisting immunity, microbiota, infections, and antibiotics). Further, environmental factors (such as geographic location, season, family size, and toxins), behavioral factors (such as smoking, alcohol consumption, exercise, and sleep), and nutritional factors (such as body mass index, micronutrients, and enteropathy) also influence how individuals respond to vaccines. Moreover, vaccine factors (such as vaccine type, product, adjuvant, and dose) and administration factors (schedule, site, route, time of vaccination, and coadministered vaccines and other drugs) are also important. An understanding of all these factors and their impacts in the design of vaccine studies and decisions on vaccination schedules offers ways to improve vaccine immunogenicity and efficacy.
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21
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Post-immunisation fever and the antibody response to measles-containing vaccines. Epidemiol Infect 2018; 146:1584-1592. [DOI: 10.1017/s0950268818001474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractFever is a common adverse event following measles vaccination, more frequent among older children and those receiving Measles-Mumps-Rubella-Varicella vaccine vs. Measles-Mumps-Rubella vaccine, two factors associated with a better antibody response. However, the role of fever in the immunogenicity of measles-containing vaccines (MCV) is unclear. We performed a post-hoc pooled analysis of data of 5 216 11 to 22 month-old children receiving MCV from 2004 to 2012 in Europe and USA to evaluate the association between post-immunisation fever and antibody response, measured by geometric mean concentrations (GMCs). We further evaluated fever as an effect modifier or a mediator in the associations between the type of MCV or the age at first vaccination and vaccine immunogenicity. After the first dose, fever was associated with 60% higher GMCs (95% CI 1.51–1.68). For children vaccinated at ⩾12 months, the fever did not modify and minimally mediated (2% to 3%) the association between age and antibody response. Fever mediated 18% of the association between type of MCV and GMCs. In a model including fever, age and type of vaccine, fever was the strongest predictor of GMCs. These results suggest that fever is associated with a stronger measles antibody response independently of age and type of MCV.
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22
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Liu Y, Liu Z, Deng X, Hu Y, Wang Z, Lu P, Guo H, Sun X, Xu Y, Tang F, Zhu FC. Waning immunity of one-dose measles-mumps-rubella vaccine to mumps in children from kindergarten to early school age: a prospective study. Expert Rev Vaccines 2018; 17:445-452. [PMID: 29478347 DOI: 10.1080/14760584.2018.1445529] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND In China, one dose measles-mumps-rubella vaccine (MMR) was administered to children aged 18-24 months. The mumps incidence was still high. Data on the waning immunity to mumps after MMR vaccination are limited. This study aimed to describe the waning immunity to mumps in kindergarten and primary school children to provide a scientific basis for confirming an optimal age for a second dose. METHODS An observational, prospective study on one-dose MMR in children in kindergarten and primary school was conducted from 2015 to 2016. Waning immunity to mumps in terms of seropositivity and geometric antibody concentration (GMC) with time was analyzed. RESULTS In total, 7436 eligible subjects in kindergarten (3435) and primary school (4001) were included in 2015. The overall GMC (201.7 U/ml) and seropositivity (75.4%) to mumps antibodies in 2016 were significantly lower compared to those in 2015 (218.7 U/ml, 78.4%). Asymptomatic infection occurred within one year in 8.8% of children who received one-dose MMR. CONCLUSIONS Children who received one-dose MMR in kindergarten and primary school were at high risk of mumps infection, and waning immunity occurred with time. Determining the optimal age for the second dose of MMR in children should be prioritized to prevent mumps epidemics.
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Affiliation(s)
- Yuanbao Liu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Zhihao Liu
- b Department of Health education , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Xiuying Deng
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Ying Hu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Zhiguo Wang
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Peishan Lu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Hongxiong Guo
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Xiang Sun
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Yan Xu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Fenyang Tang
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Feng-Cai Zhu
- c Department of Vaccine Clinical Evaluation , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
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23
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Plachouri KM, Gkentzi D, Konstantinopoulou K, Leventelli S, Kiriakou G, Dimitriou G, Georgiou S. Re-emergence of measles: ongoing current outbreak in south-western Greece since December 2017 and onwards. Infect Dis (Lond) 2018; 50:640-642. [PMID: 29484907 DOI: 10.1080/23744235.2018.1445282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
| | - Despoina Gkentzi
- b Department of Paediatrics , University General Hospital of Patras , Patras , Greece
| | | | - Sofia Leventelli
- b Department of Paediatrics , University General Hospital of Patras , Patras , Greece
| | - Georgia Kiriakou
- a Department of Dermatology , University General Hospital of Patras , Patras , Greece
| | - Gabriel Dimitriou
- b Department of Paediatrics , University General Hospital of Patras , Patras , Greece
| | - Sofia Georgiou
- a Department of Dermatology , University General Hospital of Patras , Patras , Greece
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