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Sun Y, Wang Q, Wang X, Wu S, Zhang Y, Pan Y, Zhang L, Duan W, Ma C, Yang P, Wei Z. Interruption of influenza transmission under public health emergency response for COVID-19 based on real-world data, Beijing, China. Jpn J Infect Dis 2022; 75:511-518. [PMID: 35650036 DOI: 10.7883/yoken.jjid.2021.786] [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: 11/17/2022]
Abstract
To estimate effect of COVID-19 control measures taken to mitigate community transmission in many regions, we analyzed data based on influenza surveillance system in Beijing from week 27th, 2014 to week 26th, 2020. We collected weekly number of influenza-like illness (ILI), weekly positive proportion of ILI and weekly ILI proportion in outpatients and the date of COVID-19 measures. We compared influenza activity indicators of season 2019/2020 with preceding five seasons and built two ARIMAX models to estimate the effective of COVID-19 measures which emergency response declared since 24th January 2020. Based on observed data, compared with preceding five influenza seasons, ILIs, positive proportion of ILI, and duration of influenza epidemic period in season 2019/2020 decreased from 13% to 54%, especially, the number of weeks from the peak to the end of influenza epidemic period, decreased from 12 to one. Based ARIMAX model forecasting, after natural decline considered, weekly ILIs decreased by 48.6% and weekly positive proportion dropped 15% in the second week after emergency response declared, and finally COVID-19 measures reduced 83%. We conclude public health emergency response can interrupt the transmission of influenza markedly.
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Affiliation(s)
- Ying Sun
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), China.,Department of National Immunization Program, Chinese Center for Disease Control and Prevention, China
| | - Quanyi Wang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), China
| | - Xiaoli Wang
- Office of Beijing Center for Global Health, Beijing Center for Diseases Prevention and Control (CDC), China
| | - Shuangsheng Wu
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), China
| | - Yi Zhang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), China
| | - Yang Pan
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), China
| | - Li Zhang
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), China
| | - Wei Duan
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), China
| | - Chuanna Ma
- Institute for Infectious Diseases and Endemic Diseases Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), China
| | - Peng Yang
- Office of Beijing Center for Global Health, Beijing Center for Diseases Prevention and Control (CDC), China.,School of Public Health, Capital Medical University, China
| | - Zaihua Wei
- School of Public Health, Capital Medical University, China.,Information Statistics Center, Beijing Center for Diseases Prevention and Control, China
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2
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Cimica V, Galarza JM, Rashid S, Stedman TT. Current development of Zika virus vaccines with special emphasis on virus-like particle technology. Expert Rev Vaccines 2021; 20:1483-1498. [PMID: 34148481 DOI: 10.1080/14760584.2021.1945447] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Zika virus disease received little attention until its recent explosive emergence around the globe. The devastating consequences of this pandemic include congenital Zika syndrome (CZS) and the neurological autoimmune disorder Guillain-Barré syndrome. These potential outcomes prompted massive efforts to understand the course of Zika infection and to develop therapeutic and prophylactic strategies for treatment and prevention of disease.Area covered: Preclinical and clinical data demonstrate that a safe and efficacious vaccine for protection against Zika virus infection is possible in the near future. Nevertheless, significant knowledge gaps regarding the outcome of a mass vaccination strategy exist and must be addressed. Zika virus circulates in flavivirus-endemic regions, an ideal Zika vaccine should avoid the potential of antibody-dependent enhancement from exposure to dengue virus. Prevention of CZS is the primary goal for immunization, and the vaccine must provide protection against intrauterine transmission for use during pregnancy and in women of childbearing age. Ideally, a vaccine should also prevent sexual transmission of the virus through mucosal protection.Expert opinion: This review describes current vaccine approaches against Zika virus with particular attention to the application of virus-like particle (VLP) technology as a strategy for solving the challenges of Zika virus immunization.
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Affiliation(s)
- Velasco Cimica
- American Type Culture Collection (ATCC), Manassas, VA, USA
| | | | - Sujatha Rashid
- American Type Culture Collection (ATCC), Manassas, VA, USA
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3
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Trombetta CM, Gianchecchi E, Montomoli E. Influenza vaccines: Evaluation of the safety profile. Hum Vaccin Immunother 2018; 14:657-670. [PMID: 29297746 PMCID: PMC5861790 DOI: 10.1080/21645515.2017.1423153] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/30/2017] [Accepted: 12/23/2017] [Indexed: 12/15/2022] Open
Abstract
The safety of vaccines is a critical factor in maintaining public trust in national vaccination programs. Vaccines are recommended for children, adults and elderly subjects and have to meet higher safety standards, since they are administered to healthy subjects, mainly healthy children. Although vaccines are strictly monitored before authorization, the possibility of adverse events and/or rare adverse events cannot be totally eliminated. Two main types of influenza vaccines are currently available: parenteral inactivated influenza vaccines and intranasal live attenuated vaccines. Both display a good safety profile in adults and children. However, they can cause adverse events and/or rare adverse events, some of which are more prevalent in children, while others with a higher prevalence in adults. The aim of this review is to provide an overview of influenza vaccine safety according to target groups, vaccine types and production methods.
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Affiliation(s)
| | | | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
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4
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Nilsson L, Brockow K, Alm J, Cardona V, Caubet JC, Gomes E, Jenmalm MC, Lau S, Netterlid E, Schwarze J, Sheikh A, Storsaeter J, Skevaki C, Terreehorst I, Zanoni G. Vaccination and allergy: EAACI position paper, practical aspects. Pediatr Allergy Immunol 2017; 28:628-640. [PMID: 28779496 DOI: 10.1111/pai.12762] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/15/2023]
Abstract
Immunization is highly effective in preventing infectious diseases and therefore an indispensable public health measure. Allergic patients deserve access to the same publicly recommended immunizations as non-allergic patients unless risks associated with vaccination outweigh the gains. Whereas the number of reported possible allergic reactions to vaccines is high, confirmed vaccine-triggered allergic reactions are rare. Anaphylaxis following vaccination is rare, affecting <1/100 000, but can occur in any patient. Some patient groups, notably those with a previous allergic reaction to a vaccine or its components, are at heightened risk of allergic reaction and require special precautions. Allergic reactions, however, may occur in patients without known risk factors and cannot be predicted by currently available tools. Unwarranted fear and uncertainty can result in incomplete vaccination coverage for children and adults with or without allergy. In addition to concerns about an allergic reaction to the vaccine itself, there is fear that routine childhood immunization may promote the development of allergic sensitization and disease. Thus, although there is no evidence that routine childhood immunization increases the risk of allergy development, such risks need to be discussed.
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Affiliation(s)
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
| | - Johan Alm
- Sachs' Children and Youth Hospital and Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | - Maria C Jenmalm
- Unit of Autoimmunity and Immune Regulation, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Susanne Lau
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany
| | - Eva Netterlid
- Department of Occupational and Environmental Dermatology, Lund University, Malmö, Sweden.,The Public Health Agency of Sweden, Stockholm, Sweden
| | - Jürgen Schwarze
- Child Life & Health and MRC-Centre for Inflammation Research, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | | | - Chrysanthi Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen and Marburg GmbH, Marburg, Germany
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5
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Cimica V, Galarza JM. Adjuvant formulations for virus-like particle (VLP) based vaccines. Clin Immunol 2017; 183:99-108. [PMID: 28780375 DOI: 10.1016/j.clim.2017.08.004] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/11/2017] [Accepted: 08/01/2017] [Indexed: 12/13/2022]
Abstract
The development of virus-like particle (VLP) technology has had an enormous impact on modern vaccinology. In order to optimize the efficacy and safety of VLP-based vaccines, adjuvants are included in most vaccine formulations. To date, most licensed VLP-based vaccines utilize the classic aluminum adjuvant compositions. Certain challenging pathogens and weak immune responder subjects may require further optimization of the adjuvant formulation to maximize the magnitude and duration of the protective immunity. Indeed, novel classes of adjuvants such as liposomes, agonists of pathogen recognition receptors, polymeric particles, emulsions, cytokines and bacterial toxins, can be used to further improve the immunostimulatory activity of a VLP-based vaccine. This review describes the current advances in adjuvant technology for VLP-based vaccines directed at viral diseases, and discusses the basic principles for designing adjuvant formulations for enhancing the vaccine immunogenicity.
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Affiliation(s)
- Velasco Cimica
- TechnoVax, Inc., 765 Old Saw Mill River Road, Tarrytown, NY 10591, United States
| | - Jose M Galarza
- TechnoVax, Inc., 765 Old Saw Mill River Road, Tarrytown, NY 10591, United States.
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6
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Wang L, Chang TZ, He Y, Kim JR, Wang S, Mohan T, Berman Z, Tompkins SM, Tripp RA, Compans RW, Champion JA, Wang BZ. Coated protein nanoclusters from influenza H7N9 HA are highly immunogenic and induce robust protective immunity. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2017; 13:253-262. [PMID: 27622321 PMCID: PMC5237404 DOI: 10.1016/j.nano.2016.09.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 08/05/2016] [Accepted: 09/01/2016] [Indexed: 01/08/2023]
Abstract
Recurring influenza viruses pose an annual threat to public health. A time-saving, cost-effective and egg-independent influenza vaccine approach is important particularly when responding to an emerging pandemic. We fabricated coated, two-layer protein nanoclusters from recombinant trimeric hemagglutinin from an avian-origin H7N9 influenza A virus as an approach for vaccine development in response to an emerging pandemic. Assessment of the virus-specific immune responses and protective efficacy in mice immunized with the nanoclusters demonstrated that the vaccine candidates were highly immunogenic, able to induce protective immunity and long-lasting humoral antibody responses to this virus without the use of adjuvants. Because the advantages of the highly immunogenic coated nanoclusters also include rapid productions in an egg-independent system, this approach has great potential for influenza vaccine production not only in response to an emerging pandemic, but also as a replacement for conventional seasonal influenza vaccines.
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Affiliation(s)
- Li Wang
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Timothy Z Chang
- Georgia Institute of Technology, School of Chemical & Biomolecular Engineering, Atlanta, GA, USA.
| | - Yuan He
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Jong R Kim
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Shelly Wang
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Teena Mohan
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA; Center for Inflammation, Immunity & Infection, Georgia State University Institute for Biomedical Sciences, Atlanta, GA, USA.
| | - Zachary Berman
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA; Center for Inflammation, Immunity & Infection, Georgia State University Institute for Biomedical Sciences, Atlanta, GA, USA.
| | - S Mark Tompkins
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA.
| | - Ralph A Tripp
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA.
| | - Richard W Compans
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Julie A Champion
- Georgia Institute of Technology, School of Chemical & Biomolecular Engineering, Atlanta, GA, USA.
| | - Bao-Zhong Wang
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA; Center for Inflammation, Immunity & Infection, Georgia State University Institute for Biomedical Sciences, Atlanta, GA, USA.
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7
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Dreskin SC, Halsey NA, Kelso JM, Wood RA, Hummell DS, Edwards KM, Caubet JC, Engler RJM, Gold MS, Ponvert C, Demoly P, Sanchez-Borges M, Muraro A, Li JT, Rottem M, Rosenwasser LJ. International Consensus (ICON): allergic reactions to vaccines. World Allergy Organ J 2016; 9:32. [PMID: 27679682 PMCID: PMC5026780 DOI: 10.1186/s40413-016-0120-5] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 08/10/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Routine immunization, one of the most effective public health interventions, has effectively reduced death and morbidity due to a variety of infectious diseases. However, allergic reactions to vaccines occur very rarely and can be life threatening. Given the large numbers of vaccines administered worldwide, there is a need for an international consensus regarding the evaluation and management of allergic reactions to vaccines. METHODS Following a review of the literature, and with the active participation of representatives from the World Allergy Organization (WAO), the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma, and Immunology (AAAAI), and the American College of Allergy, Asthma, and Immunology (ACAAI), the final committee was formed with the purpose of having members who represented a wide-range of countries, had previously worked on vaccine safety, and included both allergist/immunologists as well as vaccinologists. RESULTS Consensus was reached on a variety of topics, including: definition of immediate allergic reactions, including anaphylaxis, approaches to distinguish association from causality, approaches to patients with a history of an allergic reaction to a previous vaccine, and approaches to patients with a history of an allergic reaction to components of vaccines. CONCLUSIONS This document provides comprehensive and internationally accepted guidelines and access to on-line documents to help practitioners around the world identify allergic reactions following immunization. It also provides a framework for the evaluation and further management of patients who present either following an allergic reaction to a vaccine or with a history of allergy to a component of vaccines.
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Affiliation(s)
- Stephen C. Dreskin
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado Denver School of Medicine, Aurora, CO USA
| | - Neal A. Halsey
- Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - John M. Kelso
- Division of Allergy, Asthma, and Immunology, Scripps Clinic, San Diego, CA USA
| | - Robert A. Wood
- The Division of Pediatric Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Donna S. Hummell
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN USA
| | - Kathryn M. Edwards
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN USA
| | - Jean-Christoph Caubet
- Department of Pediatrics, University Hospitals of Geneva and Medical School, University of Geneva, Geneva, Switzerland
| | - Renata J. M. Engler
- Department of Medicine and Pediatrics, Uniformed Services University of the Health Sciences, Allergy-Immunology-Immunization, Walter Reed National Military Medical Center, Bethesda, MD USA
| | - Michael S. Gold
- Disipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia Australia
| | - Claude Ponvert
- Department Paediatrics, Pulmonology and Allergy service, Necker-Enfants Malades Hospital, 149 rue de Sèvres, 75015 Paris, France
| | - Pascal Demoly
- Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve - University Hospital of Montpellier, 34295 Montpellier cedex 05 – FRANCE and Sorbonne Universités, UPMC Paris 06, UMR-S 1136 INSERM, IPLESP, Equipe EPAR, 75013 Paris, France
| | - Mario Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela
| | - Antonella Muraro
- Food Allergy Referral Centre Department of Women and Child health, University of Padua, Padua, Italy
| | - James T. Li
- Division of Allergic Diseases, Mayo Clinic, Rochester, MN USA
| | - Menachem Rottem
- Allergy Asthma and Immunology, Emek Medical Center, Afula, and the Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - Lanny J. Rosenwasser
- Allergy-Immunology Division, Children’s Mercy Hospital and the University of Missouri-Kansas City School of Medicine, Kansas City, MO USA
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8
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Turner PJ, Southern J, Andrews NJ, Miller E, Erlewyn-Lajeunesse M. Safety of live attenuated influenza vaccine in young people with egg allergy: multicentre prospective cohort study. BMJ 2015; 351:h6291. [PMID: 26645895 PMCID: PMC4673102 DOI: 10.1136/bmj.h6291] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
STUDY QUESTION How safe is live attenuated influenza vaccine (LAIV), which contains egg protein, in young people with egg allergy? METHODS In this open label, phase IV intervention study, 779 young people (2-18 years) with egg allergy were recruited from 30 UK allergy centres and immunised with LAIV. The cohort included 270 (34.7%) young people with previous anaphylaxis to egg, of whom 157 (20.1%) had experienced respiratory and/or cardiovascular symptoms. 445 (57.1%) had doctor diagnosed asthma or recurrent wheeze. Participants were observed for at least 30 minutes after vaccination and followed-up by telephone 72 hours later. Participants with a history of recurrent wheeze or asthma underwent further follow-up four weeks later. The main outcome measure was incidence of an adverse event within two hours of vaccination in young people with egg allergy. STUDY ANSWER AND LIMITATIONS No systemic allergic reactions occurred (upper 95% confidence interval for population 0.47% and in participants with anaphylaxis to egg 1.36%). Nine participants (1.2%, 95% CI 0.5% to 2.2%) experienced mild symptoms, potentially consistent with a local, IgE mediated allergic reaction. Delayed events potentially related to the vaccine were reported in 221 participants. 62 participants (8.1%, 95% CI for population 6.3% to 10.3%) experienced lower respiratory tract symptoms within 72 hours, including 29 with parent reported wheeze. No participants were admitted to hospital. No increase in lower respiratory tract symptoms occurred in the four weeks after vaccination (assessed with asthma control test). The study cohort may represent young people with more severe allergy requiring specialist input, since they were recruited from secondary and tertiary allergy centres. WHAT THIS STUDY ADDS LAIV is associated with a low risk of systemic allergic reactions in young people with egg allergy. The vaccine seems to be well tolerated in those with well controlled asthma or recurrent wheeze. FUNDING, COMPETING INTERESTS, DATA SHARING This report is independent research commissioned and funded by a Department of Health policy research programme grant to the National Vaccine Evaluation Consortium. Additional funding was provided by the NIHR Clinical Research Networks, Health Protection Scotland (Edinburgh site), and Health & Social Care Services in Northern Ireland (Belfast site). PJT and MEL had support from the Department of Health for the submitted work; PJT has received research grants from the Medical Research Council and NIHR. No additional data available.Study registration ClinicalTrials.gov (NCT02111512) and the EU Clinical Trials Register EudraCT (2014-001537-92).
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Affiliation(s)
- Paul J Turner
- Section of Paediatrics, Imperial College London, London W2 1PG, UK Immunisation Hepatitis and Blood Safety Department, Public Health England, London, UK
| | - Jo Southern
- Immunisation Hepatitis and Blood Safety Department, Public Health England, London, UK
| | - Nick J Andrews
- Immunisation Hepatitis and Blood Safety Department, Public Health England, London, UK
| | - Elizabeth Miller
- Immunisation Hepatitis and Blood Safety Department, Public Health England, London, UK
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9
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Abstract
Nanoscale engineering is revolutionizing the way we prevent, detect, and treat diseases. Viruses have played a special role in these developments because they can function as prefabricated nanoscaffolds that have unique properties and are easily modified. The interiors of virus particles can encapsulate and protect sensitive compounds, while the exteriors can be altered to display large and small molecules in precisely defined arrays. These properties of viruses, along with their innate biocompatibility, have led to their development as actively targeted drug delivery systems that expand on and improve current pharmaceutical options. Viruses are naturally immunogenic, and antigens displayed on their surface have been used to create vaccines against pathogens and to break self-tolerance to initiate an immune response to dysfunctional proteins. Densely and specifically aligned imaging agents on viruses have allowed for high-resolution and noninvasive visualization tools to detect and treat diseases earlier than previously possible. These and future applications of viruses have created an exciting new field within the disciplines of both nanotechnology and medicine.
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Affiliation(s)
| | | | - Marianne Manchester
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California 92093
| | - Nicole F Steinmetz
- Departments of 2Biomedical Engineering
- Radiology
- Materials Science and Engineering, and
- Macromolecular Science and Engineering, Case Western Reserve University, Schools of Medicine and Engineering, Cleveland, Ohio 44106;
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10
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Aung AK, Trubiano JA, Spelman DW. Travel risk assessment, advice and vaccinations in immunocompromised travellers (HIV, solid organ transplant and haematopoeitic stem cell transplant recipients): A review. Travel Med Infect Dis 2014; 13:31-47. [PMID: 25593039 DOI: 10.1016/j.tmaid.2014.12.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 12/17/2014] [Accepted: 12/19/2014] [Indexed: 12/19/2022]
Abstract
International travellers with immunocompromising conditions such as human immunodeficiency virus (HIV) infection, solid organ transplantation (SOT) and haematopoietic stem cell transplantation (HSCT) are at a significant risk of travel-related illnesses from both communicable and non-communicable diseases, depending on the intensity of underlying immune dysfunction, travel destinations and activities. In addition, the choice of travel vaccinations, timing and protective antibody responses are also highly dependent on the underlying conditions and thus pose significant challenges to the health-care providers who are involved in pre-travel risk assessment. This review article provides a framework of understanding and approach to aforementioned groups of immunocompromised travellers regarding pre-travel risk assessment and management; in particular travel vaccinations, infectious and non-infectious disease risks and provision of condition-specific advice; to reduce travel-related mortality and morbidity.
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Affiliation(s)
- A K Aung
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.
| | - J A Trubiano
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Microbiology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - D W Spelman
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Microbiology, The Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia
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11
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Kang JH. Effectiveness and safety of seasonal influenza vaccination in children with underlying respiratory diseases and allergy. KOREAN JOURNAL OF PEDIATRICS 2014; 57:164-70. [PMID: 24868213 PMCID: PMC4030117 DOI: 10.3345/kjp.2014.57.4.164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 02/22/2014] [Indexed: 12/01/2022]
Abstract
Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.
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Affiliation(s)
- Jin-Han Kang
- Department of Pediatrics, Seoul St. Mary's Hospital, Vaccine Bio Research Institute, The Catholic University of Korea College of Medicine, Seoul, Korea
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12
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Ojha RP, Jackson BE, Tota JE, Offutt-Powell TN, Singh KP, Bae S. Guillain-Barre syndrome following quadrivalent human papillomavirus vaccination among vaccine-eligible individuals in the United States. Hum Vaccin Immunother 2013; 10:232-7. [PMID: 24013368 DOI: 10.4161/hv.26292] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Post-marketing surveillance studies provide conflicting evidence about whether Guillain-Barre syndrome occurs more frequently following quadrivalent human papillomavirus (HPV4) vaccination. We aimed to assess whether Guillain-Barre syndrome is reported more frequently following HPV4 vaccination than other vaccinations among females and males aged 9 to 26 y in the United States. We used adverse event reports received by the United States Vaccine Adverse Event Reporting System (VAERS) between January 1, 2010 and December 31, 2012 to estimate overall, age-, and sex-specific proportional reporting ratios (PRRs) and corresponding Χ2 values for reports of Guillain-Barre syndrome between 5 and 42 d following HPV vaccination. Minimum criteria for a signal using this approach are 3 or more cases, PRR≥2, and Χ2≥4. Guillain-Barre syndrome was listed as an adverse event in 45 of 14,822 reports, of which 9 reports followed HPV4 vaccination and 36 reports followed all other vaccines. The overall, age-, and sex-specific PRR estimates were uniformly below 1. In addition, the overall, age-, and sex-specific Χ2 values were uniformly below 3. Our analysis of post-marketing surveillance data does not suggest that Guillain-Barre syndrome is reported more frequently following HPV4 vaccination than other vaccinations among vaccine-eligible females or males in the United States. Our findings may be useful when discussing the risks and benefits of HPV4 vaccination.
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Affiliation(s)
- Rohit P Ojha
- Department of Epidemiology and Cancer Control; St. Jude Children's Research Hospital; Memphis, TN USA
| | - Bradford E Jackson
- Division of Preventive Medicine; Department of Medicine; University of Alabama at Birmingham; Birmingham, AL USA
| | - Joseph E Tota
- Division of Cancer Epidemiology; Department of Epidemiology; Biostatistics, and Occupational Health; McGill University; Montreal, QC Canada
| | - Tabatha N Offutt-Powell
- Office of Infectious Disease Epidemiology; Delaware Health and Social Services; Dover, DE USA
| | - Karan P Singh
- Division of Preventive Medicine; Department of Medicine; University of Alabama at Birmingham; Birmingham, AL USA
| | - Sejong Bae
- Division of Preventive Medicine; Department of Medicine; University of Alabama at Birmingham; Birmingham, AL USA
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13
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Abstract
Despite ample evidence for the great burden that annual influenza epidemics place on children and society in general, few European countries currently recommend influenza vaccination of healthy children of any age. The most frequently cited reasons for reluctance to extend general vaccine recommendations to children include the view that influenza is a mild illness of limited clinical importance, lack of country-specific data on disease burden, uncertainty about the efficacy and safety of influenza vaccines in children and inadequate evidence of cost-effectiveness of vaccinating children. In recent years, several clinical studies have provided new and important information that help address many of these areas of question and concern. In light of this newly available scientific evidence, influenza vaccine recommendations for children should be properly reevaluated in all European countries. Furthermore, to allow for variation in costs and patterns of healthcare delivery between different countries, cost-effectiveness analyses of influenza vaccination of healthy children should be performed in each country or region. Finally, increased efforts should be made to educate both healthcare professionals and the great public about recent findings and advances in the field of pediatric influenza.
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Orlicka K, Barnes E, Culver EL. Prevention of infection caused by immunosuppressive drugs in gastroenterology. Ther Adv Chronic Dis 2013; 4:167-85. [PMID: 23819020 PMCID: PMC3697844 DOI: 10.1177/2040622313485275] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Immunosuppressive therapy is frequently used to treat gastrointestinal diseases such as inflammatory bowel disease, autoimmune hepatitis, IgG4-related disease (autoimmune pancreatitis and sclerosing cholangitis) and in the post-transplantation setting. These drugs interfere with the immune system. The main safety concern with their use is the risk of infections. Certain infections can be prevented or their impact minimized. Physicians must adopt preventative strategies and should have a high degree of suspicion to recognize infections early and treat appropriately. This article reviews the risk factors for infections, the mechanism of action of immunosuppressive therapy and proposes preventive strategies.
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Affiliation(s)
- Katarzyna Orlicka
- Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
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