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Nybru Gleditsch R, Skogset Ofitserova T, Aubrey White R, Karoline Råberg Kjøllesdal M, Dvergsdal E, Hansen BT, Askeland Winje B. Vaccine coverage among children born to immigrant parents in Norway, 2000-2020. Vaccine 2024; 42:3049-3056. [PMID: 38582692 DOI: 10.1016/j.vaccine.2024.03.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND The Norwegian Childhood Immunization Program maintains a high national coverage of 95-97% in the most recent years. Whether there are subgroups with lower uptake is less studied. This study examines pertussis and measles vaccination coverage among six immigrant groups in Norway. These vaccines are normally administered as part of different combination vaccines and their coverage rate indicate the national vaccination coverage against a range of additional infections. METHODS Data from the Norwegian National Population Register were linked at individual level with vaccination data from the Norwegian Immunisation Registry. The final sample consisted of 53,052 children born during 2000-2018 in Norway to parents who were born in Iraq, Lithuania, Pakistan, Poland, Somalia, or Vietnam. Vaccination coverage was measured at 2-years of age. Multivariate linear regression was utilized to estimate the relationship between vaccinations status, year of birth, gender, mother's length of residency in Norway, and area of residence. RESULTS At two years of age, the majority of the children were vaccinated. Coverage among the groups varied at, above, and below the national average for the two vaccines. For most of the years examined, children born by parents from Lithuania, Poland, and Somalia had lower coverage for the measles vaccine (range 81-84% in 2020) than the national level (97% in 2020). Children born by parents from the Eastern-European countries also had lower coverage than the national level for the pertussis vaccine (range 87-89% in 2020). DISCUSSION This study illustrates how subgroups with lower vaccination coverage may exists within a well-established vaccination program with high national coverages. Differences in coverage were found for both vaccines, but the differences were more pronounced for the measles vaccine. The high vaccination coverage in Norway provides indirect protection through herd immunity for unvaccinated individuals, however, the lower vaccination coverage in some immigrant groups is a concern.
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Affiliation(s)
- Rebecca Nybru Gleditsch
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213 Oslo, Norway; The Fafo Institute for Labour and Social Research, PO Box 2947 Tøyen, N-0608 Oslo, Norway.
| | | | | | | | - Evy Dvergsdal
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213 Oslo, Norway.
| | - Bo T Hansen
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213 Oslo, Norway.
| | - Brita Askeland Winje
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213 Oslo, Norway; Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130 Oslo, Norway.
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Haralambieva IH, Chen J, Quach HQ, Ratishvili T, Warner ND, Ovsyannikova IG, Poland GA, Kennedy RB. Early B cell transcriptomic markers of measles-specific humoral immunity following a 3 rd dose of MMR vaccine. Front Immunol 2024; 15:1358477. [PMID: 38633249 PMCID: PMC11021587 DOI: 10.3389/fimmu.2024.1358477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
B cell transcriptomic signatures hold promise for the early prediction of vaccine-induced humoral immunity and vaccine protective efficacy. We performed a longitudinal study in 232 healthy adult participants before/after a 3rd dose of MMR (MMR3) vaccine. We assessed baseline and early transcriptional patterns in purified B cells and their association with measles-specific humoral immunity after MMR vaccination using two analytical methods ("per gene" linear models and joint analysis). Our study identified distinct early transcriptional signatures/genes following MMR3 that were associated with measles-specific neutralizing antibody titer and/or binding antibody titer. The most significant genes included: the interleukin 20 receptor subunit beta/IL20RB gene (a subunit receptor for IL-24, a cytokine involved in the germinal center B cell maturation/response); the phorbol-12-myristate-13-acetate-induced protein 1/PMAIP1, the brain expressed X-linked 2/BEX2 gene and the B cell Fas apoptotic inhibitory molecule/FAIM, involved in the selection of high-affinity B cell clones and apoptosis/regulation of apoptosis; as well as IL16 (encoding the B lymphocyte-derived IL-16 ligand of CD4), involved in the crosstalk between B cells, dendritic cells and helper T cells. Significantly enriched pathways included B cell signaling, apoptosis/regulation of apoptosis, metabolic pathways, cell cycle-related pathways, and pathways associated with viral infections, among others. In conclusion, our study identified genes/pathways linked to antigen-induced B cell proliferation, differentiation, apoptosis, and clonal selection, that are associated with, and impact measles virus-specific humoral immunity after MMR vaccination.
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Affiliation(s)
- Iana H. Haralambieva
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Jun Chen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Huy Quang Quach
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Tamar Ratishvili
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Nathaniel D. Warner
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Inna G. Ovsyannikova
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Gregory A. Poland
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Richard B. Kennedy
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
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Saldanha Resendes D, Tomás A, Pinção Cardoso M, von Schreeb S, Miranda Ferrão R, Vasconcelos P, Almeida MH, Novo Castro B, Ricoca Peixoto V, Lourenço Silva R, de Morais M. Contact tracing management of a measles case in a paediatric hospital: experience of the local public health unit, Portugal, January 2024. Euro Surveill 2024; 29. [PMID: 38666402 DOI: 10.2807/1560-7917.es.2024.29.17.240022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2024] Open
Abstract
In January 2024, a child was diagnosed with measles in a paediatric hospital in Lisbon. Of 123 contacts, 39 (32%) were not fully immunised, presenting a risk for a potential outbreak. The public health unit initiated control measures and identified challenges during the response, such as the lack of interoperability between information systems and accessing vaccination records. The lessons learned prompted changes to national contact tracing procedures for measles, further strengthening Portugal's preparedness.
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Affiliation(s)
| | - António Tomás
- Public Health Unit, Local Health Unit of São José, Ministry of Health, Lisbon, Portugal
| | | | - Sebastian von Schreeb
- Center for Public Health Emergencies, Directorate-General of Health, Lisbon, Portugal
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Rita Miranda Ferrão
- Public Health Unit, Local Health Unit of São José, Ministry of Health, Lisbon, Portugal
| | - Paula Vasconcelos
- Public Health Unit, Local Health Unit of São José, Ministry of Health, Lisbon, Portugal
- Center for Public Health Emergencies, Directorate-General of Health, Lisbon, Portugal
| | - Maria Helena Almeida
- Public Health Unit, Local Health Unit of São José, Ministry of Health, Lisbon, Portugal
| | - Bruno Novo Castro
- Public Health Unit, Local Health Unit of São José, Ministry of Health, Lisbon, Portugal
| | - Vasco Ricoca Peixoto
- Center for Public Health Emergencies, Directorate-General of Health, Lisbon, Portugal
| | - Renato Lourenço Silva
- Public Health Unit, Local Health Unit of São José, Ministry of Health, Lisbon, Portugal
| | - Margarida de Morais
- Public Health Unit, Local Health Unit of São José, Ministry of Health, Lisbon, Portugal
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Zayan H, Hosny AH, Mamdouh MM, Tawfik YM. Efficacy of Intralesional Candida Antigen Versus Measles, Mumps, and Rubella Vaccine Versus Topical Podophyllin in Treatment of Resistant Genital Warts. J Cutan Med Surg 2024:12034754241238012. [PMID: 38497287 DOI: 10.1177/12034754241238012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND No single treatment is ideal for genital warts with high rate of resistance using conventional modalities as topical podophyllin; however, several intralesional immunotherapies are being tested nowadays, with variable results. In this study, we compared the safety and efficacy of treating resistant and recurrent genital warts by 2 intralesional immunotherapies [Candida antigen and measles, mumps, and rubella (MMR) vaccine] and compared them with topical podophyllin. PATIENTS/METHODS A total of 45 patients with resistant or recurrent genital warts were enrolled in this study. Size and number of warts were detected in each patient, patients were divided into 3 groups. Group A injected with intralesional Candida antigen. Group B with intralesional MMR vaccine. Group C were treated with topical 25% podophyllin. Patients received a session every 2 weeks for 3 treatment sessions. RESULTS With regard to the reduction in size and number of all warts, the best response was obtained in Candida antigen group where 46.7% showed complete clearance and 40% showed partial response followed by MMR group and the last was the podophyllin group, with no significant difference between them. Complete clearance of mother warts was noticed in 86.7% of Candida group, 53.3% in MMR group, and last 40% in podophyllin group, with a significantly better response in the Candida group (P = .027). CONCLUSION Both intralesional Candida antigen and MMR vaccine are simple, safe, and effective treatment options with comparable results and better response than topical podophyllin.
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Affiliation(s)
- Hisham Zayan
- Departments of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed H Hosny
- Department of Andrology and Venereology, Faculty of Medicine, Helwan University, Helwan, Egypt
| | | | - Yasmin M Tawfik
- Departments of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Musa S, Salimović-Bešić I, Džambić JB, Tihić N, Bajramović A, Arapčić S, Dedeić-Ljubović A, Skočibušić S. Ongoing measles outbreak, the Federation of Bosnia and Herzegovina, December 2023 to February 2024. Euro Surveill 2024; 29:2400107. [PMID: 38426241 PMCID: PMC10986665 DOI: 10.2807/1560-7917.es.2024.29.9.2400107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/29/2024] [Indexed: 03/02/2024] Open
Abstract
We report on an ongoing measles outbreak in the Federation of Bosnia and Herzegovina with 141 cases notified between week 52 2023 and week 6 2024. Among those with known vaccination status, 97% were unvaccinated and the most affected group is children under the age of 5 years (n = 87) who were not vaccinated during the pandemic years. Sixty-eight cases were hospitalised, the most common complications were measles-related pneumonia and diarrhoea. The sequenced measles viruses from four cases belonged to genotype D8.
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Affiliation(s)
- Sanjin Musa
- Department of Infectious Disease Epidemiology, Institute for Public Health of the Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
- Sarajevo School of Science and Technology Sarajevo Medical School, Sarajevo, Bosnia and Herzegovina
| | - Irma Salimović-Bešić
- Unit for Clinical Microbiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Jasmina Brkić Džambić
- Department of Epidemiology, Institute for Public Health of Tuzla Canton, Tuzla, Bosnia and Herzegovina
| | - Nijaz Tihić
- Department of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Anisa Bajramović
- Department of Epidemiology, Institute for Public Health of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
| | - Suzana Arapčić
- Unit for Clinical Microbiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Amela Dedeić-Ljubović
- Unit for Clinical Microbiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Siniša Skočibušić
- Department of Infectious Disease Epidemiology, Institute for Public Health of the Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
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Dyda A, Broome A, Rawlinson W, Mahimbo A, Saha A, Kefalas B, Seale H, Macintyre CR, Zwar N, Gidding HF, Heywood AE. Measles, mumps, rubella and varicella antibodies among international and domestic university students. J Travel Med 2024; 31:taae004. [PMID: 38195239 DOI: 10.1093/jtm/taae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Vaccine-preventable infections are generally well controlled in Australia. However, gaps in immunity can lead to outbreaks and are important to identify. Young adults are a highly mobile population and a potential source of imported infections. We aimed to evaluate anti- measles, mumps, rubella and varicella (MMR&V) IgG seroprevalence and explore factors relating to antibody seropositivity. METHODS A cross-sectional online survey was conducted among students from a large Australian university to collect demographic, vaccination, infection and travel characteristics. Blood samples were collected to measure MMR&V seroprevalence. Logistic regression was used to identify factors associated with seropositivity. RESULTS Among 804 university students, seroprevalence (positive or equivocal) for measles was 82.3% (95% CI 79.6-84.8%), mumps 79.5% (95% CI 76.7-82.3%), rubella 91.5% (95% CI 89.6-93.5%) and varicella 86.2% (95% CI 84.1-88.8%), with 452 (56.2%, 95% CI 52.8-59.6) seropositive to all four viruses. Varicella seropositivity was highest in the older birth cohort (born 1988-1991). Measles seropositivity was higher for international students compared to domestic students. Among international students, mumps seroprevalence was significantly lower than measles and rubella seroprevalence. International travel in the previous 12 months was reported by 63.1% of students, but only 18.2% of travellers reported seeking pre-travel health advice prior to most recent international travel. CONCLUSIONS Overall, this study suggests immunity to MMR&V is sub-optimal. We found the university student population to be highly mobile and unlikely to seek pre-travel advice; thus, they are a potential source of infection importation. The implementation of university immunization policies could address the gaps identified and our findings can inform the development of targeted vaccination campaigns.
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Affiliation(s)
- Amalie Dyda
- School of Public Health, University of Queensland, Brisbane, QLD 4072, Australia
| | - Audrey Broome
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - William Rawlinson
- Serology and Virology Division (SAViD), NSW Health Pathology, Randwick, NSW 2031, Australia
| | - Abela Mahimbo
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Amit Saha
- The Kirby Institute, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Bill Kefalas
- UNSW Health Service, University of New South Wales, Sydney, NSW 2052, Australia
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - C Raina Macintyre
- The Kirby Institute, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Nicholas Zwar
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Heather F Gidding
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Anita E Heywood
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
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Skirrow H, Foley K, Bedford H, Lewis C, Whittaker E, Costelloe C, Saxena S. Impact of pregnancy vaccine uptake and socio-demographic determinants on subsequent childhood Measles, Mumps and Rubella vaccine uptake: A UK birth cohort study. Vaccine 2024; 42:322-331. [PMID: 38072757 DOI: 10.1016/j.vaccine.2023.11.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND We examined the association between socio-demographic determinants and uptake of childhood Measles, Mumps & Rubella (MMR) vaccines and the association between pregnant women's pertussis vaccine uptake and their children's MMR vaccine uptake. METHODS We used nationally-representative linked mother-baby electronic records from the United Kingdom's Clinical-Practice-Research-Datalink. We created a birth cohort of children born between 01.01.2000 and 12.12.2020. We estimated the proportion vaccinated with first MMR vaccine by age 2 years and first and second MMR vaccines by age 5 years. We used survival-analysis and Cox proportional hazard models to examine the association between deprivation, ethnicity and maternal age and pertussis vaccination in pregnancy and children's MMR uptake. RESULTS Overall, 89.4 % (710,797/795,497) of children had first MMR by age 2 years and 92.6 % (736,495/795,497) by age 5 years. Among children still in the cohort when second MMR was due, 85.9 % (478,480/557,050) had two MMRs by age 5 years. Children from the most-deprived areas, children of Black ethnicity and children of mothers aged < 20 years had increased risk of being unvaccinated compared with children from the least-deprived areas, White children and children of mothers aged 31-40 years: first MMR by 5 years, adjusted Hazard Ratios (HR):0.86 (CI:0.85-0.87), HR:0.87 (CI:0.85-0.88) & HR:0.89 (CI:0.88-0.90) respectively. Deprivation was the determinant associated with the greatest risk of missed second MMR: adjusted HR:0.82 (CI:0.81-0.83). Children of mothers vaccinated in pregnancy were more likely than children of unvaccinated mothers to have MMR vaccines after adjusting for ethnicity, deprivation, and maternal age (First and Second MMRs adjusted HRs:1.43 (CI:1.41-1.45), 1.49 (CI:1.45-1.53). CONCLUSION Children from most-deprived areas are less likely to have MMR vaccines compared with children from least-deprived areas. Mothers who take up pregnancy vaccines are more likely to have their children vaccinated with MMR. Healthcare services should promote and facilitate access to both maternal and childhood vaccines during pregnancy.
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Affiliation(s)
- H Skirrow
- School of Public Health, Imperial College London, United Kingdom.
| | - K Foley
- School of Public Health, Imperial College London, United Kingdom
| | - H Bedford
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | - C Lewis
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, University College London, United Kingdom; London North Genomic Laboratory Hub, Great Ormond Street Hospital, London, United Kingdom
| | - E Whittaker
- Section of Paediatric Infectious Diseases, Imperial College London, United Kingdom; Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, United Kingdom
| | - C Costelloe
- School of Public Health, Imperial College London, United Kingdom; Institute of Cancer Research, London, United Kingdom
| | - S Saxena
- School of Public Health, Imperial College London, United Kingdom
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Alonge OD, Marin M, Hickman CJ, Sowers SB, Chen MH, Hao L, Mercader S, El-Badry E, McClure DL, Icenogle JP, Sugerman DE, Crooke SN, Nguyen HQ. Long-term Neutralizing Antibody Levels Against Measles and Rubella Viruses Among Adults With 3 Doses of Measles-Mumps-Rubella Vaccine. Open Forum Infect Dis 2024; 11:ofad700. [PMID: 38213634 PMCID: PMC10783245 DOI: 10.1093/ofid/ofad700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024] Open
Abstract
Background A third dose of measles-mumps-rubella vaccine (MMR) may be administered for various reasons, but data on long-term immunity are limited. We assessed neutralizing antibody levels against measles and rubella among adults up to 11 years after receipt of a third MMR dose. Methods In this longitudinal study, healthy adults who received a third MMR dose as young adults (ages 18-28 years) were recalled around 5 years and 9-11 years after the third dose. Measles and rubella antibody levels were assessed by plaque-reduction and immunocolorimetric neutralization assays, respectively. Antibody concentrations <120 mIU/mL and <10 U/mL were considered potentially susceptible to measles and rubella, respectively. Geometric mean concentrations (GMCs) and 95% confidence intervals (CIs) over time were estimated from generalized estimating equation models. Results Approximately 5 and 9-11 years after receipt of the third dose, 405 and 304 adults were assessed, respectively. Measles GMC was 428 mIU/mL (95% CI, 392-468 mIU/mL) 5 years postvaccination, declining to 381 mIU/mL (95% CI, 339-428 mIU/mL) 11 years postvaccination. At the last follow-up visit (9-11 years postvaccination), 10% of participants were potentially susceptible to measles infection. Rubella GMCs were stable throughout the follow-up period (63 U/mL to 65 U/mL); none of the participants was susceptible to rubella at the last follow-up visit. Conclusions Eleven years after receiving a third MMR dose, measles and rubella neutralizing antibody levels remained high in adults. However, on the basis of waning antibody levels, some adults may become susceptible to measles infection over time despite receipt of 3 vaccine doses.
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Affiliation(s)
- Oluwakemi D Alonge
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Mona Marin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carole J Hickman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sun B Sowers
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Min-hsin Chen
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lijuan Hao
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sara Mercader
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elina El-Badry
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David L McClure
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Joseph P Icenogle
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David E Sugerman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stephen N Crooke
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Huong Q Nguyen
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
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Familiar-Macedo D, Dias HG, Carvalho FR, Pauvolid-Corrêa A, da Silveira MN, de Oliveira MC, Gonçalves RDCF, Vianna RADO, Cardoso CAA, Boy da Silva RT, Baumblatt AP, de-Oliveira-Pinto LM. Serological investigation of vaccine-induced antibodies for measles, rubella, and yellow fever viruses in children vertically exposed to Zika virus or with down syndrome. Front Pediatr 2023; 11:1250059. [PMID: 38155740 PMCID: PMC10753015 DOI: 10.3389/fped.2023.1250059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Background Vaccination schedules, as well as their effectiveness and contraindications, need to be evaluated regularly, especially in specific situations. Congenital Zika Syndrome (CZS) is a severe condition that results in extensive functional and neurological impairment of fetuses and newborns due to Zika virus tropism for fetal neural progenitor cells. Down Syndrome (DS) is the leading genetic cause of intellectual disability. The immune impairment in DS has already been described, but little is known about the immune response of CZS children. Thus, CZS and DS are specific conditions that can be considered for a reassessment of the available immunizations. Here, we carried out serological analyses of attenuated vaccines-induced antibodies for measles, rubella, and yellow fever viruses in children aged 2-7, grouped into asymptomatic controls, DS children, and CZS children. Methods Plasma samples were taken, and vaccination records were compiled during clinical follow-up. Enzymatic immunoassays for quantifying anti-measles and anti-rubella IgG were performed to assess the response to the Measles, Mumps, and Rubella (MMR) vaccine. Plaque Reduction Neutralization Test (PRNT) was performed to investigate neutralizing antibodies in response to the Brazilian vaccine strain of yellow fever (YF-17DD). Results We highlight similar levels of anti-measles IgG and neutralizing antibodies for YF-17DD among CZS, DS, and asymptomatic children, although low positivity of measles data was seen in the three groups. In DS children, the 2-4-year-old group had an increased level of anti-measles IgG compared to the older group of children aged five to seven years. Lower anti-rubella IgG levels were observed in CZS and DS children compared to asymptomatic children. For anti-rubella IgG, the good performance of vaccination in asymptomatic children is due to younger ones rather than older ones. Conclusions There were no reports of adverse events after the use of the MMR and YF-17DD indicating that CZS and DS could continue to receive these vaccines, but our data draws attention to the necessity of monitoring the vaccination response in CZS and DS children over time and the possible need to adhere to national measles vaccination campaigns. Scientific research needs to continue to help develop appropriate CZS and DS health guidelines.
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Affiliation(s)
- Débora Familiar-Macedo
- Laboratório das Interações Vírus-Hospedeiros (LIVH), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (IOC/Fiocruz), Rio de Janeiro, Brazil
| | - Helver Gonçalves Dias
- Laboratório das Interações Vírus-Hospedeiros (LIVH), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (IOC/Fiocruz), Rio de Janeiro, Brazil
| | - Fabiana Rabe Carvalho
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil
| | - Alex Pauvolid-Corrêa
- Laboratório de Virologia Veterinária de Viçosa (LAVEV), Departamento de Veterinária, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Mayara Neto da Silveira
- Ambulatório Multidisciplinar de Síndrome de Down (AMBDOWN), Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Cavalcante de Oliveira
- Laboratório das Interações Vírus-Hospedeiros (LIVH), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (IOC/Fiocruz), Rio de Janeiro, Brazil
| | | | | | - Claudete Aparecida Araujo Cardoso
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas (LAMAP), Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil
- Departamento Materno Infantil, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil
| | - Raquel Tavares Boy da Silva
- Ambulatório Multidisciplinar de Síndrome de Down (AMBDOWN), Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Anna Paula Baumblatt
- Ambulatório Multidisciplinar de Síndrome de Down (AMBDOWN), Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luzia Maria de-Oliveira-Pinto
- Laboratório das Interações Vírus-Hospedeiros (LIVH), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (IOC/Fiocruz), Rio de Janeiro, Brazil
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Guo A, Leung J, Ayers T, Fields VS, Safi H, Waters C, Curns AT, Routh JA, Haselow DT, Marlow MA, Marin M. Mumps vaccine effectiveness of a 3rd dose of measles, mumps, rubella vaccine in school settings during a mumps outbreak -- Arkansas, 2016-2017. Public Health Pract (Oxf) 2023; 6:100404. [PMID: 38099088 PMCID: PMC10719407 DOI: 10.1016/j.puhip.2023.100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/05/2023] [Indexed: 12/17/2023] Open
Abstract
Objectives The largest mumps outbreak in the United States since 2006 occurred in Arkansas during the 2016-17 school year. An additional dose (third dose) of measles-mumps-rubella vaccine (MMR3) was offered to school children. We evaluated the vaccine effectiveness (VE) of MMR3 compared with two doses of MMR for preventing mumps among school-aged children during the outbreak. Study design A generalized linear mixed effects model was used to estimate the incremental vaccine effectiveness (VE) of a third dose of MMR compared with two doses of MMR for preventing mumps. Methods We obtained school enrollment, immunization status and mumps case status from school registries, Arkansas's immunization registry, and Arkansas's mumps surveillance system, respectively. We included students who previously received 2 doses of MMR in schools with ≥1 mumps case after the MMR3 clinic. We used a generalized linear mixed model to estimate VE of MMR3 compared with two doses of MMR. Results Sixteen schools with 9272 students were included in the analysis. Incremental VE of MMR3 versus a two-dose MMR regimen was 52.7% (95% confidence interval [CI]: -3.6%‒78.4%) overall and in 8 schools with high mumps transmission it was 64.0% (95% CI: 1.2%‒86.9%). MMR3 VE was higher among middle compared with elementary school students (68.5% [95% CI: -30.2%‒92.4%] vs 37.6% [95% CI: -62.5%‒76.1%]); these differences were not statistically significant. Conclusion Our findings suggest MMR3 provided additional protection from mumps compared with two MMR doses in elementary and middle school settings during a mumps outbreak.
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Affiliation(s)
- Angela Guo
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Jessica Leung
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Tracy Ayers
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Virgie S. Fields
- Arkansas Department of Health, 4815 W Markham St, Little Rock, AR, 72205, USA
- Council of State and Territorial Epidemiologists Applied Epidemiology Fellowship, 2635 Century Pkwy NE #700, Atlanta, GA, 30345, USA
| | - Haytham Safi
- Arkansas Department of Health, 4815 W Markham St, Little Rock, AR, 72205, USA
| | - Catherine Waters
- Arkansas Department of Health, 4815 W Markham St, Little Rock, AR, 72205, USA
| | - Aaron T. Curns
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Janell A. Routh
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Dirk T. Haselow
- Arkansas Department of Health, 4815 W Markham St, Little Rock, AR, 72205, USA
| | - Mariel A. Marlow
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Mona Marin
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
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11
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Achdiat PA, Yunitasari, Usman HA, Maharani RH. A Case of Genital and Extragenital Warts Unresponsive to Immunotherapy Using Measles, Mumps, Rubella Vaccine. Int Med Case Rep J 2023; 16:739-746. [PMID: 38020581 PMCID: PMC10657768 DOI: 10.2147/imcrj.s426665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Anogenital warts (AGWs) are globally recognized as the most common sexually transmitted infections (STIs) caused by the human papillomavirus (HPV), particularly types 6 and 11. Meanwhile, immunotherapy is one of the treatments of choice for patients with extensive AGWs. Measles, mumps, and rubella (MMR) vaccine induce the production of various T helper 1 cytokines to elicit immune responses, resulting in the clearance of both treated and untreated warts. This study reported a case of extensive genital and extragenital warts in a 53-year-old male which had occurred for five years, with no pseudo-Koebner phenomenon. The history of MMR vaccination was uncertain but the patient received oral antibiotics for one week, one month before seeking consultation. Physical examination showed extensive verrucous and hyperkeratotic papules, plaques, and nodules in the lower abdomen, pubic, inguinal, genital, and gluteal regions. Acetowhite test results were positive, while polymerase chain reaction (PCR) results were positive for HPV types 6 and 11. The patient received an intralesional injection of 0.5 mL MMR vaccine into the largest warts with a 3-week interval. However, during the one-month follow-up after the third injection, no improvement was observed in either the size or number of warts. Based on the results, several factors must be considered to determine the best candidate for immunotherapy, particularly with MMR vaccine, to achieve an optimal outcome. These factors include the active state of diseases, duration of diseases, as well as a history of sensitization, and broad-spectrum antibiotics.
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Affiliation(s)
- Pati Aji Achdiat
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Yunitasari
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Hermin Aminah Usman
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Retno Hesty Maharani
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
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12
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Xu J, Zhang Y, Qu P, Shamseldin MM, Yoo SJ, Misny J, Thongpan I, KC M, Hall JM, Evans JP, Eltobgy M, Lu M, Ye C, Chamblee M, Liang X, Martinez-Sobrido L, Amer AO, Yount JS, Boyaka PN, Peeples ME, Liu SL, Dubey P, Li J. A next-generation intranasal trivalent MMS vaccine induces durable and broad protection against SARS-CoV-2 variants of concern. Proc Natl Acad Sci U S A 2023; 120:e2220403120. [PMID: 37796985 PMCID: PMC10576135 DOI: 10.1073/pnas.2220403120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/24/2023] [Indexed: 10/07/2023] Open
Abstract
As SARS-CoV-2 variants of concern (VoCs) that evade immunity continue to emerge, next-generation adaptable COVID-19 vaccines which protect the respiratory tract and provide broader, more effective, and durable protection are urgently needed. Here, we have developed one such approach, a highly efficacious, intranasally delivered, trivalent measles-mumps-SARS-CoV-2 spike (S) protein (MMS) vaccine candidate that induces robust systemic and mucosal immunity with broad protection. This vaccine candidate is based on three components of the MMR vaccine, a measles virus Edmonston and the two mumps virus strains [Jeryl Lynn 1 (JL1) and JL2] that are known to provide safe, effective, and long-lasting protective immunity. The six proline-stabilized prefusion S protein (preS-6P) genes for ancestral SARS-CoV-2 WA1 and two important SARS-CoV-2 VoCs (Delta and Omicron BA.1) were each inserted into one of these three viruses which were then combined into a trivalent "MMS" candidate vaccine. Intranasal immunization of MMS in IFNAR1-/- mice induced a strong SARS-CoV-2-specific serum IgG response, cross-variant neutralizing antibodies, mucosal IgA, and systemic and tissue-resident T cells. Immunization of golden Syrian hamsters with MMS vaccine induced similarly high levels of antibodies that efficiently neutralized SARS-CoV-2 VoCs and provided broad and complete protection against challenge with any of these VoCs. This MMS vaccine is an efficacious, broadly protective next-generation COVID-19 vaccine candidate, which is readily adaptable to new variants, built on a platform with a 50-y safety record that also protects against measles and mumps.
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Affiliation(s)
- Jiayu Xu
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
| | - Yuexiu Zhang
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
| | - Panke Qu
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
| | - Mohamed M. Shamseldin
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH 43210
- Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Helwan11795, Egypt
| | - Sung J. Yoo
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
| | - Jack Misny
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205
| | - Ilada Thongpan
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205
| | - Mahesh KC
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205
| | - Jesse M. Hall
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH 43210
| | - John P. Evans
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
| | - Mostafa Eltobgy
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH 43210
| | - Mijia Lu
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
| | - Chengjin Ye
- Department of Disease Intervention and Prevention, Texas Biomedical Research Institute, San Antonio, TX 78227
| | - Michelle Chamblee
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
| | - Xueya Liang
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
| | - Luis Martinez-Sobrido
- Department of Disease Intervention and Prevention, Texas Biomedical Research Institute, San Antonio, TX 78227
| | - Amal O. Amer
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH 43210
- Infectious Disease Institute, The Ohio State University, Columbus, OH 43210
| | - Jacob S. Yount
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH 43210
- Infectious Disease Institute, The Ohio State University, Columbus, OH 43210
| | - Prosper N. Boyaka
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
- Infectious Disease Institute, The Ohio State University, Columbus, OH 43210
| | - Mark E. Peeples
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205
- Infectious Disease Institute, The Ohio State University, Columbus, OH 43210
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH 43210
| | - Shan-Lu Liu
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH 43210
- Infectious Disease Institute, The Ohio State University, Columbus, OH 43210
- Center for Retrovirus Research, The Ohio State University, Columbus, OH43210
| | - Purnima Dubey
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH 43210
- Infectious Disease Institute, The Ohio State University, Columbus, OH 43210
| | - Jianrong Li
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
- Infectious Disease Institute, The Ohio State University, Columbus, OH 43210
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13
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Us MC, Coci K, Akkuş E, Okay B, Akkoç G. A Single-Center Evaluation of Pediatric Measles Cases in Istanbul, Türkiye, in 2019. Jpn J Infect Dis 2023; 76:267-274. [PMID: 37121672 DOI: 10.7883/yoken.jjid.2022.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Although measles can be prevented and eliminated by vaccination, it is a highly contagious viral disease that can lead to serious complications, disability, and death. The aim of this retrospective study was to evaluate the characteristics of measles cases in a single center. All children with clinically suspected measles who attended the Pediatric Clinic at Esenler Maternity and Child Health Hospital in Istanbul, Türkiye, between January 1 and June 30, 2019 were included in the analysis. None of the children with measles were fully vaccinated. The incidence and duration of conjunctivitis were significantly higher in the unvaccinated group than in the partially vaccinated group (P = 0.027 and P = 0.019, respectively). Unvaccinated patients had a significantly lower median leukocyte count (P = 0.019) and significantly higher median C-reactive protein level (P = 0.021). The vitamin A level and leukocyte count were moderately positively correlated (r = 0.698; P = 0.008). Children should be fully vaccinated in order to prevent measles.
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Affiliation(s)
- Mahmut Caner Us
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
- Department of Pediatrics, Haseki Training and Research Hospital, Türkiye
| | - Kübra Coci
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
| | - Erkan Akkuş
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, Istanbul University, Türkiye
| | - Berker Okay
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
| | - Gülşen Akkoç
- Department of Infectious Diseases, Haseki Training and Research Hospital, Türkiye
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14
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Khalid Z, Coco S, Ullah N, Pulliero A, Cortese K, Varesano S, Orsi A, Izzotti A. Anticancer Activity of Measles-Mumps-Rubella MMR Vaccine Viruses against Glioblastoma. Cancers (Basel) 2023; 15:4304. [PMID: 37686579 PMCID: PMC10486717 DOI: 10.3390/cancers15174304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Oncolytic viruses (OVs) have been utilized since 1990s for targeted cancer treatment. Our study examined the Measles-Mumps-Rubella (MMR) vaccine's cancer-killing potency against Glioblastoma (GBM), a therapy-resistant, aggressive cancer type. METHODOLOGY We used GBM cell lines, primary GBM cells, and normal mice microglial cells, to assess the MMR vaccine's efficacy through cell viability, cell cycle analysis, intracellular viral load via RT-PCR, and Transmission Electron Microscopy (TEM). RESULTS After 72 h of MMR treatment, GBM cell lines and primary GBM cells exhibited significant viability reduction compared to untreated cells. Conversely, normal microglial cells showed only minor changes in viability and morphology. Intracellular viral load tests indicated GBM cells' increased sensitivity to MMR viruses compared to normal cells. The cell cycle study also revealed measles and mumps viruses' crucial role in cytopathic effects, with the rubella virus causing cell cycle arrest. CONCLUSION Herein the reported results demonstrate the anti-cancer activity of the MMR vaccine against GBM cells. Accordingly, the MMR vaccine warrants further study as a potential new tool for GBM therapy and relapse prevention. Therapeutic potential of the MMR vaccine has been found to be promising in earlier studies as well.
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Affiliation(s)
- Zumama Khalid
- Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genoa, Italy; (Z.K.); (N.U.); (A.P.); (A.O.)
| | - Simona Coco
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (S.C.); (S.V.)
| | - Nadir Ullah
- Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genoa, Italy; (Z.K.); (N.U.); (A.P.); (A.O.)
| | - Alessandra Pulliero
- Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genoa, Italy; (Z.K.); (N.U.); (A.P.); (A.O.)
| | - Katia Cortese
- Department of Experimental Medicine, University of Genoa, 16132 Genoa, Italy;
| | - Serena Varesano
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (S.C.); (S.V.)
| | - Andrea Orsi
- Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genoa, Italy; (Z.K.); (N.U.); (A.P.); (A.O.)
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (S.C.); (S.V.)
| | - Alberto Izzotti
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy; (S.C.); (S.V.)
- Department of Experimental Medicine, University of Genoa, 16132 Genoa, Italy;
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15
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Santana-Gutierrez A, Pérez-Garza DM, Ocampo-Candiani J, Alba-Rojas E. Intralesional immunotherapy with MMR vaccine in a paediatric case of focal epithelial hyperplasia. Australas J Dermatol 2023; 64:e290-e291. [PMID: 37228245 DOI: 10.1111/ajd.14091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/04/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Adalberto Santana-Gutierrez
- Dermatology Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Daniela Michelle Pérez-Garza
- Dermatology Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Jorge Ocampo-Candiani
- Dermatology Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Erika Alba-Rojas
- Dermatology Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
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16
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Novilla MLB, Goates MC, Redelfs AH, Quenzer M, Novilla LKB, Leffler T, Holt CA, Doria RB, Dang MT, Hewitt M, Lind E, Prickett E, Aldridge K. Why Parents Say No to Having Their Children Vaccinated against Measles: A Systematic Review of the Social Determinants of Parental Perceptions on MMR Vaccine Hesitancy. Vaccines (Basel) 2023; 11:vaccines11050926. [PMID: 37243030 DOI: 10.3390/vaccines11050926] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Ongoing outbreaks of measles threaten its elimination status in the United States. Its resurgence points to lower parental vaccine confidence and local pockets of unvaccinated and undervaccinated individuals. The geographic clustering of hesitancy to MMR indicates the presence of social drivers that shape parental perceptions and decisions on immunization. Through a qualitative systematic review of published literature (n = 115 articles; 7 databases), we determined major themes regarding parental reasons for MMR vaccine hesitancy, social context of MMR vaccine hesitancy, and trustworthy vaccine information sources. Fear of autism was the most cited reason for MMR hesitancy. The social drivers of vaccine hesitancy included primary care/healthcare, education, economy, and government/policy factors. Social factors, such as income and education, exerted a bidirectional influence, which facilitated or hindered vaccine compliance depending on how the social determinant was experienced. Fear of autism was the most cited reason for MMR hesitancy. Vaccine hesitancy to MMR and other childhood vaccines clustered in middle- to high-income areas among mothers with a college-level education or higher who preferred internet/social media narratives over physician-based vaccine information. They had low parental trust, low perceived disease susceptibility, and were skeptical of vaccine safety and benefits. Combating MMR vaccine misinformation and hesitancy requires intersectoral and multifaceted approaches at various socioecological levels to address the social drivers of vaccine behavior.
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Affiliation(s)
| | - Michael C Goates
- Harold B. Lee Library, Brigham Young University, Provo, UT 84602, USA
| | - Alisha H Redelfs
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Mallory Quenzer
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | | | - Tyler Leffler
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Christian A Holt
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Russell B Doria
- School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, USA
| | - Michael T Dang
- School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, USA
| | - Melissa Hewitt
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Emma Lind
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Elizabeth Prickett
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Katelyn Aldridge
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
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Quach HQ, Chen J, Monroe JM, Ratishvili T, Warner ND, Grill DE, Haralambieva IH, Ovsyannikova IG, Poland GA, Kennedy RB. The Influence of Sex, Body Mass Index, and Age on Cellular and Humoral Immune Responses Against Measles After a Third Dose of Measles-Mumps-Rubella Vaccine. J Infect Dis 2022; 227:141-150. [PMID: 35994504 DOI: 10.1093/infdis/jiac351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/12/2022] [Accepted: 08/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND A third dose of measles-mumps-rubella vaccine (MMR3) is recommended in mumps outbreak scenarios, but the immune response and the need for widespread use of MMR3 remain uncertain. Herein, we characterized measles-specific immune responses to MMR3 in a cohort of 232 healthy subjects. METHODS Serum and peripheral blood mononuclear cells (PBMCs) were sampled at day 0 and day 28 after MMR3. Measles-specific binding and neutralizing antibodies were quantified in sera by enzyme-linked immunosorbent assay and a microneutralization assay, respectively. PBMCs were stimulated with inactivated measles virus, and the release of cytokines/chemokines was assessed by a multiplex assay. Demographic variables of subjects were examined for potential correlations with immune outcomes. RESULTS Of the study participants, 95.69% and 100% were seropositive at day 0 and day 28, respectively. Antibody avidity significantly increased from 38.08% at day 0 to 42.8% at day 28 (P = .00026). Neutralizing antibodies were significantly enhanced, from 928.7 at day 0 to 1289.64 mIU/mL at day 28 (P = .0001). Meanwhile, cytokine/chemokine responses remained largely unchanged. Body mass index was significantly correlated with the levels of inflammatory cytokines/chemokines. CONCLUSIONS Measles-specific humoral immune responses, but not cellular responses, were enhanced after MMR3 receipt, extending current understanding of immune responses to MMR3 and supporting MMR3 administration to seronegative or high-risk individuals.
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Affiliation(s)
- Huy Quang Quach
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jun Chen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Jonathon M Monroe
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Tamar Ratishvili
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathaniel D Warner
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Diane E Grill
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Iana H Haralambieva
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Inna G Ovsyannikova
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Gregory A Poland
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Richard B Kennedy
- Mayo Clinic Vaccine Research Group, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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18
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Kirkedal ABK, Møller JE, Stensballe LG, Zoffmann V. Parents' and Health Professionals' Attitudes to Advancing Primary MMR Vaccine Administration from Fifteen to Six Months of Age-A Qualitative Thematic Analysis Embedded in a Randomized Trial. Vaccines (Basel) 2022; 11:vaccines11010067. [PMID: 36679912 PMCID: PMC9861513 DOI: 10.3390/vaccines11010067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 12/30/2022] Open
Abstract
Declining levels and duration of passively acquired maternal antibodies prompted a Danish trial to test the feasibility of advancing administration of the first measles, mumps, and rubella vaccine (MMR1) from 15 to 6 months of age. A trial-embedded qualitative study aimed to understand parents' (N = 24) and health professionals' (N = 11) attitudes about the measles, mumps, and rubella vaccine (MMR) in general and about advancing MMR1 administration. Overly positive parent attitudes were contrasted by members of a vaccine-skeptical organization including parents considering that their child was seriously vaccine-injured long ago. Parents' attitudes to advancing MMR1 mirrored their attitudes about the MMR vaccine in general, with four positions along a continuum of trust in the healthcare system: unquestioning trust, acceptance after careful consideration, challenging indecisiveness, and defensive rejection. Low tolerance was identified between vaccine supporters and vaccine opponents. Parents of children with perceived serious vaccine-related injuries described lifelong unresolved feelings of guilt. Supporters of advanced MMR1 saw it as a timely and convenient administration of a well-known vaccine, whereas opponents feared it would disturb the children's immature immune systems and emphasized difficulties in recognizing side effects so early in life. Health professionals were supportive of advancing the MMR1 vaccine and they carefully challenged the parents. Current MMR vaccine supporters show readiness to advance MMR1 administration.
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Affiliation(s)
- Ann-Britt Kiholm Kirkedal
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
- Correspondence:
| | - Julie Elkjær Møller
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
| | - Lone Graff Stensballe
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Vibeke Zoffmann
- The Interdisciplinary Research Unit of Women’s, Children’s and Families’ Health, The Julie Marie Center, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
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19
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Kolla E, Weill A, Desplas D, Semenzato L, Zureik M, Grimaldi L. Does Measles, Mumps, and Rubella (MMR) Vaccination Protect against COVID-19 Outcomes: A Nationwide Cohort Study. Vaccines (Basel) 2022; 10:1938. [PMID: 36423033 PMCID: PMC9694832 DOI: 10.3390/vaccines10111938] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 10/10/2023] Open
Abstract
Cross-protection from previous live attenuated vaccines is proposed to explain the low impact of COVID-19 on children. This study aimed to evaluate the effect of live attenuated MMR vaccines on the risk of being hospitalized for COVID-19 in children. An exposed (MMR vaccine)-non-exposed cohort study was conducted using the nationwide French National Health Data System (SNDS). We included children born between 1 January 2009 and 31 December 2019. Exposure was defined as a claim of at least one dose of MMR vaccine since birth. Hospitalization for COVID-19 was defined using main diagnostic ICD10 codes. Non-conditional logistic regression was used to calculate the adjusted odds ratios (aORs) of the association between MMR exposure and hospitalization for COVID-19, controlling for socio-demographic and socio-economic factors, co-morbidities, and general health. In total, 6,800,542 (median age 6 IQR [3-8] years) children exposed to a MMR vaccine and 384,162 (6 [3-9] years) not exposed were followed up with for 18 months. Among them, 873 exposed to the MMR vaccine and 38 who were not exposed were hospitalized for COVID-19. In a multi-variate analysis, the exposure of children to MMR vaccination was not associated with a decreased risk of COVID-19 hospitalization versus non-exposure (aOR (95%CI) = 1.09 [0.81-1.48]). A stratified analysis by age showed an aOR = 1.03 [0.64-1.66] for children aged 1-4, an aOR = 1.38 [0.82-2.31] for those aged 5-9, and an aOR = 1.11 [0.54-2.29] for those aged 10-12. Our study suggests that the live attenuated MMR vaccine does not protect children against COVID-19 hospitalization.
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Affiliation(s)
- Epiphane Kolla
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
- INSERM (National Institute of Health and Medical Research), University of Paris-Saclay, University Versailles Saint Quentin, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
| | - Alain Weill
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - David Desplas
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - Laura Semenzato
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - Mahmoud Zureik
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
- INSERM (National Institute of Health and Medical Research), University of Paris-Saclay, University Versailles Saint Quentin, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
| | - Lamiae Grimaldi
- Clinical Research Unit AP-HP, Paris-Saclay, Hôpital Raymond Poincare, School of Medicine Simone Veil, University Versailles Saint Quentin—University Paris Saclay, INSERM (National Institute of Health and Medical Research), CESP, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
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20
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Quach HQ, Ovsyannikova IG, Grill DE, Warner ND, Poland GA, Kennedy RB. Seroprevalence of Measles Antibodies in a Highly MMR-Vaccinated Population. Vaccines (Basel) 2022; 10:1859. [PMID: 36366367 PMCID: PMC9698789 DOI: 10.3390/vaccines10111859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 09/21/2023] Open
Abstract
As an extremely contagious pathogen, a high rate of vaccine coverage and the durability of vaccine-induced immunity are key factors to control and eliminate measles. Herein, we assessed the seroprevalence of antibodies specific to measles in a cohort of 1393 adults (20-44 years old). ELISA results showed a nontrivial proportion of 37.6% study subjects being negative for measles immunoglobulin G (IgG). We also found significant influences of sex and age of the study cohort on the IgG level. Our findings suggest that even within a highly vaccinated population, a subset of individuals may still have sub-optimal immunity against measles and potentially be susceptible during any future measles outbreaks.
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Affiliation(s)
- Huy Quang Quach
- Mayo Clinic Vaccine Research Group, Division of General of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Inna G. Ovsyannikova
- Mayo Clinic Vaccine Research Group, Division of General of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Diane E. Grill
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | - Nathaniel D. Warner
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | - Gregory A. Poland
- Mayo Clinic Vaccine Research Group, Division of General of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Richard B. Kennedy
- Mayo Clinic Vaccine Research Group, Division of General of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
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21
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Gambrell A, Sundaram M, Bednarczyk RA. Estimating the number of US children susceptible to measles resulting from COVID-19-related vaccination coverage declines. Vaccine 2022; 40:4574-4579. [PMID: 35728989 PMCID: PMC9197781 DOI: 10.1016/j.vaccine.2022.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
Measles elimination hinges on vaccination coverage remaining above 95% to retain sufficient community protection. Recent declines in routine measles vaccinations due to the COVID-19 pandemic coupled with prior models indicating the country was close to the 92% herd immunity benchmark are a cause for concern. We evaluated population-level measles susceptibility in the US, including sensitivity analyses accounting for pandemic-related impacts on immunization. We estimated the number of children aged 0–18 currently susceptible to measles and modeled susceptibility proportions in decreased vaccination scenarios. Participants were respondents to the NIS-Teen survey between 2008 and 2017 that also had provider-verified vaccination documentation. The exposure of interest was vaccination with a measles-containing vaccine (MCV), and the age at which they were vaccinated for all doses given. Using age at vaccination, we estimated age-based probabilities of vaccination and modeled population levels of MCV immunization and immunity vs. susceptibility. Currently, 9,145,026 children (13.1%) are estimated to be susceptible to measles. With pandemic level vaccination rates, 15,165,221 children (21.7%) will be susceptible to measles if no attempt at catch-up is made, or 9,454,436 children (13.5%) if catch-up vaccinations mitigate the decline by 2–3%. Models based on increased vaccine hesitancy also show increased susceptibility at national levels, with a 10% increase in hesitancy nationally resulting in 14,925,481 children (21.37%) susceptible to measles, irrespective of pandemic vaccination levels. Current levels of measles immunity remain below herd immunity thresholds. If pandemic-era reductions in childhood immunization are not rectified, population-level immunity to measles is likely to decline further.
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Affiliation(s)
- Ashley Gambrell
- Emory University, Rollins School of Public Health, Dept. of Epidemiology, Atlanta, GA 30322, USA.
| | - Maria Sundaram
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI 54449, USA.
| | - Robert A Bednarczyk
- Emory University, Rollins School of Public Health, Dept. of Epidemiology, Atlanta, GA 30322, USA; Emory University, Rollins School of Public Health, Hubert Dept. of Global Health, Atlanta, GA 30322, USA; Emory Vaccine Center, Emory University, Atlanta, GA 30322, USA.
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22
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Ibrahim NA, Mahallawi WH. Rubella Humoral Immunity Among the Saudi Population of Madinah in the Western Region of Saudi Arabia. Viral Immunol 2022; 35:375-380. [PMID: 35537526 DOI: 10.1089/vim.2021.0226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Maintaining herd immunity against the rubella virus is important for controlling the spread and recurrence of rubella. Rubella vaccination for children has been affordable in Saudi Arabia since 1982. To assess the immune response derived from vaccination, we assessed the seroprevalence against the rubella virus among the population of the Madinah region. An indirect enzyme-linked immunosorbent assay (ELISA) was used to measure anti-rubella IgG antibodies in 791 serum samples obtained from 336 (42.5%) men and 455 (57.5%) women, ranging from 14 to 49 years in age. Among all participants, 94.2% were seropositive for rubella IgG antibodies, indicating a high degree of immunization. However, 5.8% of participants were seronegative, suggesting a population of either poor vaccine responders or the potential risk of waning vaccine-induced immunity. No significant difference or association with rubella seropositivity was identified according to age, sex, or pregnancy status. The median anti-rubella IgG antibody concentrations differed significantly between age groups (p < 0.001). Although a high percentage of the tested population in Madinah demonstrated anti-rubella IgG antibody seropositivity, a notable percentage of the population were seronegative, making them susceptible to infection.
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Affiliation(s)
- Nadir A Ibrahim
- Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Waleed H Mahallawi
- Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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23
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Bianchi FP, Stefanizzi P, Lattanzio S, Diella G, Germinario CA, Tafuri S. Attitude for vaccination prophylaxis among pregnant women: a cross-sectional study. Hum Vaccin Immunother 2022; 18:2031698. [PMID: 35180368 PMCID: PMC9067467 DOI: 10.1080/21645515.2022.2031698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Pregnant women and newborns are considered a subgroup of population at increased risk for several infectious diseases, some of which are vaccine-preventable. Anti-diphtheria-tetanus-pertussis vaccine (dTpa) and influenza vaccine are recommended for pregnant women. We carried out a study to evaluate the knowledge of new mothers toward the main vaccine-preventable diseases and to assess their compliance with recommended vaccinations. Using the Hospital Discharge Forms (SDO), the list of women who gave birth in 2018 was generated. Women were interviewed by a questionnaire administered by telephone. The study sample consisted of 145 subjects, with an average age of 35.0 ± 5.9 years (range = 18.0–47.0). 5/145 (3.4%; 95% CI = 1.1–7.9%) subjects were advised during pregnancy to have the flu shot; only 1/145 (0.7%; 95% CI = 0.5–71.6%) reported the flu vaccine during the last pregnancy. 94/145 (64.8%; 95% CI = 57.2–73.2%) respondents declared that they had carried out the TORCH panel exams before pregnancy; of these 18/94 (19.2%; 95% C = 11.8–28.6%) were susceptible for rubella. Of these subjects, for 7/18 (38.9%; 95% CI = 17.3–64.3%) rubella vaccination was offered and 5/7 (71.4%; 95% CI = 29.0–96.3%) decided to carry out the vaccination. Only 1/145 (0.7%; 95% CI = 0.0–3.8%) of the interviewed woman underwent anti-dTap vaccination. Greater efforts must be made by public health institutions to raise awareness and improve vaccination compliance in this population.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Sabrina Lattanzio
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | | | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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24
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Bogusz J, Augustynowicz E, Paradowska-Stankiewicz I. Rubella in Poland in 2020. Przegl Epidemiol 2022; 76:554-560. [PMID: 37017447 DOI: 10.32394/pe.76.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
INTRODUCTION Since 2005, rubella has been included in the eradication program coordinated by the World Health Organization (WHO). The elimination of rubella in the country is possible provided that it is achieved by min. 95% immunization status and monitoring of the epidemiological situation, including the recording all suspicions of rubella and conducting laboratory diagnostics in the WHO Reference Laboratory. AIM OF THE STUDY The aim of the study is to assess the epidemiological situation of rubella in Poland in 2020, taking into account the assessment of rubella vaccination status and the degree of implementation of the WHO rubella elimination program in Poland. MATERIAL AND METHODS Assessment of the epidemiological situation of rubella in Poland based on aggregated reports of suspected rubella cases sent to the National Institute of Public Health NIH - National Research Institute by the Voivodeship Sanitary and Epidemiological Stations, data from the bulletin "Infectious diseases and poisoning in Poland in 2020" and data from the Epibaza system and the bulletin "Preventive vaccination in Poland in 2020". RESULTS In 2020, 98 cases of rubella were registered, 187 cases less than in 2019 (285 cases). There was also a decrease in the incidence to 0.26 per 100,000, compared to 0.74 per 100,000 in 2019. The highest incidence, iregardless of gender and place of residence, was recorded in the 0-4 age group (2.98 per 100,000). In 2020, no cases of congenital rubella syndrome were reported. In 2020, only one case (1.02%) was classified as a case confirmed in a laboratory test. The remaining 98.98% (97 cases) were diagnosed on the basis of clinical symptoms. SUMMARY AND CONCLUSIONS In 2020, in Poland, a decrease in the number of rubella was observed. Rubella was registered in 99% on the basis of a general diagnosis, without the required laboratory confirmation, which means that other rash diseases can be registered as rubella.
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Affiliation(s)
- Joanna Bogusz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Ewa Augustynowicz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Iwona Paradowska-Stankiewicz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
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25
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Riggenbach MM, Haralambieva IH, Ovsyannikova IG, Schaid DJ, Poland GA, Kennedy RB. Mumps virus-specific immune response outcomes and sex-based differences in a cohort of healthy adolescents. Clin Immunol 2022; 234:108912. [PMID: 34968746 DOI: 10.1016/j.clim.2021.108912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 01/03/2023]
Abstract
Despite high levels of MMR-II usage in the US, mumps outbreaks continue to occur. Evidence suggests that mumps vaccine-induced humoral immunity wanes over time. Relatively few studies have examined cell-mediated immunity or reported on sex-based differences. To better understand sex-based differences in the immune response to mumps vaccine, we measured neutralizing antibody titers and mumps-specific cytokine/chemokine responses in a cohort of 748 adolescents and young adults after two doses of MMR vaccine. We observed significantly higher neutralizing antibody titers in females than in males (120.8 IU/mL, 98.7 IU/mL, p = 0.038) but significantly higher secretion levels of MIP-1α, MIP-1β, TNFα, IL-6, IFNγ, and IL-1β in males compared to females. These data demonstrate that sex influences mumps-specific humoral and cell-mediated immune response outcomes, a phenomenon that should be considered during efforts to improve vaccines and prevent future outbreaks.
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26
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Mohta A, Kushwaha RK, Agrawal A, Sharma MK, Gautam U, Jain SK. Evaluation of the Efficacy of Intralesional Measles, Mumps, and Rubella Vaccine with Intralesional Vitamin D3 as Immunotherapies in the Treatment of Recalcitrant Cutaneous Warts in Adult- A Randomized Placebo-Controlled Study. Indian Dermatol Online J 2021; 12:879-887. [PMID: 34934726 PMCID: PMC8653728 DOI: 10.4103/idoj.idoj_573_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/19/2020] [Accepted: 08/31/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction: Currently, various destructive and ablative treatment options are conventionally used for warts, but all of them are limited in some form by their adverse effects, high recurrences, suboptimal effectiveness, and the need to treat every wart. Lately, immunotherapy has emerged as a safe treatment relying on biological substances that modulate the immune system to achieve disease control. Aims and Objectives: We aimed at conducting a placebo-controlled study to compare the rate of efficacy of intralesional MMR vaccine with vitamin D3 in the management of recalcitrant extragenital warts in immune-competent adults. Follow-up was done at third and sixth month. Materials and Methods: Patients were divided into three groups, namely, group A, B, and C. Groups A, B, and C received intralesional MMR vaccine, vitamin D3 and normal saline, respectively, in the largest wart. The injections were repeated every 2 weeks, for a maximum of four injections. Results: Among injected warts, in group A, complete clearance was seen in 29 (87.8%) patients, partial clearance in two (6.1%) and no response in two (6.1%) patients. In group B, 24 (77.4%) patients, five (16.1%) patients, and two (6.5%) patients showed signs of complete, partial, and no clearance, respectively, in injected warts. Complete response in distant warts was seen in 25 (75.7%) patients in group A and 20 (64.5%) patients in group B. There was no statistically significant difference between responses of the two groups. In group C, only three (12.5%) patients had complete clearance in injected warts, and none in distant warts. Recurrence was seen in two (6.4%) patients, each in group B and C. However, for management of verruca plana MMR was found to be superior to vitamin D3. Limitations: Our study was limited by a small sample size, absence of immunological analysis, and limited follow-up period. Conclusion: MMR vaccine and vitamin D3 are equally effective and safe treatment option for multiple, recalcitrant warts, as well as warts on difficult to treat sites with minimal recurrence.
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Affiliation(s)
- Alpana Mohta
- Department of Dermatology, Venereology and Leprology, Sardar Patel Medical College, Kota, Rajasthan, India
| | - Ramesh K Kushwaha
- Department of Dermatology, Venereology and Leprology, Government Medical College, Kota, Rajasthan, India
| | - Aditi Agrawal
- Department of Dermatology, Venereology and Leprology, Government Medical College, Kota, Rajasthan, India
| | - Manoj K Sharma
- Department of Dermatology, Venereology and Leprology, Government Medical College, Kota, Rajasthan, India
| | - Umesh Gautam
- Department of Dermatology, Venereology and Leprology, Government Medical College, Kota, Rajasthan, India
| | - Suresh K Jain
- Department of Dermatology, Venereology and Leprology, Government Medical College, Kota, Rajasthan, India
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27
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Hara M, Koshida R, Nakano T. Parents' views on mumps, mumps vaccine, and the factors associated with vaccination in Japan. Vaccine 2021; 39:7677-7683. [PMID: 34815119 DOI: 10.1016/j.vaccine.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The measles-mumps-rubella vaccine was withdrawn from the National Immunization Program in 1993 because aseptic meningitis was reported as a post-vaccination adverse reaction in Japan. This study aimed to measure the uptake of and determinants influencing mumps vaccination, including concerns about adverse reactions. METHODS We conducted this cross-sectional survey for all parents whose children underwent 18-month health checkups in Kanazawa City between October 2019 and February 2020. Community nurses interviewed the parents using a unified questionnaire, and 1422 parents responded. RESULTS Based on records from maternal and child health handbooks, the mumps vaccination rate was 55.6%. The most common reason for parents not vaccinating their children against mumps was that "it is not a routine vaccine" (35.9%), whereas "concern about adverse reactions" accounted for only 2.2%. In multivariate analysis, the significantly positive factors associated with vaccination against mumps were children whose parents knew that adverse reactions were fever, rash, diarrhea, and vomiting; had received a recommendation for vaccination from their family members; had read the Vaccination Guide issued by the city; vaccinated with other voluntary vaccines or treated for gastroenteritis; and had a deep general understanding of vaccination. Conversely, the significantly negative factor was children whose parents had not received any recommendation for vaccination. CONCLUSION The mumps vaccination rate could be improved by adding the mumps vaccine in the routine vaccination program and educating parents by disseminating correct information on mumps and the mumps vaccine, and by primary care physicians routinely recommending vaccination.
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Affiliation(s)
- Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
| | - Rie Koshida
- Health Affairs Department, Kanazawa City Office, 1-1-1 Hirosaka, Kanazawa, Ishikawa 920-8577, Japan
| | - Takashi Nakano
- Department of Pediatrics, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
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28
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Mathis AD, Clemmons NS, Redd SB, Pham H, Leung J, Wharton AK, Anderson R, McNall RJ, Rausch-Phung E, Rosen JB, Blog D, Zucker JR, Bankamp B, Rota PA, Patel M, Gastañaduy PA. Maintenance of measles elimination status in the United States for 20 years despite increasing challenges. Clin Infect Dis 2021; 75:416-424. [PMID: 34849648 DOI: 10.1093/cid/ciab979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Measles elimination (interruption of endemic measles virus transmission) in the United States was declared in 2000; however, the number of cases and outbreaks have increased in recent years. We characterized the epidemiology of measles outbreaks and measles transmission patterns post-elimination to identify potential gaps in the U.S. measles control program. METHODS We analyzed national measles notification data from January 1, 2001-December 31, 2019. We defined measles infection clusters as single cases (isolated cases not linked to additional cases), 2-case clusters, or outbreaks with 3 or more linked cases. We calculated the effective reproduction number (R) to assess changes in transmissibility and reviewed molecular epidemiology data. RESULTS During 2001-2019, 3,873 measles cases, including 747 international importations, were reported in the United States; 29% of importations were associated with outbreaks. Among 871 clusters, 69% were single cases and 72% had no spread. Larger and longer clusters were reported since 2013, including seven outbreaks with >50 cases lasting >2 months, 5 of which occurred in known underimmunized, close-knit communities. No measles lineage circulated in a single transmission chain for >12 months. Higher estimates of R were noted in recent years, although R remained below the epidemic threshold of 1. CONCLUSIONS Current epidemiology continues to support the interruption of endemic measles virus transmission in the United States. However, larger and longer outbreaks in recent post-elimination years and emerging trends of increased transmission in underimmunized communities emphasize the need for targeted approaches to close existing immunity gaps and maintain measles elimination.
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Affiliation(s)
- Adria D Mathis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Nakia S Clemmons
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Susan B Redd
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Huong Pham
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jessica Leung
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Adam K Wharton
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Raydel Anderson
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Rebecca J McNall
- Division of Laboratory Systems, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Elizabeth Rausch-Phung
- New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237, USA
| | - Jennifer B Rosen
- New York City Department of Health and Mental Hygiene, 42-09 28 th St, Long Island City, NY 11101, USA
| | - Debra Blog
- New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237, USA
| | - Jane R Zucker
- New York City Department of Health and Mental Hygiene, 42-09 28 th St, Long Island City, NY 11101, USA.,Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Bettina Bankamp
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Paul A Rota
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Manisha Patel
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Paul A Gastañaduy
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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Chang SY, Bisht A, Faysman K, Schiller GJ, Uslan DZ, Multani A. Vaccine-Associated Measles in a Hematopoietic Cell Transplant Recipient: Case Report and Comprehensive Review of the Literature. Open Forum Infect Dis 2021; 8:ofab326. [PMID: 34377725 PMCID: PMC8339276 DOI: 10.1093/ofid/ofab326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/18/2021] [Indexed: 01/04/2023] Open
Abstract
Measles is a worldwide viral disease that can cause fatal complications in immunocompromised hosts such as hematopoietic cell transplant (HCT) recipients. The live attenuated measles, mumps, and rubella (MMR) vaccine is generally contraindicated post-HCT due to the risk for vaccine-associated measles. This, combined with decreasing vaccination rates due to vaccine hesitancy and the coronavirus disease 2019 pandemic, raises significant concerns for a measles resurgence that could portend devastating consequences for immunocompromised hosts. Multiple guidelines have included criteria to determine which HCT recipients can safely receive the MMR vaccine. Here, we report a case of vaccine-associated measles in a HCT recipient who met guideline-recommended criteria for MMR vaccination. The objective of this article is to query these criteria, highlight the importance of MMR vaccination, and comprehensively review the literature.
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Affiliation(s)
- Sandy Y Chang
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Anjali Bisht
- Clinical Epidemiology and Infection Prevention, UCLA Health, Los Angeles, California, USA
| | - Karolina Faysman
- Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Gary J Schiller
- Division of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Daniel Z Uslan
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Clinical Epidemiology and Infection Prevention, UCLA Health, Los Angeles, California, USA
| | - Ashrit Multani
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Wang D, Nie T, Pan F, Wang Y, Wang J, Qin W. Loss of protective immunity of two-dose mumps-containing vaccine over time: concerns with the new strategy of the mumps immunization program in China. Hum Vaccin Immunother 2021; 17:2072-2077. [PMID: 33545016 DOI: 10.1080/21645515.2020.1861877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: Currently, children aged 6-9 years have the highest incidence rate of mumps in China. Although China has introduced a two-dose schedule of measles-mumps-rubella vaccine into routine immunization (at 8 months and 18 months), the incidence rate of mumps in high-risk populations might not decrease due to waning immunity. Here we report a mumps outbreak supporting this hypothesis.Methods: The descriptive epidemiological method was used to summarize the overall characteristics of the course of the outbreak. We conducted a retrospective cohort study to evaluate the vaccine effectiveness (VE) of mumps-containing vaccine (MuCV).Results: A total of 78 cases were identified during the outbreak and the estimated vaccination coverage was 84.7%. Of 454 vaccinated students, 335 (73.8%) had received one-dose MuCV, 93 (20.5%) two-dose, and 26 (5.7%) three-dose. The VEs for both the one-dose (-17.0%, 95%CI: -120.3-38.2%) and two-dose groups (-10.0%, 95%CI: -138.0-48.8%) were not performed well, whereas the VE for the three-dose group was 100%. However, we found that the overall VE was 74.2% (95% CI: 9.7-92.6%) for students vaccinated within 5 years. We also observed that there was a broadly linear increase in mumps infection risk in both one-dose and two-dose group when the time since last dose vaccination was more than 5 years.Conclusions: The overall VE for both one-dose and two-dose MuCV was discouraging, but it appeared to be moderately effective within 5 years after vaccination. Further surveillance and seroepidemiological data are needed to understand the impact of the new vaccination strategy on mumps in China.
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Affiliation(s)
- Danni Wang
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China
| | - Tingyue Nie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Fan Pan
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - Yao Wang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - Jian Wang
- Department of Infectious Disease Control, Yu'an District Center for Disease Control and Prevention, Lu'an, China
| | - Wei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
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31
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Lundberg L, Bygdell M, Stukat von Feilitzen G, Woxenius S, Ohlsson C, Kindblom JM, Leach S. Recent MMR vaccination in health care workers and Covid-19: A test negative case-control study. Vaccine 2021; 39:4414-4418. [PMID: 34187707 PMCID: PMC8216866 DOI: 10.1016/j.vaccine.2021.06.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 01/06/2023]
Abstract
Background It has been hypothesised that the measles-mumps-rubella (MMR) vaccine may afford cross-protection against SARS-CoV-2 which may contribute to the wide variability in disease severity of Covid-19. Methods We employed a test negative case-control study, utilising a recent measles outbreak during which many healthcare workers received the MMR vaccine, to investigate the potential protective effect of MMR against SARS-CoV-2 in 5905 subjects (n = 805 males, n = 5100 females). Results The odds ratio for testing positive for SARS-CoV-2, in recently MMR-vaccinated compared to not recently MMR-vaccinated individuals was 0.91 (95% CI 0.76, 1.09). An interaction analysis showed a significant interaction for sex. After sex-stratification, the odds ratio for testing positive for males was 0.43 (95% CI 0.24, 0.79, P = 0.006), and 1.01 (95% CI 0.83, 1.22, P = 0.92) for females. Conclusion Our results indicate that there may be a protective effect of the MMR vaccine against SARS-CoV-2 in males but not females.
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Affiliation(s)
- Lisa Lundberg
- Dept. of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Bygdell
- Centre for Bone and Arthritis Research, Dept. of Internal Medicine and Clinical Nutrition, Inst. of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | | | - Susanne Woxenius
- Dept. of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Dept. of Internal Medicine and Clinical Nutrition, Inst. of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jenny M Kindblom
- Centre for Bone and Arthritis Research, Dept. of Internal Medicine and Clinical Nutrition, Inst. of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Pediatric Clinical Research Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Susannah Leach
- Dept. of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden; University of Gothenburg Vaccine Research Institute (GUVAX), Dept. of Microbiology and Immunology, Inst. of Biomedicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
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Taheri Soodejani M, Basti M, Tabatabaei SM, Rajabkhah K. Measles, mumps, and rubella (MMR) vaccine and COVID-19: a systematic review. Int J Mol Epidemiol Genet 2021; 12:35-39. [PMID: 34336136 PMCID: PMC8310886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/29/2021] [Indexed: 06/13/2023]
Abstract
This study was performed to investigate published literature about the association between measles, mumps, and rubella (MMR) vaccine and COVID-19. This is a systematic review in which the databases of Chocrane, Pubmed, Scopus, Web of Science as well as reliable journals including Lancet, New England Journal of Medicine, Jama and also Centers for Disease Control and Prevention (CDC) publications were searched.Out of 169 documents discovered during the literature review, 56 ones were somehow related to the association between MMR vaccine and COVID-19, of which 11 ones mentioned the association between these two, and 8 of them contained a hypothesis about this relationship. A quasi-trial study reported the positive effect of the MMR vaccine on reducing the severity of COVID-19 symptoms among those who received it. Also, a cross-sectional study showed an association between the level of Immunoglobulin G (IgG) mumps and COVID-19. Moreover, a genomic data analysis study also reported the effect of Rubella Immunoglobulin G (IgG) level on COVID-19. It seems that due to the similarity of respiratory diseases including measles, rubella, and mumps to COVID-19, MMR vaccine should be investigated more deeply to see if it is effective in order to deal with this novel disease.
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Affiliation(s)
- Moslem Taheri Soodejani
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical SciencesYazd, Iran
| | - Moslem Basti
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical SciencesYazd, Iran
| | | | - Kourosh Rajabkhah
- Office for Health Technology Assessment, Health Standards and Tarrifs, Department of Curative Affairs, Ministry of Health and Medical EducationTehran, Iran
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Pawaskar M, Schmidt E, Marshall GS, Fergie J, Richardson E, Saldutti LP, Li S, Neumann M, Koller L, Kuter B. Use of M-M-R II outside of the routinely recommended age range - a systematic literature review. Hum Vaccin Immunother 2021; 18:1-7. [PMID: 34128759 PMCID: PMC8920138 DOI: 10.1080/21645515.2021.1933874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
M-M-R®II (M-M-R II) is routinely used in many countries at 12–15 months with a second dose at 4 to 6 years of age. However, the vaccine may need to be administered at other ages due to delays in the immunization schedule or in certain situations such as outbreaks or international travel. A systematic literature review was conducted to evaluate efficacy, immunogenicity and safety of M-M-R II among 6- to 11-month-olds and persons ≥7 years of age. A search for randomized controlled trials (RCTs) was conducted in 2019 including Medline, Embase and Cochrane CENTRAL. Only one study reported seroconversion rates after one dose in infants at 9 months of age: 87.4% (measles), 92.3% (mumps), and 91.2% (rubella); no safety data were reported. Seven studies reported immunogenicity and safety data for M-M-R II at ≥7 years of age. Seroconversion rates ranged from 96%-100% (measles), 65%-100% (mumps), and 91%-100% (rubella). Rates of selected adverse events ranged from 5.2%-8.7% for fever (≥38°C or ≥38.1°C), 2%-33.3% for injection site reactions, and 0.4% for measles/rubella-like rash (one study). No efficacy studies were found. This literature review identified RCTs with evidence to support that M-M-R II is immunogenic and well tolerated in individuals ≥7 years of age.
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Affiliation(s)
| | - Elvira Schmidt
- Certara Germany GmbH (Formerly Analytica Laser), Loerrach, Germany
| | - Gary S Marshall
- Norton Children's and University of Louisville School of Medicine, Louisville, KY, USA
| | - Jaime Fergie
- Texas A&M University College of Medicine, Driscoll Children's Hospital, Corpus Christi, TX, USA
| | | | | | - Se Li
- Former Employee of Merck & Co., Inc., Kenilworth, NJ, USA
| | - Monika Neumann
- Certara Germany GmbH (Formerly Analytica Laser), Loerrach, Germany
| | - Linnea Koller
- Certara Germany GmbH (Formerly Analytica Laser), Loerrach, Germany
| | - Barbara Kuter
- Former Employee of Merck & Co., Inc., Kenilworth, NJ, USA
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Abstract
INTRODUCTION Measles, mumps, and rubella incidence decreased drastically following vaccination programs' implementation. However, measles and mumps' resurgence was recently reported, outbreaks still occur, and challenges remain to control these diseases. AREAS COVERED This qualitative narrative review provides an objective appraisal of the literature regarding current challenges in controlling measles, mumps, rubella infections, and interventions to address them. EXPERT OPINION While vaccines against measles, mumps, and rubella (including trivalent vaccines) are widely used and effective, challenges to control these diseases are mainly related to insufficient immunization coverage and changing vaccination needs owing to new global environment (e.g. traveling, migration, population density). By understanding disease transmission peculiarities by setting, initiatives are needed to optimize vaccination policies and increase vaccination coverage, which was further negatively impacted by COVID-19 pandemic. Also, awareness of the potential severity of infections and the role of vaccines should increase. Reminder systems, vaccination of disadvantaged, high-risk and difficult-to-reach populations, accessibility of vaccination, healthcare infrastructure, and vaccination services management should improve. Outbreak preparedness should be strengthened, including implementation of high-quality surveillance systems to monitor epidemiology. While the main focus should be on these public health initiatives to increase vaccination coverage, slightly more benefits could come from evolution of current vaccines.
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Affiliation(s)
| | - Catherine Heffernan
- NHS England (London Region), 1st Floor, Wellington House, 133-155 Waterloo Road, London, SE16UG, UK
| | - François Meurice
- GSK, Avenue Fleming 20, 1300 Wavre, Belgium.,Biomedical Sciences Department, Faculty of Medicine, University of Namur (UNamur), Rue de Bruxelles 61, 5000 Namur, Belgium
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Kraus N, Condon SB. Measles (Rubeola): A Case Of Vaccine Hesitancy And Pregnancy. J Midwifery Womens Health 2021; 66:391-396. [PMID: 34022106 DOI: 10.1111/jmwh.13223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/14/2021] [Accepted: 01/23/2021] [Indexed: 12/13/2022]
Abstract
Measles (rubeola) is a highly contagious virus. Vaccination has nearly eradicated measles in the United States, yet sporadic outbreaks persist. Although the live-attenuated measles, mumps, rubella vaccine has not been found to cause fetal harm, pregnancy is considered a contraindication for the vaccine and contracting measles during pregnancy can have serious sequelae. Furthermore, lifelong immunity conferred by childhood vaccination is questionable as the vaccine's protection may wane during the childbearing years. Reluctance to vaccinate, or vaccine hesitancy, may leave a proportion of people of childbearing age unprotected. It is unlikely that many clinicians providing preconception, primary, and perinatal care have had occasion to diagnose measles. Susceptibility to infection combined with clinician inexperience may contribute to missed opportunities to halt the spread of this highly contagious, preventable illness. A case of parents' religion-based vaccine hesitancy complicating the pregnancy of their adult daughter is presented. Guidelines for screening for immunity, identifying measles in the clinical setting, and protocols for mitigating spread are reviewed.
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Affiliation(s)
- Nancy Kraus
- Independent researcher, New Rochelle, New York
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36
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Larenas‐Linnemann DE, Rodríguez‐Monroy F. Thirty-six COVID-19 cases preventively vaccinated with mumps-measles-rubella vaccine: All mild course. Allergy 2021; 76:910-914. [PMID: 32894782 DOI: 10.1111/all.14584] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 12/25/2022]
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Geier DA, Geier MR. A longitudinal cohort study of childhood MMR vaccination and seizure disorder among American children. Brain Dev 2021; 43:251-267. [PMID: 32981784 DOI: 10.1016/j.braindev.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/09/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Measles (rubeola) is a highly contagious infectious disease with significant morbidity/mortality. Measles-Mumps-Rubella (MMR) is a live-attenuated vaccine used in the United States (US) to prevent measles. This retrospective longitudinal cohort study evaluated childhood MMR vaccination and the risk of a seizure episode and seizure disorder. METHODS The Independent Healthcare Research Database (IHRD) composed of records prospectively generated from Florida Medicaid was analyzed using SAS to identify persons continuously enrolled from birth for 120 months. Two cohorts were examined: 23,486 persons received at least one dose of MMR vaccine between 12 and 17 months (vaccinated) and 41,725 persons not receiving a measles-containing vaccine (unvaccinated). The daily incidence rate of an initial seizure episode (ICD-9 code: 780.3x) and seizure disorder (ICD-9 code: 345.xx) following an initial seizure episode diagnoses were examined using Cox proportional hazards ratio (HR) and time-trend models post-MMR vaccination compared to unvaccinated persons and in a self-controlled case-series (SCCS). RESULTS The daily incidence rate of an initial seizure episode diagnosed from 6 to 11 days post-MMR vaccination in comparison to 12 to17 months among unvaccinated persons was significantly increased (unadjusted HR = 5.73, p < 0.0001 and adjusted HR = 5.94, p < 0.0001) in HR models. The daily incidence rate of an eventual seizure disorder diagnosis among those diagnosed with an initial seizure episode from 6 to 11 days post-MMR vaccination was significantly increased (unadjusted HR = 17.7, p < 0.01 and adjusted HR = 17.4, p < 0.01) in comparison to the daily incidence rate of an eventual seizure disorder diagnosis among those diagnosed with an initial seizure episode from 12 to 17 months among unvaccinated persons. Time-trend analyses revealed a significantly increased rate ratio (RR) for an initial seizure episode (RR = 4.64, p < 0.0001) and seizure disorder (RR = 5.51, p < 0.0001) diagnoses. Time-trend SCCS analyses revealed a significantly increased daily incidence rate of an initial seizure episode (RR = 3.80, p < 0.0001) when comparing periods from 6 to 11 days post-MMR vaccination to 49-60 days post-MMR vaccination. The incidence rate of an eventual seizure disorder diagnosis among those with an initial seizure episode diagnosis from 6 to 11 days post-MMR vaccination compared to 49-60 days post-MMR vaccination was significantly increased (RR = 4.15, p < 0.01). CONCLUSION Seizure episode and seizure disorder are rare consequences of routine childhood MMR vaccination.
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Affiliation(s)
- David A Geier
- Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA.
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Abstract
Mumps is a vaccine-preventable disease. Because the mumps vaccine can cause aseptic meningitis in rare cases, this vaccine is not routine in Japan. This has led to low vaccine coverage and severe disease burden in Japan. The present review summarizes mumps epidemiology and vaccination and discusses effective future strategies to mitigate the current disease burden of mumps in Japan. Although a recent study reported that mumps vaccine coverage rates are improving in Japan, current coverage rates are far below the optimal rate to suppress the ongoing epidemic, which has caused an average annual financial loss of 85 billion JPY between 2000 and 2016. Recent reports have demonstrated a much lower incidence of vaccine-induced aseptic meningitis in newly developed vaccines, especially when administered at 1 year of age. Cost-effectiveness studies suggest that routinization of the currently distributed domestic vaccine would be highly cost-effective. In addition, questionnaire surveillance data suggest that the majority of the Japanese population accepts the nominal risk of the vaccine when the proper information is provided. Finally, there are some successful programs in Japan that have attained high vaccine coverage rates with financial support from local governments. Taken together, these data suggest that the mumps vaccine should be immediately included in routine vaccines in Japan.
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Affiliation(s)
- Taito Kitano
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada
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Bogusz J, Augustynowicz E, Paradowska-Stankiewicz I. Rubella in Poland in 2019. Przegl Epidemiol 2021; 75:588-596. [PMID: 35543505 DOI: 10.32394/pe.75.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Rubella has been included in the elimination program coordinated by the World Health Organization (WHO) since 2005. Elimination of rubella in the country is possible provided that min. 95% of the vaccination status of the population and monitoring the epidemiological situation, including recording all suspected rubella and conducting laboratory diagnostics at the WHO Reference Laboratory. AIM The aims of the present article are to analyze the epidemiological situation of rubella in Poland in 2019 and to discuss the rubella vaccination coverage. MATERIAL AND METHODS The assessment of the epidemiological situation of rubella in Poland was conducted on the basis of aggregated reports of suspected rubella cases sent to the National Institute of Public Health - National Institute of Hygiene by Voivodeship Sanitary and Epidemiological Stations, and data from the bulletin "Infectious diseases and poisoning in Poland in 2019" and "Vaccinations in Poland in 2019 ". RESULTS In 2019, there was a decrease in the number of rubella cases with registered 285 cases (in 2018 - 37 cases), and a decline in incidence (from 1.1 per 100,000 to 0.74). The highest incidence rate, regardless of gender and the environment, was observed among children agded 0-4 years (6.4 per 100,000). In 2019, no cases of congenital rubella syndrome were registered. In 2019, only 3 (1.05%) cases were classified as laboratoryconfirmed cases. The remaining 98.9% (282 cases) were diagnosed on the basis of clinical symptoms. CONCLUSIONS In 2019, there was a decrease in the number of rubella cases. In Poland rubella in reported exclusively on the basis of the clinical picture. The proportion of laboratory tests confirming/excluding rubella infection is still very low in Poland.
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Affiliation(s)
- Joanna Bogusz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Ewa Augustynowicz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Iwona Paradowska-Stankiewicz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
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Włodarska A, Raciborski F. Characterisation of the online public debate od MMR vaccine against measles, mumps and rubella on the Polish Internet. Przegl Epidemiol 2021; 75:390-401. [PMID: 35170295 DOI: 10.32394/pe.75.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION MMR vaccine is a controversial topic of public debate. The controversies include such issues as autism, adjuvants or ethical questions related to the culturing of the rubella virus on human cell lines. OBJECTIVE The objective was to characterise the public debate on MMR vaccination on the Polish Internet between January 2018 and June 2020. MATERIAL AND METHODS Quantitative and qualitative analysis of Polish-language online content between 1 January 2018 and 30 June 2020 related to MMR vaccination. The quantitative analysis comprised all available mentions of MMR vaccination in postings (n=14,632), while qualitative analysis relied on a systematic sample of 819 mentions. RESULTS Quantitative study: 79.6% of MMR vaccine-related postings were published on Facebook, 6.9% on Twitter, and the remaining 14.6% appeared on other websites. There were two surges in posting count in November 2018 and March 2019. Qualitative study: 48% of postings expressed anti-vaccination sentiment, 33% were pro-vaccination and 19% were neutral. CONCLUSIONS The social media play a significant role in the dissemination of untrue medical claims regarding MMR vaccination. A substantial part of the discussion about MMR vaccination in Poland takes place on Facebook. Despite the general availability of research results stating the absence of a link between autism and vaccination, this is an ongoing most frequent topics in the MMR debate. At the same time, more postings on that topic expressed pro-vaccination rather than anti-vaccination sentiment.
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Affiliation(s)
| | - Filip Raciborski
- Medical University of Warsaw, Department of Prevention of Environmental Hazards and Allergology
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Akbik M, Naddeh D, Ashour AA, Ashour A. Severe Immune Thrombocytopenia Following MMR Vaccination with Rapid Recovery: A Case Report and Review of Literature. Int Med Case Rep J 2020; 13:697-699. [PMID: 33376414 PMCID: PMC7755875 DOI: 10.2147/imcrj.s286335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/27/2020] [Indexed: 01/25/2023] Open
Abstract
Immune thrombocytopenia (ITP) is an autoimmune disease that occurs following viral illnesses and may also infrequently occur after measles, mumps, and rubella (MMR) vaccination. ITP typically presents with the sudden appearance of a petechial rash, bruising, and/or bleeding in an otherwise healthy-appearing child. However, ITP following MMR vaccine does not commonly cause severely depleted platelets. We report a case of ITP after MMR vaccination in a 13-month-old baby boy, who presented with petechial rash all over his body. The child had severe thrombocytopenia but was successfully treated with a single dose of intravenous immunoglobulin without complications. The study highlights that ITP post-MMR vaccine is an easily treatable condition.
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Affiliation(s)
- Majd Akbik
- Al-Thumama Health Center, Primary Health Care Corporation, Doha 26555, Qatar
| | - Dima Naddeh
- Muaither Health Center, Primary Health Care Corporation, Doha 26555, Qatar
| | - Anas A Ashour
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar.,Medical Education, Hamad Medical Corporation, Doha 3050, Qatar
| | - Azzam Ashour
- Al-Thumama Health Center, Primary Health Care Corporation, Doha 26555, Qatar
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Omersel J, Karas Kuželički N. Vaccinomics and Adversomics in the Era of Precision Medicine: A Review Based on HBV, MMR, HPV, and COVID-19 Vaccines. J Clin Med 2020; 9:E3561. [PMID: 33167413 DOI: 10.3390/jcm9113561] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
Precision medicine approaches based on pharmacogenomics are now being successfully implemented to enable physicians to predict more efficient treatments and prevention strategies for a given disease based on the genetic background of the patient. This approach has already been proposed for vaccines, but research is lagging behind the needs of society, and precision medicine is far from being implemented here. While vaccinomics concerns the effectiveness of vaccines, adversomics concerns their side effects. This area has great potential to address public concerns about vaccine safety and to promote increased public confidence, higher vaccination rates, and fewer serious adverse events in genetically predisposed individuals. The aim here is to explore the contemporary scientific literature related to the vaccinomic and adversomic aspects of the three most-controversial vaccines: those against hepatitis B, against measles, mumps, and rubella, and against human Papilloma virus. We provide detailed information on the genes that encode human leukocyte antigen, cytokines and their receptors, and transcription factors and regulators associated with the efficacy and safety of the Hepatitis B and Measles, Mumps and Rubella virus vaccines. We also investigate the future prospects of vaccinomics and adversomics of a COVID-19 vaccine, which might represent the fastest development of a vaccine ever.
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Gupta P, Tegta GR, Verma GK, Gupta A, Gupta M, Sharma S. A Study to Evaluate the Role of Intradermal and Intralesional Measles, Mumps, Rubella (MMR) Vaccine in Treatment of Common Warts. Indian Dermatol Online J 2020; 11:559-565. [PMID: 32832442 PMCID: PMC7413434 DOI: 10.4103/idoj.idoj_144_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/27/2019] [Accepted: 03/16/2020] [Indexed: 11/06/2022] Open
Abstract
Background: Warts are common cutaneous viral infection with a wide range of therapeutic modalities. Various agents have been tried for immunotherapy in warts. Objectives: Determine the role of intralesional and intradermal measles, mumps, rubella (MMR) vaccine in the treatment of common warts; to compare the efficacy of intralesional versus intradermal MMR vaccine. Methods and Materials: Patients diagnosed with verruca vulgaris were divided into two groups. In study group A, the individuals were injected with an intralesional MMR vaccine of 0.3 mL in the representative wart (largest) once in 3 weeks till there is complete clearance or maximum of four injections whichever is earlier, while in study group B, the individuals were injected with an intradermal MMR vaccine of 0.3 mL over the unilateral deltoid muscle area at similar intervals. Results: There were 33 patients in each group. In group A, 10 (30.3%) patients showed complete, 9 (27.3%) marked, 6 (18.2%) moderate, 3 (9.1%) mild, and 5 (15.2%) no response. In group B, seven (21.2%) patients showed complete, one (3.0%) marked, one (3.0%) moderate, four (12.1%) mild, and 20 (60.6%) no response. There were minimal side effects in the form of pain, erythema, itching at the injection site in a few patients, only one patient had syncope. Conclusion: We conclude that the MMR vaccine is an effective and safe modality of treatment for verruca vulgaris without any serious adverse effects. Also, the intralesional route showed better results in comparison to the intradermal route when we consider the treatment of a representative wart.
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Affiliation(s)
- Pragya Gupta
- Department of Dermatology, Venereology and Leprosy, IGMC Shimla, District Sirmour, Himachal Pradesh, India
| | - Geeta Ram Tegta
- Department of Dermatology, Venereology and Leprosy, IGMC Shimla, District Sirmour, Himachal Pradesh, India
| | - G K Verma
- Department of Dermatology, Venereology and Leprosy, IGMC Shimla, District Sirmour, Himachal Pradesh, India
| | - Abhishek Gupta
- Department of Dermatology, Venereology and Leprosy, IGMC Shimla, District Sirmour, Himachal Pradesh, India
| | - Mudita Gupta
- Department of Dermatology, Venereology and Leprosy, IGMC Shimla, District Sirmour, Himachal Pradesh, India
| | - Shikha Sharma
- Department of Dermatology, Venereology and Leprosy, IGMC Shimla, District Sirmour, Himachal Pradesh, India
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Marin M, Fiebelkorn AP, Bi D, Coleman LA, Routh J, Curns AT, McLean HQ. Adverse Events Among Young Adults Following a Third Dose of Measles-Mumps-Rubella Vaccine. Clin Infect Dis 2020; 73:e1546-e1553. [PMID: 32766827 DOI: 10.1093/cid/ciaa1090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A third measles-mumps-rubella vaccine (MMR) dose (MMR3) is recommended in the United States for persons at increased risk for mumps during outbreaks. MMR3 is also likely given to persons who might have received 2 doses of MMR but lack documentation. Since MMR3 safety data are limited, we describe adverse events in persons receiving MMR3 in a nonoutbreak setting. METHODS Young adults with 2 documented MMR doses were administered MMR3. From 2 weeks before until 4 weeks after MMR3 receipt, participants reported daily on 11 solicited, common symptoms potentially associated with MMR. Weekly rate differences in post- vs prevaccination (baseline) were evaluated by Poisson regression. Baseline rates were subtracted from postvaccination rates of significantly different symptoms to estimate the number and percentage of participants with excess risk for symptoms post-MMR3. Descriptive analyses were performed for 3 postvaccination injection-site symptoms. RESULTS The 662 participants were aged 18-28 years (median = 20 years); 56% were women. Headache, joint problems, diarrhea, and lymphadenopathy rates were significantly higher postvaccination vs baseline. We estimate that 119 participants (18%) reported more symptoms after MMR3 than prevaccination. By symptom, 13%, 10%, 8%, and 6% experienced increased symptoms of headache, joint problems, diarrhea, and lymphadenopathy, respectively, after MMR3. The median onset was Days 3-6 postvaccination; the median duration was 1-2 days. One healthcare visit for a potential vaccination-related symptom (urticaria) was reported. Injection-site symptoms were reported by 163 participants (25%); the median duration was 1-2 days. CONCLUSIONS Reported systemic and local events were mild and transient. MMR3 is safe and tolerable among young adults.
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Affiliation(s)
- Mona Marin
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amy Parker Fiebelkorn
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Daoling Bi
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Laura A Coleman
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Janell Routh
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aaron T Curns
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Huong Q McLean
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
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Sharma S, Agarwal S. Intralesional Immunotherapy with Measles Mumps Rubella Vaccine for the Treatment of Anogenital Warts: An Open-label Study. J Clin Aesthet Dermatol 2020; 13:40-44. [PMID: 33178381 PMCID: PMC7595364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION: Anogenital warts (AGWs) are one of the leading sexually transmitted infections in the world. This condition poses a number of challenges to dermatologists, including the reluctance of patients to consult a physician and the high likelihood of relapse. Individuals with AGWs suffer a substantial psychological morbidity. Intralesional immunotherapy with the measles, mumps, and rubella (MMR) vaccine has been reported to be an effective treatment for warts. However, literature on the efficacy of intralesional immunotherapy with the MMR vaccine for the treatment of anogenital warts is sparse. OBJECTIVE: We sought to determine the efficacy of the MMR vaccine for the treatment of anogenital warts at an outpatient dermatology department in Government Medical College Haldwani in India. METHODS: This was a hospital-based, longitudinal study the included 35 patients. In patients with genital warts, 0.5mL of the MMR vaccine after reconstitution with distilled water was injected intradermally into their single largest wart. Injections were given every three weeks until a maximum of three injections was achieved. Pre- and posttreatment photographs were assessed to compare the degree of reduction in the size and number of warts. The therapeutic response was evaluated as follows: No response (<50% reduction in the number of warts), Relative response (50%-99% reduction), complete response (100% reduction). RESULTS: On average, a 42.4-percent response was observed in the first three weeks after administering the MMR vaccine, which increased to 75.8 percent after the second vaccine at six weeks and nearly 98 percent after the last vaccine at nine weeks. CONCLUSION: Our results suggest that intralesional immunotherapy with the MMR vaccine can serve as a safe and effective therapy for the treatment of AGWs.
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Affiliation(s)
- Shilpi Sharma
- Dr. Sharma is Assistant Professor in the Department of Dermatology, Venereology, and Leprology at the Government Medical College Haldwani in Uttarakhand, India
- Dr. Agarwal is Professor and Unit Head of the Department of Dermatology, Venereology, and Leprology at the Government Medical College Haldwani in Uttarakhand, India
| | - Saurabh Agarwal
- Dr. Sharma is Assistant Professor in the Department of Dermatology, Venereology, and Leprology at the Government Medical College Haldwani in Uttarakhand, India
- Dr. Agarwal is Professor and Unit Head of the Department of Dermatology, Venereology, and Leprology at the Government Medical College Haldwani in Uttarakhand, India
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Klinger D, Blass I, Rappoport N, Linial M. Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis. Vaccines (Basel) 2020; 8:E378. [PMID: 32664505 DOI: 10.3390/vaccines8030378] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic that started in China has spread within 3 months to the entire globe. We tested the hypothesis that the vaccination against tuberculosis by Bacille Calmette–Guérin vaccine (BCG) correlates with a better outcome for COVID-19 patients. Our analysis covers 55 countries complying with predetermined thresholds on the population size and number of deaths per million (DPM). We found a strong negative correlation between the years of BCG administration and the DPM along with the progress of the pandemic, corroborated by permutation tests. The results from multivariable regression tests with 23 economic, demographic, health-related, and pandemic restriction-related quantitative properties, substantiate the dominant contribution of BCG years to the COVID-19 outcomes. The analysis of countries according to an age-group partition reveals that the strongest correlation is attributed to the coverage in BCG vaccination of the young population (0–24 years). Furthermore, a strong correlation and statistical significance are associated with the degree of BCG coverage for the most recent 15 years, but no association was observed in these years for other broadly used vaccination protocols for measles and rubella. We propose that BCG immunization coverage, especially among the most recently vaccinated population, contribute to attenuation of the spread and severity of the COVID-19 pandemic.
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DeStefano F, Bodenstab HM, Offit PA. Principal Controversies in Vaccine Safety in the United States. Clin Infect Dis 2020; 69:726-731. [PMID: 30753348 DOI: 10.1093/cid/ciz135] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/07/2019] [Indexed: 12/27/2022] Open
Abstract
Concerns about vaccine safety can lead to decreased acceptance of vaccines and resurgence of vaccine-preventable diseases. We summarize the key evidence on some of the main current vaccine safety controversies in the United States, including (1) measles, mumps, and rubella vaccine and autism; (2) thimerosal, a mercury-based vaccine preservative and the risk of neurodevelopmental disorders; (3) vaccine-induced Guillain-Barré syndrome (GBS); (4) vaccine-induced autoimmune diseases; (5) safety of human papillomavirus vaccine; (6) aluminum adjuvant-induced autoimmune diseases and other disorders; and (7) too many vaccines given early in life predisposing children to health and developmental problems. A possible small increased risk of GBS following influenza vaccination has been identified, but the magnitude of the increase is less than the risk of GBS following influenza infection. Otherwise, the biological and epidemiologic evidence does not support any of the reviewed vaccine safety concerns.
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Affiliation(s)
- Frank DeStefano
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Greorgia
| | | | - Paul A Offit
- Division of Infectious Diseases, The Children's Hospital of Philadelphia, Pennsylvania
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Wei Y, Wilkinson K, Rusk R, Kadkhoda K, Loeppky C. Large community mumps outbreak in Manitoba, Canada, September 2016-December 2018. ACTA ACUST UNITED AC 2020; 46:70-6. [PMID: 32281989 DOI: 10.14745/ccdr.v46i04a03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background After routine mumps immunization programs were implemented in Manitoba in the 1980s, incidence was low, with 0-9 cases of disease annually. In September 2016, a mumps outbreak began in fully vaccinated university students in Winnipeg, Manitoba. Objective We describe the investigation of this province-wide mumps outbreak, which lasted between September 2016 and December 2018. We present the details of public health measures implemented and challenges encountered. Possible contributing factors to the sustained transmission are also provided. Methods Probable and confirmed cases of mumps were investigated by public health departments using the investigation form developed for this outbreak. Confirmed mumps cases were linked to the provincial immunization registry. An outbreak response team planned and implemented control measures across the province. Results The outbreak began in vaccinated university students in September 2016 and spread across the province. Activity was high and prolonged in the northern remote areas. By the end of 2018, 2,223 cases had been confirmed. All age groups were affected, and incidence was highest among people aged 18-29 years. Two-dose coverage of mumps-containing vaccine in confirmed cases was close to 70%. Conclusion This prolonged outbreak revealed a large vulnerable population likely resulting from under-vaccination and waning vaccine-induced immunity in the absence of natural boosting from exposure to mumps virus. It is important to maintain high two-dose coverage with mumps-containing vaccines. A third dose of mumps-containing vaccine in future outbreaks may be considered.
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Qian M, Chou SY, Lai EK. Confirmatory bias in health decisions: Evidence from the MMR-autism controversy. J Health Econ 2020; 70:102284. [PMID: 32057491 DOI: 10.1016/j.jhealeco.2019.102284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 12/23/2019] [Accepted: 12/24/2019] [Indexed: 05/15/2023]
Abstract
Since Wakefield et al. (1998), the public was exposed to mixed information surrounding the claim that measles-mumps-rubella vaccine causes autism. A persistent trend to delay the vaccination during 1998-2011 in the US was driven by children of college-educated mothers, suggesting that these mothers held biases against the vaccine influenced by the early unfounded claim. Consistent with confirmatory bias, exposures to negative information about the vaccine strengthened their biases more than exposures to positive information attenuated them. Positive online information, however, had strong impacts on vaccination decisions, suggesting that online dissemination of vaccine-safety information may help tackle the sticky misinformation.
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Singh T, Smith-Ray RL, Taitel M. The Impact of Pharmacist Vaccination Privilege during a Nation-Wide Measles Outbreak. Pharmacy (Basel) 2020; 8:pharmacy8010007. [PMID: 31936563 PMCID: PMC7151689 DOI: 10.3390/pharmacy8010007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022] Open
Abstract
The 2019 measles outbreak was the worst since the USA eliminated measles in 2000. This paper presents the vaccination trends for a large chain-pharmacy, Walgreens, and examines the estimated vaccination capacity and impact of pharmacist privilege policies across states. Specifically, we estimated the number of people who could have been vaccinated in eight states with reduced or no measles, mumps, and rubella (MMR) vaccination privilege during the study period January–June, 2019. During the study period, Walgreens pharmacists administered MMR vaccines to 62,526 patients, a 231.9% increase. If pharmacists had been permitted to vaccinate against measles in the eight states investigated, Walgreens pharmacies would have administered between 12,404 and 36,551 additional vaccinations during that time. We also estimated all chain pharmacies’ capacity to vaccinate in one state that was severely impacted by the measles outbreak, New York, using a range from normal pharmacy operating conditions to maximum capacity. Assuming sufficient demand, it was estimated that chain pharmacies in New York State would have the capacity to vaccinate between 47,688 and 174,856 patients daily, achieving MMR vaccination (first dose) of the measles-susceptible population within 8–28 days. Overall, this study demonstrates the public health value of pharmacist vaccination privilege during a nation-wide outbreak of measles.
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