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Lu D, Han Y, Xu R, Qin M, Shi J, Zhang C, Zhang J, Ye F, Luo Z, Wang Y, Wang C, Wang C. Evaluation of the efficacy, safety and influencing factors of concomitant and sequential administration of viral respiratory infectious disease vaccines: a systematic review and meta-analysis. Front Immunol 2023; 14:1259399. [PMID: 38179050 PMCID: PMC10764558 DOI: 10.3389/fimmu.2023.1259399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024] Open
Abstract
Background There is no clear conclusion on the immunogenicity and adverse events of concomitant administration the viral respiratory infectious disease vaccines. We aimed to evaluate the impact of concomitant administering viral respiratory infectious disease vaccines on efficiencies, safety and influencing factors. Methods This meta-analysis included studies from PubMed, Embase, Cochrane Central Register of Clinical Trials, Web of Science, WHO COVID-19 Research, and ClinicalTrials.gov databases. Randomized controlled trials of the adult participants concomitant administered with viral respiratory infectious disease vaccine and other vaccines were included. The main outcomes were the seroconversion rate and seroprotection rate of each vaccine. Used the Mantel-Haenszel fixed effects method as the main analysis to estimate the pooled RRs and the corresponding 95% confidence intervals. The risk of bias for each trial was assessed using the Cochrane Handbook for Systematic Reviews of Interventions, while evidence certainty was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. Results A total of 21 studies comprising 14060 participants with two types of vaccines were retained for the meta-analysis. Concomitant immunization reduced the geometric mean titer (RR: 0.858, 95% CI: (0.785 to 0.939)) and the geometric mean fold rise (0.754 (0.629 to 0.902)) in the SARS-COV-2 vaccine group but increased the seroconversion rate (1.033 (1.0002 to 1.067)) in the seasonal influenza vaccine group. Concomitant administration were influenced by the type of vaccine, adjuvant content, booster immunization, and age and gender of the recipient. Conclusion This meta-analysis suggested that the short-term protection and safety of concomitant administered were effective. Appropriate adjuvants, health promotion and counselling and booster vaccines could improve the efficiency and safety of Concomitant vaccination. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022343709.
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Affiliation(s)
- Dafeng Lu
- Department of Infectious Disease Prevention and Control, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
- Department of Infectious Disease Prevention and Control, Quzhou Center for Disease Prevention and Control, Quzhou, China
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yifang Han
- Department of Infectious Disease Prevention and Control, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Ruowei Xu
- Department of Infectious Disease Prevention and Control, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
- College of Life Science, Nanjing Normal University, Nanjing, China
| | - Mingke Qin
- Department of Occupational Health, Third Military Medical University, Chongqing, China
| | - Jianwei Shi
- Department of Neurosurgery, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Caihong Zhang
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Jinhai Zhang
- Department of Infectious Disease Prevention and Control, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Fuqiang Ye
- Department of Infectious Disease Prevention and Control, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Zhenghan Luo
- Department of Infectious Disease Prevention and Control, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Yuhe Wang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chunfang Wang
- Department of Infectious Disease Prevention and Control, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chunhui Wang
- Department of Infectious Disease Prevention and Control, Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
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Abstract
Prevention of emerging infections in children is a dynamic arena where substantial medical advances have enabled intervention and prevention of infection outbreaks. This article discusses 5 infections causing significant morbidity and mortality across Asia, Latin America, and Africa. Avian influenza and the Middle East respiratory syndrome are highly contagious zoonoses spread through aerosol and droplets, affecting predominantly Asia. Dengue infection and chikungunya are endemic mosquito-borne viruses in tropical regions across Asia, Latin America, and Africa. Ebola is a highly contagious virus spread through human-to-human contact. The latest information in clinical manifestations, infection, prevention control, chemoprophylaxis, vaccination, and public health measures is reviewed.
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Affiliation(s)
- Thanyawee Puthanakit
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, 9th Floor, Sor Kor Building, Rama 4 Road, Patumwan, Bangkok 10330, Thailand.
| | | | - Watsamon Jantarabenjakul
- Center of Excellence for Pediatric Infectious Diseases, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Kostinov MP, Latysheva EA, Kostinova AM, Akhmatova NK, Latysheva TV, Vlasenko AE, Dagil YA, Khromova EA, Polichshuk VB. Immunogenicity and Safety of the Quadrivalent Adjuvant Subunit Influenza Vaccine in Seropositive and Seronegative Healthy People and Patients with Common Variable Immunodeficiency. Vaccines (Basel) 2020; 8:E640. [PMID: 33147763 PMCID: PMC7712402 DOI: 10.3390/vaccines8040640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/12/2020] [Accepted: 09/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Influenza prophylaxis with the use of quadrivalent vaccines (QIV) is increasingly being introduced into healthcare practice. METHODS In total, 32 healthy adults and 6 patients with common variable immunodeficiency (CVID) received adjuvant QIV during 2018-2019 influenza season. Depending on initial antibody titers, healthy volunteers were divided into seronegative (≤1:20) and seropositive (≥1:40). To evaluate immunogenicity hemagglutination inhibition assay was used. RESULTS All participants completed the study without developing serious post-vaccination reactions. Analysis of antibody titer 3 weeks after immunization in healthy participants showed that seroprotection, seroconversion levels, GMR and GMT for strains A/H1N1, A/H3N2 and B/Colorado, B/Phuket among initially seronegative and seropositive participants meet the criterion of CHMP effectiveness. CVID patients showed increase in post-vaccination antibody titer without reaching conditionally protective antibody levels. CONCLUSION Adjuvant QIV promotes formation of specific immunity to vaccine strains, regardless of antibodies' presence or absence before. In CVID patients search of new regimens should be continued.
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Affiliation(s)
- Mikhail P. Kostinov
- Federal State Budgetary Scientific Institution, I.I. Mechnikov Research Institute of Vaccines and Sera, Malyi Kazenniy pereulok, 5a, 105064 Moscow, Russia; (M.P.K.); (N.K.A.); (E.A.K.); (V.B.P.)
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Trubetskaya Str., 8/2, 119991 Moscow, Russia
| | - Elena A. Latysheva
- National Research Center—Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoe Shosse, 24, 115478 Moscow, Russia; (E.A.L.); (T.V.L.); (Y.A.D.)
| | - Aristitsa M. Kostinova
- National Research Center—Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoe Shosse, 24, 115478 Moscow, Russia; (E.A.L.); (T.V.L.); (Y.A.D.)
| | - Nelly K. Akhmatova
- Federal State Budgetary Scientific Institution, I.I. Mechnikov Research Institute of Vaccines and Sera, Malyi Kazenniy pereulok, 5a, 105064 Moscow, Russia; (M.P.K.); (N.K.A.); (E.A.K.); (V.B.P.)
| | - Tatyana V. Latysheva
- National Research Center—Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoe Shosse, 24, 115478 Moscow, Russia; (E.A.L.); (T.V.L.); (Y.A.D.)
| | - Anna E. Vlasenko
- Novokuznetsk State Institute for Advanced Training of Physicians—Branch Campus of the Russian Medical Academy of Continuous Professional Education, Prospect Stroiteley, 5, 654005 Novokuznetsk, Russia;
| | - Yulia A. Dagil
- National Research Center—Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoe Shosse, 24, 115478 Moscow, Russia; (E.A.L.); (T.V.L.); (Y.A.D.)
| | - Ekaterina A. Khromova
- Federal State Budgetary Scientific Institution, I.I. Mechnikov Research Institute of Vaccines and Sera, Malyi Kazenniy pereulok, 5a, 105064 Moscow, Russia; (M.P.K.); (N.K.A.); (E.A.K.); (V.B.P.)
| | - Valentina B. Polichshuk
- Federal State Budgetary Scientific Institution, I.I. Mechnikov Research Institute of Vaccines and Sera, Malyi Kazenniy pereulok, 5a, 105064 Moscow, Russia; (M.P.K.); (N.K.A.); (E.A.K.); (V.B.P.)
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Lei H, Gao T, Cen Q, Peng X. Haemagglutinin displayed on the surface of Lactococcus lactis confers broad cross-clade protection against different H5N1 viruses in chickens. Microb Cell Fact 2020; 19:193. [PMID: 33059676 PMCID: PMC7557258 DOI: 10.1186/s12934-020-01453-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/09/2020] [Indexed: 01/01/2023] Open
Abstract
Background The highly pathogenic avian influenza (HPAI) H5N1 virus poses a potential threat to the poultry industry. The currently available avian influenza H5N1 vaccines for poultry are clade-specific. Therefore, an effective vaccine for preventing and controlling H5N1 viruses belonging to different clades needs to be developed. Results Recombinant L. lactis/pNZ8148-Spax-HA was generated, and the influenza virus haemagglutinin (HA) protein of A/Vietnam/1203/2004 (H5N1) was displayed on the surface of Lactococcus lactis (L. lactis). Spax was used as an anchor protein. Chickens vaccinated orally with unadjuvanted L. lactis/pNZ8148-Spax-HA could produce significant humoral and mucosal responses and neutralizing activities against H5N1 viruses belonging to different clades. Importantly, unadjuvanted L. lactis/pNZ8148-Spax-HA conferred cross-clade protection against lethal challenge with different H5N1 viruses in the chicken model. Conclusion This study provides insights into the cross-clade protection conferred by unadjuvanted L. lactis/pNZ8148-Spax-HA, and the results might help the establishment of a promising platform for the development of a safe and effective H5N1 cross-clade vaccine for poultry.
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Affiliation(s)
- Han Lei
- College of Medicine, Southwest Jiaotong University, Chengdu, 610031, Sichuan, China.
| | - Tong Gao
- College of Medicine, Southwest Jiaotong University, Chengdu, 610031, Sichuan, China
| | - Qianhong Cen
- College of Medicine, Southwest Jiaotong University, Chengdu, 610031, Sichuan, China
| | - Xiaojue Peng
- Department of Biotechnology, College of Life Science, Nanchang University, Jiangxi, 330031, China
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Yang J, Zhang J, Han T, Liu C, Li X, Yan L, Yang B, Yang X. Effectiveness, immunogenicity, and safety of influenza vaccines with MF59 adjuvant in healthy people of different age groups: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e19095. [PMID: 32049815 PMCID: PMC7035094 DOI: 10.1097/md.0000000000019095] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Influenza is a severe disease burden among all age groups. This study aimed to review the efficacy of inactivated influenza vaccines with MF59 adjuvant and non-adjuvanted inactivated influenza vaccines among all age groups against specific influenza vaccine strains. METHODS Literature search of PubMed, Embase, Medline, OVID, and Cochrane Library Trials (CENTRAL) was implemented up to March 1, 2019. Homogeneity qualified studies were included forData were extracted such as study country location, demographic characteristics, and measure outcomes, and were analyzed by a random effect model and sensitivity analyses to identify heterogeneity. Risk of bias was evaluated using the Cochrane Risk of Bias Tool. RESULTS We retrieved 1,021 publications and selected 31 studies for full review, including 17 trials for meta-analysis and 6 trials for qualitative synthesis. MF59-adjuvanted influenza vaccines demonstrated better immunogenicity against specific vaccine virus strains compared to non-adjuvanted influenza vaccine both in healthy adult group (RR = 2.10; 95% CI: 1.28-3.44) and the healthy aged (RR = 1.26; 95% CI: 1.10-1.44). CONCLUSION The quality of evidence is moderate to high for seroconversion and seroprotection rates of influenza vaccine. MF59-adjuvanted influenza vaccines are superior to non-adjuvanted influenza vaccines to enhance immune responses of vaccination in healthy adults and older adults, and could be considered for routine use especially the monovalent prepandemic influenza vaccines.
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Affiliation(s)
- Jing Yang
- National Institute of Engineering Technology Research in Combination Vaccine
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, Hubei province
| | - Jiayou Zhang
- National Institute of Engineering Technology Research in Combination Vaccine
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, Hubei province
| | - Tian Han
- National Institute of Engineering Technology Research in Combination Vaccine
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, Hubei province
| | - Chen Liu
- National Institute of Engineering Technology Research in Combination Vaccine
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, Hubei province
| | - Xinghang Li
- National Institute of Engineering Technology Research in Combination Vaccine
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, Hubei province
| | - Luyao Yan
- National Institute of Engineering Technology Research in Combination Vaccine
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, Hubei province
| | - Baifeng Yang
- National Institute of Engineering Technology Research in Combination Vaccine
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, Hubei province
| | - Xiaoming Yang
- National Institute of Engineering Technology Research in Combination Vaccine
- China Biotechnology Co., Ltd., Peking China, China
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Van Hoeven N, Fox CB, Granger B, Evers T, Joshi SW, Nana GI, Evans SC, Lin S, Liang H, Liang L, Nakajima R, Felgner PL, Bowen RA, Marlenee N, Hartwig A, Baldwin SL, Coler RN, Tomai M, Elvecrog J, Reed SG, Carter D. A Formulated TLR7/8 Agonist is a Flexible, Highly Potent and Effective Adjuvant for Pandemic Influenza Vaccines. Sci Rep 2017; 7:46426. [PMID: 28429728 PMCID: PMC5399443 DOI: 10.1038/srep46426] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/20/2017] [Indexed: 11/30/2022] Open
Abstract
Since 1997, highly pathogenic avian influenza viruses of the H5N1 subtype have been transmitted from avian hosts to humans. The severity of H5N1 infection in humans, as well as the sporadic nature of H5N1 outbreaks, both geographically and temporally, make generation of an effective vaccine a global public health priority. An effective H5N1 vaccine must ultimately provide protection against viruses from diverse clades. Toll-like receptor (TLR) agonist adjuvant formulations have a demonstrated ability to broaden H5N1 vaccine responses in pre-clinical models. However, many of these agonist molecules have proven difficult to develop clinically. Here, we describe comprehensive adjuvant formulation development of the imidazoquinoline TLR-7/8 agonist 3M-052, in combination with H5N1 hemagglutinin (HA) based antigens. We find that 3M-052 in multiple formulations protects both mice and ferrets from lethal H5N1 homologous virus challenge. Furthermore, we conclusively demonstrate the ability of 3M-052 adjuvant formulations to broaden responses to H5N1 HA based antigens, and show that this broadening is functional using a heterologous lethal virus challenge in ferrets. Given the extensive clinical use of imidazoquinoline TLR agonists for other indications, these studies identify multiple adjuvant formulations which may be rapidly advanced into clinical trials in an H5N1 vaccine.
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Affiliation(s)
- Neal Van Hoeven
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Christopher B Fox
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Brian Granger
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Tara Evers
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Sharvari W Joshi
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Ghislain I Nana
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Sarah C Evans
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Susan Lin
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Hong Liang
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Li Liang
- University of California Irvine, Department of Medicine, Irvine CA 92697, USA
| | - Rie Nakajima
- University of California Irvine, Department of Medicine, Irvine CA 92697, USA
| | - Philip L Felgner
- University of California Irvine, Department of Medicine, Irvine CA 92697, USA
| | - Richard A Bowen
- Colorado State University Department of Biomedical Sciences, Foothills Campus, Fort Collins, CO 80523, USA
| | - Nicole Marlenee
- Colorado State University Department of Biomedical Sciences, Foothills Campus, Fort Collins, CO 80523, USA
| | - Airn Hartwig
- Colorado State University Department of Biomedical Sciences, Foothills Campus, Fort Collins, CO 80523, USA
| | - Susan L Baldwin
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Rhea N Coler
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Mark Tomai
- 3M, Inc., St. Paul, Minnesota 55121, USA
| | | | - Steven G Reed
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
| | - Darrick Carter
- Infectious Disease Research Institute, 1616 Eastlake Ave E., Seattle WA 98103, USA
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Halder N, Kelso JK, Milne GJ. A model-based economic analysis of pre-pandemic influenza vaccination cost-effectiveness. BMC Infect Dis 2014; 14:266. [PMID: 24884470 PMCID: PMC4045999 DOI: 10.1186/1471-2334-14-266] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 05/06/2014] [Indexed: 11/10/2022] Open
Abstract
Background A vaccine matched to a newly emerged pandemic influenza virus would require a production time of at least 6 months with current proven techniques, and so could only be used reactively after the peak of the pandemic. A pre-pandemic vaccine, although probably having lower efficacy, could be produced and used pre-emptively. While several previous studies have investigated the cost effectiveness of pre-emptive vaccination strategies, they have not been directly compared to realistic reactive vaccination strategies. Methods An individual-based simulation model of ~30,000 people was used to examine a pre-emptive vaccination strategy, assuming vaccination conducted prior to a pandemic using a low-efficacy vaccine. A reactive vaccination strategy, assuming a 6-month delay between pandemic emergence and availability of a high-efficacy vaccine, was also modelled. Social distancing and antiviral interventions were examined in combination with these alternative vaccination strategies. Moderate and severe pandemics were examined, based on estimates of transmissibility and clinical severity of the 1957 and 1918 pandemics respectively, and the cost effectiveness of each strategy was evaluated. Results Provided that a pre-pandemic vaccine achieved at least 30% efficacy, pre-emptive vaccination strategies were found to be more cost effective when compared to reactive vaccination strategies. Reactive vaccination coupled with sustained social distancing and antiviral interventions was found to be as effective at saving lives as pre-emptive vaccination coupled with limited duration social distancing and antiviral use, with both strategies saving approximately 420 life-years per 10,000 population for a moderate pandemic with a basic reproduction number of 1.9 and case fatality rate of 0.25%. Reactive vaccination was however more costly due to larger productivity losses incurred by sustained social distancing, costing $8 million per 10,000 population ($19,074/LYS) versus $6.8 million per 10,000 population ($15,897/LYS) for a pre-emptive vaccination strategy. Similar trends were observed for severe pandemics. Conclusions Compared to reactive vaccination, pre-emptive strategies would be more effective and more cost effective, conditional on the pre-pandemic vaccine being able to achieve a certain level of coverage and efficacy. Reactive vaccination strategies exist which are as effective at mortality reduction as pre-emptive strategies, though they are less cost effective.
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Affiliation(s)
| | - Joel K Kelso
- School of Computer Science and Software Engineering, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
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