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Kurasawa K. Maternal vaccination-current status, challenges, and opportunities. J Obstet Gynaecol Res 2023; 49:493-509. [PMID: 36444417 PMCID: PMC10100318 DOI: 10.1111/jog.15503] [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: 09/29/2022] [Revised: 11/01/2022] [Accepted: 11/09/2022] [Indexed: 12/03/2022]
Abstract
AIM Maternal vaccination is a promising strategy for protecting pregnant women and newborns against severe infections. This review aims to describe the current status and challenges associated with maternal vaccination against seasonal influenza, tetanus-diphtheria-pertussis (Tdap/DTaP), and novel coronavirus disease of 2019 (COVID-19) in Japan and other countries, mainly the United States and the United Kingdom. METHODS A literature search was conducted in PubMed and other public websites (e.g., Centers for Disease Control and Prevention) to obtain information on maternal vaccination. RESULTS Inactivated vaccines are recommended for pregnant women by gynecologic societies in Japan, the United States, and the United Kingdom. Among pregnant Japanese women, the influenza and COVID-19 (two doses) vaccine coverage rates were 27.0%-53.5% (six studies) and 73.6% (one study), respectively; there are no studies on maternal vaccination with DTaP. Concerns regarding vaccine safety are a major barrier to maternal vaccination across countries. Maternal vaccination is effective in preventing severe disease in pregnant women and protecting infants aged <6 months, is generally safe, and does not increase the risk of adverse maternal and fetal outcomes. Providing accurate information regarding vaccination through healthcare providers and the government and government funding for vaccines may help improve maternal vaccination rates in Japan. CONCLUSION Current coverage for maternal vaccination is still low globally mainly because of vaccine hesitancy among pregnant women. The government, drug-regulatory authorities, and healthcare professionals must educate pregnant women about the effectiveness and safety of maternal vaccines and encourage vaccination when the benefits outweigh the risks.
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Affiliation(s)
- Kentaro Kurasawa
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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2
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Malange VNE, Hedermann G, Lausten-Thomsen U, Hoffmann S, Voldstedlund M, Aabakke AJM, Eltvedt AK, Jensen JS, Breindahl M, Krebs L, Christiansen M, Hedley PL. The perinatal health challenges of emerging and re-emerging infectious diseases: A narrative review. Front Public Health 2023; 10:1039779. [PMID: 36684933 PMCID: PMC9850110 DOI: 10.3389/fpubh.2022.1039779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
The world has seen numerous infectious disease outbreaks in the past decade. In many cases these outbreaks have had considerable perinatal health consequences including increased risk of preterm delivery (e.g., influenza, measles, and COVID-19), and the delivery of low birth weight or small for gestational age babies (e.g., influenza, COVID-19). Furthermore, severe perinatal outcomes including perinatal and infant death are a known consequence of multiple infectious diseases (e.g., Ebola virus disease, Zika virus disease, pertussis, and measles). In addition to vaccination during pregnancy (where possible), pregnant women, are provided some level of protection from the adverse effects of infection through community-level application of evidence-based transmission-control methods. This review demonstrates that it takes almost 2 years for the perinatal impacts of an infectious disease outbreak to be reported. However, many infectious disease outbreaks between 2010 and 2020 have no associated pregnancy data reported in the scientific literature, or pregnancy data is reported in the form of case-studies only. This lack of systematic data collection and reporting has a negative impact on our understanding of these diseases and the implications they may have for pregnant women and their unborn infants. Monitoring perinatal health is an essential aspect of national and global healthcare strategies as perinatal life has a critical impact on early life mortality as well as possible effects on later life health. The unpredictable nature of emerging infections and the potential for adverse perinatal outcomes necessitate that we thoroughly assess pregnancy and perinatal health implications of disease outbreaks and their public health interventions in tandem with outbreak response efforts. Disease surveillance programs should incorporate perinatal health monitoring and health systems around the world should endeavor to continuously collect perinatal health data in order to quickly update pregnancy care protocols as needed.
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Affiliation(s)
| | - Gitte Hedermann
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ulrik Lausten-Thomsen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Steen Hoffmann
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | | | - Anna J. M. Aabakke
- Department of Obstetrics and Gynecology, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital - Holbæk, Holbæk, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anna K. Eltvedt
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Global Health Unit, Department of Paediatric and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jørgen S. Jensen
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Morten Breindahl
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lone Krebs
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Michael Christiansen
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Department of Biomedical Science, University of Copenhagen, Copenhagen, Denmark
| | - Paula L. Hedley
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Brazen Bio, Los Angeles, CA, United States
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3
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Chow EJ, Beigi RH, Riley LE, Uyeki TM. Clinical Effectiveness and Safety of Antivirals for Influenza in Pregnancy. Open Forum Infect Dis 2021; 8:ofab138. [PMID: 34189160 DOI: 10.1093/ofid/ofab138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/19/2021] [Indexed: 11/14/2022] Open
Abstract
Seasonal influenza epidemics result in substantial health care burden annually. Early initiation of antiviral treatment of influenza has been shown to reduce the risk of complications and duration of illness. Pregnant and postpartum women may be at increased risk for influenza-associated complications; however, pregnant women have been generally excluded from clinical trials of antiviral treatment of influenza. In this review, we summarize the available evidence on the clinical effectiveness and safety of antiviral treatment of pregnant women with influenza. Observational data show a reduction of severe outcomes when pregnant and postpartum women are treated with oseltamivir and other neuraminidase inhibitors without increased risk of adverse maternal, fetal, or neonatal outcomes. Due to lack of safety and efficacy data for baloxavir treatment of pregnant and postpartum women, baloxavir is currently not recommended for use in these populations.
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Affiliation(s)
- Eric J Chow
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Richard H Beigi
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,University of Pittsburgh Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, USA
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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4
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Hoshi SL, Shono A, Seposo X, Okubo I, Kondo M. Cost-effectiveness analysis of influenza vaccination during pregnancy in Japan. Vaccine 2020; 38:7363-7371. [PMID: 33020012 DOI: 10.1016/j.vaccine.2020.09.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/20/2020] [Accepted: 09/08/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pregnant women and infants are known as high risk groups for influenza. WHO recommend pregnant women be vaccinated with inactivated influenza vaccine. In Japan, some municipalities started to give subsidy to encourage pregnant women to receive a shot on their own accord, which has made the introduction of seasonal antepartum maternal vaccination program (AMVP) into the routine vaccination list a current topic in health policy and has raised the need to evaluate the value for money of such possibility. METHODS We conducted a cost-effectiveness analysis to evaluate the efficiency of conducting AMVP in Japan. A decision tree model was adopted taking into consideration the duration of single-year vaccine effectiveness for infants and for mothers. The program targeted pregnant women aged 20-49 years old at or over 12 weeks gestation during October 1 through March 30. Estimated probabilities of treatments received due to influenza for pregnant/postpartum women or their infants varied by calendar time, vaccination status, and/or gestational age. Incremental cost-effectiveness ratio (ICER) compared with current no-AMVP from societal perspective was calculated. Transition probabilities, utility weights to estimate quality-adjusted life year (QALY), and disease treatment costs were either calculated or extracted from literature. Costs per vaccination was assumed at ¥3,529/US$32.1. RESULTS AMVP reduces disease treatment costs, while the reduction cannot offset the vaccination cost. Incremental QALYs were at 0.00009, among them 84.2% were from infants. ICER was ¥7,779,356/US$70,721 per QALY gained. One-way sensitivity analyses revealed that vaccine effectiveness for infant and costs per shot were the two main key variables affecting the ICER. CONCLUSION We found that vaccinating pregnant women with influenza vaccine to prevent unvaccinated infants and pregnant/postpartum women from influenza-associated disease in Japan can be cost-effective from societal perspective, under the WHO-suggested "cost-effective" criteria (1-3 times of GDP).
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Affiliation(s)
- Shu-Ling Hoshi
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577, Japan
| | - Aiko Shono
- Department of Public Health and Epidemiology, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 2048588, Japan; Social Pharmacy and Regulatory Science, Showa Pharmaceutical University, 3-3165, Higashi-Tamagawagakuen, Machidashi, Tokyo 194-8543, Japan.
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 8528523, Japan
| | - Ichiro Okubo
- Yokohama City Institute of Public Health, 7-1, Tomiokahigashi 2-chom, Kanazawa-ku, Yokohama City 2360051, Japan
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577, Japan
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5
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Shono A, Hoshi SL, Kondo M. Maternal influenza vaccination relates to receiving relevant information among pregnant women in Japan. Hum Vaccin Immunother 2020; 16:1364-1370. [PMID: 31850838 PMCID: PMC7482762 DOI: 10.1080/21645515.2019.1697109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/02/2019] [Accepted: 11/20/2019] [Indexed: 12/19/2022] Open
Abstract
Maternal vaccination for seasonal influenza is currently not listed as a routine vaccination in the national vaccination schedule of Japan. However, many pregnant women voluntarily receive an influenza vaccination. We explored the factors related to influenza vaccine uptake. We particularly focused on factors related to any recommendation, such as advice or suggestions from another individual. We conducted a cross-sectional web-based questionnaire survey in Japan among pregnant women or mothers who had recently given birth in March 2017 and 2018. Logistic regression models were used to determine the factors influencing vaccination uptake. Key individuals regarding maternal vaccination were examined using the network visualization software Gephi. The total number of valid responses was 2204 in 2017 and 3580 in 2018. Over 40% of respondents had been vaccinated with the seasonal influenza vaccine at some point in both years. Of the vaccinated respondents, over 80% received advice regarding the influenza vaccination. Obstetricians were the most common source of advice in both years. Among respondents who chose more than two sources, the largest link in the network of sources was found between the obstetrician and family members. Attention to public concern or potential recommenders, by public health authorities, not just pregnant women, about the benefits of maternal influenza vaccination is important.
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Affiliation(s)
- Aiko Shono
- Department of Public Health and Epidemiology, Faculty of Pharmaceutical Sciences, Meiji Pharmaceutical University, Tokyo, Japan
| | - Shu-Ling Hoshi
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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6
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Takeda J, Takeda S. Adding "pregnancy" to the Centor score, aim to reduce maternal death. J Infect Chemother 2019; 25:835. [PMID: 31358434 DOI: 10.1016/j.jiac.2019.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Jun Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
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7
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Hurt AC. Antiviral Therapy for the Next Influenza Pandemic. Trop Med Infect Dis 2019; 4:tropicalmed4020067. [PMID: 31003518 PMCID: PMC6630704 DOI: 10.3390/tropicalmed4020067] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/02/2019] [Accepted: 04/15/2019] [Indexed: 11/16/2022] Open
Abstract
Influenza antivirals will play a critical role in the treatment of outpatients and hospitalised patients in the next pandemic. In the past decade, a number of new influenza antivirals have been licensed for seasonal influenza, which can now be considered for inclusion into antiviral stockpiles held by the World Health Organization (WHO) and individual countries. However, data gaps remain regarding the effectiveness of new and existing antivirals in severely ill patients, and regarding which monotherapy or combinations of antivirals may yield the greatest improvement in outcomes. Regardless of the drug being used, influenza antivirals are most effective when treatment is initiated early in the course of infection, and therefore in a pandemic, effective strategies which enable rapid diagnosis and prompt delivery will yield the greatest benefits.
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Affiliation(s)
- Aeron C Hurt
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia.
- Department of Microbiology and Immunology, University of Melbourne, Parkville, VIC 3010, Australia.
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8
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Hoshi SL, Seposo X, Okubo I, Kondo M. Cost-effectiveness analysis of pertussis vaccination during pregnancy in Japan. Vaccine 2018; 36:5133-5140. [DOI: 10.1016/j.vaccine.2018.07.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 02/05/2023]
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9
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Abstract
Data on outpatients with relatively mild disease should not form the basis for policies on the management of more severe disease. A debate about the market-leading influenza antiviral medication, oseltamivir, which initially focused on treatment for generally mild illness, has been expanded to question the wisdom of stockpiling for use in future influenza pandemics. Although randomized controlled trial evidence confirms that oseltamivir will reduce symptom duration by 17–25 hours among otherwise healthy adolescents and adults with community-managed disease, no randomized controlled trials have examined the effectiveness of oseltamivir against more serious outcomes. Observational studies, although criticized on methodologic grounds, suggest that oseltamivir given early can reduce the risk for death by half among persons hospitalized with confirmed infection caused by influenza A(H1N1)pdm09 and influenza A(H5N1) viruses. However, available randomized controlled trial data may not be able to capture the effect of oseltamivir use among hospitalized patients with severe disease. We assert that data on outpatients with relatively mild disease should not form the basis for policies on the management of more severe disease.
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10
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Abstract
Despite the prevalence of viral infections in the American population, we still have a limited understanding of how they affect pregnancy and fetal development. Viruses can gain access to the decidua and placenta by ascending from the lower reproductive tract or via hematogenous transmission. Viral tropism for the decidua and placenta is then dependent on viral entry receptor expression in these tissues as well as on the maternal immune response to the virus. These factors vary by cell type and gestational age and can be affected by changes to the in utero environment and maternal immunity. Some viruses can directly infect the fetus at specific times during gestation, while some only infect the placenta. Both scenarios can result in severe birth defects or pregnancy loss. Systemic maternal viral infections can also affect the pregnancy, and these can be especially dangerous, because pregnant women suffer higher virus-associated morbidity and mortality than do nonpregnant counterparts. In this Review, we discuss the potential contributions of maternal, placental, and fetal viral infection to pregnancy outcome, fetal development, and maternal well-being.
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11
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Yamada T, Kawakami S, Yoshida Y, Kawamura H, Ohta S, Abe K, Hamada H, Dohi S, Ichizuka K, Takita H, Baba Y, Matsubara S, Mochizuki J, Unno N, Maegawa Y, Maeda M, Inubashiri E, Akutagawa N, Kubo T, Shirota T, Oda Y, Yamada T, Yamagishi E, Nakai A, Fuchi N, Masuzaki H, Urabe S, Kudo Y, Nomizo M, Sagawa N, Maeda T, Kamitomo M, Kawabata K, Kataoka S, Shiozaki A, Saito S, Sekizawa A, Minakami H. Influenza 2014–2015 among pregnant Japanese women: primiparous vs multiparous women. Eur J Clin Microbiol Infect Dis 2016; 35:665-71. [DOI: 10.1007/s10096-016-2585-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/13/2016] [Indexed: 11/28/2022]
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12
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Hurt AC, Hui DS, Hay A, Hayden FG. Overview of the 3rd isirv-Antiviral Group Conference--advances in clinical management. Influenza Other Respir Viruses 2015; 9:20-31. [PMID: 25399715 PMCID: PMC4280814 DOI: 10.1111/irv.12293] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2014] [Indexed: 12/30/2022] Open
Abstract
This review highlights the main points which emerged from the presentations and discussions at the 3rd isirv-Antiviral Group Conference - advances in clinical management. The conference covered emerging and potentially pandemic influenza viruses and discussed novel/pre-licensure therapeutics and currently approved antivirals and vaccines for the control of influenza. Current data on approved and novel treatments for non-influenza respiratory viruses such as MERS-CoV, respiratory syncytial virus (RSV) and rhinoviruses and the challenges of treating immunocompromised patients with respiratory infections was highlighted.
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Affiliation(s)
- Aeron C Hurt
- WHO Collaborating Centre for Reference and Research on Influenza, VIDRL at the Peter Doherty Institute for Infection and Immunity, Parkville, Vic., Australia; Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic., Australia
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13
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Yamada T, Abe K, Baba Y, Inubashiri E, Kawabata K, Kubo T, Maegawa Y, Fuchi N, Nomizo M, Shimada M, Shiozaki A, Hamada H, Matsubara S, Akutagawa N, Kataoka S, Maeda M, Masuzaki H, Sagawa N, Nakai A, Saito S, Minakami H. Vaccination during the 2013-2014 influenza season in pregnant Japanese women. Eur J Clin Microbiol Infect Dis 2014; 34:543-8. [PMID: 25311988 DOI: 10.1007/s10096-014-2259-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 09/29/2014] [Indexed: 11/24/2022]
Abstract
This questionnaire survey was conducted at 11 hospitals in Japan to determine vaccination coverage against seasonal influenza and the prevalence rate of influenza among pregnant Japanese women. Of 2,808 postpartum women who gave birth at the 11 hospitals during the study period from March 1, 2014, to July 31, 2014, 1,713 (61 %) participated in this study and 876 (51 %) reported having received vaccination against influenza in or after October 2013. Women aged <25 years had a significantly lower vaccination rate than those aged ≥25 years (31 % vs. 53 %, respectively; p = 0.0000). Eighty-seven (5.1 %) and 1,626 (94.9 %) women did and did not contract influenza, respectively. Although prior birth did not affect overall vaccination coverage (50 % for primiparous vs. 53 % for multiparous), multiparous women had a significantly higher rate of contracting influenza than primiparous women, irrespective of vaccination status (5.6 % vs. 2.2 % [p = 0.0216] and 9.7 % vs. 3.5 % [p = 0.0003] for women with and without vaccination, respectively). The 2013-2014 vaccination program significantly reduced the influenza infection rate by 35 % (3.9 % vs. 6.3 % for women with and without vaccination, respectively; p = 0.0272). Seventy-two (83 %) of the 87 women took antiviral agents for the treatment of influenza and two (2.3 %) required hospitalization. These results suggested that pregnant Japanese women had a high level of concern regarding seasonal influenza. However, campaigns targeting young pregnant Japanese women, as well as multiparous women, for vaccination are needed in order to further reduce the incidence of influenza among pregnant Japanese women.
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Affiliation(s)
- T Yamada
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, N15W7, Kita-ku, Sapporo, 060-8638, Japan,
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14
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Berera D, Zambon M. Antivirals in the 2009 pandemic--lessons and implications for future strategies. Influenza Other Respir Viruses 2014; 7 Suppl 3:72-9. [PMID: 24215385 DOI: 10.1111/irv.12172] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The World Health Organization's declaration of an imminent swine-origin influenza A pandemic in April 2009 triggered the global launch of national pandemic preparedness plans. An integral component of pandemic preparedness in many countries was the targeted use of antiviral therapy for containment, disease mitigation, and treatment. The 2009 pandemic marked the first pandemic during which influenza antivirals were available for global use. Although most national pandemic plans included provisions for antiviral treatment, these pre-determined protocols required frequent updating as more information became available about the virus, and its susceptibility to antiviral agents, the epidemiology of infection, and the population groups that were most susceptible to severe disease. National public health agencies in countries with both plans for use of antivirals and pre-existing stockpiles, including those in Japan, the United Kingdom, and the United States, operated distinctly different antiviral distribution and treatment programs from one another. In the 3 years following the pandemic, there is still little comparison of the diversity of national antiviral treatment policies and drug distribution mechanisms that were implemented, whether they had any mitigating effects and which might be most efficient. The purpose of this study is to outline roles of antiviral medicines in a pandemic period, provide insights into the diversity of antiviral treatment and distribution policies applied by selected countries between April 2009-July 2010, and to stimulate discussion on whether these policies remain appropriate for implementation in future pandemics.
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Affiliation(s)
- Deeva Berera
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA; College of Medicine, University of Central Florida, Orlando, FL, USA
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Hurt AC, Ison MG, Hayden FG, Hay AJ. Second isirv antiviral group conference: overview. Influenza Other Respir Viruses 2014; 7 Suppl 3:1-7. [PMID: 24215376 PMCID: PMC6499332 DOI: 10.1111/irv.12207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Aeron C Hurt
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Vic., Australia
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16
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Wong VWY, Tarrant M. Influenza-like illness among Hong Kong Chinese pregnant women. J Matern Fetal Neonatal Med 2014; 28:116-9. [DOI: 10.3109/14767058.2014.900042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Aoki FY, Hayden FG. The beneficial effects of neuraminidase inhibitor drug therapy on severe patient outcomes during the 2009-2010 influenza A virus subtype H1N1 pandemic. J Infect Dis 2012. [PMID: 23204176 PMCID: PMC7313909 DOI: 10.1093/infdis/jis727] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fred Y. Aoki
- Medicine, Medical Microbiology, and Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Canada
- Correspondence: Fred Y. Aoki, MD, Room 510 Basic Medical Sciences Building, 745 Bannatyne Ave, Winnipeg, MB, Canada R3E 0J9 ()
| | - Frederick G. Hayden
- Department of Medicine, University of Virginia School of Medicine, Charlottesville
- International Activities, Wellcome Trust, London, United Kingdom
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