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Wanyoike S, Ramirez Gonzalez A, Dolan SB, Garon J, Veira CL, Hampton LM, Chang Blanc D, Patel MM. Disposing of Excess Vaccines After the Withdrawal of Oral Polio Vaccine. J Infect Dis 2017; 216:S202-S208. [PMID: 28838168 PMCID: PMC5853297 DOI: 10.1093/infdis/jiw572] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Until recently, waste management for national immunization programs was limited to sharps waste, empty vaccine vials, or vaccines that had expired or were no longer usable. However, because wild-type 2 poliovirus has been eradicated, the World Health Organization's (WHO's) Strategic Advisory Group of Experts on Immunization deemed that all countries must simultaneously cease use of the type 2 oral polio vaccine and recommended that all countries and territories using oral polio vaccine (OPV) "switch" from trivalent OPV (tOPV; types 1, 2, and 3 polioviruses) to bivalent OPV (bOPV; types 1 and 3 polioviruses) during a 2-week period in April 2016. Use of tOPV after the switch would risk outbreaks of paralysis related to type 2-circulating vaccine-derived poliovirus (cVDPV2). To minimize risk of vaccine-derived polio countries using OPV were asked to dispose of all usable, unexpired tOPV after the switch to bOPV. In this paper, we review the rationale for tOPV disposal and describe the global guidelines provided to countries for the safe and appropriate disposal of tOPV. These guidelines gave countries flexibility in implementing this important task within the confines of their national regulations, capacities, and resources. Steps for appropriate disposal of tOPV included removal of all tOPV vials from the cold chain, placement in appropriate bags or containers, and disposal using a recommended approach (ie, autoclaving, boiling, chemical inactivation, incineration, or encapsulation) followed by burial or transportation to a designated waste facility. This experience with disposal of tOPV highlights the adaptability of national immunization programs to new procedures, and identifies gaps in waste management policies and strategies with regard to disposal of unused vaccines. The experience also provides a framework for future policies and for developing programmatic guidance for the ultimate disposal of all OPV after the eradication of polio.
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Affiliation(s)
| | | | - Samantha B Dolan
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention
| | - Julie Garon
- Division of Infectious Diseases, Emory University School of Medicine
- Task Force for Global Health, Atlanta, Georgia
| | | | - Lee M Hampton
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention
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Akbar SMF, Al-Mahtab M, Khan SI, Shrestha A, Tabassum S, Hiasa Y. Current trends in hepatitis B vaccination. Future Virol 2016. [DOI: 10.2217/fvl-2016-0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
One of the major successes in the area of vaccinology is the emergence, development and usage of hepatitis B vaccine (a prophylactic vaccine against HBV). Hepatitis B vaccine has protected millions of individuals from acquiring HBV infection and has prevented liver cancer in the majority of vaccinated subjects. Although initially designed as prophylactic vaccines, accumulative evidence has shown that these vaccines may also be used to treat patients with chronic hepatitis B. At present, there are two main areas of discussion in hepatitis B vaccination; development of more effective prophylactic hepatitis B vaccine that can provide protection to all vaccine recipients, and designing hepatitis B-based therapeutic vaccines for treatment of chronic hepatitis B patients.
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Affiliation(s)
- Sheikh MF Akbar
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - Mamun Al-Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sakirul I Khan
- Department of Anatomy & Embryology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ananta Shrestha
- Department of Hepatology, The Liver Clinic, Liver Foundation, Nepal
| | - Shahina Tabassum
- Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Yoichi Hiasa
- Department of Gastroenterology & Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
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Development of a custom pentaplex sandwich immunoassay using Protein-G coupled beads for the Luminex® xMAP® platform. J Immunol Methods 2016; 433:6-16. [PMID: 26921630 DOI: 10.1016/j.jim.2016.02.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/09/2016] [Accepted: 02/22/2016] [Indexed: 11/20/2022]
Abstract
Multiplex bead-based assays have many advantages over ELISA, particularly for the analyses of large quantities of samples and/or precious samples of limited volume. Although many commercial arrays covering multitudes of biologically significant analytes are available, occasionally the development of custom arrays is necessary. Here, the development of a custom pentaplex sandwich immunoassay using Protein G-coupled beads, for analysis using the Luminex® xMAP® platform, is described. This array was required for the measurement of candidate biomarkers of vaccine safety in small volumes of mouse sera. Optimisation of this assay required a stepwise approach: testing cross-reactivity of the antibody pairs, the development of an in-house serum diluent buffer as well as heat-inactivation of serum samples to prevent interference from matrix effects. We then demonstrate the use of this array to analyse inflammatory mediators in mouse serum after immunisation. The work described here exemplifies how Protein G-coupled beads offer a flexible and robust approach to develop custom multiplex immunoassays, which can be applied to a range of analytes from multiple species.
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Hwang TJ, Kesselheim AS. Vaccine Pipeline Has Grown During The Past Two Decades With More Early-Stage Trials From Small And Medium-Size Companies. Health Aff (Millwood) 2016; 35:219-26. [DOI: 10.1377/hlthaff.2015.1073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Thomas J. Hwang
- Thomas J. Hwang is a venture capitalist at Bain Capital, in Boston, Massachusetts
| | - Aaron S. Kesselheim
- Aaron S. Kesselheim (
) is an associate professor of medicine at Harvard Medical School, in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, in Boston
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Desai SN, Kamat D. Closing the global immunization gap: delivery of lifesaving vaccines through innovation and technology. Pediatr Rev 2014; 35:e32-40. [PMID: 24986933 DOI: 10.1542/pir.35-7-e32] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
One of every 5 children does not receive basic vaccines because of concerns related to storage and delivery in resource limited countries. Transporting vaccines over long distances in extreme temperatures is a common challenge. Issues that involve production and formulation, delivery technologies, cold chain logistics, and safety factors need to be addressed to properly adapt vaccines to resource constrained settings. Current successful field interventions include United Nation Children's Fund cold boxes, which are used to store and distribute vaccine in disaster struck areas, and vaccine vial monitors, which allow health workers to gauge whether vaccine is still usable in areas with unreliable electricity and refrigeration. This review aims to provide a general overview of innovative approaches and technologies that positively affect vaccine coverage and save more lives.
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Affiliation(s)
| | - Deepak Kamat
- Department of Pediatrics, Wayne State University, and Children's Hospital of Michigan, Detroit, MI
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6
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Kaljee LM, Pach A, Thriemer K, Ley B, Jiddawi M, Puri M, Ochiai L, Wierzba T, Clemens J, Ali SM. Desirability for a typhoid fever vaccine among rural residents, Pemba Island, Tanzania. Vaccine 2013; 31:2994-9. [DOI: 10.1016/j.vaccine.2013.04.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/28/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022]
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Nossal GJV. Immunology and world health: key contributions from the global community. Ann N Y Acad Sci 2013; 1283:1-7. [PMID: 23387415 DOI: 10.1111/nyas.12035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The contributions of immunology to world health must be seen in the context of the severe disadvantage prevailing in many countries. Low life expectancy, high infant and maternal mortality rates, and continued prevalence of infections as causes of preventable deaths highlight what vaccines can do to improve the situation. This paper will briefly review some major new international health programs, including the GAVI Alliance; the Global Polio Eradication Initiative; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the President's Emergency Plan for AIDS Relief; and the Global Malaria Action Plan. It will also outline the state of research progress for vaccines that are not yet licensed but that, in many cases, appear within reach. Of course, vaccines are not the be-all and the end-all of global health, so brief reference will be made to nutrition, vector biology and control, and the emergence of noncommunicable diseases as threats.
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Affiliation(s)
- G J V Nossal
- Department of Pathology, The University of Melbourne, Melbourne, VIC, Australia.
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Maiden MCJ, Frosch M. Can we, should we, eradicate the meningococcus? Vaccine 2012; 30 Suppl 2:B52-6. [PMID: 22607899 PMCID: PMC3366072 DOI: 10.1016/j.vaccine.2011.12.068] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 12/13/2011] [Accepted: 12/13/2011] [Indexed: 12/28/2022]
Abstract
The eradication of infectious agents is an attractive means of disease control that, to date, has been achieved for only one human pathogen, the smallpox virus. The introduction of vaccines against Neisseria meningitidis into immunisation schedules, and particularly the conjugate polysaccharide vaccines which can interrupt transmission, raises the question of whether disease caused by this obligate human bacterium can be controlled, eliminated, or even eradicated. The limited number of meningococcal serogroups, lack of an animal reservoir, and importance of meningococcal disease are considerations in favour of eradication; however, the commensal nature of most infections, the high diversity of meningococcal populations, and the lack of comprehensive vaccines are all factors that suggest that this is not feasible. Indeed, any such attempt might be harmful by perturbing the human microbiome and its interaction with the immune system. On balance, the control and possible elimination of disease caused by particular disease-associated meningococcal genotypes is a more achievable and worthwhile goal.
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Affiliation(s)
- Martin C J Maiden
- Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, United Kingdom.
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Licciardi PV, Toh ZQ, Dunne E, Wong SS, Mulholland EK, Tang M, Robins-Browne RM, Satzke C. Protecting against pneumococcal disease: critical interactions between probiotics and the airway microbiome. PLoS Pathog 2012; 8:e1002652. [PMID: 22685396 PMCID: PMC3369940 DOI: 10.1371/journal.ppat.1002652] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Paul V Licciardi
- Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia.
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Greenwood B, Salisbury D, Hill AVS. Vaccines and global health. Philos Trans R Soc Lond B Biol Sci 2011; 366:2733-42. [PMID: 21893534 DOI: 10.1098/rstb.2011.0076] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vaccines have made a major contribution to global health in recent decades but they could do much more. In November 2011, a Royal Society discussion meeting, 'New vaccines for global health', was held in London to discuss the past contribution of vaccines to global health and to consider what more could be expected in the future. Papers presented at the meeting reviewed recent successes in the deployment of vaccines against major infections of childhood and the challenges faced in developing vaccines against some of the world's remaining major infectious diseases such as human immunodeficiency virus (HIV), malaria and tuberculosis. The important contribution that development of more effective veterinary vaccines could make to global health was also addressed. Some of the social and financial challenges to the development and deployment of new vaccines were reviewed. The latter issues were also discussed at a subsequent satellite meeting, 'Accelerating vaccine development', held at the Kavli Royal Society International Centre. Delegates at this meeting considered challenges to the more rapid development and deployment of both human and veterinary vaccines and how these might be addressed. Papers based on presentations at the discussion meeting and a summary of the main conclusions of the satellite meeting are included in this issue of Philosophical Transactions of the Royal Society B.
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Affiliation(s)
- Brian Greenwood
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
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