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Al-Dury S, Kanberg N. Advancements in Vaccine Strategies for Chronic Liver Disease Patients: Navigating Post-COVID Challenges and Opportunities. Vaccines (Basel) 2024; 12:197. [PMID: 38400180 PMCID: PMC10892133 DOI: 10.3390/vaccines12020197] [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: 01/09/2024] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
This review addresses the vital role of vaccinations in managing patients with chronic liver disease (CLD), especially in the context of the post-COVID-19 landscape. The pandemic has highlighted the unique vulnerabilities of CLD patients, including those awaiting liver transplantation and post-transplant individuals, who face heightened risks of infection due to compromised immune responses. Recent advancements in vaccine technology, such as mRNA platforms, novel adjuvants, and advanced delivery systems, have significantly accelerated vaccine development, enhancing both speed and efficacy. Moreover, the emergence of personalized vaccines, tailored to everyone's unique immunological profile, presents new opportunities, particularly for those with chronic conditions. This review synthesizes the current state of evidence regarding vaccine recommendations for CLD patients, focusing on their response to vaccinations and proposing effective strategies to protect this vulnerable group from vaccine-preventable diseases. It also explores the challenges in implementing these strategies and considers the impact of emerging vaccine delivery systems on improving outcomes for CLD patients. The paper aims to provide nuanced guidance on vaccination in the rapidly evolving healthcare landscape, addressing both technological innovations and comprehensive patient care strategies.
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Affiliation(s)
- Samer Al-Dury
- Department of Medicine, Gastroenterology and Hepatology Unit, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
- Institution of Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Nelly Kanberg
- Department of Infectious Diseases, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden;
- Institution of Biomedicine, University of Gothenburg, 405 30 Gothenburg, Sweden
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de Waure C, Gärtner BC, Lopalco PL, Puig-Barbera J, Nguyen-Van-Tam JS. Real world evidence for public health decision-making on vaccination policies: perspectives from an expert roundtable. Expert Rev Vaccines 2024; 23:27-38. [PMID: 38084895 DOI: 10.1080/14760584.2023.2290194] [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: 11/04/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Influenza causes significant morbidity and mortality, but influenza vaccine uptake remains below most countries' targets. Vaccine policy recommendations vary, as do procedures for reviewing and appraising the evidence. AREAS COVERED During a series of roundtable discussions, we reviewed procedures and methodologies used by health ministries in four European countries to inform vaccine recommendations. We review the type of evidence currently recommended by each health ministry and the range of approaches toward considering randomized controlled trials (RCTs) and real-world evidence (RWE) studies when setting influenza vaccine recommendations. EXPERT OPINION Influenza vaccine recommendations should be based on data from both RCTs and RWE studies of efficacy, effectiveness, and safety. Such data should be considered alongside health-economic, cost-effectiveness, and budgetary factors. Although RCT data are more robust and less prone to bias, well-designed RWE studies permit timely evaluation of vaccine benefits, effectiveness comparisons over multiple seasons in large populations, and detection of rare adverse events, under real-world conditions. Given the variability of vaccine effectiveness due to influenza virus mutations and increasing diversification of influenza vaccines, we argue that consideration of both RWE and RCT evidence is the best approach to more nuanced and timely updates of influenza vaccine recommendations.
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Affiliation(s)
- Chiara de Waure
- Public Health, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Barbara C Gärtner
- Department and Institute of Microbiology, Saarland University Hospital, Homburg, Germany
| | | | - Joan Puig-Barbera
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Region, Valencia, Spain
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Marchi S, Fallani E, Salvatore M, Montomoli E, Trombetta CM. The burden of influenza and the role of influenza vaccination in adults aged 50-64 years: A summary of available evidence. Hum Vaccin Immunother 2023; 19:2257048. [PMID: 37778401 PMCID: PMC10760501 DOI: 10.1080/21645515.2023.2257048] [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: 07/04/2023] [Accepted: 09/06/2023] [Indexed: 10/03/2023] Open
Abstract
Influenza is a vaccine-preventable disease and a global public health problem. Although most national influenza vaccination recommendations focus on subjects aged ≥65 years, an extensive burden of influenza has also been reported in those aged ≥50 years and is exacerbated by immune system aging. The main purpose of this review is to provide an overview of the burden of influenza and its potential prevention within the 50-64 age-group. These subjects account for a large proportion of the workforce, and play a central economic and social role. Individuals aged 50-64 years had a 3-times higher rate of hospitalization and a 9-fold higher mortality rate attributable to influenza than those aged 18-49-years, generating higher influenza-related hospitalization costs. Available data suggest that including healthy subjects aged 50-64 years in influenza vaccination recommendations would allow a broader population to be reached, reducing the economic and social burden of influenza.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Elettra Fallani
- Seqirus S.r.l., Monteriggioni, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | - Marco Salvatore
- Seqirus S.r.l., Monteriggioni, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
- VisMederi Research srl, Siena, Italy
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4
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Takagi MA, Hess S, Gawronski K, Haddad N, Noveloso B, Zyzanski S, Ragina N. COVID-19 Virus and Vaccination Attitudes among Healthcare Workers in Michigan: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:1105. [PMID: 37376494 DOI: 10.3390/vaccines11061105] [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: 05/11/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Defining the characteristics of healthcare worker (HCW) attitudes toward the coronavirus disease 2019 (COVID-19) vaccine can provide insights into vaccine hesitancy. This study's goal is to determine HCWs' attitudes regarding the COVID-19 vaccination and reasons for vaccine hesitancy. METHODS This cross-sectional study surveyed HCWs working in institutions in Saginaw, Sanilac, and Wayne counties in Michigan (N = 120) using tipping-scale questions. Analysis of variance and t-test were used to measure HCWs' attitudes toward the COVID-19 virus and vaccines. RESULTS Most HCWs received (95.9%) and recommended (98.3%) a COVID-19 vaccine. The top three factors that HCWs cited for recommending a COVID-19 vaccine were: (1) efficacy of the vaccine, (2) current exposure to patients with active COVID-19 infection and risk of virus spread, and (3) safety of vaccine and long-term follow-up. Female HCWs or HCWs aged 25-54 years were more concerned about contracting COVID-19. Physicians or HCWs aged 55-64 were less concerned regarding the effectiveness and side effects of the vaccine. CONCLUSIONS Gender, age, ethnicity, provider type, and medical specialty showed statistically significant differences among COVID-19 attitudes. Focusing educational efforts on HCW demographics who are more likely to have negative attitudes can potentially decrease vaccine hesitancy.
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Affiliation(s)
- Maya Asami Takagi
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Samantha Hess
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Karissa Gawronski
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Nicholas Haddad
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Bernard Noveloso
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
| | - Stephen Zyzanski
- Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Neli Ragina
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48859, USA
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Bednarczyk RA, Brewer NT, Gilkey MB, Zorn S, Perkins RB, Oliver K, Saslow D. Human papillomavirus vaccination at the first opportunity: An overview. Hum Vaccin Immunother 2023:2213603. [PMID: 37218520 PMCID: PMC10294726 DOI: 10.1080/21645515.2023.2213603] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
The Advisory Committee on Immunization Practices (ACIP) has recommended human papillomavirus (HPV) vaccination for adolescents in the United States since 2006. Though recommended at a similar time to the routine recommendations for adolescent tetanus, diphtheria, and acellular pertussis vaccination (Tdap) and quadrivalent meningococcal vaccination (MCV4), HPV vaccine uptake has consistently lagged behind these other adolescent vaccines. The ACIP recommends HPV vaccination at 11-12 y, with vaccination starting at 9 y of age included as an option that is routinely encouraged by the American Academy of Pediatrics and American Cancer Society. To support efforts to increase HPV vaccination at the first opportunity, this commentary summarizes the current HPV vaccination recommendations and available evidence regarding HPV vaccination starting at 9 y - including recent studies and trials documenting the effectiveness of HPV vaccination at 9 in supporting vaccine series completion, while providing future directions for research and implementation to improve HPV vaccination.
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Affiliation(s)
- Robert A Bednarczyk
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Cancer Prevention and Control Program, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sherri Zorn
- Washington State HPV Free Taskforce, Seattle, WA, USA
| | - Rebecca B Perkins
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Kristin Oliver
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Debbie Saslow
- Prevention and Early Detection, American Cancer Society, Atlanta, GA, USA
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Ujiie M. Resumption of active recommendation of the human papillomavirus vaccine in Japan and future challenges for the National Immunization Program. Hum Vaccin Immunother 2022; 18:2090777. [PMID: 35767827 DOI: 10.1080/21645515.2022.2090777] [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: 12/15/2022] Open
Abstract
Japan's immunization program resumed proactively recommending the use of the human papillomavirus (HPV) vaccine nationwide in April 2022, after suspending this recommendation in June 2013. The promotion of catch-up vaccinations is an urgent issue to reduce the increase in cervical cancer and other cancers caused by low vaccination rates. In addition, the National Immunization Program still has issues to be considered, such as the adoption of the 9-valent vaccine, establishment of an appropriate number of vaccinations according to age, and routine immunization of males. There is a history of eliminating the use of the measles, mumps, and rubella vaccine and the mouse brain-derived, purified inactivated Japanese encephalitis vaccine, as well as suspending the HPV vaccine recommendation in Japan. These decisions have led to the current preventable infectious disease burden. In order to make the right policy decisions based on science-based assessments, it is necessary to establish a safety assessment platform to evaluate the causal relationship between vaccines and adverse events following immunization. Information technology, which has been promoted with the coronavirus disease 2019 vaccine in the current pandemic, may assist in providing more detailed vaccine safety evaluations for other vaccines.
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Affiliation(s)
- Mugen Ujiie
- Vaccination Support Center, National Center for Global Health and Medicine, Tokyo, Japan
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Welzel T, Kuemmerle-Deschner J, Sluka C, Carlomagno R, Cannizzaro Schneider E, Kaiser D, Hofer M, Hentgen V, Woerner A. Vaccination completeness in children with rheumatic diseases: A longitudinal, observational multicenter cohort study in Switzerland. Front Pediatr 2022; 10:993811. [PMID: 36160778 PMCID: PMC9493270 DOI: 10.3389/fped.2022.993811] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Children with pediatric inflammatory rheumatic diseases (PRD) have an increased infection risk. Vaccinations are effective to avoid vaccine-preventable diseases. This study aimed to assess the vaccination completeness in Swiss PRD patients stratified by immunosuppressive treatment (IST). MATERIALS AND METHODS This multicenter observational cohort study of PRD patients was performed in Basel, Geneva, Lucerne, Lausanne, and Zurich in PRD patients aged < 18 years included in the Juvenile Inflammatory Rheumatism Cohort. Completeness was assessed for i) the overall vaccination status (Swiss national immunization program (NIP) and specific additional PRD-recommended vaccinations), ii) for all and each vaccination of the NIP at PRD diagnosis and reference date (RefD) and iii) all and each specific additional PRD-recommended vaccination at RefD. Completeness was assessed over the disease course and stratified by IST. RESULTS Of 616 eligible patients, 234 children were analyzed. Of these, 147 (63%) were girls. Median age at PRD diagnosis was 6.5 years (IQR 2.9-10.3) and 10.9 years at RefD (6.9-14.3). The median follow-up since PRD diagnosis was 3 years (1.1-5.5). 120/234 children received IST. At RefD, overall vaccination completeness was 3.8% (9/234 children), completeness for the NIP vaccinations was 70.1% (164/234 children; IST 65%, no IST: 75.4%) and for all specific additional PRD-recommended vaccinations was 3.8% (9/234 children; IST 2.5%; no IST 5.3%). Vaccination completeness against pneumococcal disease, hepatitis B virus, and human papilloma virus (HPV) was 50.4, 20, 37.9%, respectively. In 25/35 children with negative varicella zoster virus history vaccination status was complete (IST: 94.4%, no IST: 47%). Annual non-live influenza vaccination was complete in 24.2% of children during IST; adherence decreased over the disease course. DISCUSSION This study identified a low overall vaccination completeness in children with PRD. Particularly, the completeness of specific additional PRD-recommended vaccinations was low. If not performed early after PRD diagnosis, vaccination status remained frequently incomplete. Close collaboration between pediatrician and rheumatologist to improve vaccination completeness is essential. Exchange of vaccination records, standardized assessment of specific PRD-recommended vaccinations and those of the NIP, and annual reminder for influenza vaccination are crucial to improve vaccination completeness in this vulnerable pediatric population.
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Affiliation(s)
- Tatjana Welzel
- Pediatric Rheumatology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Jasmin Kuemmerle-Deschner
- Department of Pediatrics, Division of Pediatric Rheumatology, Autoinflammation Reference Center Tuebingen (arcT), University Hospital Tuebingen, Tuebingen, Germany.,European Reference Network for Rare and Low Prevalence Complex Diseases, Network Immunodeficiency, Autoinflammatory and Autoimmune Diseases (ERN RITA), Tuebingen, Germany
| | - Constantin Sluka
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Raffaella Carlomagno
- Pediatric Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.,Pediatric Rheumatology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | | | - Daniela Kaiser
- Pediatric Rheumatology, Children's Hospital Lucerne, Lucerne, Switzerland
| | - Michael Hofer
- Pediatric Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.,Pediatric Rheumatology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Veronique Hentgen
- Reference Center for Autoinflammatory Diseases CeRéMAIA, Versailles Hospital, Versailles, France
| | - Andreas Woerner
- Pediatric Rheumatology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
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Milito C, Soccodato V, Collalti G, Lanciarotta A, Bertozzi I, Rattazzi M, Scarpa R, Cinetto F. Vaccination in PADs. Vaccines (Basel) 2021; 9:vaccines9060626. [PMID: 34207916 PMCID: PMC8230118 DOI: 10.3390/vaccines9060626] [Citation(s) in RCA: 6] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/27/2021] [Accepted: 06/04/2021] [Indexed: 11/22/2022] Open
Abstract
Primary antibody deficiencies (PADs) are the most common primary immunodeficiencies (PIDs). They can be divided into the following groups, depending on their immunological features: agammaglobulinemia; common variable immunodeficiency (CVID) isotype; hyper IgM isotype; light chain or functional deficiencies with normal B cell count; specific antibody deficiency with normal Ig concentrations and normal numbers of B cells and transient hypogammaglobulinemia of infancy. The role of vaccination in PADs is recognized as therapeutic, diagnostic and prognostic and may be used in patients with residual B-cell function to provide humoral immunity to specific infective agents. According to their content and mechanisms, vaccines are grouped as live attenuated, inactivated (conjugated, polysaccharide), mRNA or replication-deficient vector vaccines. Vaccination may be unsafe or less effective when using certain vaccines and in specific types of immunodeficiency. Inactivated vaccines can be administered in PAD patients even if they could not generate a protective response; live attenuated vaccines are not recommended in major antibody deficiencies. From December 2020, European Medicines Agency (EMA) approved vaccines against COVID-19 infection: according to ESID advises, those vaccinations are recommended in patients with PADs. No specific data are available on safety and efficacy in PAD patients.
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Affiliation(s)
- Cinzia Milito
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (V.S.); (G.C.)
- Correspondence:
| | - Valentina Soccodato
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (V.S.); (G.C.)
| | - Giulia Collalti
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (V.S.); (G.C.)
| | - Alison Lanciarotta
- Department of Medicine, University of Padua, 35122 Padua, Italy; (A.L.); (I.B.); (M.R.); (R.S.); (F.C.)
- Internal Medicine I, Ca’ Foncello Hospital, 10103 Treviso, Italy
| | - Ilaria Bertozzi
- Department of Medicine, University of Padua, 35122 Padua, Italy; (A.L.); (I.B.); (M.R.); (R.S.); (F.C.)
- Internal Medicine I, Ca’ Foncello Hospital, 10103 Treviso, Italy
| | - Marcello Rattazzi
- Department of Medicine, University of Padua, 35122 Padua, Italy; (A.L.); (I.B.); (M.R.); (R.S.); (F.C.)
- Internal Medicine I, Ca’ Foncello Hospital, 10103 Treviso, Italy
| | - Riccardo Scarpa
- Department of Medicine, University of Padua, 35122 Padua, Italy; (A.L.); (I.B.); (M.R.); (R.S.); (F.C.)
- Internal Medicine I, Ca’ Foncello Hospital, 10103 Treviso, Italy
| | - Francesco Cinetto
- Department of Medicine, University of Padua, 35122 Padua, Italy; (A.L.); (I.B.); (M.R.); (R.S.); (F.C.)
- Internal Medicine I, Ca’ Foncello Hospital, 10103 Treviso, Italy
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Affiliation(s)
- Anja Kwetkat
- Klinik für Geriatrie, Universitätsklinikum Jena, Bachstraße 18, 7743 Jena, Germany
| | - Hans Jürgen Heppner
- Klinik für Geriatrie, Universitätsklinikum Jena, Bachstraße 18, 7743 Jena, Germany
| | - Anne-Sophie Endre
- Klinik für Geriatrie, Universitätsklinikum Jena, Bachstraße 18, 7743 Jena, Germany
- - Heinrich-Heine-Univ. Düsseldorf -, Klinik f. Geriatrie u. Gelbfieber-Impfstelle\/Alexiander Krefeld GmbH, Dießemer Bruch 81, 47805 Krefeld, Germany
| | - Andreas H. Leischker
- - Heinrich-Heine-Univ. Düsseldorf -, Klinik f. Geriatrie u. Gelbfieber-Impfstelle\/Alexiander Krefeld GmbH, Dießemer Bruch 81, 47805 Krefeld, Germany
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10
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Huang L, Goren A, Lee LK, Li VW, Dempsey A, Srivastava A. Disparities in healthcare providers' interpretations and implementations of ACIP's meningococcal vaccine recommendations. Hum Vaccin Immunother 2020; 16:933-944. [PMID: 31634035 PMCID: PMC7227692 DOI: 10.1080/21645515.2019.1682845] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/27/2019] [Accepted: 10/10/2019] [Indexed: 11/11/2022] Open
Abstract
Invasive meningococcal disease (IMD) caused by the bacteria Neisseria meningitidis is rare but potentially fatal. For healthy adolescents, the US Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination with MenACWY and recommends MenB vaccination under shared clinical decision-making (previously "Category B"). The recommendation for MenB vaccination was the first category B recommendation in adolescents, and it is unclear how healthcare providers (HCPs) implement these guidelines. This 2017 web-based survey of US HCPs explored characteristics associated with prescribing or receiving MenB and MenACWY vaccines, HCP knowledge of vaccine recommendations, and real-world practice patterns. Of 529 respondents, 436 prescribed MenB vaccines to their eligible adolescent/young adult patients and 93 prescribed MenACWY vaccines only. MenB vaccine prescribers were more likely to be pediatricians compared with MenACWY vaccine only prescribers, and patients who received MenB vaccines were more likely to be non-Hispanic whites living in shared spaces (eg, college dormitories) than those not receiving the vaccine. Seventy-seven percent of HCPs indicated that they prescribe MenACWY vaccines consistently with ACIP recommendations (to all members of an age group), whereas only 7% indicated that they prescribe MenB vaccines consistently with ACIP recommendations (individual clinical decision making). Patient-related factors, disease-related factors, and guidelines all influenced HCP decisions to prescribe meningococcal vaccines. Providing HCPs with clear guidance on how to initiate discussion of MenB vaccines with patients and their caregivers may aid in fully protecting US adolescents against meningococcal disease caused by 5 of the disease-causing serogroups.
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Affiliation(s)
- Liping Huang
- Vaccine Medical Development, Scientific & Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Amir Goren
- Real World Evidence, Kantar Health, New York, NY, USA
| | - Lulu K. Lee
- Real World Evidence, Kantar Health, New York, NY, USA
| | - Vicky W. Li
- Real World Evidence, Kantar Health, New York, NY, USA
| | - Amanda Dempsey
- Department of Pediatrics, University of Colorado, Denver, CO, USA
| | - Amit Srivastava
- Vaccine Medical Development, Scientific & Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
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11
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Soeters HM, McNamara LA, Blain AE, Whaley M, MacNeil JR, Hariri S, Mbaeyi SA. University-Based Outbreaks of Meningococcal Disease Caused by Serogroup B, United States, 2013-2018. Emerg Infect Dis 2019; 25:434-440. [PMID: 30789140 PMCID: PMC6390773 DOI: 10.3201/eid2503.181574] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We reviewed university-based outbreaks of meningococcal disease caused by serogroup B and vaccination responses in the United States in the years following serogroup B meningococcal (MenB) vaccine availability. Ten university-based outbreaks occurred in 7 states during 2013–2018, causing a total of 39 cases and 2 deaths. Outbreaks occurred at universities with 3,600–35,000 undergraduates. Outbreak case counts ranged from 2 to 9 cases; outbreak duration ranged from 0 to 376 days. All 10 universities implemented MenB vaccination: 3 primarily used MenB-FHbp and 7 used MenB-4C. Estimated first-dose vaccination coverage ranged from 14% to 98%. In 5 outbreaks, additional cases occurred 6–259 days following MenB vaccination initiation. Although it is difficult to predict outbreak trajectories and evaluate the effects of public health response measures, achieving high MenB vaccination coverage is crucial to help protect at-risk persons during outbreaks of meningococcal disease caused by this serogroup.
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Kempe A, Allison MA, MacNeil JR, O’Leary ST, Crane LA, Beaty BL, Hurley LP, Brtnikova M, Lindley MC, Liang JL, Albert AP, Smith JC. Knowledge and Attitudes Regarding Category B ACIP Recommendations Among Primary Care Providers for Children. Acad Pediatr 2018; 18:763-768. [PMID: 29678594 PMCID: PMC6123258 DOI: 10.1016/j.acap.2018.04.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 12/04/2017] [Revised: 04/03/2018] [Accepted: 04/09/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE In 2015, the Advisory Committee on Immunization Practices (ACIP) made a category B recommendation for use of serogroup B meningococcal (MenB) vaccines, meaning individual clinical decision-making should guide recommendations. This was the first use of a category B recommendation pertaining to a large population and the first such recommendation for adolescents. As part of a survey regarding MenB vaccine, our objectives were to assess among pediatricians (Peds) and family physicians (FPs) nationally: 1) knowledge of the meaning of category A versus B recommendations and insurance coverage implications, and 2) attitudes about category A and B recommendations. METHODS We surveyed a nationally representative sample of Peds and FPs via e-mail and mail from October to December 2016. RESULTS The response rate was 72% (660 of 916). Although >80% correctly identified the definition of a category A recommendation, only 24% were correct about the definition for category B. Fifty-five percent did not know that private insurance would pay for vaccines recommended as category B, and 51% did not know that category B-recommended vaccines would be covered by the Vaccines for Children program. Fifty-nine percent found it difficult to explain category B recommendations to patients; 22% thought ACIP should not make category B recommendations; and 39% were in favor of category B recommendations because they provide leeway in decision-making. CONCLUSIONS For category B recommendations to be useful in guiding practice, primary care clinicians will need to have a better understanding of their meaning, their implications for insurance payment, and guidance on how to discuss them with parents and patients.
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Affiliation(s)
- Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colo; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colo.
| | - Mandy A. Allison
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children’s Hospital Colorado, 13199 E. Montview Boulevard, Suite 300, Aurora, CO 80045,Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13123 E. 16th Avenue, Aurora, CO 80045
| | - Jessica R. MacNeil
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027
| | | | - Lori A. Crane
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children’s Hospital Colorado, 13199 E. Montview Boulevard, Suite 300, Aurora, CO 80045,Department of Community and Behavioral Health, Colorado School of Public Health, 13001 E. 17th Place, Mail Stop B119, Aurora, CO 80045
| | - Brenda L. Beaty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children’s Hospital Colorado, 13199 E. Montview Boulevard, Suite 300, Aurora, CO 80045
| | - Laura P. Hurley
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children’s Hospital Colorado, 13199 E. Montview Boulevard, Suite 300, Aurora, CO 80045,Division of General Internal Medicine, Denver Health, 777 Bannock St, Denver, CO 80204, United States
| | - Michaela Brtnikova
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children’s Hospital Colorado, 13199 E. Montview Boulevard, Suite 300, Aurora, CO 80045
| | - Megan C. Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027
| | - Jennifer L. Liang
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027
| | - Alison P. Albert
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027
| | - Jean C. Smith
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027
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Soeters HM, Dinitz-Sklar J, Kulkarni PA, MacNeil JR, McNamara LA, Zaremski E, Chang HY, Lujan E, Granoff D, Lasky M, Montana B. Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016. Emerg Infect Dis 2017; 23:867-869. [PMID: 28418307 PMCID: PMC5403061 DOI: 10.3201/eid2305.161870] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In response to a university-based serogroup B meningococcal disease outbreak, the serogroup B meningococcal vaccine Trumenba was recommended for students, a rare instance in which a specific vaccine brand was recommended. This outbreak highlights the challenges of using molecular and immunologic data to inform real-time response.
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Baum S, Hitschold T, Becker A, Smola S, Solomayer E, Rody A, Rissland J. Implementation of the Recommendation to Vaccinate Pregnant Women against Seasonal Influenza - Vaccination Rates and Acceptance. Geburtshilfe Frauenheilkd 2017; 77:340-351. [PMID: 28552997 PMCID: PMC5406234 DOI: 10.1055/s-0043-103970] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 01/04/2017] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 10/19/2022] Open
Abstract
Introduction In Germany vaccination recommendations are revised annually and published by the Standing Committee on Vaccination at the Robert Koch Institute (STIKO). In 2010 the vaccination recommendations were amended to include the proposal that pregnant women in the 2nd trimester of pregnancy and pregnant women with additional underlying disease in the 1st trimester of pregnancy should be vaccinated against seasonal influenza. This paper reports on vaccination rates and the factors influencing them. Method A cross-sectional study was carried out in two level 1 perinatal centers in two different German federal states (Saarland and Rhineland-Palatinate) during the influenza seasons of 2012/2013 and 2013/2014. A total of 253 pregnant women were included in the study. Pregnant women were interviewed using a standardized, pre-tested questionnaire and asked whether they were aware of the recommendation to vaccinate against seasonal influenza and about possible factors which might influence their decision to be vaccinated. In addition, data from their vaccination certificates and pregnancy passports were evaluated. Results Overall, the records of only 19.5 % of the pregnant women showed that they had been vaccinated against influenza in pregnancy. Among the group of pregnant women who had a previous history of vaccinations against influenza the willingness to be vaccinated was high (43.3 %) and this figure was statistically significant. The vaccination rate was even higher (49.9 %) and even more statistically significant among pregnant women whose gynecologist or family physician had recommended that they should be vaccinated. In contrast, only 3.3 % of pregnant women who had not been given the recommendation to vaccinate by their physicians were vaccinated against influenza. Discussion The failure to recommend that pregnant women be vaccinated against influenza and women's lack of any previous experience of influenza vaccination were the main reasons for the inadequate influenza vaccination coverage in pregnancy. Conclusion One of the key points to increase the influenza vaccination rate is to intensify the counselling of the pregnant women through the gynecologist.
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Affiliation(s)
- Sascha Baum
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin des Universitätsklinikums des Saarlandes, Homburg/Saar, Germany
| | | | - Anouck Becker
- Institut für Virologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Sigrun Smola
- Institut für Virologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Erich Solomayer
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin des Universitätsklinikums des Saarlandes, Homburg/Saar, Germany
| | - Achim Rody
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Jürgen Rissland
- Institut für Virologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
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15
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Riffelmann M, Littmann M, Hellenbrand W, Hülße C, Wirsing von König CH. Pertussis: not only a disease of childhood. Dtsch Arztebl Int 2008; 105:623-8. [PMID: 19471626 PMCID: PMC2680566 DOI: 10.3238/arztebl.2008.0623] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Accepted: 06/17/2008] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Pertussis is not just a childhood disease, but a respiratory infection that causes persistent cough in all age groups, from newborns to the elderly. METHODS The authors performed a selective literature search and reviewed national and international recommendations for treatment and vaccination. RESULTS Pertussis is found principally in young unvaccinated infants, but school-age children, adolescents, and adults are also affected. Up to 1% of infants contract pertussis, and their respiratory symptoms are often accompanied by apnea. School-age children occasionally display the coughing spasms typical of the disease. Annually, 0.2% to 0.5% of all adolescents and adults are infected and suffer from prolonged, frequently non-paroxysmal coughing. Severe and fatal cases of pertussis occur mainly in newborns and infants, and 25% of affected adults experience complications. Bordetella DNA may be detected by polymerase chain reaction (PCR) for four weeks after symptom onset; except in infants, the sensitivity of this diagnostic technique is low. Although the diagnosis can be confirmed by serological tests, the methods are not well standardized. Treatment with a macrolide prevents the spread of infection, but generally does not alleviate the symptoms. Combination vaccines are the most effective means of prophylaxis. DISCUSSION Pertussis is usually not included in the differential diagnosis of persistent respiratory symptoms. The considerable burden of disease could be reduced in adults and young infants by vaccinating adults with acellular combination vaccines.
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